What is "real self-care?" Why bubble baths can't always cut it : Code Switch "You can't meditate yourself out of a 40-hour work week with no childcare and no paid sick days," says Dr. Pooja Lakshmin. But when you're overworked and overwhelmed, what actually can you do? On this episode, host B.A. Parker asks: What are your options when a bubble bath won't cut it?

Real self-care takes real systemic change

Real self-care takes real systemic change

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Psychiatrist Pooja Lakshmin next to the cover of her new book, Real Self Care (Crystals, Cleanses and Bubble Baths Not Included.) Courtesy of the publisher hide caption

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Courtesy of the publisher

Psychiatrist Pooja Lakshmin next to the cover of her new book, Real Self Care (Crystals, Cleanses and Bubble Baths Not Included.)

Courtesy of the publisher

So, safe space — I do reiki. And not just any reiki – virtual reiki. (We're still in a pandemic, people!) Once a week, I light a candle, place my crystals, and then pull up Zoom, where a nice lady sends energy into my chakras. I set an intention, and then she angles her hands towards the camera, and eventually I feel a warm static travel through my crown and down my back.

Reiki is a healing technique that was popularized in Japan. It's based in metaphysics – not science – and a lot of people think of it as kind of "woo woo." My friends regularly remind me that in clinical studies, reiki is no better at generating healing results than a placebo. (I regularly remind my friends to mind their business.)

But with all of the madness in the world, that half-hour virtual session feels nice. It's not just about getting my "energy cleansed." It's also about ignoring my neighbor's toddler stomping on the floor above me, or the police sirens outside my window, or the back-to-back meetings I sometimes have for hours on end.

In other words, it's my form of self-care. At least — I thought it was.

That was before reading Real Self-Care: Bubble Baths, Cleanses and Crystals Not Included. It's a new book by Dr. Pooja Lakshmin. Lakshmin is a psychiatrist who specializes in women's mental health. In her practice, she says, her patients bring up the idea of self-care a lot. But the definitions of self-care they had been sold weren't real solutions to their problems because, as she told me, "You can't meditate your way out of a 40-hour work week with no childcare, without health insurance, without access to actual, real, systemic support that is going to take care of the fact that our world is pretty much constantly on fire."

On the latest episode of Code Switch, I ask Dr. Lakshmin: What is "real" self-care? What is "faux" self-care? And why are those distinctions especially important for women of color?

Our conversation has been edited and condensed for clarity.

B.A. Parker: So, in 2020-2021, I – like the rest of the world – was going through a rough patch. I was stressed with work, with the news, with life, and a lot of people told me I needed to prioritize self-care. So I tried everything: meditating, breath work, edibles. I went into a sensory deprivation tank. I have a section on my phone that's called "Calm Down Sis," and it includes all of the calming apps. But nothing was working and I was still really stressed. In your book, you're making the argument that none of that is actually self-care?

Pooja Lakshmin: Yes, with a caveat. Buying a new day planner and signing up for a meditation class isn't gonna change the fact that 30 million Americans are uninsured and that a quarter of American workers don't have paid sick days. Or the fact that if you're a Black woman, you have to work for 19 months to make the same amount of money that a White man will make in 12 months.

So the meditation apps, the bubble baths, the sensory deprivation tanks – all that stuff is sold to us as the solution, but it doesn't actually fix any of the real external problems that have caused us to feel so terrible to begin with, whether we're talking about white supremacy, whether we're talking about, you know, toxic capitalism, patriarchy, right?

So I'm curious how you would define "faux" self-care?

It's always gonna be something that's prescribed from the outside. It's usually a noun, so it's usually describing some sort of activity or a product. It's something to buy or something to do. And it usually maintains the status quo in your relationships or in your family life or in your workplace, and it doesn't actually do anything to change any of these larger systems.

And usually, especially for women and for people of color, it's an escape. It's not that escape is bad, but it's an escape so that you can get away from all of the terribleness that's going on, or sometimes it can end up being something that actually gets turned into an achievement metric.

You just reminded me there were a few years where I was obsessed with spin classes. And then I stopped doing them, because I realized I was so mean to myself during the classes that I thought it was making me better, but it was also just making me feel really bad about myself. Why do you think faux self-care is so appealing?

When you're drowning, you just want that life raft, right? You just want the thing that's just gonna make you feel better immediately, and that's what faux self-care is. I don't want anybody to feel ashamed about the ways in which you turn to that, whether it's bubble baths or mani-pedis, because usually you're coming there out of desperation.

The entire U.S. economy is built on the unpaid or underpaid labor of women, and particularly women of color, of Black women, of brown women, of immigrants, of people who are "less than" in the caste system. So we are living in an economy that is incentivized to have us believe that the solution to our problems is to buy something or to work harder.

