Re-envisioning Self-Care

Self-care is a topic that can readily provoke cognitive dissonance (an internal conflict occurring when new knowledge contradicts an existing belief).

On one hand, self-care is known to be important (Skovholt & Trotter-Mathison, 2014). Though it may be particularly essential for health care providers, self-care practices contribute to well-being for all people, something that is now widely recognized.

Despite general knowledge of the benefits of self-care, in practice, there is often little follow-through (Wardley, Flaxman, Willig, & Gillanders, 2016). Further, although much of the available research focuses on health care provider or caregiver burnout, which may result from a lack of self-care, the effects of inadequate self-care have pervaded a number of other occupations (Shockey, Zack, & Sussell, 2017).

While noting that caring for the self is an essential step in avoiding burnout, it is also relevant to consider what factors may hamper a person’s ability to create a context of caring. In this article, I’d like to consider how personal and relational factors interact and contribute to a culture of inadequate self-care.

In westernized societies, especially in the United States, there is a strong belief in individualism. In particular, there exists a narrative that each person authors their own self, with little to no help from others. This, by extension, can make it seem as if a person’s work is akin to their worth. It is not uncommon to hear phrases such as, “Pull yourself up by your bootstraps” or “If you just try hard enough, you’ll succeed.” While these words can certainly motivating to some, in certain contexts, several potential pitfalls are inherent in the idea of the self-made man, especially as to how this concept affects a person’s relationship with the self and others.

Consider this example:

"You work for a construction company as one of many crane operators, and the company for which you work has received a new building project. You and your coworkers begin the project, and all of you seem to be working in perfect harmony. One day you wake up feeling rather ill, but instead of calling in sick, you decide to go into work, despite increasing nausea and slight vertigo. Your coworkers notice your slowed working pace and encourage you to go home, but you brush them aside, saying you’ll be fine. Despite your illness, you are able to make it through the day. Although by staying at work you avoided letting your co-workers down, your boss pulls you aside before you leave to discuss the multiple errors you made that day. This makes you feel unappreciated."

In the scenario above, the motif is that our physical and, by extension, emotional work is a resource, and production of this is to be valued above all else. In individualist cultures that primarily rely upon supply and demand, this makes complete economic sense: when demand increases beyond what the supplier can supply, additional resources must be created.

When applied on an individual level, however, whether speaking in physical or emotional terms, it’s often the case that a person must create “resources” that may be available only at their own expense. This makes burnout almost inevitable (Bharadwaj, Pai, & Suziedelyte, 2017). Additionally, as illustrated above, a further emotional message stating that the person should feel shame at being unable to perform beyond their physical or emotional resources, may be the result. Therefore, not only has burnout become more common, the cultural norm also encourages people to believe they must perform, regardless of illness, fatigue, or burnout, and that if they cannot, they are likely to be perceived as less hard-working.

What are we to do, then, when our physical and emotional “tank” is empty, but cultural beliefs dictate taking care of ourselves is shameful or selfish?

Rather than provide you with a list of prescriptions—and effectively reinforce the norm that self-care is just another task to complete—I want to recommend changing our very relationship with the process.

Truly caring for ourselves moves beyond instant gratifications (i.e. shopping sprees or spa days) toward creating a life from which we do not frequently need to “get away” (though of course there is nothing wrong with, and something to be said for, an occasional spa day).

What this does mean is that we may need to create boundaries around certain activities, even seemingly important ones, that overwhelm us or contribute to undue stress in our daily lives. Turning off work devices after work may be one form of self-care that can help us manage burnout, for example. It’s also important to point out that self-care does not always feel “good.” We might dread our regular check-up and cleaning at the dentist, for example, but this is also a form of self-care.

Changing our relationship with self-care requires a commitment to changing the entire system of care. But when we no longer have the need to emotionally escape from life, we may inadvertently find ourselves more fully living it, practicing self-care without thinking about it.

References:

1. Bharadwaj, P., Pai, M. M., & Suziedelyte, A. (2017). Mental health stigma. Economics Letters, 159, 57-60.
2. Cognitive dissonance. (2017, November 3). In Encyclopedia Brittanica (Online edition). Retrieved from https://www.britannica.com/topic/cognitive-dissonance
3. Grise-Owens, E., Miller, J. J., Escobar-Ratliff, L., & George, N. (2017). Teaching self-care and wellness as a professional practice skill: A curricular case example. Journal of Social Work Education, 1-7.
4. Shapiro, S. L., Brown, K. W., & Biegel, G. M. (2007). Teaching self-care to caregivers: Effects of mindfulness-based stress reduction on the mental health of therapists in training. Training and Education in Professional Psychology, 1(2), 105.
5. Shockey, T. M., Zack, M., & Sussell, A. (2017). Health-related quality of life among US workers: Variability across occupation groups. American Journal of Public Health, 107(8), 1316-1323.
6. Skovholt, T. M., & Trotter-Mathison, M. (2014). The resilient practitioner: Burnout prevention and self-care strategies for counselors, therapists, teachers, and health professionals. New York, NY: Routledge.
7. Wardley, M. N., Flaxman, P. E., Willig, C., & Gillanders, D. (2016). ‘Feel the Feeling’: Psychological practitioners’ experience of acceptance and commitment therapy well-being training in the workplace. Journal of Health Psychology, 21(8), 1536-1547.