We Need To Talk About Self-Care


Posts on Facebook rarely stick with me anymore, even with the small amount of time I spend on the site these days. But I still remember one status update an acquaintance made several months ago: “I may not pick up your call or answer your text right away. I may not show up to stuff I said I’d show up to. I may cut you off and have to leave in the middle of things. It’s called self-care. Don’t take it personal.”

I wholly support taking time away from one’s cell phone and not feeling beholden to a five-second response time, but those last two — breaking commitments and dismissing people you care about — worry me. The fact that this status got several “Amens” and “you do you” comments and almost 50 thumbs-ups worries me more.

It’s not personal; I’m worried about what this means for our capacity to stay connected to each other, what the fact that it received the social-media equivalent of an ovation means for our ability to form and sustain meaningful relationships. I worry that my worry about it sounds like a bunch of hand-wringing at a time when hand-wringing is the new black even as it remains ineffective at sparking change. But my fear is sincere: having happily abandoned the belief that social connections are important, let alone what sustain us, we have created, intentionally or not, a culture where self-care not only permits and excuses the neglect of others; they are becoming increasingly synonymous. We have taken capitalism’s twist on self-care (take care of yourself so you can keep participating in the system), combined it with individualism to get “take care of yourself so others don’t have to” and become hostile about it. As if the adage about caring for yourself first so you can care for others well has been exactly transposed: “In order to care about me, I have to withhold care from you.” Or “I can’t care about me while caring about you.”

Those of us who’ve experienced mental or emotional distress and done what that trendy exhortation that crops up all over the internet instructs (that is, “reached out”) have likely been victims of this breed of self-care. Despite the work the scientific community has done to show that those three familiar responses to fear — fight, flight or freeze — only manifest after social engagement has failed, this culture not only dismisses but demonizes the need for others. But needing others is not the neediness or co-dependency both capitalism and the mental-health system have labeled it. Needing to not have everything rest on your own shoulders, needing, for once, to not be responsible for every need you have as a human being — including the basic life necessity of connection to others — is the basis of any self-care worthy of the name.

But my attempts to find and feel those vital relational bonds have produced rigid shame and made isolation not only more desirable, but logical. I can’t take the state of the world. I can’t breathe, and I’m having trouble wanting to, when I think about the future those much more powerful than me are creating with their ineffably hidebound decisions, actions and inactions. Most of my thoughts tell me I’m alone — I can only recall being alone, especially in the hard moments. It’s not alone in the sense that others haven’t felt flaying despair or traumatic dread but that such emotional camaraderie cannot penetrate me as deep as it would need to to matter. I combat the almost convincing pleas of my shamed self who has taken on the culture’s assault on human emotion: I call someone anyway. When they don’t answer, I manage to collect enough optimism to call another. This friend doesn’t answer, either, and of course, neither is obligated to answer. But neither mention it the next time they see me. No “hey, I saw you called,” forget about “I’m sorry I missed it” or the longshot “are you okay?”

This all sounds dramatic and pathetic. We should be able to take care of ourselves. I should, in that moment, be able to practice my own self-care since that’s likely what my unreachable friends were doing at the time I called each of them. But what the structure of self-care that excuses or even champions disregarding others in favor of the self does is till the soil for ideas like, among others, the “toxic person.” I’ve talked about this before. I don’t mean that everyone should be allowed free and full access to us and our lives. There are such things as perpetrators, abusers, victimizers. But, if we’re honest, we all know that the term “toxic person” is applied way more liberally than to people who’ve committed serious shit against us. The first criterion for diagnosing a person as toxic in a world where self-care is accepted as an excuse for mistreating your friends is seeking attention. Only in this world, where caring for yourself almost mandates not caring for others, is a hard-wired human need that persists from womb to tomb considered pathological.

Once a person is deemed toxic, they not only have no more place in your life, but you are released from caring about their needs or feelings. This maybe doesn’t matter to you. You shouldn’t have to care about everyone’s feelings. Does imagining you’re the toxic person change anything for you? Are your feelings any less valid? Are the reasons for your “toxic” behavior irrelevant?

