What do we really mean when we talk about ‘self-care’? Liz Scarfe shares her exploration of the topic. 


Earlier this year I was facilitating a workshop about inner criticism and a fellow in the workshop asked me “What is self care?” He had recently broken up from a long term relationship and was being told by lots of his friends to “take care of himself”, “don’t forget self-care”, but he said “I literally have no idea what they are talking about.”

As a therapist, I probably should have had an answer at the ready, but the way he asked the question made me think he wasn’t lacking in information about the general theory, neither was he short on ideas about the rituals or practices of self-care, but he didn’t understand the deeper essence of self-care, and I realised, neither did I.


For most of my life I’ve conceived of self-care as a necessary task so I could get on with life. That sleep, good food, exercise, social connection etc, were all strategies to support physiological and psychological wellbeing so I could do the stuff I wanted to do (work basically). I did them slightly begrudgingly and mostly not very reliably (except sleep, I’ve almost always prioritised eight hours a night, but probably because I really love sleep).

Self-care has been a means to an ends and over time, I’ve noticed that all the little strategies and rituals are not that effective for me; I’ve been barking up the wrong lavender scented bath. While the tasks of self-care (making good food, walks, baths blah blah) do matter, on their own they’ve never been enough because they don’t deal with the underlying issues of why I need self-care.

I’ve been doing what many activist group cultures do, and what many corporate business cultures do; promoting and engaging in self-care in service of productivity, so I can give more and give longer. But as I’ve come perilously close to learning first hand, self-care that is only in service of productivity doesn’t prevent burn out.

ptt_suffering1For me, being told to self-care so I can sustain my activism longer is oppressive. It reduces me to a resource, not a person. It sees my only value and role in life as someone working for a better life, not getting to live a better life now or experience a diversity of experiences and social roles. It’s faulty logic to fight for something in the future without living it a little in the present e.g. the environmental activist who never spends time in nature because they’re too busy campaigning.

I’ve come to realise that to be effective, self-care has to be undertaken not only as a political act of rebellion (although it is, see the work of activist and writer Audre Lorde who popularised this framing), and not to sustain productivity (although it does for awhile), but as an act of self-love. Sadly, genuine self-love is something most people can barely conceptualise because almost every message we’ve ever received our whole lives, is against real self-love.


For personal and professional reasons, I started researching this concept of self-care. I like to read a lot of diverse work when I’m researching, but one of my most potent research methods is the work I do with my therapist. I usually then take my new findings to clinical supervision to bounce around with my supervisor, and then into my own therapy practice to see if they fit or somehow support the dynamics my clients are working through.

What I discovered in my own therapeutic work but not in any of the reading I did, was that the everyday practices of self-care were a crappy band-aid solution for a much bigger issue: self-care isn’t just dealing with tiredness or overwork, it’s about making space for suffering.


As a culture, talking about, acknowledging and responding to suffering borders on taboo. And if you’re an activist it can be even more so (almost all activists feel like they don’t do enough, and many activist group cultures support martyrdom and excessive self-sacrifice).

If you’re a somewhat white, middle-class, heterosexual or cis-gendered activist, you can also marginalise your own suffering because in comparison to the suffering of those without all your social privileges you judge your own struggles unworthy (check out the video Why It’s Important to be a Victim for more on this). Feeling guilty about our privilege makes us imagine it can absorb all the minor slights we experience without consequence.

And then if you’re not so white, middle-class, heterosexual or cis-gendered, you can marginalise your suffering and need for self-care as a result of internalised –isms and –obias from the culture that has contributed to an inner atmosphere that’s hostile to your own wellbeing.

Our families of origin also have a huge impact on how we relate to struggle and hurt. I was raised by a very stoic mother who sought to make me similarly stoic, so I’ve had to work really hard to notice my own suffering and view it as anything but a problem to be ignored.

Unsafe family situations also condition us to prioritise the needs of others ahead of our own (as a strategy to try and stay safe) and make it difficult for people to later learn self-care and self-prioritising.

For whatever reason (and it’s often a combination of several factors), a lot of people work hard, albeit unconsciously, to marginalise their experiences of suffering, and are suffering even more as a result. A pervasive feeling of undeservedness, judgements about self-indulgence, and aligning self-care with self-pity, form the internal discourse of disavowal in an attempt to keep our suffering hidden from awareness.


Our need for self-care often feels like tiredness, exhaustion or overwhelm, not only because we are over-working, but because we expend a lot of energy marginalising our suffering. I’m not exhausted because I work too much, but because I spend inordinate amounts of psychological energy trying to stay sane, hopeful and grounded in an insane, unjust and terrifying world. Making space and time to feel our feelings, while in the moment can make us tired, actually relieves of us of a massive psychological burden.

This is similar to the theory underlying Joanna Macy’s fantastic work, whereby making space to connect to the despair we feel as part of a struggling planet, ultimately leads to heightened empowerment.

“When we deny or repress our pain for the world, or treat it as a private pathology, our power to take part in the healing of our world is diminished. This apatheia need not become a terminal condition. Our capacity to respond to our own and others’ suffering–that is, the feedback loops that weave us into life–can be unblocked.” Joanna Macy.

