A New Definition of Self-Care
A bit of my academic writing for your perusal today. :-)
An Instagram search of the hashtag “#selfcare” yields over twenty-one million results, featuring a mind-boggling variety of images. Glittery lip gloss, exercise machines, salads, face masks (on sale for 70% off, today only!), cute puppies, and candle-lit baths are only a few of the photos people have shared on their social media account, labeled as “self-care.” But are they really? The World Health Organization currently defines “self-care” as “the ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider” (WHO 2019). The International Self-Care Foundation, however, references the WHO’s much longer 1998 definition of self-care on their “What is Self-Care” page: “Self-Care is what people do for themselves to establish and maintain health, and to prevent and deal with illness. It is a broad concept encompassing hygiene (general and personal), nutrition (type and quality of food eaten), lifestyle (sporting activities, leisure etc.), environmental factors (living conditions, social habits, etc.) socio-economic factors (income level, cultural beliefs, etc.) and self-medication” (ISCF 2019). Occupational therapists list “self-care” as one part of their definition of “occupations,” along with “productivity” and “leisure,” implying that self-care somehow sits outside of “leisure” and is also not productive (Hammell 107). In the occupational therapy context, self-care includes things like bathing, brushing one’s teeth, dressing independently, and similar activities.
If social media platforms such as Instagram are any indication, when the term “self-care” enters common usage, it has no widely accepted definition. Charlotte Lieberman, in her article “How Self Care Became So Much Work,” argues that Americans today consider “busyness and stress” to be a sign of success, and that self-improvement has become another thing to add to the to-do list (Lieberman, 2018). According to this thinking, if you’re better at self-care—or better at trying to do self-care—you must be more successful and important. Being “better at” self-care requires the purchase and usage of self-care products: a fit-bit to count your steps so you can prove you have done enough “self-care” today to reward yourself with a candle-lit bath at the end of the day. An expensive face mask to care for your complexion or a home-cooked meal with all the most natural ingredients, a gym membership or piece of exercise equipment. Each of these Instagrammable “self-care” products cost—a lot. Additionally, all of them require some form of “doing” that feels compulsory. But if you aren’t doing your self-care, what kind of person are you? After all, self-care is what you need to feel better.
Except maybe it’s not. Kristi Pahr writes about the double-edged sword that self-care can become for people with anxiety. When self-care is touted by professionals as the solution to common mental health struggles and the key to maintaining your physical health, it’s easy to see how engaging in self-care can become just another thing to add to a long to-do list. For a person with anxiety, “obsessing over the ‘correct way’ to self-care” or worrying about failure to accomplish self-care can induce severe anxiety and a sense of hopelessness (Pahr 2018). Conversely, taking time to engage in activities that you consider self-care can trigger guilt and feelings of excessive selfishness in a person with anxiety.
Feelings of selfishness and self-recrimination around taking time to care for oneself can be present in other circumstances as well. An October 2019 study by Susan M. Long et al. explored the wellness and self-care experiences of single mothers experiencing poverty and found that these mothers often experienced feelings of guilt when they attempted to practice self-care, as well as that they felt others perceived them as selfish when they did take time for self-care (Long 349). The fact that most forms of popular self-care are associated with spending money created a barrier for some of the mothers, as they felt that they could not afford to practice self-care beyond sleeping, eating, and showering (Long 350-351). Long also found that “It was clear that many of these women did not know how, when, or what to do for self-care” (Long 355). The lack of knowledge about what self-care is and how it can be practiced by persons with minimal time or money is the result of the un-defined popular use of “self-care.” When “self-care” is used to signify a mental health practice that has become a status symbol, something a person would feel guilty for doing—or for failing to do—the term falls so far from the World Health Organization’s multi-pronged and detailed definition that no one seems to know what self-care is after all.
But some people do take a stab at defining self-care or, at least, describing what it’s like. “True self care is about being reflective and aware of your physical, mental and emotional state,” says Elissa T. Mitchell et al. in their article “Self-Care Summer: Self-Care-Choice or Chore?” (Mitchell, 2019). “The goal is to create space for yourself, to experience curiosity and explore without pressure,” Lieberman says. “…there are plenty of times when what we need to do to feel better—and actually get better—is less.” This quote suggests that, rather than being something you must actively do, leisure itself can be self-care. Far from the busy, active, fit-bit step-counting, skin-care-product-shopping image of self-care that is plastered across Instagram, sometimes true self-care consists of finding the free moments in a busy day and reflecting on your emotional, physical and mental state. Sometimes that means doing nothing but being present with your body.
Since popular American self-care practices have little to do with the WHO’s definition of self-care as promoting health, preventing disease or coping with illness, and popular conceptions of self-care create unrealistic expectations that leave many believing they have neither money nor time to engage in self-care, it is clear we need a new definition of self-care. I propose the following definition:
Self-care is active engagement in activities or behaviors that promote the mental, physical, emotional and spiritual wellness of an individual. Effective self-care activities and behaviors are individualized, voluntary, and can be preventative or reparative.
