Steve_Bamlett_blog

How do you practice self-care?

The self-care INDUSTRY tries to pretend it is not a money-making business but a tool of love and esteem. There is still money in practicing that self-care is not self-interest or self-indulgence.

The questions of ‘self-care’ were thrown into the air philosophically by the attention the philosopher, Michel Foucault, gave to these ideas in his later works, where the technologies or practices of self-care become central to his thinking. One examination of these ideas by Edward Demenchonok puts them into a comprehensible form in its abstract, though you can read the whole chapter at this link:

It examines Michel Foucault’s theory of the practices of the self and its contribution to the emergence of a new philosophical anthropology. It is focused on Foucault’s analysis of the history of practices of the self in Christianity, mainly of the practices of confession and of pastoral power, paying special attention to his critique of the Western “morality of asceticism” and “self-renunciation” as a form of control of individuals and domination. Foucault saw an alternative in Hellenistic and Byzantine models of practices of the self, which inspired him to sketch an ethics of taking care of oneself as a practice of freedom. Taking care of the self always aims for the well-being of others, which implies that power relations should be managed in a nonauthoritarian manner. The postulate of this morality was that free persons properly care for themselves are able to relate properly to others. Foucault’s theory is considered an important step toward a new philosophical anthropology. Its further development is traced in “synergic anthropology” based on the spiritual tradition and practices of Eastern Orthodox Christian hesychasm. In the world spiritual traditions, despite their differences, spiritual practices share some universal ontological and anthropological elements. The universal elements of spiritual practices can facilitate communication among people from different religious backgrounds and dialogue between their respective traditions. The practices of the self and spiritual practices, philosophically conceptualized in a new anthropology, promote the ideas of human freedom, justice, and peace. [1]

No doubt I oversimplify, but why not, in what follows. However, I will continue by using an understanding of Foucault based on the above that insists that it is a practice or technology based on ancient ideas that the self must be regulated, to the point of ‘renunciation’ of some contemporary views of it, in order for it to become a discipline that equates revision of the self with a care practice that is directed at a philosophical freedom from current understandings of the ‘self. Its aim becomes for a type of ‘care’, not only for the person who practices it, but others, especially those to whom care is never or rarely offered, the marginalised. And lo! here I am and finding that idea in one of my go-to texts, King Lear (from Act 3 Scene 4) – the other go-to being Paradise Lost. Lear, before madness descends, allows his love for his Fool to extend to the ‘houseless’ and hungry, the one’s powerful people, like he himself was, have ‘ta’en too little care of’.

Lear asks to be exposed to a kind of self-care, a kind of medicine or ‘physic’, that will change his ‘self’, regulate the luxury of its self-concern into one for justice for all, starting with those neglected when he cared only for himself, his self as the the monarchical ego realised in the form of a political state.

Against this stands a ‘technology’ (one that Foucault had long spoken of as a technology of power acting in the interests of the entitled few not the many) of self-care seen as the basis of health-care. Such technologies, forcing responsibility for their own health on the individual alone, allow a state, and those who live in it, to renounce its and their common duty to universal care; a duty realised in twentieth-century UK by a comprehensive health service free at the point of need for all.

Of course, there is an element of this thinking that would subsist even in a well-funded health system, for self-care can be, and is always justified as even when it is merely a state spending cost-cutting practice, a means of passing freedom and autonomy to people to prevent their future ill-health. In such a context, international nursing care theory, for instance. seems to wish for a better definition of the practice of self-care, even where it is merely seen as a function of health maintenance amongst all individuals likely otherwise to require ‘heroic’ intervention (by massive rescuing processes at the last minute) by the state. Martínez and colleagues in 2021 tried to provide one based on an analysis of the otherwise pre-supposed antecedents, attributes, and consequences that together define an acceptable definition of the concept. Here is their charting of it. [2]

This is careful definitional practice, if based on a literature search confined to the professional and biomedical literature alone. Such literature shows self-care, if not seen in its wider contexts, is only understandable from the point of view of a self seen as differentiated entirely from society. For fuller understanding, it needs other models of social care implied by its ‘system-related antecedents’ necessary to enable personal technologies like ‘self-reliance,’ for instance, like adequate resources and support.

