Summary - Real Self-Care: A Transformative Program for Redefining Wellness (Crystals, Cleanses, and Bubble Baths Not Included) - Pooja Lakshmin MD
The psychiatrist author argues against superficial “self-care” solutions and for meaningful change from within. Based on her experiences overcoming burnout and leaving a cult, she advocates authentic self-care guided by principles, not external fixes.
Real self-care can positively impact lives and society. It involves clarifying values, setting boundaries, self-compassion, and empowerment. It leads to eudaimonic well-being, not escape and achievement.
Self-care began as a way for marginalized groups to preserve humanity and empowerment but became a burden, especially for women. Social media influencers promote an unrealistic image of self-care to sell products.
Barriers to mental healthcare have led many to substitute faux self-care. Faux self-care should not replace treatment and there are signs when professional help is needed. A case example shows the difference between bogus self-care methods and fundamental self-care principles.
Real self-care principles include: setting boundaries, developing self-compassion, identifying values, and asserting power. Implementing these principles helps establish purpose, understand yourself, feel balanced, gain control, and achieve results.
Faux self-care as escape provides temporary euphoria through avoiding hard decisions and responsibilities. Examples include wellness retreats and vacations. The flight feels good momentarily but needs to be more sustainable. A story example shows the temporary nature of flight through faux self-care.
In summary, the author promotes authentic self-care guided by principles over faux self-care fixes and escape. Authentic self-care leads to meaningful change and empowerment. It involves eudaimonic well-being through clarifying values, boundaries, meaning and power. Faux self-care and escape, on the other hand, provide only temporary relief. Real change comes from within, not external solutions.
Here is a summary of the key points:
The passage discusses how societal systems and structures, like racism, sexism, and capitalism, create barriers and hardships for many women that lead to feelings of betrayal and burnout. The author argues this is “societal betrayal,” not individual failings.
The author shares examples of patients facing systemic obstacles due to race, gender, immigration status, sexuality, etc. These include unequal pay, lack of parental leave, healthcare discrimination, and unequal division of household labor. The author recognizes her training did not address these systemic issues.
The author believes that through authentic self-care, women can demand changes to these broken systems and create positive change. Authentic self-care involves recognizing society’s role in our struggles, honoring our needs, setting boundaries, and refusing to internalize the message that we are the problem.
The “mental load” refers to the invisible labor in managing a household and family. Studies show women disproportionately bear the mental load, negatively impacting their well-being. Examples are given of Mikaleh and other women facing heavy cognitive loads.
While women may choose to take on the mental load, culture shapes our choices by promoting contradictory values for women, like being selfless and ambitious. This contradiction leads to feelings of guilt, self-doubt and despair in women. Faux self-care products do not help resolve this.
To enact change, women must challenge contradictory cultural values and logical flaws through “dialectical thinking.” Mikaleh would be an example of someone who allowed herself to prioritize her mental health, even if it meant letting others down. She began to think differently about the systems around her.
In summary, the key message is that societal structures and expectations place unfair burdens on women, contributing to their stress and burnout. Through authentic self-care and dialectical thinking, women can demand changes to these systems. But change starts from within, by honoring one’s own needs and boundaries.
Real self-care involves changing your internal reality and way of thinking, not just superficial acts. For a change, embrace internal change and dialectical thinking.
Mikaleh loved her father but realized she couldn’t care for him alone. She understood two truths could coexist: she loved him but needed help. This was hard to accept as she equated it to love and self-sacrifice.
Mikaleh’s responsibilities triggered her OCD. She took a leave to focus on her mental health, get her OCD under control, asks her brothers for financial help, and find home health support. Her workplace was understanding. She and a coworker started a group for those with or supporting people with mental health issues. Her work recognized her advocacy.
The author acknowledges only some workplaces/families are understanding. “Burning it all down” doesn’t solve problems. Authentic self-care involves changing systems from within. Audre Lorde said, “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
Regarding men's roles, issues are complex. While some men must do more, blaming/attacking them is counterproductive and ignores systemic issues. Real change requires all genders challenging social systems. Possible solutions: public/workplace policy changes, better systems within families.
The path forward requires recognizing systems failed us, doing profound internal work not quick fixes, and understanding self-care as an internal process driving external change. Authentic self-care is taking back control and choosing what matters.
