The Self-Care Debate

Those of you who know me well, know that I am a fervent proponent of self-care. I would go so far as to say it is the cornerstone of my health coaching practice – helping others find ways to prioritize day-to-day lifestyle choices that will optimize their health and well-being. Some people, particularly women, think it is selfish to focus on self-care. I have always argued the opposite – that it is one of the most selfless things you can do, as you can’t take care of others in your life if you are not feeling or functioning at your best. I often use the oxygen mask analogy from the airline safety protocol – put on your own oxygen mask first before assisting those around you. After all, you can’t help your family or fellow passengers if you are passed out – or in this case, burned out or close to it.

I recently had my ideas about self-care challenged at a Sunday service at the Unitarian Universalist Fellowship of Raleigh. We had a guest minister, Rev. Nate Hollister, preach a sermon titled “The Nonsense of Self-Care.” I have to admit that I found myself feeling defensive as soon as I saw the title. How dare this person cut down the work about which I am so passionate and have spent most of my life promoting as essential to health and well-being? However, I reminded myself to keep an open mind and hear what we had to say before making any snap judgments.

Rev. Hollister started off his sermon by acknowledging that we do need to take care of ourselves, but he challenged us to think about how we do so and why. He then addressed three points of contention with what he called the “reigning culture of self-care.” He suggested that we did not necessarily have to agree with his points but that he simply wanted to start a dialogue around the concept. I have outlined his three points as well as my thoughts about them.

Self-care is rooted in classism and consumerism
Rev. Hollister started with the notion that today’s concept of self-care is rooted in classism and consumerism, i.e., only people with time and money can afford to engage in the types of activities that are commonly associated with self-care. Think massages and other spa services. Splurging on a gourmet dinner. Activities that most “blue collar” workers don’t have the luxury of enjoying. He admitted that we all deserve to have access to nice things, but we head into “moral trouble” when taking care of ourselves means consuming material things – especially in a world that is becoming increasingly damaged due to overconsumption.

I would challenge his first point as, to me, self-care means different things to different people and thus, you can’t just lump it all into one generalized category. For example, he defined self-care as indulging in luxurious activities or services that take time and often cost a great deal. Although I agree that these activities can be part of self-care, to me self-care falls more in line with the little things we do (or should do) every day or every week to maintain our health and well-being.

I am more inclined to agree with the idea put forth by Tami Forman of Path Forward – that self-care is not an indulgence, but a discipline. As she so eloquently states, it takes discipline to “do the things that are good for us instead of what feels good in the moment.” She also reminds us that self-care is not something you do every now and then when life gets a little crazy. It’s about “taking care of yourself in a way that doesn’t require you to ‘indulge’ in order to restore balance. It’s making the commitment to stay healthy and balanced as a regular practice.” Thus, perhaps what is needed in our culture is a new image, a rebranding if you will, about the true essence of self-care that falls more in line with these daily habits that help sustain our health.

Self-care as the opiate of the masses
Rev. Hollister’s second point of contention with self-care was that its primary purpose is to “inure us to the injustices of our world” and desensitize us to the current structures of power. In his words, self-care could thus be considered the “opiate of the masses,” allowing us to escape from the harsh realities of the real world. He quoted Dr. Martin Luther King, Jr. who called for the need for “creative maladjustment,” wherein people refuse to normalize inequality and work continuously to expose injustice. Rev. Hollister argued that we are in terrible trouble when self-care keeps us resigned to the way things are, to accept the status quo rather than try to change things.

Anyone who is familiar with the UU faith knows that it is steeped in social justice. Thus, I wasn’t surprised when he made this argument – that for some, self-care is a way to cope with injustice rather than attempt to do something to change it. I’m willing to concede a little more on this point as I can see how some people could use what he defines as self-care activities as a way to soothe themselves when dealing with challenges in their day-to-day lives. It’s a lot easier to have a girls’ night out and complain about the state of politics in this country than it is to volunteer on a political campaign or – gasp – run for office yourself. I would propose that this goes back to my previous point of needing to redefine and broaden the definition of self-care, such as expanding the idea of self-care to include engaging in activities that serve a higher purpose. For example, one could volunteer at a local food bank or donate blood. Do something good for oneself as well as the community. For many people, it takes participating in these types of volunteer activities to truly open their eyes to the inequalities present in our society. After all, awareness is often the first step needed to bring about change – in ourselves and our communities.


Self-care promotes a culture of hyper-individualism
Rev. Hollister’s third and final argument was that the current approach to self-care is steeped in a culture of hyper-individualism, where it is “all about me” and has likely contributed to the recent epidemic of loneliness and separation in today’s society. You have probably heard that despite being more connected than ever through technology, humans in general report feeling lonelier and more disconnected than ever before. Rev. Hollister linked this back to the traditional American story of individualism – that you are essentially on your own and that you need to pull yourself up by the bootstraps in order to succeed. He noted however that this concept is relatively new, that most historical cultures and societies thrived on cooperation, not competition.

