Beyond self care...

One of my friends met me after a long time last week. She told me "I felt like giving you a Jaadu Ki Jappi" (a magical hug). She meant that I looked sad (her perception!) and she wished that a 'magical hug' could make me feel better. While saying this she also said, "...self-care is very important. take care of yourself first. Working for the society and everything else comes secondary..." In recent times there is a lot of discourse on self-care. Self care is popularly defined as adopting behaviours which ensure a complete state of physical, mental and social well being. In the context of chronic diseases like diabetes and high blood pressure the word self-care refers to adopting healthy life styles like reducing carbohydrates and fats in diet, following regular physical activity, avoiding smoking and alcohol and practicing yoga and meditation to maintain good mental health. However, even when someone is healthy and do not have any illness, self care has been proposed as an important strategy to maintain a good quality of life. 

Engaging in self care involves practices like adopting a healthy diet, exercising regularly, joining a gym to maintain physical fitness, having hobbies, spending adequate time to relax and recharge to prevent burn-out at work, spending time specifically for socialisation to maintain meaningful friendships and relationships. When my friend told me to take care of myself first, she meant these things. I need to provide some context here about what is happening in my life right now, before I can go into my reflections on self-care. 

I am a medical doctor working in a rural clinic. I live in Chennai and commute to the village on a day to day basis. For a 8 hour work day, my travel takes about 4 hours. I leave home at the wee hours of the morning and return only late in the evening. This is the routine for 3 days in a week. On the other 4 days I have other teaching and research engagements in Chennai. I have had repeated sprain of my low back, because of the long and extensive travel and some of these episodes have left me paralysed and unable to move about. Fortunately, I have not had any permanent disabilities. My family, friends and loved ones who are aware of this schedule have been advising me to go slow and practice some 'self care'. 

It is in this context that my friend advised me, "...self-care is very important. take care of yourself first. Working for the society and everything else comes secondary..." It was good advice. I felt the warmth and kindness with which she said this and it made me feel good. I started thinking about this whole concept of self-care. I believe that some assumptions go behind the prescription of 'self care' for persons who seem to have a very 'busy' lifestyle. Two of these assumptions are:

1. Self-care pertains largely to physical, mental dimensions of wellbeing. We need to take care of ourselves so that we feel well physically and mentally. The body should feel optimal and  should cooperate with all activities that we want to perform. The mind should feel happy, satisfied and cheerful. 

2. Social and Spiritual wellbeing are concerning how we interact with others and therefore they are other-centric. They do not have much to do with how we feel about ourselves and whether we feel well or not. Therefore activities done for furthering social and spiritual wellbeing are not part of self-care activities. 

I think these two assumptions are problematic. They do not represent self-care accurately. I will try and explain why these are problematic and how I think self-care should be viewed. 

I would like to begin by defining what is 'self'. Self refers to a person's being, identity, and values. My being, identity and values pertain to how I relate to the society around me. In other words, I cannot make meaning of myself other than as a part of my larger society. A simple thought experiment will help understand this. Let us try and explain who we are in our own words as if explaining it to someone who doesn't know us. I would say I am a 46 year old, Tamil, Indian, man who is a doctor by profession. All the components of the identity 46 years old, man, Indian, Tamil and doctor are socially constructed and make sense only in relation to the larger society. In other words there is no 'self' other than as a part of a society. This concept is crucial for understanding what is self-care. If viewed from this perspective self-care is defined as all behaviours that we adopt to maintain physical, mental, social, spiritual wellbeing. Caring for myself involves caring for my society, people around me, giving of my time, energies and efforts to benefit the larger society and the feeling of belonging to something larger and more purposeful than just the material world around me. 

Most advocates for self-care recommend adopting healthy behaviours like healthy eating, physical fitness, meditation, mindfulness, yoga, hobbies, recreation and 'me time'. This is what my friend told me. She asked me to prioritise 'myself'. In her exact words "take care of yourself first". But I think this perspective of 'self' is very reductionist. Taking up a hobby, attending a yoga and wellness retreat, joining a gym, eating healthy, are all good practices no doubt. But being self-effacing, standing in solidarity with an oppressed community, giving one's time and efforts for the welfare of the larger society, denying oneself of indulgences in preference to giving what the society needs, are all essential aspects of self-care too. These acts are behaviours we adopt for care for the social and spiritual dimensions of the self. They care for that 'self' which derives meaning from being part of the society. Therefore I believe that people who are denying themselves of pleasures for the sake of benefiting the larger society are as much indulging in 'self care' as someone who choses not to deny themselves. 

Having said this, I anticipate the question, "then can we say that the manual labourer who is exploited by the master is actually performing a self care activity?" "Can we say a woman who denies herself of small pleasures because she has to serve her family is practicing self care?" The answer is a resounding no. There is a difference between what I am doing by traveling to the rural clinic to work there and giving of my time and efforts without proper remuneration, and the work that a manual labourer is doing for meagre wages. The difference is volition. The manual labourer slogs in the hot sun hurting his body and shedding sweat and blood, because he has no other choice. I am doing my travel and work in the rural clinic by my own free choice. The 'good' mother who denies herself of her small pleasures for the sake of her family, does it forced by the social construct of patriarchy and expectations out of a woman in a mother's role. But if someone choose to do this because they feel that they belong to that family and their family is integral to their identity it is by choice. I argue that when such acts of self denial are done by full choice, for furthering social or spiritual goals, they are self-care activities. 

In recent days I have noticed a trend of increasing indulgence in material pleasures and luxuries in the name of self-care. In some situations this has even translated to waning of the attitude of solidarity, altruism and social connectedness. So much so that if someone is expressing solidarity with the society and is giving of one's time, efforts and money, it is celebrated as a rare event. The individualistic constructs of over-work and burn out are imposed on them and they are advised (with good intentions nevertheless) to practise self care. I think we must reorient the way we see ourself in relation to our society and look at self-care as more than just care of our physical and mental self. Viewing self-care as care for physical, mental, social and spiritual wellbeing, in addition to creating healthy people, will also create healthy societies!