Several years ago, I met Sarah*, mother of two school-age children, married for eleven years, working part-time as dental hygienist. Sarah had been referred to me by her primary care physician when her symptoms of fatigue, anxiety and restlessness paired with insomnia and exhaustion were not the cause of an underlying medical issue, as Sarah thought. Sarah’s physician observed her symptoms were the result of stress and recommended cognitive-behavioral therapy to increase her support and improve coping. Sarah was not taking care of herself, she was stressed and overwhelmed.

*Please note: Sarah, is not the real name of client. I have taken aspects of clinical issues from years of clinical practice and condensed it into a fictionalized version. All identifying information has been changed to protect confidentiality. 

As a began to learn about Sarah’s day to day life, it became clear; she had virtually no self-care behaviors. Each morning Sarah woke up and focused on getting her children to school: preparing breakfast, orchestrating dressing, packing snacks and lunches and eventually getting her children to the bus and school. The remainder of her day was filled with cleaning, shopping for groceries, either volunteering at her children’s school or working part-time as a dental hygienist, followed by shuttling her children to after-school activities; soccer and basketball practice, music lessons and dance classes. Every evening she would return home to make dinner, corral her children to complete homework, shower and clean-up before starting again the next day.

During the evaluation, Sarah said something to me that was so honest,

“I love my children and husband. I love being a mom. I never thought being a mother would be this hard. There are days I do not want to be in my life. I feel like I am going through the motions without enjoying much of anything.”

Sarah had no energy left by 7 pm for anything except watching television and eating. She had no energy to talk to her husband or friends. Sarah’s sex-life was sporadic and physical intimacy felt more like a chore or obligation than anything enjoyable or bonding with her husband. When her children were finally asleep, her husband retreated to bed to read, and Sarah sat in-front of the television to watch reality shows, which often led to comfort eating late into the night. She frequently ended her day later than she planned, staying up long past her body’s cues to sleep, checking emails and social media on the internet, because she relished the quiet time without tending to anyone else but herself.

My work with Sarah immediately began to focus on increasing self-care behaviors. When I asked Sarah what she did for self-care, she responded “nothing.”

Sarah is not atypical to the women I work with in therapy and what I have heard from my friends or experienced at times in my own life. Many women do not prioritize self-care behaviors. Sarah was confused about the definition of self-care. This is where our work started. Let me first start by saying what self-care is not.

Self-care is not:

1. Self-pampering: The definition of self-pampering is to treat or gratify with kindness, care or indulgences. Examples of pampering include massages, pedicures, manicures, baths and sleeping late. There is nothing problematic with self-pampering. However, if the only way you take care of yourself is through self-pampering, you may find these behaviors do not sufficiently help you cope with day-to-day stress.

2. Self-indulgence: The definition of self-indulgence is the inability to resist and often excessive gratification of one’s appetite, desires, or whims. Examples of self-indulgence include eating a fantastic unusual meal you consider a treat, engaging in a marathon of television or movie watching doing nothing else all day, and at the extreme include overeating, excessive shopping, drinking alcohol to excess.

3. Optional: I often see the belief women have that self-care is optional. It is not, self-care is a necessary life skill. When we take care of our own needs in a balanced healthy way, we increase our ability to deal with the inevitable stress and demands of life, especially raising a family.

4. Selfish: I am familiar with the phenomena passed down from previous generations; the belief that taking care of yourself is selfish and all of your energy needs to be focused on your children. The reality is, if you take care of yourself, you have more energy to be present and take care of your children. Self-care is not selfish, it’s self-preservation. If we do not take care of ourselves, it is challenging to take care of our children and the other roles in our life.

5. A one-time event. Balancing the demands of raising children and the accompanying responsibilities can be overwhelming. Instead of being overwhelmed with where to start, pick one small way to increase self-care. Starting any new behavior can seem daunting. When reviewing examples of self-care behaviors, remember that self-care is a process, not a one-time event. Increasing self-care takes time, effort, planning, commitment and energy.

Later in the week, Part 2: How to Increase Self-Care. If you would like to read more on self-care, please go here.