There are two well-being approaches: hedonic (happiness, pleasure, escape) and eudaimonic (meaning, purpose, growth). Eudaimonic well-being links to better health/well-being.
Cultivating eudaimonic well-being looks different for each person based on values/beliefs. It could mean volunteering, family time, or career change. The key is doing what matters/gives life meaning.
Real self-care leads to eudaimonic well-being. It’s not quick fixes or pleasure seeking. It requires:
Boundaries/overcoming guilt. Learning to say no, prioritizing needs, and managing guilt.
Self-compassion. Meeting needs, overcoming negative self-talk/’martyr mode.’
Knowing yourself. Gaining insight into core values, beliefs, desires. Your outsides match insides.
Asserting power. Making correct decisions for you. Recognizing your matter/facing pressures.
The four principles build on each other. Clara’s example shows how authentic self-care led to insight, boundaries, overcoming guilt, starting her own business, and aligning life with values.
Real self-care requires work. It involves tough questions, reflecting on what matters, and complicated conversations. But it leads to an authentic, meaningful life where values/actions align.
Many only turn to authentic self-care after exhausting other options. The work is challenging but effective for cultivating well-being.
• Setting boundaries and practicing self-compassion are keys to self-care. Boundaries communicate your limits to others while self-compassion involves being kind to yourself.
• "Martyr Mode" refers to overextending yourself to help others until you burn out. It often stems from the unmet expectation that your sacrifices will be rewarded. The signs include resentment, loss of control, and neglecting your needs.
• Escape Martyr Mode by saying "no," asking others for help, and making self-care a priority. Your needs matter too.
• Self-compassion is different from self-esteem. Self-compassion focuses on self-kindness and seeing your shared humanity. It is linked to fewer negative thoughts and a healthier self-view.
• Practice self-compassion by noticing harsh self-talk and replacing it with kinder language. Limit stress, accept yourself as you are, and set boundaries.
• Shame involves feeling inherently flawed or unworthy. It leads to self-criticism and inadequacy. Combat shame with self-compassion by adopting a "good enough" mindset, balancing your inner critic, and realizing perfection are impossible.
• Your inner critic relies on shame, while your internal drive motivates by self-acceptance. Notice the diversity of your inner voices. Your worth isn't defined by achievement.
• Self-compassion requires practice. Be patient and gentle with yourself. Self-compassion is the antidote to shame and an overly harsh inner critic.
• The author shares examples from her IVF experience and a patient's journey to illustrate cultivating self-compassion. The key is permitting yourself to prioritize your needs.
• Connecting your experiences to those of others can validate feelings and build support. Speaking up together may feel safer. Difficult decisions are sometimes necessary to protect well-being despite risks. But first, try setting boundaries, self-care, and improving the situation.
• There are always opportunities for empowerment by respectfully communicating your limits and fairness concerns. But prepare for potential challenges and have a self-care plan. Your health and family depend on you to avoid burnout.
Does this summary cover the main points and advice around self-care, boundaries, self-compassion, and overcoming feelings of shame or inadequacy? Let me know if you have any other questions.
The author was a doctor but became an author and entrepreneur instead after realizing it aligned more with her values of creativity and connection. Though risky, she was able to make the change due to her circumstances.
Years later, an interview with her former field's top researcher affirmed she had made the right choice. We all face hard choices and must determine our path based on our values rather than what others expect. Trying to do less leads to burnout; focus on what fulfills you.
The anxiety-values relationship is complex. When overly focused on what we "should" do, anxiety rises. But choosing our path can also be anxiety-provoking. The solution is accepting anxiety as part of life and having self-compassion. Stay connected to your values - they provide guidance and purpose, reducing anxiety in the long run.
To choose your path:
Identify your core values through self-reflection on times you felt most alive and engaged. Typical values include creativity, connection, growth, purpose, etc.
Evaluate options based on how well they align with your values. Some values may be more important than others.
Start with small steps toward the option(s) that most align with your values. Review and adjust as needed.
Connect with supportive others who encourage you to live according to your values.
Accept anxiety as usual and practice self-care. Your values provide purpose and meaning to sustain you through hard times.
