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The first of its kind, self-paced online program that supports hormonal balance, food-relationship-first weight loss, food peace, and a sustainable self-care plan for perimenopause and menopause. 

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  • Joanna Pustilnik

Prioritizing Women's Health: Where to Start with Self-Care

Self-care is defined as "the set of activities in which one engages throughout life on a daily basis” and “a person’s attempts to promote optimal health and prevent or manage illness”.1 It can include the small, route daily tasks (such as brushing our teeth) as well as the deep, meaningful choices we make from week to week, like making time for social connection, mindfulness, seeking out new recipes, or movement.


Self-care theory assumes that we all have a basic need to participate in self-care, but we don’t all respond to this drive with the same sense of importance, consistency, or awareness. And in our diet-driven, body-obsessed culture, the basic self-care need can be highjacked by the drive for thinness which turns self-care into weight loss attempts that ultimately increase our stress and influence weight cycling and metabolic disruptions.

We also must believe the self-care behavior is worth the effort. The Health Belief Model states that we are more likely to do a behavior if we truly believe the outcome is possible and helpful for us. How we view the impact of our behaviors can be a profound motivator, helping with the activation energy needed to begin that behavior. This is where knowledge about food, movement, and stress and coping can be very useful.


But our ability to focus on or follow through on self-care is impacted by several things. Here are some of the barriers:


  • how we identify ourselves in relation to each behavior (we identify as being or not being a person who engages in a particular behavior)

  • our overall self-concept and identity (we are worthy or not worthy of taking time for ourselves, our roles and how they define us, etc.)

  • our self-efficacy (belief that we can be do it well enough)

  • our executive function or focus (ability to make or follow through on plans)

  • our perception of our overall health

  • lack of mindful awareness of needs

  • our mental capacity and health

  • our environmental stressors and demands on our time and energy

  • our sense of enjoyment and knowledge involving the self-care behavior itself

Requisites for Self-Care Success

 

To be successful in our self-care endeavors, it is helpful to view any changes as ongoing, positive and enjoyable processes that are adding meaning to our lives, not stress. Self-talk (such as “shoulding” ourselves) can create a sense of inner resistance as it threatens our sense of autonomy. We also might feel we are not overall worthy of the time and attention required to change our eating, food relationship, or movement in a more positive direction. It is helpful to increase awareness around any of these psychological barriers.


Other important requisites include:


  • Taking responsibility for our own needs by carving out the time and energy and aligning with our sense of purpose and values

  • Increasing awareness of what our body is telling us we need

  • Willingness to gather the knowledge and skills necessary to support self-care efforts


Our success is impacted by the attitude of those around us as well. If we don’t feel supported in a behavior, we are less likely to continue self-care behaviors. Alternatively, having the support of others increases the likelihood we will continue and be successful in reaching goals or continuing behaviors.

Prioritizing Self-Care

What we prioritize as self-care may also be learned behaviors from our family of origin or environment generally, and the views we have might not be serving us well. Taking a closer look at what you enjoy and working to become attuned with those enjoyable behaviors instead of just continuing any learned habits increases the likelihood we’ll stick with self-care in the long run.


It can be challenging to choose self-care when there are external demands, loved ones needing our attention, and a limited amount of energy and time. 

 

But we all deserve to carve out time for ourselves! And our loved ones will get a better version of ourselves as well. It’s important to balance our external roles with our inner world of thoughts, feelings, and emotions. If you start to notice that a barrier to self-care is time, then setting boundaries and having discussions with a therapist or loved ones can start creating space to allow for unapologetically creating self-care rituals and habits.


Choosing self-care is also easier with a positive attitude toward aging generally. If we are choosing self-care specifically to maintain a certain body shape, size, or weight or to hold on to youth, it can backfire into our judging ourselves or feeling defeated.


Self-compassion is helpful here in that we may not always be able to follow through when we want to, but instead of judging, it’s better to be curious about how we may adjust and adapt in the future to meet our needs. This helps us gain a sense of responsibility for our own self-care with a gentle touch and free of guilt.


Self-care is Not Self-Centered

In an IPSOS self-care survey of women, 80% believed self-care is important and wanted to engage in it. Unfortunately, these same women spent very little time actually engaged in self-care. For those who did find time (about 1/3 of them), they only spent about 30 minutes daily addressing their own needs.


This same study identified that almost 80% of women were spending up to 10 hours a day engaged in care for partners, husbands and/or children. A shocking 1 in 5 women spent more than 10 hours a day caring for other people. This is an incredible amount of time spent in care for others and is not often balanced by the self-care necessary to not increase allostatic load (overall physiological stress on the body).


Research has found that women feel higher guilt around taking time for themselves for self-care when they are raising young children or have more external demands on their time. Engaging in self-care also means we need continual resilience to overcome daily obstacles and responsibilities and make time and space for our needs.


