“True Self-Care”

Prairie Doc Perspective Week of March 17th, 2024
“True Self-Care”
By Debra Johnston, MD


During our most recent family movie night, we watched one of my favorites: Encanto. At one point in the movie, a character who has been gifted supernatural strength confesses that she fears she will crumble under the weight of all that is expected from her. Although she accomplishes amazing things, it never feels like enough. She never feels like she, herself, is enough. 


Popular culture suggests she should prioritize "self-care," which is usually represented by manicures or massages and long soaks in the tub, or perhaps half an hour of meditation or spin class. 


Now, to be clear, I'm a big fan of massages and getting my nails done, and I spend a lot of my professional time nagging people about exercise, as my patients can certainly attest. But I'd suggest this perspective on self-care is at best incomplete. Protecting your mental well-being goes well beyond little escapes, and even beyond tending to your physical health.


The specifics of true self-care are unique to each individual, because each individual is unique, in their needs, their desires, and their circumstances. You simply can't meditate quality daycare into existence, or a nasty coworker into a team player, or a loved one into sobriety.


Self-care, meaningful self-care, means being able to recognize that you are human, and you have limits and that it’s not just ok, it's critical, to acknowledge and respect those limits. The demands vying for your time and energy are endless. Those resources, however, are not. True self-care means standing up for your right to be the one who decides how you will allocate them.


This means setting boundaries, and that's an incredibly difficult thing to do. With those limits will naturally come guilt, because you simply can't do everything for everyone, or even all the things you yourself want to do. No one else can decide where your lines are, and no one else will hold those lines on your behalf.


In order to hold those boundaries, you must be kind to yourself. Most of us have a perpetual self-commentary of criticism that tells us we could do better, we should do better, we aren't enough. Honest self-reflection is important, but why does that so often mean a laser focus on where we fell short, without recognizing how far we came? We internalize the message that if we can't keep up with demands that escalate until we crack, the fault is ours. It's not. To draw these boundaries, and make that self-compassion meaningful, we each must clarify our own values.


Spending our limited energy in ways that conflict with the ideas we hold most dear is the antithesis of self-care. We need a clear idea of what those values are to hold that line. Massages and meal delivery services can be great tools, but the real key to protecting your mental well-being is a lot harder to define and a lot harder to do.


Debra Johnson, M.D. is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, South Dakota. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook featuring On Call with the Prairie Doc® a medical Q&A show providing health information based on science, built on trust for 22 Seasons, on SDPB and streaming live on Facebook most Thursdays at 7 p.m. central