Self-Care When You Always Put Others First

Once upon a time, no one expected you to do everything for them.

This is true for you as an individual (because once upon a time you were a baby and a child and a young adult etc who relied on others for food, shelter and nurturing); but it’s also true for you as a Physician. Once upon a time, people didn’t think that you would take care of everything for them, all day, every day, just a click away (refills! Answer this question! Order this for me now!). 

So imagine my delight when I finally sat down to read Good Inside by Dr Becky Kennedy (known to many as “Dr Becky”), and found lots and lots of advice acknowledging the difficulty of caring for yourself when others (kids, family members, society) expect that you as a parent will always put others first. So this month, I am sharing nuggets from this wonderful book, and translating them to our lives in medicine (you are welcome to also use them for home life….because let’s be honest, if you care for people at home, young or old, the same stuff happens to many of us.

It starts with us normalizing that starting to put yourself on your list (eek, maybe even *first*?) is uncomfortable, and confuses other people (mostly those that benefit from us doing stuff for them). 

Think about it: the last time you tried to set a boundary, say “no,” etc, what happened?

-Someone was upset

-You felt guilty

-Things weren’t “the same” according to someone (which then commonly triggers guilt

-You didn’t know what to do with yourself, procrastinated, didn’t rest/relax/have fun and then felt guilty

(do you notice the theme here? Guilt? Yup.)

Let me be clear: this is normal. And it’s common.

When you change how you do things, when you aren’t always available, when you say no, when you let other people come up with solutions (even if it’s not as good as your solution), you make other people wait, etc, your brain will struggle for a while. It’s a change for you AND you are likely also to unearth all the underlying thoughts about what you “should” do or “shouldn’t” do that you are used to thinking, even if subconsciously.

This is the number one reason why we revert; when we bump up against the uncomfortable emotions of feeling guilty, feeling like we are being lazy or selfish because we are used to always putting others first, we feel struggle. Again, this is normal.

Stick with it.

Engage with self-compassion, as taught by Kristen Neff, and literally put your hand on your heart in those moments and tell yourself “It’s normal that I feel this way. It’s normal that it is uncomfortable to say no, to disappoint others. Nothing has gone wrong, I’m just having a feeling.”

Tell others; “I’m realizing that I need to make some changes in how I prioritize my time, and this will lead to some changes in my availability to help you. I trust that you’ll be able to figure things out.”

Remind yourself that although you are used to feeling responsible for meeting the expectations of others, this isn’t actually your job. 

-It’s not your job as a parent to never disappoint your children

-It’s not your job as a physician to take care of all the things your patient expects you to do

-It’s not your job as a physician to robotically click all the boxes for your employer; especially when your clinical judgment tells you that other things are more important

The conversation continues next week….