The Problem with 'Self Care'

On the individualization of systemic failures

Controversial opinion: I love the movie Love Actually. Yes, it’s flawed and at times, cringy, but it’s also funny and I will continue to watch it every December thankyouverymuch. There is a scene, though, that hits a little too close to home. The American woman, Sarah, who cares for her mentally ill brother - who calls her constantly - is finally hooking up with the coworker that she’s been in love with for years. They are back at her apartment and her upset brother calls right as things are getting steamy.

The guy, Karl, asks her “will it make him any better if you answer it?”

“No.” She says.

“Then maybe, don’t answer it.”

But Sarah can’t ignore the call. She agrees to go see her brother right then - which obviously kills the mood with Karl. At that moment, Sarah realizes she doesn’t have anything left for a new relationship, because she gives it all to her unwell brother. She resigns herself to her role as a caretaker and prioritizes his needs above her own; their relationship above any other.

In this fictional example, Sarah could have prioritized her own needs and her brother would have been fine. But the storyline is a representation of how caregiving can take over your life, and how the wishes and needs of those you care for can usurp your own, especially when you are the sole support person.

The truth is, many caregivers are not prioritizing or caring for themselves, with more than 60% showing symptoms of burnout.¹ According to Caregiver Action Network:

“Nearly three quarters (72%) of family caregivers report not going to the doctor as often as they should and 55% say they skip doctor appointments for themselves. 63% of caregivers report having poor eating habits than non-caregivers and 58% indicate worse exercise habits than before caregiving responsibilities…40% to 70% of family caregivers have clinically significant symptoms of depression with approximately a quarter to half of these caregivers meet the diagnostic criteria for major depression.²

In response to the stress, caregivers are often advised to engage in self-care, with examples like taking a break, getting a massage, meditating, or shopping - i.e., do things that make you feel good (which could include hooking up with the guy you have a crush on or prioritizing other relationships). Sure, those are good things - but there are several problems with constantly pushing this message on caregivers.

As a caregiver, being told to “just take a bubble bath” feels dismissive of how physically, mentally and emotionally taxing caregiving can be. A bubble bath is also not going to change the fact that there are not enough hours in the day to schedule and attend the appointments, handle medical issues that arise, deal with drama in the nursing home, manage finances for another person, feed and pick up children and shuffle everyone to activities and on and on while maybe trying to work and sleep. Now I’m supposed to schedule myself a massage, too?

Self-care can inadvertently become another burden on our to-do lists, one that forces us to make impossible decisions between tending to our own needs in ways that can feel luxurious, and the basic needs that our loved ones depend on us for.

Perhaps most importantly: the “self-care” hype reinforces the idea that we can do and be everything we need for ourselves, by ourselves. Which is ironic when the source of burnout is the need to care for others. The focus on individual solutions suggests that our burnout and stress are personal failures, rather than systemic ones. Self care is easily weoponized by institutions to offload responsibility, and by capitalism to sell us more stuff with the promise of relief.

The real problem is that for the most part caregivers - whether we are caring for children, parents, or both - have little societal and community support. This starts with the stress of figuring out unpaid leave and managing healthcare bills, and continues with the lack of backup/respite care, mental health support and increasingly isolated lives. We may not (yet) be disabled or need physical and cognitive support, but we still need support for our health and wellbeing; we, too, depend on care from others.

Snuggles and breakfast in bed with my kiddos after my dad died.

For a while, I was in a bit of a Sarah-situation with my mother. Sure, part of this involves finding a balance and distinguishing others’ care needs from preferences. I and others may have found ways to protect our own peace to continue in our care roles in a way that is sustainable, and I was fortunate to have Alex and dear friends to lean on. However, it can be difficult to figure out what that balance is, and there is a lot of caregiver guilt and shame that comes into play. I still distinctly felt the lack of broader support for navigating all of the complicated financial and health decisions, and felt thrown into a complicated world that I knew nothing about and had no one to guide me.

I’m fortunate that my disabled brother has a wonderful placement with a non-profit that fully manages his daily living and caregiving while he lives in his own apartment. And my mother is now stable in a nursing home and well cared for day-to-day. I am not needed or drawn in emotionally on a daily basis the way I am for my children; but even the high-level oversight of medical, financial and social plans, guardianship, goals and activities pulls from my emotional and mental energy reserves. Many people who are managing the day-to-day for elders and children are silently drowning.

If you’re trying to figure out what to say to someone who you see is struggling under the weight of caregiving responsibilities, instead of suggesting self-care, try a simple action of care instead: drop off a meal, send a “thinking of you” text, if you’re at their house, do a chore that you see needs to be done. While we continue to advocate for policies that would support caregivers, perhaps we also need to shift the messaging from ‘self care, to ‘community care.’

Share with me, dear readers, what is one choice you make that prioritizes your own wellbeing? And what is one thing that you do for others (or that helps when others do for you) when it’s clear they need care but don’t know what to ask for?

Also - I know it’s June, but are you team ‘Love, Actually’ or is a hard pass?

Some Good News

👶🏽 Colorado became the first state in the U.S. to pass paid NICU leave! Parents who have a premie baby in the Neonatal Intensive Care Unit will get up to 12 weeks of additional leave, paid for by the state insurance program.

🚸 Connecticut passed a bill to provide free infant, toddler and pre-k childcare to families making under $100k, and families making more capped at paying 7% of their income. It also improves salaries and funds facility improvements.

📱 care.com’s new app was designed with Sandwich Generation caregivers in mind. Their rebrand seeks to move away from simply a childcare app to one that helps people juggle the mental load and find all types of care, including eldercare, summer camps and pet care.

1. Mayo Clinic

2. Caregiver Action Network