For Women in America, the Fight for ‘Real Self‑Care’ Never Ends

The following is an excerpt from Real Self-Care: A Transformative Program for Redefining Wellness (Crystals, Cleanses, and Bubble Baths Not Included) by Pooja Lakshmin, out March 14, 2023.

Join Lakshmin and Ms. editor Roxy Szal in conversation on Wednesday, March 22, at 7 p.m. CT, at BookPeople in Austin, Texas. RSVP here.

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In the fall of 2021, something groundbreaking was happening: The U.S. was coming up on nearly two years of being ravaged by a global pandemic. And for the first time in decades, the federal government had paid leave for caregivers and new parents on the table in the form of the Build Back Better Act. In the initial iteration of this legislation, Congress proposed 12 weeks of paid parental leave. And then, as quickly as we cheered, paid leave was removed from the bill due to opposition from several senators.

Women and mothers were furious. So they took to the streets—literally. Thousands of mothers showed up at the steps of our nation’s Capitol, in the rain, to demand that paid leave be brought back into the proposed legislation. Grassroots movements popped up all over the country. On social media, a coalition of advocates and leaders came together, and we called ourselves the Chamber of Mothers. Nearly overnight a movement of 10,000 women came together to take action.

Due to the work of new advocates and groups that have been working on this issue for decades, lawmakers put paid leave back into the legislation—albeit at four weeks instead of 12.

The work of real self‑care is about changing our relationships with ourselves, and, in turn, what naturally follows such internal change is a reorganizing of larger systems.

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Families, parents and caregivers call on Congress to include paid family and medical leave in the Build Back Better legislative package during an all-day vigil on Nov. 2, 2021 in Washington, D.C. (Paul Morigi / Getty Images for PL+US)

What was striking to me about this movement is that many of the women who signed up, donated and showed up in the rain were done having children. They were not going to personally benefit from a federal leave policy. But they were willing to donate their time, energy and money for others who would benefit. They were paying it forward.

Moreover, the logistics around this movement took into account the fact that people who had the privilege to show up to protest and to organize had resources—such as childcare or support at home—so that they could get on a bus to Washington, D.C. Groups organized donation campaigns to pay for childcare so that women who did not have those choices could come and fight for this cause.

Another phrase for the collectivism of paying it forward is community care. I believe that community care is a byproduct of real self‑care—for with power comes responsibility.

Angela Garbes, author of Essential Labor: Mothering as Social Change, says minority communities have been engaging in community care for centuries—it’s how folks who do not have access to systemic resources survive: neighborhood libraries, trading off playdates, carpooling to work. “One of the central pieces of community is decentering yourself,” she said. “Sometimes you are the person who is giving, you are not always the person receiving.”

Ultimately, the work of real self‑care is about changing our relationships with ourselves, and, in turn, what naturally follows such internal change is a reorganizing of larger systems. In order for this reorganization to be equitable for the women who are most disadvantaged, those of us who hold privilege must share the power we build through real self‑care. This might mean giving up opportunities, convenience or status so that resources can be distributed to women who are lacking.

In my own life, when I made the decision to leave full‑time academic work, I recognized there were privileges involved with being able to make that choice. Now I hold office hours for physicians and trainees who are looking to start their own practices, to write articles and books for a nonscientific community, or to explore entrepreneurship. It’s one small way that I can pay it forward to the next generation of physician creatives who are building careers outside of the traditional framework.

To Practice: Cultivating Community Care

Real self‑care has the power to change the systems that we live and work inside. When we think about community care, it’s helpful to understand the areas of your life wherein you have experienced oppression and the areas of your life in which you hold privilege. When you make this explicit, it’s easier to pay it forward.

Ask yourself the following questions to assess how privilege and oppression show up in your own life:

  1. What privileges or advantages do I hold (e.g., partnered or married, American citizen, cisgender, light skin)?
  2. What factors put me at risk for oppression (e.g., lack of finan‑ cial resources, single parent, disabled, coming from a his‑ torically marginalized or oppressed identity group)?
  3. What is easy and simple for me that is harder for other people?
  4. What is one way I can be generous in my personal life?
  5. What is one way I can be generous in my professional life?
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Laksmin is a board-certified psychiatrist and a clinical assistant professor at George Washington University School of Medicine. (Courtesy)

Reflecting on these questions is not meant to induce guilt or shame. Instead, I’m gently proposing that you spend time reflecting on the areas of your life in which you can afford to be generous. Keep in mind that community care does not need to be grand, sweeping gestures—it can be dropping off dinner to a neighbor whom you don’t know but who just had a baby, or reaching out to a younger colleague whom you have nothing in common with to grab coffee.

We could sink in despair over policy and advocacy failures. Or we could recognize that the energy and collective power that was harnessed by individuals in 2021 has led to real and tangible changes at the state level and in the corporate sector.

The reality of living as a woman in America means that our fight for real self‑care never ends. You could think of this as a failure, or you could embrace it for what it is—looking truth in the eye: We are living in the gray space of “both, and.”

For example, at the time of writing this book, federal paid leave policy has stalled and reproductive and human rights have been rolled back in the United States. I’m not sure where legislation supporting caregivers or other progressive causes will be when you read these lines.

That said, focusing on the results of specific legislation misses the point. Remember our chessboard: We could sink in despair over policy and advocacy failures. Or we could recognize that the energy and collective power that was harnessed by individuals in 2021 has led to real and tangible changes at the state level and in the corporate sector. In Maryland and Delaware, state legislators passed paid leave policies in 2022. We saw huge multinational corporations come out with progressive family leave policies—not just for parents, but for all caregivers—and policies for mental health leave and other benefits.

Of course, there is much more work to be done (for example, it’s not sustainable to depend on corporate America to provide services and protections that should come from our government), and recognizing individual and collective agency is a powerful source of hope.

Audre Lorde said, “Your power is relative, but it is real. And if you do not learn to use it, it will be used against you, and me, and our children. Change did not begin with you, and it will not end with you, but what you do with your life is an absolutely vital piece of that chain.”

Especially in times of trauma at the national and international levels, our power comes from the practice of hope and focusing, unflinchingly, on the fact that our agency comes from the collective will to empower ourselves. We do this through embracing the complexity of ourselves and others, and by lifting up those of us who are the most vulnerable.

Join Pooja Lakshmin and Ms. editor Roxy Szal in conversation on Wednesday, March 22, at 7 p.m. CT, at BookPeople in Austin, Texas. RSVP here.

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About

Dr. Pooja Lakshmin, MD, is a board-certified psychiatrist and the founder and CEO of Gemma, the women's mental health platform centering impact and equity, which she is building along with her physician colleagues, Dr. Kali Cyrus, MD, MPH, and Dr. Lucy Hutner, MD.