This definition has several important implications. First, self-care requires active engagement. Self-care is not something that happens to a person, nor is it something that can be posed, photographed and posted. Self-care must be engaged in, with a better mental, physical, emotional or spiritual state as the goal. Any activity that promotes wellness in an individual, such as cooking a healing meal or participating in physical activity can be self-care, but it is not so by default. In order to engage in self-care by this definition, a person must be able to be aware of their emotional, mental, physical or spiritual need in the moment, and must then engage in an activity that will positively impact one or more of these areas. Implicit to this idea is the fact that the behavior of creating space for yourself and sitting quietly with the question of what areas of your being are in need of attention is in itself self-care. Getting to know yourself and being able to recognize your own needs is self-care, and so is taking action to address those needs.
The individualized nature of self-care is also key to this definition. Once a person has identified an area of their physical, mental, emotional or spiritual being that is in need of increased wellness, they must then be allowed to address that need in a personalized way. Self-care cannot be mandatory. If a person is required to perform self-care, they are no longer making the choice; someone else is making it for them. This twists self-care into other-care accomplished by forcing the other to do the care themselves. When this happens, the gift of being cared for by a compassionate person is lost, since that person is forcing you to do the care yourself. Simultaneously, a situation is created where “self-care” is not individualized based on self-knowledge and thus likely ineffective. No matter how intimate the relationship, another person can never truly know what you need, and so all attempts by someone external to force self-care on a practitioner will ultimately fail to accomplish the intended effect and may even cause harm. If self-care is “what you need to feel better,” then it is your own needs you must listen to when you decide to engage in self-care (Pahr). Listening to your own needs will allow you to stop a particular activity if it begins to induce anxiety, and choose instead to do nothing but sit if you need to allow yourself to just be. Mindfulness, silence, taking a break, and validating yourself are all ways to practice self-care as well.
Another implication of this definition of self-care is that it makes self-care accessible. Global wellness is often a protective factor for stress and mental health concerns, and it is vital that wellness be achievable regardless of your life situation or socio-economic status (Long 344). The single mothers in Long’s study indicated that they knew the importance of self-care for themselves and their children, but they faced a number of barriers to being able to practice it. Among the barriers they listed “lack of resources,” “lack of support” and guilt (Long 349). If self-care were taught to these mothers using my definition, a mental health professional might highlight the importance of self-care being a behavior, or a way of being. It is not necessary to purchase self-care products you can’t afford or spend time you don’t have practicing self-care. A daily shower can be self-care if it’s entered into voluntarily and intentionally, with recognition of its impact on one’s physical, mental and emotional health.
The idea that self-care can be either preventative or reparative offers hope to people with anxiety who are trying to engage in self-care. When self-care is marketed as “#selfcare” or when it is weighed down with the WHO’s wordy definition about preventing disease or maintaining health, it’s easy to see how someone would become anxious at the idea of trying to satisfy the expectation of what self-care should look like, and to worry about getting it wrong. When self-care is viewed as both actions and behaviors that are preventative or reparative, having twenty minutes a day to meditate is no less self-care than allowing yourself time to cry when everything is really just the worst. Being gentle with yourself is just as much self-care under this definition as spending an hour sweating at the gym. It is just as important to note that no activity is self-care, no matter how “good” it might be for someone else, if it has a negative impact on your personal mental, physical, emotional or spiritual health. Self-care is for you. It’s not for anyone else, and no one else knows what you need, or when. Learn your body, get to know your mind, notice what makes your spirit sing and what gives your body that extra umph it needs in the middle of the day. Learning yourself is self-care, and acting on what you learn is both self-care and self-love. And everyone needs more of both of those.
Hammell, Karen Whalley. “Self-care, productivity, and leisure, or dimensions of occupational experience? Rethinking occupational ‘categories’”. Canadian Journal of Occupational Therapy. Vol. 76 Issue 2, 2009, pp. 107-114.
International Self-Care Foundation. “What is self-care?” https://isfglobal.org/what-is-self-care/ Accessed 22 November 2019.
Lieberman, Charlotte. “How Self-Care Became So Much Work”. Harvard Business Review. August 10 2018. https://hbr.org/2018/08/how-self-care-became-so-much-work Accessed 22 November 2019.
Long, Susan M. et al. “The Wellness and Self-Care Experiences of Single Mothers in Poverty: Strategies for Mental Health Counselors.” Journal of Mental Health Counseling.Vol. 4 Number 4, October 2019, pp. 343-358. https://doi. orgl10.17744/mehcA 1.4.05 Accessed 23 November 2019.
Mitchell, Elissa T. “Self-Care Summer: Self-Care-Choice or Chore?”. The New Social Worker. 2019. https://www.socialworker.com/extras/self-care-summer/self-care-summer-self-care-choice-or-chore/ Accessed 23 November 2019.
Pahr, Kristi. “For Many People with Anxiety, Self-Care Just Doesn’t Work.” Healthline. June 12 2018. https://www.healthline.com/health/mental-health/self-care-is-hard#1 Accessed 22 November 2019.
World Health Organization. “Sexual and reproductive health.” https://www.who.int/reproductivehealth/self-care-interventions/definitions/en/. Accessed 22 November 2019.