Is Your Self-Care Just Another Achievement?
How to know if you are using self-care as a measuring stick.
Hello folks! Welcome back to another Real Self-Care letter. And, a special Hello! to the hundreds of new folks who found us through my interview on We Can Do Hard Things (!!).
As a reminder, I’m Dr. Pooja Lakshmin — psychiatrist, author of the book Real Self-Care (Crystals, Cleanses, and Bubble-Baths Not Included), frequent contributor to The New York Times, and clinical assistant professor at George Washington University School of Medicine. You are reading my weekly(-ish) newsletter.
I’m currently writing to you from Italy. My partner Justin and I are here for ten days. It’s the first time we’ve been away from our toddler for a real vacation. As I shared on IG, the leaving part was more difficult than I expected.
The good news is that it’s been much, much easier since we got here. I get pictures and videos from my parents who are taking care of K. I’ve been able to let go and only look when I miss him, not because I’m worried or feeling guilt. And, man, sleeping and waking up without a baby monitor is one of life’s major delights right now.
We spent the first few days of our trip in a small town called Ravello, up the mountain from the Amalfi coast. I am no travel blogger, but if you find yourself in the fortunate position of picking an Amalfi coast destination — I highly recommend Ravello. I would avoid Amalfi or Positano. We hiked up (and, then down) to Amalfi one afternoon and it was wildly crowded and overwhelming. We barely lasted an hour before heading back to Ravello.
This is also my long winded way of saying sorry for not delivering a newsletter last week. I made a real self-care decision to enjoy my time away, take in the views, and hang out with Justin.
It’s interesting — since getting back on a regular writing schedule with this newsletter, I’ve noticed that familiar eldest immigrant daughter, doctor-ey trait of wanting to DO IT RIGHT and DO IT BEST. Partly, I feel a responsibility to all 13,000 of you who have agreed to read me in your inbox. You hitting subscribe is a big deal. And, that said, I had to remind myself that missing an “appointment” (eg. email send) with you is not the same thing as standing up a patient.1
Earlier this week, we left Ravello and arrived in Rome. Justin has a big work meeting in the city. I’m spending my time eating burrata and working in my “BOOK 2” Google doc. My goal is to send something coherent off to my agent by the end of the week.
Since I’m focusing my creative juices on book writing this week, today I am sharing one of my favorite excerpts from Real Self-Care. In the book I outline three coping mechanisms that seduce us towards faux self-care: escape, achievement, and optimization. Before we dive in, let’s review what real self-care is for the new folks:
Real self-care is an internal process
It consists of four principles: boundaries, compassion, values, and power.
In contrast to faux self-care (eg. the juice cleanses, the bubble-baths, and the bullet journals), which keeps you stuck in a cycle of consumerism and consumption wherein you need to earn your mental health and well-being externally, with real self-care your well-being is internally generated. It is self-sustaining.
Real self-care always leads to a shift in the power dynamics in your relationships, and, in the best of cases, it can lead to systemic and social change (eg. the mom who sets boundaries, talks to herself with compassion, speaks up at work, and ends up enacting policy change).
Keep these real self-care bullets in the back of your mind as you read the excerpt below.
Faux Self-Care as Achievement
(An excerpt from Real Self-Care: Crystals, Cleanses, and Bubble-Baths Not Included)
My patient Sharon, forty-five, a white woman who had recently moved to Washington, DC, from New York, built her life around the accumulation of professional successes. She'd been laser focused on her career as a journalist in her twenties and early thirties, rising through the ranks of the newsroom and building an impressive portfolio of assignments. Having come of age in a culture that prizes wellness, she was not someone who ignored her own well-being. Sharon's drive was no doubt influenced by her family of origin- growing up with a single mother who didn't have the opportunity to go to college, Sharon was determined to build a different life for herself than what she experienced as a child. She ate well and was fit, with a membership to Soul-Cycle and a strict diet of clean foods. Twice a year she went to a yoga retreat to recharge. When I met Sharon, though, she had just been laid off, a victim of the volatile media industry.
Without the structure of climbing the professional ladder, she felt lost. So she doubled down and dove headfirst into the world of wellness. She signed up for yoga teacher training, ran a 5K, and read every self-help book she could find. Sharon brought the same laser focus she had utilized in the professional world to her newfound passion for diving deep into "self-care." But despite this frenzy of activity, she still felt isolated and desperate.
