The Privilege of Self-Care

A friend and colleague shared a tweet with me last week that pointed out a simple truth that there is a certain amount of privilege associated with self-care. In this case, it was the privilege of knowing you need care, what kind of care, and having the resources to do something about it.

“Why do I rally against the rhetoric of self help in academia? It isn’t because it doesn’t work for those with stress or mild anxiety or any other condition, it’s because it puts the responsibility to stay well and get better on those who are too unwell to participate.”

I’ve written before about self-care as capitalist plot, and it is. Capitalism doesn’t care all that much for individuals, save as how they can be leveraged to produce wealth for other individuals. Pushing us all to self-care is along the same lines of creating self-repairing, self-correcting machinery to reduce costs in producing widgets. After all, if a machine is self-repairing, it doesn’t need technicians and mechanics to support it.

Of course, there really is no argument (as far as I can tell you) that self-care is a personally good thing to do. It is definitely a private good and in your best interest. Self-care does take resources, it does take privilege. If nothing else, it takes the privilege to be able to stop and breathe, to stop activities that add no value or are harmful.

When one is suffering from depression, anxiety, chronic pain, or other disabling condition it is next to impossible to self-care your way to a better space. You need help identifying your situation, your needs, and a way to get those needs met. I certainly needed those things.  Having someone point out my depression, the way I was ignoring it, and what I could do about it, made all the difference. I still needed to act on that information, which I did, and I needed the resources (medical care, insurance, counseling) whcih I had. So I got better.

Unfortunately many people don’t have those resources, including a friend or colleague that helps them to identify their problem or needs. That’s why self-care is so often for those with privielege. We need to create systems where everybody has access to the tools, information, and support they need to perform self-care. We can’t just preach about it or write about it and tell people to just do good self-care.

In fact, I would make the point that good self-care is a collaborative effort since it relies on the support and/or input of others. For this reason, we should being about self-care of the community. How do we take care of all of us, by taking care of ourselves through taking care of others? It seems delightfully mutually supportive and cyclical. The only problem is that we would have to give up all the divisions among us that we love to cherish, shout about, and chew on in deep, dark thoughts that are really antithetical to good self-care.

 

 

 

 

Work as Self-care; and Being There

Last week I was reminded that sometimes, it is necessary to skip self-care and just work like the devil. I had stuff to do that couldn’t wait. I was also in a productive mode. And so I spent a couple of evenings working late, working hard, but feeling pretty good about it. This is markedly different from the years I spent doggedly working each and every night after a full day in the office. During that time, no matter how much progress I made, it never seemed to be enough.

When I took those two nights working, the lack of exercise was on my mind, as much as the lack of just giving myself breathing space for a while. I kept reminding myself that I was only going to do this for two nights and I stuck to that. The next night I rested and began to return to what amounts to routine for me. (My routines are amorphous, chaotic things. Kind of like blobs of imprecise activities.) I felt it was critical that I got back to my regular activities quickly, since they still hadn’t quite settled after being away over the holidays.

The nice thing about these two evenings, especially the second, was the downright sense of flow on a coding project. It was fun, creative, and dangerous – just like painting. I like it when that happens. Rarely am I able to get in to that state of mind and work. Too many distractions, too many tasks that pop up that require immediate attention. So it was good.

Sometimes the work itself is self-care, especially if it meets a need and releases stress.

***

Household chores can also be self-care. I think it is easy to forget that. It seems easy to get into the habit of defining self-care as exercise, meditation, nutrition, time for self, and perhaps other activities. Having a clean, orderly space, clean clothes, car properly maintained, trash put out, all the daily chores that allow us to be properly functional. All of this is self-care, or what some call “adulting.”

Self-care is being there. It is being where you are at and taking care of your needs. Taking care of yourself. Which may also include taking care of your relationship(s).  (I think I will that for a separate post.)  Self-care is nothing more than recognizing what you need to be ____________ and then doing the work. That blank is hard to fill meaningfully. It’s too easy to put “successful” there but that has its own implications for what self-care is, as does “happy.” I’m thinking that each of us need to fill in that blank with the word that makes most sense for the current moment of time, and that will help us determine what self-care really means to achieve that. I don’t think anything goes away, it just gets weighted differently.

