Why are we so bad at making the self-care message stick?
“I looked at that list you gave me.” There was no mistaking the anger in my patient’s eyes. “I can’t believe you would suggest that I could get better from this by taking some deep breaths or going for a walk! I don’t think you understand my situation at all”
Oops!
Talking to people about self-care can be a minefield. Many people want YOU to fix them and the news that they might have to do something for themselves comes as a big shock. Most people want quick and easy fixes – the thought of having to do something regularly day after day before any benefit becomes apparent is just unacceptable. Changing behaviour is so difficult! Some people hear you start to talk about self-care and think you are abdicating your responsibility to them or, worse still, abandoning them. And some people jump straight to manicures, facials and gym membership without thinking about the simple kinds of self -care that are probably much more important. Self-care and self-indulgence are not the same thing.
My angry patient went on to say “I can’t afford the time or the money to do all that self-care stuff. I just want you to give me some pills that will make me feel better.”
What does the internet say?
Put self-care into your web browser and you will not be able to see the end of the list of hits you get. I tried for “self-care strategies” and got 658 million hits! With so much information out there about how to look after ourselves it can be overwhelming. No wonder people close their ears.
Of course, much of the information on the net is contradictory. Just before closing their ears many people get very confused indeed. The best example is probably web-based dietary advice. Who knows what to do when we are being told to reduce our animal protein; no, reduce our carbohydrates; no, eat small amounts regularly; no, try intermittent fasting; no, only eat organic food; no, exclude gluten, lactose, fodmaps …….. I’m exhausted already and I haven’t even scratched the surface!
Self-care advice is like dietary advice – there’s so much of it around nobody knows what to do.
I want to suggest that as health practitioners there are two really important things to do:
The first is to do the work to convince people to take care of themselves. The second is to encourage them to find and do the simple things that work for them.
What works?
Everybody is different. What works for me may not work for you. Above a certain amount of exercise I start to feel miserable and my body hurts so much I can’t move. For me, reading is good, as long as the books are well written and it doesn’t keep me sedentary for too long. Knitting helps me but I admit it may drive you to distraction. I love to lie in the bath to get some thinking time but that’s not for everyone and besides, your toddlers may not do so well without supervision. Different strategies work at different times in the lifespan.
Finding the things that keep you well is an ongoing experiment throughout life. There is no recipe that fits for everyone – it’s a menu from which we need to choose. The important thing is to know that, just like when we go out for dinner, we do need to choose from the menu and not sit and watch everyone else eat. We also need to select different things from the menu depending on our own particular needs.
So, what I’ve learned is that I need to talk to people about what works for them, to encourage them to experiment with self-care and not to give up if their initial attempts are not a success.
Where to start
This recent article in the New York Times sums up some of the most basic self-care strategies and may be a good place to start a conversation.
Make sure you read the comments while you are there though. There are lots of lessons to be learnt from people’s reactions.
Jan is Sydney GP, private psychological medicine practitioner in Sydney’s inner west and a GP educator for Black Dog Institute.
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