Through our work together, we came to understand that the "self-care" Sharon had been engaged in during her time at her job, and even after the layoff, had been a means to an end: Her goal was to win, and to make sure the people in her life knew she was a winner. A selfie followed every yoga class. She obsessively charted her running times on a spreadsheet. Whatever activity she tackled, she had a meticulous internal measuring stick in her mind, and constantly judged herself to see if she measured up. Sharon once revealed to me that after coming home from an exclusive yoga retreat, she didn't feel any better about herself. She had spent the whole week obsessing over holding a headstand and how she looked in her yoga outfits.
That's because Sharon, at her core, had a deep-seated feeling of worthlessness. From a young age she had developed a shield of perfectionism. She had been taught-by her family and the larger culture-that her value was tied to her accomplishments, and no matter how big the win, she was never convinced of her essential, intrinsic worth. Sharon, like many of us, had a hungry ghost inside her, playing tricks on her appetite. In Buddhist philosophy, hungry ghosts are described as skeletal creatures with long, thin necks and large potbellies that are constantly ravenous but never satiated. Here was Sharon, racking up accolades in her work life, running triathlons, and becoming a yoga teacher in the name of "wellness," but never actually feeling a sense of mastery or pride in any of it. That was because her self-care was not grounded in caring or compassion for herself. In-stead, the internal voice that drove her to faux self-care was the same internal voice that drove her to stay up late at night working on slide decks: shame.
Sharon is not alone. Many of us grow up with a feeling that we are not good enough just the way we are. But for some women, this deficit is so strong that the need to succeed becomes blinding.
A 2016 survey of two thousand women conducted by Weight-Watchers found that women criticized themselves on average eight times a day, with almost half reporting that the self-critical thoughts started before 9:30 in the morning? Sixty percent of women in this survey said they had days in which they criticized themselves nonstop. For women fueled by this kind of self-criticism, as so many of us are, life can feel like a series of races, each of which must be won in order to prove our worth. In this context, faux self-care becomes another activity to excel at, an endeavor to be conquered just like everything else in life. No matter that getting locked into such a cycle is exhausting and does nothing to provide a long-lasting sense of accomplishment or worth.
The drive to succeed, often unconsciously motivated by shame, commonly manifests in a relentless pursuit of faux self-care achievements, none of which actually nourish our true selves. To the contrary, engaging in faux self-care as a coping mechanism in this way only sets us down a path of endless com-petition, leaving us tired, burned out, and less engaged with what really matters in life.
Unlike women who use faux self-care as an escape, which at least feels like a relief even if it doesn't provide lasting benefits, women who engage in achievement oriented, performative self-care often buckle under its weight. Take my patient Priya, thirty-two, who was pregnant with her first child when she came to see me. Priya had struggled with an anxiety disorder for most of her adult life. Raised in a South Asian family that prioritized achieve-ment, she had been a straight-A student, went on to a prestigious law school, and joined a top firm in DC before deciding to start a family. Being pregnant added a new layer of expectation to her life, and the way Priya coped with this pressure was to dive into self-care orthodoxy. She obsessively tracked her steps on her Fitbit, religiously monitored her diet, and became zealous about prenatal yoga. She joined several pregnancy-related Facebook groups and took pride in posting pictures and updates on her self-care routine in the groups, even giving advice to other women about how they could practice self-care.
It's not that a healthy diet or physical activity is bad—in fact, they are advisable practices for pregnancy. The lesson here is that Priya was using diet and exercise in the wrong way; the pressure that came with them hurt her and did nothing to improve her emotional well-being. She became panicked when she missed a yoga class and stopped having dinner out with friends to control her diet. She was conflicted about how to balance self-care and the increasing demands of her law firm job. When she developed gestational diabetes in her third trimester, Priya was distraught.