Because when you believe that the problem is inside of you, then you don't question the status quo. You don't ask yourself, "Well, why doesn't my employer give me paid sick days off? Why don't we have paid parental leave in America? Why is it so hard to find a therapist who takes insurance and is accepting new patients?"

The real work of self-care is actually invisible, and it takes a really long time, and it's not something that you can measure or check off a list. The shortcut is to just believe that I can just buy this packet of pretty beige branded vitamins that's being shoved in my face on Instagram every day.

So what does real self-care look like?

The whole premise behind real self-care is that I can't tell you what to do, because everybody's real self care is completely different. But what I can do is I can share four principles. And these aren't anything revolutionary. This is stuff that we hear all the time. I think what is different is framing it in the context of our oppressive systems – and that very much comes from folks like Audre Lorde, [who helped articulate what radical self-care could look like for Black women back in the 80s].

The four principles are: setting boundaries and learning to deal with guilt. That is step one. And the reason is because learning to set a boundary is the only way that you can ever make space for yourself.

Principle two is developing self-compassion. Actually paying attention to how you talk to yourself.

Principle three is getting clear on your values. This is the hard part, right? I mean, it's all hard. But this is the part where you need to use an internal lens to make the big choices in your life. Who are you going to choose as your life partner? Are you going to have a life partner? What's your job? What do you really want for your life? Do you want that to change? Are you happy?

Oh my God. It's 11:30 in the morning and all of those questions just stressed me out.

That's why you gotta do the boundaries and the self-compassion first, and then you can come to those values questions!

Then the fourth principle is that this is actually power. When real self-care is a personal solution and not a commercial solution, that is the only chance that we have to lead to collective action. If you are somebody that has privilege, if you are somebody who has lighter skin, if you have financial resources, if you are able-bodied, knowing that you get power from this, you have a responsibility to put it back into your communities.

You're a psychiatrist, and in your book you write about many of your different patients and what they're going through, and you work with them to create a different framework. So can you tell us about "Mikaela" and her situation in the book?

Mikaela was a patient that came to originally see me for her obsessive compulsive disorder. So we treated that with psychotherapy and with medication. And during the course of working together, her mom passed away and then her dad got really sick, so her dad had to move in with her, basically. And she had two teenage daughters and was co-parenting with her ex-husband. And prior to this crisis in her life, she had been really excited to start to put more energy and time into herself.

But then this crisis happened. Mikaela is a Black woman. She came from a family of all brothers and she was always the caretaker, right? She never set boundaries in her family. She was always the one to step in, do the thing, take care of everything, lend people money, plan on the holidays, right?

This all came to a head while we were working together, and her OCD got a lot worse. So her version of real self-care was deciding to take a risk and take a medical leave from her job. During that time, she was able to see me more regularly, we were able to get a handle on her anxiety, and figure out a plan for taking care of her father and asking her brothers for some money to chip in.

As a Black woman, she was really worried about how she would be perceived, whether she would lose her job, whether she would, you know, not get that next promotion, right? And then what actually ended up happening was when she came back to work, she connected with a colleague and started a support space for others at the company who were dealing with mental health issues. When she was up for her next performance review, she was praised for this and she actually got some funding for it. So the thing that she was really worried about ended up being something that was celebrated in her workplace.

Of course, I have patients who say things like, "But my employer's never gonna do that for me. Or, my family's terrible, they're not gonna support me in that way." So I'm not saying that it all works out great. This is hard stuff. If you're a person of color, or in particular a Black person working in the U.S., we do know that you will be penalized, right? That's not imaginary. That's not in your head. So you have to figure out when is it worth taking the risk, and what are the potential costs of the risk? There will be some times where it's not worth it, and there will be other times where it is.

What you're describing is really hard. And contrary to faux self-care, there aren't these immediate rewards to it. What makes it worth it in the long run?

What makes it worth it is that your life gets to be your own and you get to believe that your choices matter. I think the alternative is just too terrible. In the book, I say most people who are coming to real self-care from a place of either desperation or inspiration. Usually desperation, right? You feel like you've done everything, but it's not working.

So for me – it is always a risk calculation, and the risk of staying in the doom scroll, the like "treat yourself" escapist place – I guess that's just not enough for me.

OK, last question. Is my reiki real self-care, or faux self-care?

The crux of it is it's not about the "thing," it's about the process you take getting there. So I think "is reiki faux self-care" is the wrong question. I think the question is more around, "Why do I feel like I want this and need this in my life?" It sounds like it does have you setting boundaries and being compassionate with yourself to some extent, so that's good. But that's about the process, not the form. So it's not necessarily wrong, but it may also not be enough. I think it's about understanding that the answers come from you, not someone else.

Edited by: Leah Donnella Produced by: Diba Mohtasham and Christina Cala Visual design and development by: LA Johnson