***

Sometimes in caregiving there are moments of despair. Some minor thing goes wrong and cascades into a major, or near major, other thing. When this happens, generally the two people involved have to find a solution together. Say for example when there is a fall and the person you’re caring for can’t get back up on their own or with somewhat “typical” assistance, like a hand up. It can take time, creativity, and very serious effort if the caregiver simply just can’t pick their charge up off the floor. A situation like this when it is not quickly resolved can result in panic for one or both.

When this happens, there is nothing to do but stay calm and do the work. The work being the solving of the problem at hand with as much calmness and patience as can be mustered. The less drama can you be bring to an event like this, the easier it is to cope. Far easier to cope, for both of you.

***

I think the one thing that overlaps these three sections, besides “work” is “being there.” Whether you think about it as mindfulness or being in the moment, just being there is key. Being there for yourself, your partner, your family, your work (which is not necessarily the same thing as your “job”), whatever it is, it is a question of being present. I’ve said before, I spent too much time when I was young thinking about the future instead of being there. No time now to dwell on that,  or anything else in the past, there are things to do now, even if it is just sitting and breathing.

 

 

Self-Care as a Capitalist Plot

“The next morning, I had an epiphany—this whole self-care push is just another capitalist boondoggle. We won’t take care of you. In fact, we will continue to push you until you are a broken body and we won’t change a thing about our working conditions, and then we will claim that it was on you to take care of yourself, to practice self-care. After that, we’ll take away your health care too, so that you can just go away and die.”

from Why I Can’t Have Coffee with You: Saying No to the Patriarchy (http://www.vidaweb.org/why-i-cant-have-coffee-with-you-saying-no-to-the-patriarchy/ )

This resonated.  I’m not yet convinced I agree fully, but I sure do see the point. Its not like there is any evidence that employers would treat people this way. Oh wait,  I guess perhaps there is. Apparently delivery drivers for Amazon don’t have time have time to go the bathroom, let alone eat.  And I don’t think this is limited to Amazon as on a recent  trip to DC, one morning I observed a commercial van driver empty a bottle of urine into the street. Nor was it the first time.  It’s amazing what one can see when paying attention to the world around you.

Unfortunately, the truth is that the push for self-care is not just a capitalist boondoggle,  but a recognition that the world,  the universe,  does not care for your well-being. Your god does, whatever your faith, I think, but as far as the world,  not so much.  You are just an unrealized nutrient collection for other lifeforms.

That’s pretty depressing I know.  Really though, it is simply to the make the point that self-care is your responsibility. Unless, of course,  you are Peter Pan,  in that case there will always be Wendy to take care of you. Most of us don’t have a Wendy.  If we are lucky,  we have a partner that watches (and perhaps, washes) our back.  So,  self-care it is, or trusting to luck and the good graces of a hungry world full of things that want to n eat us.

For me, engaging in self-care has made everything better. I’m happy,  healthy, fit,  and far more relaxed. Even if it is a capitalist boondoggle, it is still an improvement.

But,  it does seem like there might be a relevant song.
Some people say a man is made outta mud
A poor man’s made outta muscle and blood
Muscle and blood and skin and bones
A mind that’s a weak and a back that’s strong

You load sixteen tons, what do you get?
Another day older and deeper in debt
Saint peter don’t you call me ’cause I can’t go
I owe my soul to the company store

I was born one mornin’ when the sun didn’t shine
I picked up my shovel and I walked to the mine
I loaded sixteen tons of number nine coal
And the straw boss said “well, a-bless my soul”

You load sixteen tons, what do you get?
Another day older and deeper in debt
Saint peter don’t you call me ’cause I can’t go
I owe my soul to the company store

Sixteen Tons – Merle Travis

Reflection as Self-care

Progress can be an iffy thing to observe. It is easy to become frustrated and discouraged because some changes just take time. This is especially true of subtle changes in behavior and choice.

Today is the first anniversary of taking a specific steps to improve my life. Truth to tell, it actually represents the end of a week of decisions and actions, but it all came together on December 2nd. Together these decisions represented steps toward achieving one goal: to become healthy.  This came down to three major activities – losing weight through a healthier lifestyle, learning and practicing good self-care, recognizing, accepting, and then getting treatment for depression.