It’s not something you do once and are then forevermore bursting with energy. Because the traumatic situation (and life) is ongoing and there is no final healing or closure to be had, the practice of making space for suffering needs to be a regular one.

Because suffering, be it personal or collective, is real, it comes and goes, sometimes it’s light sometimes it’s heavy; but our aversion to acknowledging it in ourselves and others is detrimental to our wellbeing, both personal and collective.


Luckily, suffering doesn’t just have to be suffering. Learning to connect to suffering isn’t just self-care, it builds skills and personal power.

Being more sensitive to your own suffering and building more empathy for yourself, helps you become more sensitive and empathetic towards others. Every time we marginalise a hurt or stuff our suffering down, we send a message to others that they should do the same, and that you can’t be trusted to congruently or safely witness their suffering.

Demonstrating your willingness and capacity to hold suffering provides the encouragement and safety for others to do the same – the gift of modelling.

It also supports kindness. The kinder we are to ourselves the kinder we can be to others, and kindness saves lives (PostSecret taught me this long before becoming a therapist did).

Fluidity with your own emotional states is a characteristic of personal power (see this free Little Book of Power for more about power). Being able to identify how you’re feeling not only gives you more options about how to respond, take care of yourself, and set better boundaries, it also gives you greater insight into how others might be feeling so you manage interpersonal relationships better which brings personal and professional benefits, and absolutely makes a more effective activist.

ptt_suffering2This fluidity is also a kind of detachment whereby you don’t get too stuck in any particular state – you’ve worked on self-awareness and processed past traumas to the point that you have more freedom in your own psyche. This is an incredible personal power that protects you from manipulation, personal accusation, and taking things too personally.

I’ve also noticed a more spiritual dimension to suffering. Well expressed suffering usually leaves me feeling more connected to the world and less attached to my everyday self – a kind of transcendent experience if you will. Other than being pleasant, the kind of healthy detachment from self-importance that transcendent experiences can offer is relieving and makes us less prone to being triggered or irritated by those around us.


Many popular self-care strategies placate our suffering, reducing the symptoms of suffering so we can ignore it. I liken it to shutting a crying child in a bedroom so you can get on with your work; or shoving chocolate at them instead of connecting and being with them while they express what needs to be expressed.

Thinking about it like this highlights the cruelty of such strategies; but it’s what we commonly do to ourselves to quieten our suffering inner experience. We placate, distract, ignore or drug our suffering selves instead of just giving them time and space to be expressed.

But popular self-care strategies do have their place, particularly if our intention when we do them is to engage in an act of self-love purely for the purpose of loving one’s self.

To connect with suffering requires time out to ask ourselves “How am I? What’s been getting me down lately? What am I trying to pretend isn’t bothering me? Where do I hurt? Who in me is being shut in their room (or fed chocolate)?”

Then get beyond the story you might create about the feelings, and just have the feelings without judgement or reason. Understanding why you’re having those feelings can come later (and it might not, if it’s not necessary).

Or do it in the moment you get hurt. It happens to me everyday reading through a fairly depressing Facebook feed. When I feel upset by something I’ve read, I try and sit with the upset and express it (crying usually), rather than pushing it down and moving onto the next article.


There is a lot of fabulous discourse about reconceptualising self-care as a task of community-care (like this article by B. Loewe, An End of Self Care).

There’s no doubt that meaningful social connection and interdependence is one of the most powerful preventative and healing life factors (one of the reasons we therapists have so much work is the decay of social fabrics).

But if the community care framework simply replicates current dominant self-care patterns – that is if it’s motivated by productivity, uses strategies that placate suffering, and sides with strength and resilience paying only lip service to the importance of vulnerability – it will fall short of providing the depth of care required.


An infuriating issue with much of the prevailing self-care discourse is its positioning in white middle-class privilege (which is absolutely me), and that it’s commonly a thinly veiled advertisement for products and services that require financial and time resources that not everyone has (the co-opting of self-care by capitalism, think retail therapy, girls weekend, manicures and ‘you deserve it’ rhetoric).

While I’m not spruiking ideas that require money, they do require time and a certain degree of inner and outer support, which not everyone has. My promotion of connecting to suffering will be completely inappropriate for some people at certain times in their lives (perhaps their whole lives).

Sometimes we cannot afford, psychologically, to acknowledge the depth of our suffering. Sometimes it’s not safe. So, as with all advice, it’ll be spot on for some people, and the opposite advice will be exactly right for others.

Self-care is ultimately horses for courses of course.

Post Script

While putting the finishing touches on this article I came across this great piece about the Sad Girl Theory by artist Audrey Wollen, which aligns with and extends this theory in interesting ways.



Liz Scarfe is a process-oriented psychotherapist, trainer and facilitator based in Melbourne. Working from a liberation psychology framework, she runs a #nopathology practice whereby the struggles and symptoms of her clients are seen as meaningful and sensical in the context of their lives, not a result of personal failings or pathology. She blogs and vlogs here.