The Correspondent
Tanmoy Goswami – The time has come to take the self out of self-care

A strong contender for Word of the Year in Hindi this year will surely be "aatmanirbhar", meaning self-reliant. It has emerged as perhaps the favourite word of the Indian government in 2020, with the prime minister aggressively championing it as an antidote against the pandemic-hit global economy.

An idea that might have felt old-fashioned in a hyperconnected "global village" makes sense this year. Self-reliance is what 2020 has taught many of us anew, and some of us, for the first time in our lives. We were yanked loose from our connections and left hopelessly disoriented. We found ways to survive, at first kicking and screaming, but soon enthusiastically, showing off our proud new lockdown skills, sourdough loaves, or steely abs.

If fostering self-reliance is a solemn duty to the nation, embracing self-care is a joyous duty to yourself. In 2020, those two ideas have melded into one.

And now, just like that, the year is over. We are set to enter the New Year’s season, when self-care resolutions cover the world like snow. At least 2020 has given us a lot of practice.

But 2020 has also exposed something frighteningly fragile in our culture. Not every self can be reliant on, or care for, itself. Sick, unemployed, homeless, lonely – what happens to those selves?

Even the Ancient Greeks loved self-care

Shubhrata Prakash has a self-care story that has nothing to do with the pandemic. Four years ago, in the middle of a long struggle with depression when she often wanted to “end the agony”, stopped taking her pills.

“I was on a lot of medication, but it wasn’t helping,” Prakash, a senior Indian bureaucrat and mental health advocate, told me over a phone conversation last year. “Instead, I would get these tremors [as a side effect of the pills]. I spoke to my doctor about de-prescribing, but she didn’t agree. That’s when I had an epiphany that I needed to look out for myself. I decided to listen to my body and taper off my medication.”

Initially, she was hit hard by withdrawal. “Then one day I had a small window when I felt normal. I hung on to that and took charge of my wellbeing. I started doing yoga, exercising, swimming, journalling, meditating.”

Illustration of a blue box with icons related to the internet spilling out, balancing on top of two pill, one blue and one blue and green.

In the space of a few months, Prakash began to feel like a different person. “I can’t say for sure what worked, but it’s like my brain was rewired.”

Prakash stressed that she does not recommend ditching medication against professional advice. However, she insisted that going off meds was for her the “fiercest expression of  

When I revisit the story of Prakash’s recovery from a deadly illness today, it sounds like a rousing endorsement of an increasingly loud slogan in health and wellness circles – especially in the wake of a pandemic that has left us painfully aware that whatever we thought will protect us, can’t:

Invest in self-care. Take control of your own healing.

Of course, the idea of caring for the self is not a newly minted fad, though the recent explosion of self-care messaging – much of it aimed at superfoods-loving – makes it difficult to imagine otherwise. In Michel Foucault’s the French philosopher explains that to the ancient Greeks Care was considered a “privilege-duty”: a privilege because it set us apart from animals, and a duty because without care for ourselves, we cannot survive.

Thousands of years after the ancient Greeks, the narrative today is that self-care is a magic solution to all our existential problems. The reality? While self-care is a powerful tool, its current golden age has brought with it four disturbing problems.

1. Self-care is … everything, so it starts to mean nothing

What constitutes self-care? Instagram and Twitter are good places to get some answers. A quick search on the platforms shows its burgeoning appeal – and confounding scope. Aside from bingewatching Netflix or shampooing your dog, #selfcare (AKA #selflove) is also attached to some odd pursuits – such as axe throwing.

Screenshot of a twitter post by Anita Ridge showing a woman trowing an axe at a wooden board.

Meanwhile, the global self-care industry has, by one frequently quoted estimate, serving up a hodgepodge of sexily branded bric-a-bracs. For instance, Marie Kondo, the Japanese “tidying expert” who became famous for teaching minimalist living, triggered an avalanche of media coverage by that will sell, among other things, “a tuning fork” with which you can strike a crystal – also available on the site – in order to “clarify the energy” around you.

Giants from diverse sectors, such as Ikea and Google, are angling to get in on the action with their own wares. featuring a “fashionably dressed coffee shop worker find[ing] her Nirvana by making a Lego ship”. The company calls it “zen, in the shape of a brick”.

Don’t get me wrong – I’m a firm believer in the Gospel of Whatever Works. But even the wise ancient Greeks wouldn’t have bargained for this – its productisation, to use a term beloved in Silicon Valley, where companies, eager to cash in, are shipping out a cornucopia of meditation and mindfulness apps.

Does all this make you feel like Burger King has you covered.

Screenshot of a tweet by Burger King showing a commercial stating "not sure who needed to hear this today, but it’s ok not to be happy all the time. All that matters is that you #FeelYourWay." It also shows an image with their products and the text "No one is happy all the time".

So disorienting is the deluge that there are now guides on Instagram to help you determine if you are doing self-care right, with questions such as “How much money am I spending on it?” and “Does it take care of my future self?”

Screenshot of an instagram post by therapyforwomen with an image with the following text: "How do I know if Something is Self Care? Ask Yourself... 1. How do I feel before, during and after I engage in this behavior? 2. Am I using this behavior to numb or avoid my emotions? Do they come back more intensely afterwards? 3. How much money am I spending on it? Is it realistic for me to use as long term coping skill? 4. Does it take care of my future self? etc"

2. The onus is often solely on the individual

of self-care by the UK’s health service illustrates its problems: “The actions people take for themselves ... to stay fit and maintain good physical and mental health; meet social and psychological needs; prevent illness or accidents; care for minor ailments and long-term conditions; and maintain health and wellbeing after an acute illness or discharge from hospital.”