So, following some sound advice from someone I trusted, I tackled all of these that one week.

  • I consulted my PCP and started a mild antidepressant.
  • I sought a recommendation for therapist and set up an appointment and did nine months of really hard work.
  • I started with a weight-loss clinic.
  • I gave up my diet soda habit cold turkey (it was a very bad habit in terms of quantity).
  • I dropped quite a few food choices from my diet.

A year later, I have lost 66 pounds and 10 inches from around my waist, a total of 86 pounds over the last 18 months (I had made some changes in the preceding spring, but hit a plateau). And, yes, I have bought quite a few new clothes, multiple times. I am very close to my goal, which is not about my weight itself, but how I see myself in the mirror.

One of the problems in working with working with a weight-loss clinic is that they are focused on the big number on the scale. This is despite the fact that they measure and record your heart rate and blood pressure on each visit.  Why mention this? Because a year ago my resting heart rate was 78 beats per minute (bpm). It is now routinely measured around 52 bpm. Of course, this is not just a function of losing weight, but of also engaging in regular exercising and averaging at least 11,000 steps a day on a bad wee, and 15,000 on a good week. My blood pressure has also dropped and on occasion is very near the low range of values. I might be able to give up the meds at some point.

There was no magic bullet in anything I did. It was all interrelated and all very basic stuff. Treating the depression helped with the weight-loss and lessened the desire to eat crap. The losing weight helped the depression. Counseling led to working on mindfulness. “Mindful eating” assists weight-loss. Studying mindfulness (probably not yet as rigorously and deeply as I hope to do) led to readings in meditation and trying to develop a practice of meditation. Meditation led to early efforts in yoga.

There were also a whole slew of blog posts along the way as I worked my way through the year.

I feel phenomenal. I look better than I have in decades. I am now at about the weight I was in college and in the Army. My health is improved. My attitude and inner self is better, and closer to normally calm.

But my golf game still sucks badly.

Today it was painfully horrible at times. However, I still had fun throughout. I enjoy the game in a way that I hadn’t before. And there is an explanation for the horribleness.

Last spring I played golf and strained my left ankle. The next day I went out for a 10-mile hike in the forest. And then I went to the driving range. On the fifth ball, I screamed. I had clearly torn something in my ankle. So I quite playing for a few weeks and took anti-inflammatories. I played golf again and on the sixth hole I nailed a perfect 275 yard three wood and, you guessed it, screamed.

I got in to see a sports medicine doc and he put in an ankle brace, loaded me with anti-inflammatories, and sent me to physical therapy. After pointing out just how stiff my body was, particularly my ankles, she went to work and gave me a boatload of exercises to do. I complied, she and the doc were satisfied that I had made adequate progress, and I was released with the proviso that I must always wear the brace when playing golf and continue to work on the exercises. The yoga helps with this.

However, because the ankle brace interferes with a normal swing stance and because clearly a normal stance is not ideal for me, I have had to rebuild my swing and that takes time. More often than not it has been better as of late, but not today.

Something else happened in parallel. In the spring I was also experiencing discomfort and pain from my jaw popping while I ate. When it didn’t go away, I schedule an appointment with an oral and facial surgeon….but that was for October. The popping eventually disappeared but I kept the appointment. It was good that I did. He determined that the muscles on the left side of my face were too thick and stiff (and also subject to hemifacial spasms multiple times a day) and that, in all likelihood, the anti-inflammatory used for my ankle had also helped my jaw. He prescribed a med change and more physical therapy.

With another physical therapist telling me just how stiff I am and seemingly unable to relax.

As luck would have it, this therapist also specializes in facial movement. Now, almost eight years following surgery, I am finally getting treatment for the spasms, muscle weakness, and asymmetry in my face. These things may not get completely eliminated, but after only a month of effort, there is progress. And honestly, I haven’t cared enough about my appearance until now to really worry about my face.

More importantly, I don’t think I would have been ready to really do the work until now. The effort, the concentration, it requires to sit an stare in a mirror trying to move just one or two muscles is significant. Mindfulness is required and acceptance that this effort is of value to do.