I’m not trying to advocate for the renewed popularity of the idea that you can’t care for others unless you care for yourself first, as if others are the end and you are merely a means. I’m not about to lambaste people for not doing enough to care for others for the sake of others. I’m not aiming to remind you to secure your own oxygen mask before assisting others. We are not on an airplane for there is nowhere to land, no separate places to disperse to after deboarding: we are already home. Together. We are tired, we are terrified, we are terrorized by the seemingly interminable blows to justice and decency and integrity being allowed at all levels of our society, including the highest. We don’t need any more items on our to-do lists. We don’t need one more person telling us what failures we are at yet one more thing.

All of this is exactly why dismissing other people and devaluing relationships in the name of self-care is so concerning. “We need each other” isn’t a fluffy phrase to get us all to love each other more because love is a neat idea. It’s much more concrete than that. We need each other because isolation kills. We need each other because we fight, flee or freeze when we can’t connect. These mechanisms can serve as awesome protests against the juggernaut of capitalism and its insatiable need to warp every aspect of existence; they also exact deep tolls on the body and psyche (which is not to mandate wellness but to affirm the goodness of the body and the psyche quite apart from anything they produce). We need each other to not dump poison in our shared water supply; we need each other not to sell out to legal, social and economic systems, which is the good-manners word for strongholds, but to help us topple them. We need each other in the perilously untheoretical realms of oppression, action and causation. We aren’t going to survive the present onslaught and the damage of its aftermath — from the specters of climate change, thermonuclear war, artificial intelligence, the poverty that technological automation in a vastly under-regulated capitalist economy will unleash, to the pile-driving destruction of truth and the ability to create the shared experiences vital to the social bonding that is itself vital to being human — without each other. The darkness and hopelessness threatening to spread cannot be withstood in solitude.

This, our nonnegotiable need for each other, is why hurting our relationships is not good self-care. The current approach to self-care erodes relationships by wantonly blowing other people off and subordinating their needs to one’s own. The problem with that is more serious than selfishness, since we all have that trained in us by actively surviving childhood and it is thus a pesky but understandable coping mechanism of most people. Whether selfishness is good or bad morally, it precludes what it seeks, which is self-preservation. Our lives our inextricably bound up with others; self-care the way we’re currently practicing it is unfulfilling in the dangerous way empty carbs are: it requires more and more to sustain itself, further sinking us in isolation and the illusion of self-sufficiency.

Making the self paramount makes the self and the other adversaries. We cannot afford to cede more territory to the us-vs-them thinking that turns everything it touches into fodder. I don’t mean that there is no enemy and that we should all be able to hold hands and sing kumbaya. I just mean that self-care is the wrong place to be drawing battle lines. These are acutely difficult times and there’s a reason consuming the news is triggering in ways it hasn’t been in recent memory, and there is much about the current administration in particular that should not be normalized. But a cursory study of history will demonstrate that not everything going on in American politics or civic life is entirely new, especially for people of color, women, people with disabilities, the LGBTQ community, immigrants, refugees and the poor. Life in this country was doggedly unjust in the 1960s and ‘70s, for example, and what came out of the suffering wasn’t spiraling inward focus and isolative behaviors but movements. Marches and protests, yes, but also philosophies of life that emphasized our connection and our connectedness with each other, with lifeforms and with the earth. Self-care included a component of caring for others — not just that we care for ourselves so that we can care for others, but that caring for others is a way of caring for ourselves.

But, wait, doesn’t that sound selfish?

If it does, that’s because there’s an unexpected aspect of our tangling up self-care and other-neglect: the conception that rejecting one’s self is somehow noble. Caring for yourself so you can care for others is okay; caring for others so you can care for yourself sounds objectifying. This culture practically expects it of mothers. We may have gotten to the point of encouraging them to take a nap when their kids are down, but every friend of mine who’s a mom feels searing guilt for every second she spends on a personal hobby or activity that doesn’t directly relate to her children. It still seems like bad mothering to put yourself first, even with all the lip service to the contrary. People with a diagnosis of depression are similarly encouraged by friend and therapist alike to find ways to serve other people and “get outside” themselves, as if the way toward recovery is to set yourself and the psychological and physical needs that have been called “depression” to the side. Somehow, it’s praiseworthy to do for others what you will not do for yourself, in the same culture that supports breaking your word to your friends and other relationally damaging conduct in the name of taking care of yourself.

