Self-Care Versus Pampering
I’ve heard many people talk about self-care recently. Frequently, they reference getting the occasional massages, bubble baths, and pedicures to elevate how they are feeling. To me, that isn’t self-care. That’s pampering. And pampering is perfectly lovely, but it differs from self-care in purpose, intent, and individual optimal frequency.
Real self-care is about actively taking care of yourself, as I discussed here. It's about the intentional actions and practices you engage in to maintain or improve your body, mind, and spirit in the present. (Bonus, it also takes care of future you.)
Pampering is taking care of yourself right now or in the future with something unusual or luxurious. It feels indulgent to you. A special treat. Not something you’d do regularly. Something that you need to look forward to, to lift your spirits, or to repay yourself for, well, not taking good care of yourself. The intention behind pampering is to change the state of your body, mind, or spirit. It is meant to be recuperative because where you are isn’t where you want to be.
Notice that it isn’t the activity that defines whether it is self-care or pampering. It is the result you are trying to create. Many things could be self-care or pampering, like a mani-pedi, a facial, a delicious meal, an evening out with friends, or a massage.
When I was in practice, I did occasionally pamper myself with a vacation or splurging on something material, but I didn’t practice regular self-care. Now that I’m no longer practicing, I engage in self-care daily.
Granted, I have more time and energy to devote to it, but self-care doesn’t have to be challenging or time-consuming. It can be as simple as doing something daily that contributes to your well-being. Eating in a way that supports your body. Exercising to release stress while gaining strength and endurance. Getting the sleep you need. Prioritizing time with friends.
Pampering attempts to restore you to your baseline. Regular self-care raises the baseline.
Pampering is splurging on that special item you’ve had your eye on. Self-care is paying your bills on time.
Both are valuable. Be aware of the balance of the two in your life. Consider whether you need more of one or the other right now and make the necessary adjustments.
More Musings
Last week I drove to my favorite trails in Point Defiance Park. The roads seemed oddly empty and quiet, even for “the time between the years” as I’ve heard it called. Perhaps I hadn’t noticed it before, since in medicine it’s always been just another week when most people don’t work, but we always had a full schedule.
The day was overcast, as it so often is during winter in the PNW. The trails seemed unusually quiet and dark as well, with fog surrounding the woods and blanketing the Sound.
This year I have become reacquainted with grief. Grief is not anyone’s idea of a desired companion. And yet, to be alive, to be in the world, to love, is to inevitably invite grief into your life. Grief is an interesting emotion. Unlike some which blaze and extinguish, grief rolls in and out like the tide, catching you off guard when you take your eye off it, it can slap you to the shore when a rogue wave hits you, unsuspecting and unprepared.
Summer marked the start of medical school, with July being when clinical rotations commenced in the third year and when the transition to the fourth year occurred. July was when internship began, followed by each new year of residency. Fellowships began later but still in the summer. Each year brought advancement and a new role commenced, finally culminating in graduation to being an attending. An independent practitioner. Free to practice medicine out in the real world. With each advancement, I found myself thinking, “I’m not ready for this. And yet, I can’t imagine what would have prepared me further.” This makes me wonder, did I receive informed consent for medical education and training? Did you?
Doctors have been conditioned since childhood to experience not knowing information as a trigger. Daily messages telling you you're not doing it right bring back memories of implied or overt criticism from school and training. There are steps you can take to minimize this effect.
There have been changes to how residents are taught, with the hours they work. There has traditionally been a lot of pushback to this.
The unhealthy pushback goes like this: “I was trained that way. I’m fine. I survived, they can survive too!”
The healthier pushback also has concerns: “If they work fewer hours, they’ll see less patient care, participate in fewer surgeries, and not see the same evolution of a patient’s condition, following the clinical course from beginning to end. This could hurt their eventual knowledge base and clinical acumen.”
I recently read a story written by a friend and business coach about a time when she volunteered at an event. During the event, she had given away all her food to support others. Now she was hungry and the event was still going on. Instead of being praised (as she had expected) by one of the more senior volunteers, she was told “If you don’t take care of yourself you can become an emergency someone else needs to tend to.”
That’s what has happened to our healthcare system.
It’s become an emergency that someone else has to tend to.
“Until I know you better, I will be telling you how to breathe!”
It’s my first day at the Pediatric Orthopedic Hand Specialty Clinic on my peds rotation in my third year of residency.
I have just been barked at by the Professor Emeritus, a retired Army colonel, who runs the service.
Acceptance means taking stock of the situation and not fighting it. Instead of judging it or having a strong emotional reaction to it, take a deep breath. Stop arguing with yourself or others about how it “should” be. You can easily argue that you’re right about how it should be. But being right won’t really help you. It just keeps you stuck fighting an illusion. How it “should” be is a distraction. It is different from the reality you are actually facing.
You already know how to round on patients. Now you need to learn how to round on yourself. Self awareness is critical to your health and effectiveness as a physician. Your physical, emotional and mental health.
One of the biggest lessons I’ve learned about perfectionism is that done is better than perfect. In my medical school and residency, we learned about “The Enemy”, a shortened version of “The enemy of good is better.” This is a well-known aphorism that originated in the 1700s and not in medicine.
Perfectionism seems to help physicians succeed in school and in training. Chasing perfection appears to be the acceptable standard during that time. But after we arrive at our intended destination–medical practice–it can make our life miserable if we continue to adhere to it. Not just work life. All life. It is no way to create a happy life because it adversely affects our relationships, both with ourselves and with others.
World events have me thinking about boundaries. Boundaries are created over time and they often change for a variety of reasons. So too are our human boundaries. Physicians need boundaries as well to function at their best. We can mean the physical boundaries of our skin or the cell’s boundaries of membranes. Or we mean the psychological or social boundaries that we live with, and sometimes without. These boundaries can protect us from burnout and enhance our sense of well-being.
Recently I’ve been sharing some coaching tools that can help doctors experience more of what they want in life and less of what they don’t. But just like in medicine, it’s not enough to memorize facts or steps in a procedure. Practice is necessary to really make progress.
We think we need external autonomy, and control of our surroundings and activities (and other people) in order to be happy, but what if awakening internal autonomy is all we need to shift to a more positive mental and emotional state?
Previously, I published a post entitled “Stop Triaging Your Life”. I had worked on it for quite a while until I was pretty happy with how it turned out. Then I realized that I had missed the first step in triage.
I’m currently reading “What Happened to You” by Oprah Winfrey and Bruce D Perry, MD, PhD, and being reminded that when I am in a trauma activation, I react rather than respond. When that happens, I don’t have access to higher cortical functions like critical thinking.
Last year I had the opportunity to hear Gabor Mate, MD speak over several days at a conference. He is the epitome of the compassionate witness, the person you’d want sitting in a confessional.
I first learned about the art of triage watching MASH with my parents growing up. I also learned about the critical timing of one-liners. Both followed me into a career in pediatric orthopedic surgery, which I practiced for 21 years.