Progress in many things over the year. Today I am recognizing and celebrating that progress. I am also mindful of just how connected and related all these things are.

It’s good.

 

Advanced Self-Care

There can be discomfort in accepting care and support from others. This has been a theme in the last couple of weeks in a number of unrelated conversations.

 “Thank you for caring about me. It is uncomfortable to be cared for but for you I am suffering through it. :)”

Those of us who are counter-dependent or lean in that direction, struggle with relying on others. We believe we can do it all ourselves, without assistance. It’s unhealthy approach to autonomy and independence.

The key in understanding counter-dependency is differentiating it from healthy autonomy. Healthy autonomy is a state of confident self-reliance in which an individual a) recognizes their interdependency with others; b) has an agentic sense of self (i.e., a sense that one can effectively control one’s destiny) and c) is not unduly controlled or influenced by others. The primary defining feature of a healthy autonomy is first that the autonomy motive is an “approach mindset,” meaning that the individual desires to be (relatively) self-reliant because they want to recognize their full potential as an individual, but one who is simultaneously and securely interconnected with others. Second, healthy autonomous individuals can regularly form effective, meaningful, intimate long term relations with others. That is, they can share, be vulnerable, and are comfortable relying on others when it is reasonable to do so.

Signs of Counter-Dependency, Psychology Today.

This mindset gets in the way of good self-care. After all, there is never enough time to do everything. There is also, if we are honest, never truly enough to competency in every single thing we attempt. (This is kind of a harsh reality for those that really believe they can do anything, and do it well enough.) More importantly, there are simply times when we can’t be our own caregiver, although it might take extreme situations to make that clear, such as my own 32 hours of brain surgery.

I’ve written previously about my efforts at self-care. Improved nutrition, exercise, rest, working at mindfulness, learning to be vulnerable and open, are all parts of self-care. I think I have come to see that letting others in to provide care for you, even if it is just assistance, is really an advanced and necessary form of self-care.

This is easier to do with someone you know and trust. Although, I think if trust is really there, then it is much less of a problem to do. Part of counter-dependency is the inability to trust that someone can do something at least as well as you. So, with one-on-one relationships, we can at least begin to negotiate trust pathways to let someone care. It is much harder if we are alone in a community, or worse, believe we are alone in a community, and feel there is no one to trust enough to even reach out to. This is a tremendous place of discomfort.

At this point, I think the only answer is this. Ask yourself, “How much do I truly value my well-being compared to challenging my comfort levels in asking for, and accepting, help?” Like most things, it is something of a cost-benefit analysis, but with the added confusion of “comfort” actually being on both sides of the equation. We balance risks of physical and emotional comfort against generally the emotional discomfort of admitting we need help and need to trust someone to provided.

Needing help is not a bad thing. It is merely a recognition of the existence of limits. Accepting help is really good self-care.

Giving up stress as habit

I’m working with a healthy lifestyle coach through work to reduce my stress. Today I realized that stress, for me at least, is a habit in the same way  anger is (was) a lifestyle.

Stress initiates the same “fight or flight” response that anger does. Both release cortisol and adrenaline/epinephrine into the body. Both disrupt. They disrupt sleep, well-being, physiology, and perhaps worse of all, they disrupt communication.

Adrenaline is a rush. You can get the same rush from stress and anger as you do from downhill skiing. There are just different emotions and responses attached. The adrenaline rush can be addictive.

In other words, you can get hooked on being stressed. You may not enjoy it the way you might other addictions, but you are hooked the same way. If this happens, you start creating situations where stress develops naturally. Say, by taking on more responsibilities, creating a greater vision than you can possibly realize given real-world limitations, procrastinating, or simply by creating conflict – even if it is only through responding conflictually. You create stress to get the adrenaline, and it cycles and spirals in such a way you keep creating more stress.

This has negative effects on the body.

This also has negative effects on relationships.

For the past few months I have been working at breathing and meditation. Slowly and imperfectly. I have at least learned to count breaths as a way to manage stress in the moment. This has helped. But. I wrote a post a few weeks that makes the point that counting is an act of control. We only count things we wish to control in some manner. While there is a certain amount of value in controlling your breathing, if your goal in focusing on your breathing is “to be in the moment,” then counting seems to be the wrong way to go about it. Counting is about controlling more than it is about being. Counting is about moving on because it is always a step further away from zero on the number line or whatever axis you are using.