‘People don’t seem to recognise that when they say "you can at least meditate", that it’s not that easy’

Look at that list again. Can maintaining good physical and mental health, meeting social and psychological needs, and preventing illness or accidents be So what happens when people presume that it is?

Aparna Mittal has given a lot of thought to those questions. Mittal is the founder and CEO of PatientsEngage, an online platform in India that supports patients and caregivers with the management of chronic diseases. “People don’t seem to recognise that when they say ‘you can at least meditate’, it’s not that easy,” she told me in a phone interview.

“When you are stressed or anxious, getting your breathing right is hard. Running or colouring might work for you – but you can only get there by trial and error. Yoga may work – but you need a trainer. Most people don’t have the bandwidth to try out so many things.”

Mittal told me she is particularly worried about the flood of “well-meaning” advice aimed at caregivers, who often aren’t given space in healthcare conversations. “Someone recently WhatsApped me a three-minute video that talks about seven things to do for self-care – things like sleep time, me time, etc. It is overwhelming,” she said. “If someone looking after a person with Alzheimer’s or Parkinson’s is asked to go join art therapy, do they really have the time or the choice?”

Illustration of a torn off blue piece of paper with a paperclip on it and pen scribbles

3. Performative self-care is contributing to burnouts

For those fed up with unhelpful WhatsApp forwards, Barbara Riegel and Tiny Jaarsma, co-directors of the International Center for Self Care Research (ICSCR), have a They break self-care down into three phases: maintenance, monitoring, and management. 

According to this framework, self-care is a continuum, relevant in both healthy and ill states. (So that midnight visit to the emergency room after years of neglecting panic attacks isn’t self-care because you skipped the maintenance and monitoring parts and went straight to management.)

The ICSCR’s website makes a compelling point: “Of 8,760 hours in a year, only about 10 hours or 0.001% are spent with healthcare professionals. All other health maintenance, monitoring and management activities are done by individuals and their families as self-care activities. Performing self-care will improve wellbeing, decrease morbidity and mortality, and reduce healthcare costs.”

‘It wouldn’t be wrong to say that performative self-care is actually leading to self-care burnout’

Difficult to quarrel with anything there – but the last sentence gave me pause. Performing self-care reminded me of a recent piece by Pooja Lakshmin, assistant professor of psychiatry at George Washington University School of Medicine. Writing in The New York Times, Lakshmin focuses on a specific group that is perhaps at the receiving end of the greatest torrent of self-care advice:

“[T]he images we’re sold of self-care include meditation apps and Peloton binges. For mothers in particular, with self-care just an app click or exercise class away, there is a haunting sense that if you feel burnt out, you must not be taking care of yourself. Cue more stress and guilt,” Lakshmin says. “I’m seeing more mothers who feel an overwhelming pressure to live up to not only the crushing expectations of motherhood but also the obligations of performative self-care.” (My emphasis.)

I asked Prakash, who has two young children, whether this is a western problem. But the guilt of not performing well enough is real here in India too, she confirmed.

“When I started my self-care routine, I decided that I wouldn’t go on a guilt trip, which I was very prone to at the time,” Prakash said. “I told myself it was okay if I woke up one morning and didn’t feel like doing anything. If all I wanted was to sleep, then that’s what I’d do.”

Shayonee Dasgupta, whom I follow on Twitter for her pithy insights on coping with mental-health challenges, told me that the pressure to conform to acceptable self-care practices leaves her “fatigued at times”. She added: “It wouldn’t be wrong to say that performative self-care is actually leading to self-care burnout.”

Self-care burnout. How did we get to this perversity?

4. Self-care is weaponised against disadvantaged people

For the American poet and civil rights activist Audre Lorde, "it [was] self-preservation ... an act of political warfare”. In other words, self-care was not just another way of saying “retail therapy”.

If you live with a mental illness, “self-preservation” could mean the revolutionary act of wresting away power from the overly medicalised, one-size-fits-all healthcare establishment. But that revolution doesn’t seem to be working as intended.

British cultural theorist where the complete burden of your wellbeing is shunted on to you – because hey, hasn’t the free market given you access to everything you’ll ever need? If you still don’t manage to feel better, the fault must be within you.

Illustration of a phone showing an instagram post with a picture of a mouth speaking.

Fisher argued that people with mental illnesses are trapped within this system. For so long, the conversation around probable causes of depression has focused overwhelmingly on serotonin deficiency in the suffering individual’s brain, ignoring the social roots of unhappiness, such as competitive individualism and income inequality. As he wrote: “It is clearly easier to prescribe a drug than perform a wholesale change in the way society is organised ... [and now]

The dangers of this framing are felt most by those who can’t “buy” self-care: poor and dispossessed people. Low-income countries continue to lag behind in public health spending, according to the World Health Organization. In India, And mental health care accounts for – a pathetic figure given the massive population that needs care. 

Thankfully, it may not be too late to stop self-care from being weaponised against the self. Establishments around the world can learn from New Zealand, where Jacinda Ardern, the prime minister, has announced an to take on mental illness, family violence, and child poverty. In Australia, mental health has been called prime minister

Ultimately, the self needs more than perky help manuals to feel in control. “Even when you say something simple like ‘eat right’, underlying those two words is a complex set of tasks and activities,” says Mittal of PatientsEngage. “The ownership of those activities has to belong to the self. But before that, you have to empower the self.”

An earlier version of the story incorrectly implied that only English has a Word of the Year contest.

Dig deeper

Man wearing a suit standing in a university classroom with his hands on one of the red chairs in it - the wall on the right is white, the one on the left is green. A neuroscientist’s guide to what happens in your brain when you feel guilt I spoke with Roland Zahn, a psychiatrist at King’s College London, whose cutting-edge research on brain activity and mood disorders could transform the way we treat depression. Read more here