What We Mean When We Say “Self-Care”
The Appropriation of Disability Terminology
Each day, I brush my teeth a minimum of two times for about two minutes each. I try to eat at least 1 vegetable. I aim to have a minimum of 6 hours of sleep (really closer to 8 or 9 to actually function). In the evening, after eating, I take one pill. Before I go to bed, I take 3 other pills. Every 3 months I get blood work that adds up to between 7–10 tubes being filled. I drink 3 liters of water a day.
And if I’ve been too happy for too long, I lock myself in a dark room and remove all joyous stimulus.
Most of this seems easy. When I’m well it is easy. It’s easy to get up, brush my teeth, and shower. This is “normal”. Then there are times my life is derailing, my mental state is unraveling, and suddenly, the very action of putting toothpaste on a brush becomes Herculean. Or that getting in or out of the shower is impossible because I can’t stop crying. That sleep either eludes me completely or that I can barely wake up.
What Is Self Care?
For this piece, I made the terrible mistake of searching the tag #SelfCare on Instagram. Every once in awhile you find an earnest post, but well over half are advertisements for products that cheekily state buying those items is “self-care”.
As a mental health worker, I’ve come to be intimately familiar with the word, but chances are we use it very differently than you do.
When I talk to a peer about self-care, or self-care routine, we’re talking about the essentials. We’re talking about the habits, practices, needs, necessities people have to do in order to keep well. Self-care is an ever-evolving list of habits that you need in order to live a life that fits your parameters for a satisfactory life. Your self-care is individual, feasible, necessary.
It is not, and I cannot stress this enough, product placement.
In large part, everyone should have a self-care practice. Most likely, if you’re in good health, you might already have one in place even if you aren’t calling it that. You might be eating a balanced diet regularly, exercising regularly, making time for friends or relaxation regularly. If you’re relatively “OK”, and you have a set of habits keeping you that way, you are already practicing self-care, even if it’s by another name.
Habits, routine, stability can be essential to managing mental illness and other illnesses. Creating those habits and making self-care a priority, or even possible, can be extremely difficult. In the most basic of scenarios, you have to be introspective enough to understand what you need in your life, what your triggers are, and aware of how to troubleshoot problems before they worsen. These are practices that a person needs to be able to dictate on their own.
There isn’t a one-size-fits-all narrative for it. I’ve seen people incorporate very unique items into their self-care to keep them well. Some might dance daily. Some might do a craft. Some read affirmations. Some use essential oils.
Self-Care Should Be Free
Where my job gets harder is when we confuse self-care with self-indulgence. When we turn self-care into a money scheme or a jokey meme, we are making it difficult for mental health and disability advocates to communicate with the people we serve. When we turn self-care into a joke about spa days, eyeshadow palettes, and over-priced milk shakes, we turn the vocabulary of an essential set of practices into a joke as well. And when we turn self-care into products and not a practice, we make self-care an unreachable item for a lot of people.
Here’s the big thing that these cosmetic and vacation companies don’t want you to know: self-care should largely be free or cost no more than your essentials.
The majority of people we work with at my organization are impoverished. There are a good half that are unhoused or were unhoused previously. And we still will work with them to obtain certain specific self-care practices. It costs no money to recognize your triggers. It’s free to say a mantra.
Undoubtedly, they face even larger challenges that make most general self-care absolutely out of reach. This includes access to medical care, nutritious food, and a safe place to sleep (1). But self-care is about prioritizing the self and our needs in whatever situation we might be in. It is about creating coping mechanisms to sustain oneself and mitigate damages.
It is often a mix of the necessary and the pleasant. Practices that we may not enjoy (like taking medication, eating well, etc.), have to be enumerated and practiced. Then there are the practices that help give our life joy and meaning, also essential in self-care, but they don’t have to cost anything, and if you want to make them a habit, find things that are free.
What is necessary may not only be not pleasant, but arduous. For a good portion of the CBT(2) I underwent, part of my practice was to say nice things to myself, about myself, in a mirror. If you’re a person with adequate self-esteem, this should be fine. If you’re a person like me- Bipolar with an eating disorder and casual suicidality- it literally feels like torture. But I did it regularly.
Which backfired. Now I’m 80% ego.
Self-Care is Self-Work
Self-care is a lot of work. So it’s disheartening when people turn it into a meme to Instagram their expensive pedicure. I understand that many people (outside of companies using the phrase to market) who use it in a jokey way often also have mental health issues as well, and joking about it this way is a community-bonding strategy.
There are a couple of questions I would suggest asking yourself before you post or use the phrase:
Is this self-care or self-indulgence? There is nothing wrong with self-indulgence. You don’t need to justify it, by the way.
Does the concept of having to partake in self-care to manage my health make me uncomfortable?
Is “self-care” funny to me because it is inherently making fun of a population that is derided by the majority of the population? The disabled and mentally ill?
When I’m asked about my self-care routine, I don’t usually bring up the fact that I monitor my moods to ensure that I am not happy for too long. Happiness, if sustained for more than a day, is a trigger for my mania. At that point, I have to remove joy and stimulus to “cool down”, because mania usually ends in depression or a mixed episode.
It is one of the great tragedies of my life that in my necessary self-care, I cannot allow myself to be happy. But keeping myself from cycling means I can have daily joys, a happy marriage and consistent time and ability to write. Self-care can be very difficult, it can be unpleasant, but experience has taught me that it is also necessary.
That part of self-care sucks. As do the medications, the doctor’s appointments, the effort. Especially on days when it’s hard. Those are the days I need these practices the most. But being able to live a life of sustained relationships and accomplishments… For that, self-care is a fair price to pay.
(1) Unhoused people face high rates of theft, abuse, assault, and sexual abuse. Even in shelters. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/216287
(2) Cognitive Behavioral Therapy. The actual exercise I had to do was more complex than stated in the article.
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