This contradiction, whatever you make of it, reveals the instability of the currently trending approach to self-care. In other words, there’s nothing inevitable about it. These are dark and hope-challenging times, to be sure, but that’s why we need to resist the individualistic tendencies that tempt us to accept and perpetuate the attitudes my acquaintance’s Facebook post displays. This concept of self-care is deeply impoverished and doesn’t do the idea of self-care justice. It is yet one more iteration of “us vs. them,” a sicklier version than some others because it corrupts an otherwise beautiful skill that can, if practiced rightly, be a small but vital protest against the forces that would sooner see those who don’t conform to today’s insatiable capitalism and rabid individualism destroyed than flourish. Self-care can be so much more than turning off your phone in the middle of a conversation with a friend or deactivating your social media profiles or not keeping commitments. What self-care ultimately is is saying yes to what bigotry, discrimination and systemic exclusion scream a fractalized no to. There’s no reason saying yes to yourself has to injure relationships.

To be clear, the change in self-care practice I’m advocating for is not one that mandates taking care of other people or overly involving ourselves in the feelings and needs of others. What needs revisiting in the current model of self-care is the dismissive attitude toward relationships. You can care for and about yourself without pitting your needs against the existence of other people. We are not going to create a society that works for everyone by approaching the task of meeting needs as a zero-sum game. If this sounds like the third or fourth time I’ve said something like this in this article, it’s because the mentality that someone’s gain is another’s loss is so totally embedded in the fibers of our thinking that even I worry that this is overwrought.

But the way we treat each other is a big deal. The way we treat ourselves is irretrievably linked to how to we treat other people. And the depth and strength of our connections to each other is, besides an end in itself, what will determine if our hopes for transforming society come to pass. Practices like involuntary treatment and forced medication aren’t going to end without a big, long fight, and people aren’t going to see why they need to be abolished as long as we allow individualism to dictate how we care for ourselves. It may seem like a longshot in the current social and political climate to even consider renovating how we think about so-called mental illness, let alone overhauling the whole mental health system, but, as just one example, people used to think cancer was contagious and shunned and blamed those who “caught” it. The reason most of us now reflexively respond with compassion for cancer patients is because of the culture shift that uncompromising grassroots movements forced over time.

It’s hard to understand just how huge a shift this was if you weren’t around before it happened, but it’s what the mad community needs today. I invite you to join me: Refuse to settle for a society where real self-care is so frantically needed and feeble, consumer-based self-care is substituted. Refuse to settle for an environment that demands we each shoulder all our burdens in isolation. Insist on relationship, connection, undiminished interdependence as the way things are supposed to be.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. My experience is that keeping “toxic” people away has been one of the most important steps I have taken for my well-being.
    I agree that the term is misused and easily becomes a horrible kind of superficial selfishness. there is nothing new about finding excuses to be selfish.
    My defintion of “toxic” has nothing to do with distress. It is about an orientation of exploitativeness and a raft of behaviours that create a kind of stockhom syndfome, particularly in “preconditioned” people who can easily be trained into being minions and slaves in someone elses grandiose entitlement. it is about manipulative, aggressive and destructive behaviours that are designed to destroy self-esteen and facilitate interpersonal oppresssion and a pattern of escalating abuse and de-selfing another person in order to use them.

    No-one I have removed or avoided has a mental health label.