If we hold the core belief that self-care is selfish or indulgent, we are less likely to participate in self-care behaviors, and this may make us less likely to maintain health in the long run which is the opposite of what our loved ones want!


Becoming someone who chooses self-care as a lifestyle and for the joy of it, we must remove any sense that it is underserved, self-centered, or shouldn’t be an even priority with other demands in our lives.

If there is a general sense in our family or friend group that certain self-care behaviors are indulgent or not necessary (or other unsupportive views), then research shows we will struggle more with it. A study on Finnish primary care patients found social support and a sense of belonging reinforced the self-care behaviors.


I like to think of self-care as “me too!” not “me first!”. Self-care as a priority doesn’t mean we have to neglect others, and it shouldn’t engender a sense of guilt. We deserve to prioritize ourselves too! Everyone benefits from our vibrant health and happiness.

Also, whatever health concerns or chronic illness we may struggle with, when we can find symbolic meaning in our struggles, reframe them as something we can accept and work to manage, we can increase confidence and find peace with our routines.


Mastering and sustaining self-care behaviors takes time and patience. Whenever we aim to start a new self-care behavior or routine, there is a period of time when it takes more thought and energy initially. This increased focus period doesn’t last, as the more we do something, the greater the mastery and the less effort needed to sustain.


Expectations as Detaching Us from Self-Care

I’ve seen many clients cease self-care efforts because they had the expectation around big, quick changes for their efforts. If we feel overwhelmed or hopeless by expecting swift change in our physical body or feeling hopeless in the face of the aging process, we are more likely to ditch our efforts. It’s important to try to only set goals around what we intuitively know is realistic and try to release any expectations from these goals. When we have a higher sense of self-efficacy that we can follow through and maintain a self-care behavior, it increases the likelihood that we will. Evaluating our sense of confidence on a scale of 1 to 10 is helpful.


For example, how confident am I that I will walk on my lunch break this week at least 3 times? If you are an 8 out of 10, then you can expect that you will follow through, and this helps you examine why you are an 8 and not a 10. And then you can go a step further by asking, what am I expecting to happen as a result of following through on this goal? If you are expecting a big outward change, you might be motivated by an externally unrealistic expectation which ensures disappointment and low likelihood of maintaining the behavior over time.


Coping is Not Self-Care

Self-care is also separate from maladaptive coping and dieting. Maladaptive coping has a cost and that we engage in to maintain mental balance and stress relief when feeling already dysregulated. Self-care is something we do to help keep us balanced, before the dysregulation occurs, and it increases our ability to adapt to stress. Adaptive coping behaviors are often positive self-care preventative behaviors, such as how movement can increase stress resilience. But maladaptive coping, with alcohol, for example, should not be considered self-care. When there is a net negative cost to a behavior, it can’t be qualified as a helpful, self-care activity.


Awareness around compulsive coping habits can help support development of self-care, because we often prioritize time spent engaging in maladaptive behaviors as a reaction to stress while self-care is a preventative, ongoing process.


Dieting is NOT Self-Care

Also, dieting or calorie counting to lose weight is not self-care. Many clients believe they are doing well by counting calories as it makes them feel powerful in their sense of control. But research supports that calorie counting is associated with increased cortisol as well as weight regain. Weight cycling increasing inflammation and mortality risk. In a review of calorie counting interventions, Mann et al. found that 2/3 of those with weight loss ending up gaining more weight than they lost on the diet, and four years later, 83% gained 11 lbs more than they lost in the program.4


Disconnecting self-care from weight loss efforts is essential for long-term overall well-being.


What is standing in the way between you and your self-care goals?

 

Joanna specializes in women's health concerns such as perimenopause/menopause and PCOS, metabolic health (insulin resistance, diabetes, elevated triglycerides, ect), food-relationship-first weight loss, and nutrition therapy for disordered eating, eating disorders, chronic dieting, and Intuitive Eating coaching. She works collaboratively with clients in finding a self-compassionate inner voice with food and body concerns and a sustainable approach to eating, stress management, and movement. Interested in working with Joanna? Reach out for a free discovery call!


1.          Godfrey CM, Harrison MB, Lysaght R, Lamb M, Graham ID, Oakley P. The experience of self-care: a systematic review. JBI Libr Syst Rev. 2010;8(34):1351-1460. doi: 10.11124/01938924-201008340-00001. PMID: 27819888.

2.         IPSOS Self-Nurture Survey

3.         Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J. Medicare's search for effective obesity treatments: diets are not the answer. Am Psychol. 2007 Apr;62(3):220-33. doi: 10.1037/0003-066X.62.3.220. PMID: 17469900.

4.        Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J. Medicare's search for effective obesity treatments: diets are not the answer. Am Psychol. 2007 Apr;62(3):220-33. doi: 10.1037/0003-066X.62.3.220. PMID: 17469900.

 

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