“Self-care” seems like the new and woke response to any mention of anxiety or depression. “I’ve been really anxious today.” “Self-care!” The word gets said again and again until it means almost nothing at all. For many, this could feel invalidating without recognizing a deeper definition of self-care. Here goes some clearer definitions of self-care that won’t leave you feeling ignored, as well as some reasons why “self-care” as a suggestion might stand as an avoidance tactic.
The Internal Parent
Many people find themselves moving on from their parents into independence. They get a house or apartment, an automobile, and sometimes even a white picket fence. But just as children need to be directed: “Brush your teeth!” “Do your homework!” sometimes we need to be directed as adults. Dr. Thomas Harris invented an entire style of therapy centered around the “parent-tape” inside of our own thought patterns (see: I’m OK – You’re OK). Basically, the things our parents once told us to do – whether for better or worse – still play on repeat in our minds.
From the view of Dr. Harris’s text, self-care could have more to do with the way we fulfill our own basic care activities without external prompting. Nobody is telling us to brush our teeth, but we do. No parent is present telling the depressed person to put on their clothes in the morning during that exact moment – but by choosing this activity, they start a whole chain reaction that could lead to a less depressed day. Following the helpful aspects of this internal parent script might act as the most basic form of self-care.
When therapists tell clients and each other to practice self-care, usually they mean self-soothing. “Soothing” conjures up images of babies chomping on their own feet, or a box of fluffy kittens. Adults ignore their own need for self-soothing on a daily basis. It’s part of being an adult, since so many moments of the day are not worth our limited emotional energy. Unfortunately, those moments add up, and then we have a big pile of anxiety, muscle tension, irritability, that seems otherwise unexplainable.
The simple solution that everyone is talking about? Yes, a robot-shaped bath-bomb from Lush. But also – anything that satisfies that need similar to a baby eating her own foot. A warm blanket, a cup of tea, a chance to listen to the birds outside. The challenge might be in finding the time to do this activity, and getting your head into the pleasurable moment. (For a hilarious example of self-soothing in this regard, see Parks and Recreation – Season 4 Episode 4). But just as Donna and Tom find out in Parks and Recreation – the challenge also lies in experiencing this hedonism not as pleasurable means-to-an-end, but as a full and mindful experience.
Self-Care as Everything Healthy
Notable self-care and mindfulness researchers Dr. Catherine Cook-Cottone and colleague Dr. Wendy Guyker created a comprehensive, two-part definition of mindful self-care: “. . .an iterative process that involves (a) mindful awareness and assessment of one’s internal needs and external demands and (b) intentional engagement in specific practices of self-care to address needs and demands in a manner that serves one’s well-being and personal effectiveness,” (Cook-Cottone & Guyker, 2017). Simply put, these researchers view mindful self-care as an ongoing process where one connects to oneself about what could help, then intentionally engages in what could help.
Their mindful self-care scale includes six categories:
- mindful relaxation
- physical care
- self-compassion and purpose
- supportive relationships
- supportive structure
- mindful awareness
The researchers’ original article encompasses a wide definition of self-care, but maybe that’s needed for such a comprehensive topic. At the same time, this definition could be overgeneralizing – can anything a person does that is purposefully healthy really be considered “self-care?” The scale was tested for validity in a 2019 study, showing that the scale does target the concept of self-care (Hotchkiss & Cook-Cottone). While this definition may be the broadest, it also shares the strength of containing layers with detailed aspects of self-care.
Why is “Self-Care” As a Suggestion so Invalidating?
Asking someone to perform “Self-Care” without further specification is basically saying “Oh, look over there!!!” It’s deflection, distraction, and ignoring the root of the problem. As Linehan’s DBT states – there’s many moments where this ability is crucial (Linehan, 2014). Sometimes there’s no option to address the problem and we must bide our time by addressing the feeling of crisis instead – and why not enjoy that time if possible? However, in cases where the other person may be playing a role or hold responsibility to the problem, such as workforce complaints or relationship conflicts, suggesting “self-care” is the ultimate modern avoidance tactic.
Self-care also holds a deeply personal connotation. Each unique person will soothe differently – I may love Rocky Horror as a comfort movie but my partner might hate it! To follow, employers suggesting self-care also ignore the root of the problem within one’s own workplace, while acting overly vague to the point of inertia. It’s like asking an ice cream vendor for simply “ice cream.” Well do you want the SpongeBob shaped popsicle or do you want soft serve? Asking a person to “do self-care” without specifying meaning is as empty as asking someone to “make me lunch.” Well – what’s your order – sandwich, soup, escargot?
Therapists and supervisors must do better when it comes to teaching about self-care, and remain close to evidence-based practices like DBT, which promotes specificity when teaching about soothing and distraction as specific, separate skills. And for the rest of us – we might benefit from taking that mindful self-care survey to find out exactly what areas we’re ignoring…
Cook-Cottone, C. P., & Guyker, W. M. (2017). The development and validation of the mindful self-care scale (MSCS): an Assessment of Practices that Support Positive Embodiment. Mindfulness, 1-15.
Linehan, M. M. (2014). DBT Skills Training Manual, Second Edition (Second Edition, Available separately: DBT Skills Training Handouts and Worksheets, Second ed.). The Guilford Press.
Hotchkiss J. T., & Cook-Cottone C. P. (2019). Validation of the mindful self-care scale (MSCS) and development of the Brief-MSCS among hospice and healthcare professionals: a confirmatory factor analysis approach to validation. Palliative and Supportive Care, 1–9.
Harris, T. A. (1999). I'm OK -- you're OK: A practical guide to transactional analysis. New York, NY: Galahad Books.