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  2. Pretty fancy writing, Megan, THANKS! But you know I have to say something. I think you give way too much credibility to the “scientific community” for that deficient definition of *3* responses: “fight, flight, and freeze”. That’s biologically incorrect. (I won’t get into the genetic details here….) We humans have *4* fluid systems in our bodies. Blood, lymph, bile, and digestive. We have *4* nervous systems. (I forget what they’re called….,whatever….) So too do we have *4* responses: FIGHT, FLIGHT, FREEZE, and RUN-and-HIDE. Both “fight” and “freeze” can look similar, because in both we’re still “there”, or “here”, or where ever. And “flight” and “run-and-hide” can look the same, because they both involve “running away”. But “flight” is running away as fast and far as possible, for the sake of getting as far away as fast as possible. “Run-and-hide” is only about running as far as fast as possible to get to a safe place to duck into and hide. “Freeze” is an attempt to hide in plain sight. “Fight” is, well, FIGHT.
    Thinking we have only 3 responses needlessly handicaps us.
    As for the current “administration” in the D.C. White House, remember, you’re young. Most of your distress has been deliberately inflicted by the controlled media. It’s BOTH really not as bad as you think, and worse than you can possibly imagine. That’s the paradox of reality. The paradox of DUALITY. We see this duality in the self/other dichotomy. In the female/male dichotomy. In the sane/insane dichotomy. In the healthy/unhealthy dichotomy. It’s all just US. Or all just THEM. Or EVERYBODY. Or NOBODY. Darn. There’s that “4” thing again!
    Ultimately, the kind of mental masturbation we’re engaging in here is only somewhat satisfying, but not very productive. Thank-you for writing what you’ve written here, which inspired me to write what I’ve written here. You could have done it without me, but I couldn’t have done it without you.

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  3. It’s wrong to make generalizations. Some of us need solitude more than relationships. Or we need both and need to not have to imbibe the mental heath mantra that ‘we all need to reach out’.

    What I think is problematic about the kind of self-care that makes a show of itself, is that it’s defensive and it relies on a mental health prescription to do something that the person finds necessary. Also it can amount to a mental health labeling of the people you decide to avoid.

    How about if we all acknowledge a variety of human needs and predilections, and don’t make general prescriptions for anyone else’s well-being?

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  4. I shouldn’t have quickly read this and replied even more quickly in a rush or being late for where i was going.

    Yet i feel there are different ideas in this which don’t necessarily fit together. I feel as though there are somehow different articles in one and the connection between them is obscured somehow. That’s just an impression and I will read this again.

    One impression I have is that there is an implicit acceptance of a concept of mental illness hidden within these words. That there is a “special’ kind of distress that requires particular responses. Of course we have our crises and pains and we rely on our connections with others in our times of need. We need others to ‘see’ us when we most need to be ‘seen’.

    But my experience is that this need not be perfect. ‘Sometimes’ is the best most of us are capable of and the attempt is more important than anything: Imperfect people juggling a whole lot of external and internal stuff but caring and trying, communicating and understanding more, getting to know each other over time and a whole lot of situations.

    You seem to be comparing something with cancer but you haven’t described exactly what. I think there are a few things in this that I’d prefer to be clearer about.

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    • I like your attention to nuance, it made me go back and notice this:

      Practices like involuntary treatment and forced medication aren’t going to end without a big, long fight, and people aren’t going to see why they need to be abolished as long as we allow individualism to dictate how we care for ourselves.

      The positive changes the author advocates, i.e. away from “an environment that demands we each shoulder all our burdens in isolation” to a society based on “relationship, connection, undiminished interdependence” do in fact reflect what is needed. Problem is, the alienation and individualism she opposes are part and parcel of a system based on private profit. Which leaves the question of whether the system must be totally overthrown and/or transformed as a prerequisite to exposing and discrediting psychiatry. I think not; in fact it might work the other way around.

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      • I’m starting to wonder if psychiatry is likely to be a boon to revolutionary movements. (i’m not sure if that’s what you were implying but it has been on my mind).

        With a third of college/university students deemed to have a diagnosable mental illness, with rising numbers of school children and even pre-schoolers being labelled and treated, with differences in ‘MI’ rates between countries, and even parts of countries and parts of populations increasing, with psychiatry overtly interfering in matters of governance, and other individual and collective choices and beliefs….. –
        I can’t help thinking that people will become less likely to locate causes within “faulty’ individuals and less tolerant of the authoritarianism of psychiatry as it becomes ‘us’ rather than ‘them’ who suffer the consequences.

