The Self-Care Conundrum

Have you taken some time to really take care of yourself lately? I recently returned from some time off, but before I could even get there I had to push past the guilt that always seems to seep in when I indulge in caring for myself. Thoughts of my young children and the money that could be better spent somewhere else intruded while I relaxed with a novel on the beach. Does this ever happen to you too?

Taking care of ourselves isn’t always easy. There are a million reasons not to do it; being too busy, not having the financial resources, feeling guilty. And yet none of us are capable of functioning our best when we aren’t properly caring for ourselves. When we are properly nourished in both body and mind we are most able to serve those we love as well as our community and world.

When I talk to patients about self care, one of two reactions is likely. Either, “Oh, yes, I take great care of myself!” Or, more often, a look of confusion followed by, “what does self-care mean?”

Real self-care means attuning to one’s personal needs and taking steps to meet those needs, sometimes at the expense of other priorities. At its most basic, self-care is meeting one’s needs for food, water, sleep, shelter and physical activity. Sometimes, even that much is hard; but most often self-care involves the higher end of Maslow’s hierarchy of needs; belongingness and love, esteem; or feeling of purpose and accomplishment and self-actualization.

Higher Level Needs

Meeting these higher level needs isn’t as straightforward as meeting basic needs. Put simply, in order to function at that level one must manage stress effectively, have adequate self-esteem and feel connected to others. This condition means intentionally balancing career and responsibilities with time off, investment in hobbies and being with loved ones. Science has uncovered evidence of the mind/body connection, so we must also include an awareness of one’s sense of this delicate balance. Finding space for mind/body pursuits such as yoga, meditation and other spiritual outlets is key to ultimately meeting that highest level need–self-actualization.

Even when my patients think they’re doing a decent job of caring for themselves, we almost always discover at some point in therapy that that’s not entirely true. Although most have surface reasons for not prioritizing self-care; usually lack of time or resources, the root cause is often guilt.

Guilt for prioritizing their own needs ahead of someone else’s. Guilt for spending money. Guilt for taking time off work. Guilt for doing something that a loved one cannot. The reasons are as unique as the people themselves. But why?

What purpose does guilt about taking care of oneself serve? Perhaps guilt keeps us locked into our familiar dynamics; not disrupting the silent agreements we make with each other about how we interact. A typical example of such a dynamic would be the parentified child. That is someone who, as a child, had to function as an adult in her family, while the parent took on a more child-like role. Doing normal things like playing with friends wouldn’t be okay for a parentified child, who might have had to worry about caring for younger siblings and running the household.

This child learns that taking care of others is paramount and there’s no room for meeting her own needs. As an adult, the parentified child has an internalized sense of guilt when daring to care for herself rather than for others. If she’d indulged in typical child’s play as a young one, the entire family dynamic would have been upset. Therefore, even though her adult self may intellectually know that is not longer true, the psyche holds onto these early lessons.

Therefore, when we dare to behave differently, an internal feeling of shame around having “disobeyed” parental rules is triggered. Tuning into this guilt, particularly with the help of a therapist, can be a powerful lesson. Once we have a greater understanding of where it comes from, it is often easier to consciously let go of guilt and choose a new path forward.

Although guilt can be powerfully convincing, I encourage you to resist its pull. Self-care is vital for all of us and pushing through the guilt that accompanies it can lead us farther along that ultimate path to self-actualization.

Jamie Katoff is a Marriage & Family Therapist in San Francisco, where she works with individuals and couples. Her specialties include relationships, stress management, and postpartum disorders.
The Self-Care Conundrum


APA Reference
Katoff,, J. (2019). The Self-Care Conundrum. Psych Central. Retrieved on October 29, 2020, from


Scientifically Reviewed
Last updated: 21 Sep 2019
Last reviewed: By John M. Grohol, Psy.D. on 21 Sep 2019
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