Self-Care Skills

Are you the kind of person who cares for everyone but yourself?  In #4 of my series of posts about the DSM-5, I proposed a new definition for Complex Somatic Symptom Disorder.  Part B of the definition included the concept that symptoms improve in response to treatment of ongoing social or psychological stresses including insufficient self-care skills.  In this post I want to elaborate on the latter.

A large number of my patients have such limited time in their lives to use for their own enjoyment that eventually they develop physical symptoms.  One of my patients, who initially claimed to have a low-stress lifestyle, later told me about her six children and an invalid parent at home, working full time (while her husband worked a swing shift) and volunteering at a community center on weekends.  She had taken no significant personal time for years.

Many of my patients care for the needs of many others in their world but have difficulty putting themselves on the list of those who need care.  Often this is linked to a difficult childhood where circumstances limited their ability to play.  Child abuse, neglect, responsibilities not appropriate for a child, parental substance abuse or violence may distract a child’s attention from where it belongs, on themselves.  Children whose environments are not conducive to play may not learn self-care skills.  Later, as adults, they feel guilty if they self-indulge even a little.

My recommendation for these patients is to take 4-5 hours per week (admittedly not practical for everyone) for self-care and self-indulgence. They need to use trial and error to learn what gives them joy.  Once learned, this essential human skill keeps the stress level much lower than it would be otherwise.  This technique has relieved symptoms in hundreds of my patients.

Tags: ,