        I agree with you and the writer about connection, interdependence and collectivism, but I feel the reduced suffering would not and does not resemble a psychological/psychiatric model of “reaching out” to seek ‘relief’, but is a natural outcome of a realistic (ie not naive), equal and reciprocal interconnectedness between people, – in and of itself.

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        • Only a boon in the sense that anything taken to extremes will eventually provoke resistance, which could maybe then spread to other arenas of struggle. Without psychiatry as a fifth column the level of unmedicated dissatisfaction with the system could become cataclysmic, so learning how to channel our emotions and our anger productively will be vital for everyone.

          Nothing to disagree with in your last paragraph, so I didn’t get the “but”; the nature of organic support vs. to “support” as a bulk commodity seems to be coming up a lot lately.

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  5. A big challenge to being human is creating harmonious relationships with others. It’s hard work and takes humility on both sides.

    To me, self-care is needing to ground, replenish my energy, come back to center. Then I can be supportive to others when I am asked for assistance. Otherwise, I’m just no good to anyone, not until I ground, center, and replenish. And if I don’t take the time to do this, then I risk becoming sick and energy-depleted. For me it’s like eating–replenishing energy with rest, connecting to nature, quieting the mind, doing something which brings joy, etc., is self-nourishing, and we need it daily (or at least semi-daily, in order to live with well-being).

    To me, a toxic person would be one who judges and shames my need to self-care (because it takes my attention off of them), will not respect personal boundaries (which to me, is hostile and intrusive), and attempts to sabotage my energy by fear-mongering, projecting stigma, and/or gaslighting. No space for this in my life any longer, I’ve had my fill.

    In fact, too much of this in my early years is what led me to seek psychotherapy in the first place, and I had no idea that this is what was causing my crippling anxiety and self-destructive thinking. To repeat this in the “mental health” industry was insane-making, and that’s all it was.

    For me, now, this is the rule of thumb to stay clear, grounded, and healthy–stay away from the latter group. My life, sense of self, and well-being depend on it. Walking away from and leaving behind all aspects of the mh industry and culture is the most powerful and effective self-care I’ve ever practiced–transformative, in fact.

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  6. this may be gross….I am old and I have a urinary tract problem…
    I urinate frequently and it can be triggered by a sound …
    so when I need to go and take care of myself…sorry I am selfish…
    we don’t understand a lot of things…but we certainly have opinions..

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  7. Wow, long article. I admit to skimming some of it. But I think this deals with something we need to explore further — the idea that “support” is something that people need to “go somewhere” for, generally to some sort of “expert.” This turns what should be simply a facet of how people interact into a commodity, which reinforces a state of alienation. People speak of “alternatives to psychiatry” — but even in the most positive interpretation of the phrase they are implying that what is needed is an alternate “place to go.” This is a problem in and of itself, and leads to an ongoing state of alienation. We shouldn’t have to “go” anywhere when experiencing our sometimes unbearable pain, rage, etc. It should be considered par for the course in a toxic culture. There is nowhere to go where oppression will be less oppressive. Welcome to amerika.

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  8. I will not call anyone toxic. I can think of a few toxins, such as psych drugs and Agent Orange, but humans are not truly poisonous. I have done multiple blog entries on this topic and also, I believe, a podcast. I feel very strongly about this. I believe everyone deserves a chance. In fact, I will make a point of befriending people that others diagnose as toxic, because loneliness and being labeled is a horrible thing to endure.

    In the name of self-care, a group of about ten friends kicked me out right at the time I needed them most. They couldn’t have timed it better. That was eight years ago and it took me a long time to get over it. I went back to their forum and they kept telling each other they’d done the right thing and “taken care of ourselves.” Okay, they may have thought so, but they hurt me badly in the process. They continued to call me horrible names such as “not a person anymore,” “toxic,” and “negative.” Those words. It hurt so badly I wanted to cry. Then they’d go congratulate each other again for “doing the right thing.” I hated it.

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