This week is depression awareness week (11-17 April). The most important thing I have to say in relation to depression is about self-care.
Towards the end of this week I'm going to an event about which asks, among other things, how people can nurture practices of 'self-care'. Towards the end of last year I ran a weekly workshop on self-care practices, and I'm running a day for therapists on the same topic this Autumn. The first chapter of the book I've recently written about relationships focuses on self-care. Here I want to look at why I think self-care is so important, what it is, and how we can build it into our lives (both when we are depressed and when we aren't).
There's something wrong with me that needs fixing.
The most striking thing, for me, after several years of working as a psychotherapist, has been that virtually every person who comes for counselling or therapy believes that there is something wrong with them which needs fixing. A big part of this is the sense that everyone around them is managing life fine, whilst they are really struggling. There must be some lack or flaw in them in comparison with the rest of the world and they are desperate to put it right. Why can't they just be normal? What is wrong with them? Why aren't they like everyone else?
Sound familiar? I was certainly extremely grateful for this experience of person after person expressing sentiments that I had felt myself so many times. I now try to imbue therapy sessions with this sense that what is normal is to feel abnormal and wrong in this kind of way.
Reading about this sense of lack I've recognised that much of it is down to the difference between the image we present to others and our own inner experiences. The reason that people feel that there must be something wrong with them is that they are comparing themselves against the perfect, shiny people they see every day at work, on television, in the shopping mall, on facebook. But of course they themselves are likely also presenting a similar image to other people. When someone asks how we are we generally say 'fine' and accentuate the positive. Recent research has found that we write about the good stuff in our lives on social networking sites far more than what we are finding difficult. We know the messy, ugly and frightening stuff of our own selves because we live in them, but our point of comparison is a bunch of people who are unlikely to reveal that similar stuff to us unless we are very close to them indeed, or perhaps their therapist!
There may have been an element of this kind of comparison through history, but it is certainly exacerbated at the time we currently live in. Just think about the number of times each day that you receive the explicit or implicit message that there is something wrong with you which needs fixing. Maybe try counting for just one day. The explicit messages are easiest, although we don't often think about them. Every billboard advert and commercial on television, radio, or at the cinema, tells us that we need to be younger, more attractive, more successful and happier by owning more products or have more experiences of the kind that they are offering. This is also an implicit message in many newspaper articles, Hollywood movies, and reality television stories which tell accounts of the achievement of happiness, success or beauty through doing certain things, or sometimes of failure to achieve because of not having done such things as going on a diet, buying a lottery ticket, starting up a business or appearing on a television show. And we are certainly encouraged to compare ourselves to the airbrushed images in magazines, the snapshots of people we get in a brief news story, or to the characters who are being acted out by professional performers. We become used to comparing against a selective version of somebody's life rather the full warts-and-all picture. We could also think more widely about educational systems and organisational processes which are about comparing people against each other and striving for 'excellence' rather than being good enough.
Clearly there are important political conversations to have about this socioeconomic situation which underlies a good deal of current human misery. This is something that is frequently ignored by solutions which focus entirely upon the individual, including many forms of therapy, drug treatments, and people suggesting that we 'pull our socks up' (not that these things can't be helpful in their place, but if they obscure the wider context then there is a danger that they reinforce the idea that there is just something wrong with the individual person). In addition to addressing the wider context, what can we do as individuals to protect against this kind of toxicity, to help us to see these process as they operate through us, and to support each other better?
One suggestion is self-care.
What is Self-care?
It could be argued that, at the same time that society has become so consumer-oriented and focused on individual improvement, we have also lost some of the means we had in the past for caring for ourselves and for reflecting on our lives. It is very easy now to go through days and weeks without ever having a moment of quiet alone. We can easily fill our lives with noise, work and distraction such that we are always playing games on our phone, listing to podcasts, emailing, watching television, meeting people, getting tasks done, or socialising. When we do this it often gets increasingly frightening to be alone with ourselves. We can be anxious about what we will find. If we are struggling this means that it can often reach a crisis point before we do anything about it.
I'm not saying that those kinds of activities can't be done in caring ways (see my last blog entry on mindfulness), but I'm arguing that it is useful to ensure that we have some time in our daily lives devoted to being quiet, to looking after ourselves and to tuning in to where we are at. Otherwise it becomes increasingly difficult to tune into our needs (are we getting enough rest, food, support, activity, etc.) and also to tune outwards towards other people and the wider world.
Self-care is not just another form of monitoring ourselves and finding ourselves lacking, although we are so used to doing this that we need to watch out for it ('damn I haven't built any self-care into today – bad me!'). Similarly it isn't about just giving up on ourselves and thinking we may as well do comfortable nice stuff because we are no good anyway.
People's biggest block to doing self-care is often the idea that it is a selfish or self-absorbed thing to do. My own view is quite the opposite. Constant self-monitoring and self-improvement is self-absorbed because it is so internally focused that it often prevents us from seeing the fullness and struggles of other people. It also exhausts us to the point that we have very little to give to anyone else.
Caring for ourselves means that we are more aware of the kind of painful processes going on for us that make us despondent or fearful. This means that we can tune in better to the fact that other people likely have those same processes, so we can be more compassionate with their snappiness, withdrawal or neediness. We are less likely to just feel hurt and betrayed when others treat us poorly, because we understand it better. Also, when we have looked after ourselves we generally have more energy and patience for looking after others and for engaging with the world more broadly. We are more able to open up because we are less fearful of showing the fact we are lacking and imperfect: we know that everybody is.
What kind of self-care, and how to build it in, is up to each person. Different things work for different people at different times. I'd suggest making space for two things: kindness and reflection. Kind self-care is a way of demonstrating to ourselves that we are as deserving of kindness as anyone else (even when we don't quite feel that we are). Reflective self-care is a way of checking in with ourselves, tuning into our body and our emotions, asking ourselves how we are, thinking through any issues we are currently dealing with, making sense of why we are finding something difficult.
Examples of kind self-care that work for some people include: having a hot bath, giving yourself a treat, taking half an hour in a cafe, spending time with friends, being in the garden or park, sharing a hug with a friend or pet, and watching your favourite programme. Example of reflective self-care include writing in a journal, having a session with a close friend where you both have time to talk through whatever is on your mind, going for a walk, and meditating.
It seems to be really hard to build these into our everyday life. Our tendency is often to leave them till last (if we get everything else done) rather than prioritising them. When things get tough we are often even less likely to do these things because we feel that we don't deserve it, and we are often scared to be quiet or to tune into ourselves because we fear that we really will find something terribly wrong with us. Gently trying to build in a daily kind act towards ourselves is often a good first step at such times, followed later by also taking some time to kindly listen and reflect upon what is going on in our minds and bodies.
Given the world that we live in it is likely that we will keep forgetting self-care and needing to remind ourselves, and that we will easily slip into beating ourselves up about it or doing it with the secret hope that it will make us all 'better' or stop us from ever struggling again. When those things happen it is just another reminder of our imperfect humanness, and of the messages that surround us and others that make this so hard.