The author realized that while engaging, the research fulfilled her less than creative work and connecting with readers did. Facing burnout helped clarify her values and purpose, giving her the courage to change paths. Though the road was difficult, she could find meaning and experience less anxiety by connecting choices to her values.
In summary, identifying and using your values as a compass for hard life choices can lead to a life of greater meaning, fulfillment, and purpose and less anxiety and burnout. Have compassion for yourself along the journey.
The author values independence and freedom, but her priorities have evolved as she has gotten older. People's values change throughout their lives.
The "Real Self-Care Compass" helps identify what matters to you. It has three parts: goals in critical areas of life, how to achieve them based on your values, and your manifesto or what nourishes you.
The compass can guide decisions and help you stay true to yourself. You can adapt it as needed. Authentic self-care is an ongoing practice.
Rochelle realized she stopped making time for writing, which was essential to her. She started journaling and submitting essays, aligning with her value of self-expression. This nourished her and helped her advocate for a raise at work.
Identifying your values can be hard when disappointing others. Saying no, setting boundaries, and dealing with guilt are critical. Seek relationships that support you.
Productivity is good, but keep sight of why things matter. Goals matter secondary to values. Achieve goals but know why they matter.
Your values vocabulary: Goals are tangible, and values are ongoing. Turn inward for decisions. You're aligned when the outsides match the insides. Avoiding hard choices means not connecting to values. Appreciate good to make room for more. Values shift with life seasons.
Self-care asserts your power and fights oppression by holding onto agency and making changes. It's not toxic positivity, which rushes past hard feelings. Feelings matter. While optimism says things will be okay, hope means believing you can make things better without denying reality.
Personal choices can spur systemic change. A system changes after enough individuals change. Personal and systemic change form a loop where personal changes inspire more, pressuring the system. Even marginalized people can fight back in small ways.
Naomi Osaka and Simone Biles put mental health first, influencing their sports. Enough individuals come together to make real change.
Approach situations with a “both-and” mindset, recognizing paradoxes and complexities in yourself and your choices. You are both powerful agents of change and subject to forces outside your control.
To practice this: Imagine how different voices in your head would narrate a situation where you felt powerless. See beyond one-dimensional roles and simplistic explanations. Share your story with others. You are more than any single experience.
Real self-care requires embracing paradox and complexity. Accept you are both subject to external forces and an agent of change. Focusing on “both-and” can help you feel more empowered and hopeful.
Hope can be established through problem-solving, emotion regulation, activating a core identity, and relational coping. These require ongoing work and practice. An example shows a mother using all these to maintain hope facing obstacles and her child's health issues.
The key is balancing extremes. With hope comes a sense of power and agency. Identify your hope-building skills. Seek professional help if consistently hopeless.
An example shows people advocating for paid parental leave, even if they wouldn't benefit. This "paying it forward" and community care fosters hope.
Real self-care focuses on meaning and purpose, not just stress reduction. It incorporates dialectical behavior therapy, acceptance and commitment therapy, self-compassion, community connections, values alignment, gratitude, hope, and collective action.
Dialectical behavior therapy teaches mindfulness, distress tolerance, emotion regulation, and interpersonal skills. It helps with various mental health conditions. It incorporates dialectical thinking, holding opposing ideas.
Acceptance and commitment therapy teaches psychological flexibility and commitment to meaningful actions.
Setting boundaries reduces guilt, resentment, and burnout. For trauma survivors, it may feel unsafe so counseling can help.
Self-compassion reduces self-criticism and increases well-being. The "good enough mother" concept reduces judgment about imperfect parenting.
Friends and community are essential for self-care. Make time to connect.
A "self-care compass" connects you to your values and priorities. Look inward, not to social pressures.
Gratitude and mindfulness increase life satisfaction.
Hope and optimism increase well-being. Testimonial psychotherapy builds hope through storytelling. Collective action improves individual well-being.
The author, a psychiatrist, focuses on women's mental health and an alternative to unrealistic self-care promises of "extreme wellness." Authentic self-care transforms culture by empowering individuals.
The summary covers the essential elements the author recommends for authentic self-care, including forms of therapy, concepts, practices, connections, and actions at both individual and community levels. The summary reflects the author's psychiatrist approach to supporting women's mental health and well-being through a more holistic self-care model.
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