Rev. Hollister took a deeper look at this idea and challenged us to shift from the independent philosopher Descartes’ proclamation “I think, there I am” to the more interdependent African philosophy of ubuntu, which can be loosely translated as “I am because we are.” He wrapped things up by reminding us that yes, it is important to take care of ourselves but perhaps it is time to change the whole concept of self-care and move away from the perception that it is all about consumerism and being resigned to the status quo. In his closing words, he urged us to redefine self-care as taking care of one another, as we might survive on our own, but we can only thrive with each other.

By the end of the sermon, after making his final point, I found myself less in a place of defensiveness and more in a state of appreciation for having the opportunity to revisit my own ideas about self-care. Rev. Hollister made some compelling arguments for why we need to shift our perspective about self-care. For me, self-care is still about taking care of yourself so that you are able to take care of others – family, friends, colleagues and even strangers in your community. It is clear now that not everyone sees it that way, so I will do my part to try to help change perceptions about self-care. I am also more inclined to broaden what kinds of activities fall into my own self-care – and encourage others to do the same. Maybe next time I need a little break, it will mean picking up litter when I walk in my local park versus splurging on frozen treats at the local ice cream parlor. This way, I benefit from the walk and we all benefit from a cleaner environment. That’s a win-win situation.

(Note: Click here if you would like to listen to Rev. Hollister’s sermon on self-care.)

The Wheel of Health and Your Optimal Health Journey

wheel2-878x1024Today I’d like to share an overview of the Duke Integrative Medicine Wheel of Health (WOH). This wheel provides a framework for creating your personalized health plan – and a map of your optimal health journey. We will explore the various parts of the wheel in-depth in subsequent posts, but for now, let’s look at the big picture.

The WOH represents the whole picture of your health and wellbeing. It is a multidimensional, whole person approach that considers body, mind and spirit. As you can see, it does not focus on just physical health. It goes beyond managing disease and instead emphasizes optimizing health.

Dimensions of the Wheel

You

At the center of the wheel is YOU, because health coaching is a person-centered process. Your health journey is driven by your values, goals and desires. As a coach, I won’t tell you what to do or not to do – you get to decide based on your priorities and what works for you.

Mindful Awareness

Surrounding the center of the wheel is Mindful Awareness. The concept of mindfulness – paying attention on purpose, in the present moment, and non-judgmentally – is a powerful tool and resource for behavior change.  Being more present and aware of what is happening to you and in you can help you respond to changes in your life in a more proactive, engaged way.

Self-Care

The green ring in the wheel represents the seven areas of self-care. People often focus their efforts here when making changes to their health behaviors. Evaluating your current and desired states in each of these areas can help you create a healthier life. These include:

Movement, Exercise and Rest – This area addresses physical activity, whether it be formal exercise (for example, running 30 minutes a day) or general activities of daily living (such as cleaning the house or grocery shopping). Just as important, it also incorporates the need for adequate rest (good sleep is vital!) and relaxation or “down time”.

Nutrition – In a nutshell, eating a balanced, healthy diet that fuels and nourishes your body and mind. There is no specific diet that is recommended. There are some key healthy eating strategies that we’ll discuss in a future post, but it is also based on what works for your body.

Personal and Professional Development –  It is helpful to assess where you are with personal, career or life goals, particularly at times of transition or milestones. These may include work-life balance, financial goals, and personal growth that will support optimal wellbeing. Regular assessment of your goals can reinforce healthy behavior choices.

Physical Environment – Studies have suggested that your surroundings at work and home can impact your health, either positively or negatively. Exposure to light, noise or toxins in your home or work space can have a major impact on how you feel physically and emotionally. On the other hand, a supportive, nurturing physical environment can enhance your sense of peace and wellness.

Relationships and Communication – Research demonstrates that positive relationships built on open, respectful communication with family, friends and colleagues can have a beneficial impact on your health. Identify those relationships in your life that fuel you and those that drain you. In doing so, you can invest in your positive connections and minimize or re-evaluate those relationships that don’t serve you.

Spirituality – This area is about finding purpose and meaning in something larger than oneself. For some people, it may include a religious affiliation. For others, it may be a connection to nature or the arts. Although the definition of spirituality is very personal in nature, the role that it plays in your life can transform your health.

Mind-Body Connection – This area relates back to the inner ring of Mindful Awareness. It focuses on mind-body practices that can help you be more present. Techniques include things that activate the body’s relaxation and healing response, like breathing practices, meditation, yoga, or guided imagery.

Professional Care

It is important to seek routine preventive medical care such as an annual physical exam, recommended cancer screenings (e.g., mammogram, colonoscopy) and vaccinations. In addition, you can supplement your usual medical care with complementary approaches such as acupuncture, massage, hypnosis or energy work. A primary goal of Integrative Medicine is to remove the distinction between conventional and complementary approaches and create one integrated approach to health care. In this model, patients and their providers work together to determine the most effective, evidence-based personalized health plan to achieve life-long wellbeing.