Counting takes you away.

So, instead of counting breaths, I count each breath. I count to one and stop. And I do it again. And again. After all, the value in focusing on your breathing in meditation is breathing is always the thing you do now. Past breaths don’t matter. Future breaths don’t matter. All that matters is this breath now. By counting each breath and starting over, I am embracing each breath as its own moment. I am not moving farther down the axis., I am staying rooted in the Now.

This is hard work though. It would be much easier to simply get rid of everything that causes stress. But I am pretty sure that would leave me very lonely and very bored. For that reason, I will stick with the things that cause stress, but continue to learn to be more aware of each moment, and less focused on what makes me feel stressed. All of this is part of developing much greater mindfulness than I am capable of currently.

Actions:

  • Continue to develop and practice attitudes that lead toward greater mindfulness.
  • Learn to pause or stop before responding. (I have a bad habit of responding immediately. Sometimes I think this is about creating more stress than anything else.)
  • Continue to give up ideas and practices of control. (Let more things be done by others. Share the wealth of opportunities that exist with all the stuff that needs doing.)
  • Identify things/behaviors that cause stress and develop workarounds.

This last thing is kind of big. I’m not a big planner. I’ve traveled across country multiple times with the only known stops to be the beginning and the end. I like the looseness of no plans and potentialities of discovery. I admit though, I dislike driving farther and farther into the night looking for a motel. So as we prepare to leave on a 4,500 mile roadtrip, I have made reservations for every night. We know what motels and hotels the first two weeks, what campsites the second two weeks. Further, I have put this is all into an itinerary and shared it with people. Most importantly, I have shared it with my wife, in hard copy. She now knows the plan. I am not always very good about sharing my plans, especially those that are all in my head, because I like the flexibility of changing my mind and not having to admit to changing my mind. Or worse, being wrong. I have bad habits of responding in irritation to questions about the plan in my head. In part, because I was typically irritated that I hadn’t told anybody so now I have to explain it – while in midst of executing it. Blecch.

It’s liberating. And it might even work. We are about to find out.

 

 

 

Continuing Self-Care

I have found that the hardest thing about self-care is time management. Of course, this makes sense. All the things we often do, things that become habit, out of convenience, we tend to do to save time. Leastways, that is true for me.

Depending on what you find when you search, there are about six or seven domains of self-care. And about billion pieces of advice on what to specifically do for self-care. I like these domains as a starting point: physical, emotional, spiritual, intellectual, relational, safety and security. Honestly, without having done some research, some of these areas would not have occurred to me.

I’ve focused most on physical self-care. I have been trying to reshape and rebuild my body. Because, health; and because men can have body issues, too. Recreating a physical image of self is probably easier than creating a new emotional image of self, but it still takes hard work and a great deal of time. In the last four and a half months, I’ve made significant progress. At an annual specialist consult this week, it was noted (with some surprise) that I had lost 60 lbs since a year ago. My diet has changed dramatically and I exercise daily. I’ve also made the attempt to get seven hours of sleep each night. I’m not quite there yet, about 10 or 15 minutes short on average, so more discipline is required.

For emotional self-care, apart from getting more sleep, I really have worked on moving away from anger as a lifestyle. While I still have have work to do, it has been quite amazing how much of a difference this has made in my life. I really am less angry.  By changing how I think, I have reduced anger and upsettedness. I am more pleasant to be around and this has been noticed. I have worked also on being more in the moment, on mindfulness. These are hard for me the way my mind races. This will take continuing practice, like most things do.

My efforts in spiritual self-care are simple and private. I will mention that spending more time outside, away from all the glowing rectangles in my life is part of this. Finding peace and solace on the trails is renewing. Stillness is also part of this. In Tinnitus and Morning  Coffee I wrote about my struggles with accepting the noise and discomfort of tinnitus. After these weeks of effort, we are at least at a grudging accord, tinnitus and me. I may not have made friends with tinnitus as I hope to do, but I am finding the quiet much more pleasant and desirable. I am finding comfort in stillness, despite the constant ringing in my head.

