Is Self-care Selfish?

October 15, 2012

Self-absorbed or self-sustaining? Metamorphosis by Salavdor Dali

Navel-gazer! Self-absorbed! Selfish! Harsh names sometimes given to those us devoted to self-care. We meditate, we introspect, we dissect our daily lives. We  fuss over what to eat and what to avoid, we are disciplined about exercise. Heck, we are disciplined about discipline. So is the criticism fair? Are we just glorified narcissists?

The question startled me when it was posed to me by Mary, a young woman whom I have known for many years. I had observed her during her turbulent adolescent years but now she has managed to find her grove by helping others. Initially her question knocked me sideways and then it made me look at myself critically (but of course).

I think people misunderstand self-care because they confuse it with self-indulgence. Wanting the best for yourself does not mean over-indulgence. Starlets such as Lindsay Lohan are examples of over-indulgence that is detrimental to self-care.

In my own volunteer work I come across any number of less famous persons who do not take care of themselves: substance abusers, gamblers, the socially challenged. Such people end up requiring a great deal of assistance from strangers and institutions. At homeless shelters, at hospitals, at welfare offices, and of course the prison system. Let me hasten to add that I am not a Republican nor a Conservative. I do believe in a compassionate society. I accept that people have greater and lesser capabilities. Some of the people needing assistance did not chose to be in that circumstance. That said, I wonder how many of them would have been better positioned to cope with adversity had they acquired the skills of self-care during better times?

I grew up in family where we had little money to go around. Which meant we learned early on how to manage finances, how to prioritize expenses, when to be thrifty. Skills which are paying off to this day. There was no ‘helicopter parenting’ in those days. We were left to independently discover the skills for better living. And I am grateful for that. Coddled children  seem to grow up under-equipped for the stress of adult life. We had no Papa Walton to sort out our problems, and June Cleaver was not there to mend our clothes and pack our school lunches. If we needed clean clothes, we figured out how to do laundry. You want to eat? then better learn to cook. If you want nutritious meals, then read up on what is good for you and which is harmful. Sure, we made some errors along the way (even a few massive ones), but we acquired the skills of independence, self-reliance and self-care.

Of course none can go it totally alone. Self-care does not preclude seeking out external assistance when required. But it does involve liking yourself enough to want the best for yourself–the best health, the greatest happiness, the least stress. It requires self-respect.

One of my patients, Marty, jokes about swallowing a fistful of pills, thereby ending his predicament (he has had a leg amputated and is due for several more surgeries). I do not believe his threat is sincere because he puts in so much graft in getting better. He soaks up advice, he follows his medication regime, he is diligent with his physiotherapy. As he lays in his hospital bed he sometimes gets frustrated by the enormity of the recovery ahead of him, hence he speaks of overdosing on pills. But lying in that same hospital bed he also plans the changes he is going to make in his life when he returns to his apartment. After years of self-neglect, he has discovered self-care and therefore I do not believe he is serious about suicide. The two things are contradictory. He said that thanks to me he now has self-respect. People with self-respect do not self-harm, we have others skills at our disposal for mitigating our suffering. We have had ample practice.

Whenever you take an air flight, there is the mandatory safety instructions before take-off. Interesting that we need to be reminded that in the event of an emergency “to secure your own oxygen mask first before assisting your children and family members.” Self-care feels counter-intuitive. But rationally it makes sense. You can be of no use to little Johnny and baby Jessica if you are gasping for air yourself. The same applies in daily life. How can you help people around you if you yourself are struggling? You need to have credibility before others respect your advice. I very much doubt that I would have inspired self-respect in Marty had I  not had it myself.

Which brings me back to Mary. She got so caught up in helping so many others that she burnt out. She was hospitalized from exhaustion, both physical and emotional. Her family had to intervene to get her back to functioning. So to answer her question, no Mary, self-care is the opposite of being selfish: if you don’t give yourself adequate attention, you become the  center of attention for others.


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