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“Put on your own oxygen mask first.”
How self-care leads to improved outcomes in obesity
By Dr Michael Vallis, October 2020
What is the difference between self-care and selfishness? Would it surprise you to know that people living with obesity have to constantly navigate the world of judgement and stigma?
No surprise to know then that individuals living with obesity seek to avoid criticism by becoming sensitive to others and often will adjust their behaviour to avoid criticism.
This leads to two worries for me as a psychologist. One: this dynamic sets people up to become people pleasers. Two: this pattern erodes self-esteem because no matter what a person living with obesity does, stigma is unavoidable. You may have heard the sentiment that bias against obesity is one of the last acceptable biases.
Humans are social beings and as a result, for most of us, we are sensitive to others’ feelings toward and attitudes about us. So, we can be easily hurt. In fact, unlike the childhood rhyme sticks and stones can break my bones but words… words can definitely wound me.
Self-esteem can be fragile. We take knocks and scrapes and bumps and bruises as we go through life. Now, this is true for all of us, regardless of how strong our self-esteem is. What about those with low self-esteem? How much can they take before there is nothing left at the bottom of that bucket?
So, this tells us that self-esteem needs to be protected, repaired and rejuvenated. This requires self-care, self-compassion and kindness. Not so easy if you feel bad about yourself, and if you face constant criticism (explicit or implied).
Much of our behaviour can be understood through the lens of psychological drives. Would it surprise you to know that our drives can be summarized quite simply? Most of us can describe our basic drives as some degree of combination of two main drives.
First, the drive to make a difference, to accomplish something worthwhile (many people want to make a mark on the world, to leave something behind). We call this achievement motivation. Second, and at the same time, we want to have meaningful, deep connections to others (we want to be cared about, we don’t want to die alone). We call this affiliation motivation. Some people have a balance between these two drives, some people are stronger in one area than another.
If you have a strong achievement motivation you will likely be the type of a person who is hard working, responsible and accountable. Great traits, but they might get in the way of self-care. If you have a personal need but have a deadline or a commitment, a person with high achievement motivation will put their needs aside and make their commitment.
Now if you have a strong affiliation motivation, you will likely be the type of person who is kind, reliable and supportive. Great traits, but they may get in the way of self-care as well. If you have a personal need but someone you care about needs support a person with high affiliation motivation will put their needs aside and take care of the needs of others.
I think you can see what I am getting at. For a number of reasons, it is easy for people to put their personal needs second. Now, let’s revisit my question: what is the difference between self-care and selfishness?
If you have low self-esteem, if you have developed the pattern of putting your needs below either the things you need to accomplish or the needs of others, focusing on your needs will take time and energy away from these external drives.
After all, we only have so much time, so much energy, so much money, etc. It can be easy for people to initially be uncomfortable with diverting energy, time, money to personal needs. You may accomplish less or you may not be as attentive to the needs of others. This is where the confusion between self-care and selfishness comes in.
Think about when you are at your best, when everything comes together and you are thinking, feeling and acting like the person you most want to be. This best self will put you in a situation where you are likely to do your best work or be the most sensitive and caring. In other words, both achievement motivation and affiliation motivation are linked to self-care.
It is true that you can travel a far distance ignoring your own needs, but usually, things don't work out well in the long run. For instance, have you ever wondered why suicide rates are so high amongst physicians?
Well, even though medicine is a very noble profession that generally pays well and is treated with a high level of societal respect, physicians are caregivers.
And if we look at the other side of the coin, being a physician may be very stressful. It involves attending to never ending demands for service and dealing with medical tragedy on a regular basis. Imagine being a surgeon and despite your best efforts the person on the table dies. Now imagine if this happens repeatedly over the years through no fault of your own.
Self-care is required to prevent burnout, depression and addictions – all of which contribute to the high suicide rates of physicians.
Here is a second story. Have you ever heard of the successful business person who achieves great wealth, working 24/7 and accumulating more and more? But as all this wealth accumulates it is at the cost of having no time to focus on personal needs or relationships. This story doesn’t end well. The person might end up alone and in poor health.
We commonly see people in these situations dying of heart attacks at a young age. Self-care is required to prevent this drifting away of important relationships (spouse, children, family and friends) and the drifting away of health (weight gain, high blood pressure, diabetes, heart disease).
I hope I have convinced you that to be your best you need to address your personal needs. Let me end this blog by repeating something that I said in a previous blog. Self-esteem is the esteem that you have about yourself; sorry if that sounds simple. Hang on, in some ways maybe it could be simpler.
Self-esteem is between you and you:
- Self-esteem cannot be earned.
- Self-esteem cannot be given
- Self-esteem cannot be borrowed
- Self-esteem cannot be downloaded
- Self-esteem cannot be bought
- Self-esteem can ALWAYS be CLAIMED
Self-care is a pathway to building self-esteem.