However, the consequences of self-care in this model still seem entirely confined to personal and individual pay-offs, which is entirely unlike Foucault’s view that there is no self-care that that is not a free choice of justice within ‘system-related’ domains. Like the unreformed Lear, Martinez and colleagues really and only promoting care that does not expose self ‘to feel what wretches feel’? In effect they still have ‘ta’en / Too little care of this’ when it comes to rhe oppressed and marginalised and binds the ‘self’ it serves to self-interest alone, in neoliberal or authoritarian forms most usually in global.practice.

Martínez and her colleagues are not however, in their view, in the hock of neoliberal campaigns against universal provisions, that which the latter like to call, after Thatcher, the ‘nanny-state’. They conclude in their own words:

Chronic disease patients ultimately spend more time managing their conditions and providing self-care than they spend with their providers. Legitimizing this realization as an equal aspect of medical care within the context of chronic disease reinforces the importance of disseminating this information to both professional and lay audiences [1]. Self-care is an active decision-making process that enables people to effectively engage in their care.

What they intend it appears is something that links to reforms in health-care delivery based in service-user participation and involvement, co-production and other modern concepts based on theories of preserving the autonomy of decision-making of people. Such thinking helps in contexts where people using services are exposed to large impersonal-feeling systems, at least as they are experienced by ‘users at the front-end of delivery’. HOWEVER, note the technologising language I fall into here, after long exposure to such systems as a worker in, or user of, them. It shows that I, too, have a self that needs careful handling if it is to be really focused on the project of liberation.

Hence, I think there are dangers in participating in the discourses of self-care. Try as it might to pretend that self-care is not the same as self-interest, popular psychology fails to problematise, in the way Hellenic (Christian and otherwise) philosophy after Plato did, the idea of the ‘self’. It is unclear that self is a good starting point for any practice if the ‘self’ is not an object of the practice as well as being its originating subject. We have to see ‘I’ as itself something require reframing, and / or some kind of renunciation or hesychasm ±of at least its unspoken frameworks that have tried since the Cartesian revolution in philosophy to his behind ‘I think therefore I am’. That phrase was complicit in the changing of the concept± of self-care in ways we in the West have failed to address since. Even if Foucault tried, not all are convinced he succeeded, though some have tried to integrate it into psycho-therapeutic approaches.

However, I do not think that the issue can be left to institutions – of healthcare or academia – for we can do nothing that does not involved ‘practices of the self’. Most of us involve them in our lives by a suppression of them that is  so deep that they can be denied to exist. The ‘self’ is a matter of common sense to those people and its self-critique seen as an example of ‘overthinking’. But self-care practices are not merely physical (going to the gym and so on) or contemplative activities. They are the stuff of a world where power operates in interpersonal and intrapersonal spaces. We need to practise (yes I am staying with the Englist practice of spelling the verb differently) to ensure that our goal is not the achievement of a self that satisfies only when it is dominance over others just as much as we seek a self that is not defined by the dominance of selective others over us. This is a job for life.

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[1] Edward Demenchonok (2018) ‘Chapter 11: Michel Foucault’s Theory of Practices of the Self and the Quest for a New Philosophical Anthropology’ from Peace, Culture, and Violence,  218–247 , Available online : DOI:  https://doi.org/10.1163/9789004361911_013 (https://brill.com/display/book/edcoll/9789004361911/B9789004361911_012.xml)

[2] Nicole Martínez, Cynthia D. Connelly, Alexa Pérez, and Patricia Calero, (2021) ‘ Self-care: A concept analysis’ in the International Journal of Nursing Science (Int J Nurs Sci) [ Oct 10 2021; 8(4): 418–425]. Published online 2021 Sep 5. doi: 10.1016/j.ijnss.2021.08.007