20170422_102711

One of my favorite trails in Pocohontas SP.

I’ve been broadening my reading for intellectual self-care. I am reading a mix of higher ed, math policy,  and personal memoirs. A couple have been a mixture of both. I’ve also been investigating new challenges in programming for the web, especially after I realized that I had been developing web pages for 22 years. While I probably should be writing less code than I do, I enjoy it, and I enjoy learning new things. I struggle with new languages that use different constructs than those I am used to, but that is part of the challenge. However, I have to work to ensure that I am not falling back into a counter-dependency mode by trying to master everything. Instead I try to do these things with narrow purpose and intent.

Relational self-care is why I am doing a lot of these things. It is about renewing and rebuilding the relationships with family and friends that have degraded because of my inward focus. It is a slow process because it has to start with how I feel about myself, repair that, so I can relate to others more openly and accurately. (Accuracy and validity are surprisingly important to healthy relationships.) It also can’t wait until I have done all the work on myself.

As for safety and security, I am a giant, middle-aged, white male. I don’t get too worried about this. For me it is a question of avoiding activities that accompany the phrase “here, hold my beer.” Putting aside the fact that I have given up all forms of alcohol right for the time being, it is about not being stupid, not showing off.

I said at the beginning that time management is the hardest thing about self-care. It is. If you look at these seven domains of self-care, you see the six of them require action.  They also  require time. When I started using a step counter (initially the one on my phone), I set a goal for 5,000 steps a day and then upped it to 10,000 steps. For the past three weeks I have been trying for 15,000 steps a day. Generally I achieve this or more. However, it takes more than walking for an hour at lunch. It requires brief indoor walking breaks (which rejuvenates my thinking and allows me to read documents and articles while walking in a space of about 18′ by 40′. It’s amazing how many steps you can do in such an area if you put boredom aside and make it productive.

Still, this isn’t enough. I have to either walk or run many evenings. Right now I am trying to run about three days a week. It is still more of run-walk thing, but since it is generally out on trails, that’s appropriate (walk up hills, run the downhills and the flats). These have to be scheduled. I also still try to keep a few hours of stationary bike and video games in the mix each week. The really uneven cardio work that happens when my hindbrain kicks and makes me pedal faster to make my Mii go faster in Super Mario Kart 8 has really helped me return to trailrunning faster than I thought possible. Like I used to do when I was running marathons and ultramarathons years ago, I take advantage of opportunities to walk – as I did last night when I walked 4.5 miles to pick up my car from the dealer after servicing rather than catch a ride.

I haven’t even mentioned golf and range time. These are significant time commitments as well. I work to balance all these things, so that no one thing dominates everything else. This alone is a change.

These things take time that must be scheduled. I have to also allow time to spend with Melinda in the evenings and weekends, which is part of the relational self-care. Making time to read, or to just be (i.e. meditate or sit in stillness), are also time commitments. This is not to say I schedule everything, but rather that I am aware of what I need to do and make time for it. Making time to write or paint (more about that shortly) is also important. I try to recognize the specific needs of each day.

Even my diet changes require a time commitment. I spend an hour or two each Sunday prepping my lunches for the week, trying to anticipate my protein and calorie needs relevant to the physical goals for the week. Other meals require time as well because we have moved so much of the quick and easy foods out of our lives.

So, time management is necessary and critical to my self-care. Along with that is prioritizing what matters. If I can’t do everything, what am I going to give up? I am trying to make the seven hours of sleep the highest priority, but that is such a radical change for my life, it hasn’t happened quite yet. But given the way getting close to it has made me feel, it is about to happen.

I mentioned that I have begun painting. I don’t know that this is a permanent return. What it is now is a self-portrait as self-study. Confronting self-image as I work through these changes in my life. I have only done one previous self-portrait and it was small and quickly done when my skills were pretty sharp. I’ve just jumped into this trying to use skills long-dormant and trying to recall how to think about the act of painting. It’s happening. It’s good (the effort, not necessarily the painting).

All of this is working. I feel better physically and emotionally. I feel more positive than I remember having felt before. So I want more.