Over many sessions, we uncovered that Priya had been using self-care during her pregnancy as a report card for herself. In her mind, if she was perfect at self-care, it meant she was being a good mom to her baby and thus her delivery would go smoothly and her baby would be safe. Moreover, her self-care performance meant she was mastering motherhood from the beginning, her baby having unconsciously become a reflection of her own desire for success. Through work in therapy, Priya, who had been raised in a chaotic family and endured emotional abuse as a child, came to understand that she was deeply worried that she was going to be a bad mother. The focus on performative self-care as a means of achieving an idealized version of motherhood was the way she defended herself psychologically against her deeper fears.
Like Priya and Sharon, whether it's through a hyperfocus on diet, exercise, or self-improvement, you might be using faux self-care as a measuring stick to track your performance. Our social media-obsessed culture has only intensified this pattern, making sure every faux self-care performance has an audience. Here faux self-care gets wrapped inside the bubble of perfectionism, workaholism, and capitalism. Getting your weekly facial and heading off to your thirty-dollar fitness class is another badge to hold up. Unfortunately, it's impossible for these external activities to sustainably produce the feelings we are looking for them to deliver-worthiness, acceptance, relief. For women who are caught up in this tendency to use faux self-care as a performative defense against inner feelings of unworthiness, the antidote is not more SoulCycle or turmeric lattes. It's the ongoing work of real self-care.
Things to Do Now
This week, I'd love for you to reflect on your relationship to achievement and to think more deeply on the ways in which achievement serves you, and the ways in which it may not.
To consider:
You might engage in faux self-care as achievement if you identify with these statements:
I often have a mental measuring stick running in the back of my mind.
The thought of losing-in my professional life or personal life-makes me feel sick.
My self-worth strongly depends on my ability to be seen as a success.
I often compare myself with others.
I predictably feel down or worthless when I don't measure up to others.
To change:
If you identify with any of the statements above, you are not alone. Can you think of a wellness practice or activity that has become achievement-like to you? How could you soften your relationship with said activity? Could you do it with a friend or a group? Could you stop “tracking” it? We are conditioned to substitute achievement as a stand-in for care because achievement is measurable and externally validated. The first step to changing achievement addiction is recognizing it, and then, slowly, making tiny changes. The changes may feel almost outrageous to you (letting go of counting your steps! deleting the timer when you meditate!). When your brain tells you that this is unreasonable or counter-productive, tell yourself that you are collecting data and the shift can be temporary if you hate it.
To Read:
Fellow psychiatrist and author Saumya Dave sent me this essay by
and I loved it: There is no top, so stop trying to get there.
To Listen:
I was on We Can Do Hard Things! In my conversation with Glennon and Abby (sadly, Amanda was out sick, bummer) we focused quite a bit on how, as women, we spend so much time trying to “do it right” and “do it best.” Being on WCDHT was definitely a peak author moment for me. I’ll have more to say about it later, but for now, listen to the episode. It turned out so so good.
Thanks for spending your precious real self-care time with me this week. Ciao for now!
xo, Pooja
From the Real Self-Care Archives
If you found today’s newsletter helpful, you will enjoy these companion pieces. Paid subscribers get full access to the archives. If you are a free subscriber, you’ll see a brief preview.
Off the top of my head, I think this has happened two times since I started practicing psychiatry independently in 2016. Once was when my cat had a stroke and was admitted inpatient (don’t worry, Kitty recovered, and is still Queen bee of our house— just a Queen who takes amlodipine). The second time was when I left my laptop on a plane and had to turn on the waterworks to convince a poor Delta rep to let me past security to find the cleaning crew (it worked! miracle of miracles).
I got kicked out of high school my junior year and got married that year. When I was fifty I began college and the summer after graduation (I was supposed to start my masters) I found out I had a brain tumor. I defied local doctors (who said it was inoperable) and flew out of state to have brain surgery. This left me unable to walk for three years, unable to see clearly (my left eyeball looked towards my nose) and deaf on one side. The fatigue was unimaginable. But instead of fully recovering, I started my masters while lying in bed and pushed, pushed, pushed myself to become a psychotherapist. I see all the same reasons in your article for why I did that. It was complicated...there were other aspects too long to write here about...but definitely, shame and perfectionism were part and parcel of it. I don't regret it and still at 72 work in the field...but it wasn't the wisest thing to do, for sure. And now, my measuring stick is different, but I still use one and I need to stop. Thank you Pooja!
Thanks for the work you do, Pooja, and thanks for sharing my essay! ❤️