The Self-Care Challenge by John Mader

Lama Losang (David Bole), Sue Erlewine and I will be examining various challenging issues of self-care in our program, “Compassionate Self-Care for Caregivers,” on August 10-12 at KTD.

The challenges to being an effective and compassionate caregiver are many. There are big questions and conundrums that often arise for caregivers. While there may not be a “right answer” (sorry), we will consider how we can address these questions to find what works better for each of us.

How do I balance adequate care for myself while caring for others?

In caregiving, our objective is to, naturally, provide care for another. This intended focus on the other person (your mother, child, partner, colleague, client,  or patient), inevitably invites an imbalance of focus on their needs versus your own needs. The greater the imbalance, the greater the likelihood of burnout, resentment, or ineffectiveness.

So, we have a dilemma here in the very nature of caregiving.

Marsha Linehan, the originator of Dialectical Behavior Therapy or DBT, might call this a dialectical dilemma. In DBT, the word “dialectical” refers to three assumptions about reality: everything is connected, everything is constantly changing, and truth continuously evolves from the integration of opposites.

Faced with the above dilemma, we will use this dialectical perspective to move from a polarized, depleting focus of caregiving to a more balanced, integrative relationship of providing care while maintaining sufficient self-care.

Marsha Linehan offers the analogy of a “teeter-totter” or what some of us call a “see-saw.” You may recall your childhood playgrounds when you would seat yourself on one end of the board and your friend would get on the other. Whoever was smallest was promptly lifted skyward. Yikes – the dialectic of connected, changing, and opposing forces in action! That is … until the larger child moved toward the middle of the board or the fulcrum point … where a new balance could be gained.

DBT works to help establish a new, working balance with the needs of others and ourselves, with independence and depending on others, with acting from emotions and acting from our thoughts, and the many dialectical dilemmas that arise in daily life.
Modern philosophers talk about the dialectical process as addressing the important features of a thesis along with its opposing anti-thesis to arrive at synthesis that incorporates some these key features of both. Similarly, we want to clearly identify and genuinely understand the needs of our loved one or our work relationship, while also doing just the same with our own needs.

How often do we caregivers take the time to clearly identify and genuinely understand our own needs?

In DBT, we look at the situation and ask, “What’s missing?” For many caregivers, what has been left out of the planning are in fact, the caregivers.
Let’s take a moment and consider a few questions: What needs of mine are especially relevant in this situation? What has been missing for me? Which of my needs do I typically ignore, minimize or forget to address? 

Notice if you have any reluctance to consider these questions. Some caregivers object to including their needs, perhaps viewing this as selfish, or un-Christian, or un-Buddhist.

I want you to think about the following scenario: you are on a sailing expedition and have been tossed overboard during a storm … the waves are intense … you cannot grab hold of the boat. Would you want your friend on the boat to immediately jump in after you, or to first secure herself to the boat prior to extending her hand?
We are not necessarily going to provide the most effective care to our loved one if we do not attend to our essential needs. This is not inconsiderate of the other person – it’s actually more effective.

Perhaps this synthesis of the needs of another and ourselves is what H. H. Dalai Lama referred to as “wise selfishness” in his book, “Beyond Religion.”

Being wise selfish means taking a broader view and recognizing that our own long-term individual interest lies in the welfare of everyone. Being wise selfish means being compassionate.

After identifying which of our personal needs we have been missing or neglecting, then we want to establish some concrete goals for meeting those needs. This will not be so different from what we would do for our loved one.

Let’s take a moment to ask ourselves what one or two actions can we take today that will be a step towards more effective balance as a caregiver.

What can we do that will help us balance the see-saw so we are not caught in the extreme and unstable position of failing to attend to our needs? What specific, concrete actions can we initiate today?



Taking this step or two today can help restore needed balance in our caregiving for others and compassionate self-care. We may need to remind ourselves that meeting our own needs, in the long run, serves our important mission – effective care given to our loved one, friend, client, or patient.

The human capacity to care for others isn’t something trivial or something to be taken for granted. Rather, it is something we should cherish. Compassion is a marvel of human nature, a precious inner resource, and the foundation of our well-being and the harmony of our societies. If we seek happiness for ourselves, we should practice compassion: and if we seek happiness for others, we should also practice compassion.
                                                                                     H.H. Dalai Lama

— John Mader

All photos by Svetlana Aniskina

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2 thoughts on “The Self-Care Challenge by John Mader

  1. Thank you, this a lovely clear explanation of framing how we can keep perspective of this balancing act I feel is needed in family life.

  2. Thanks Karma Rinchen Tashi!
    These balancing acts are typical of the dialectical challenges we face in daily life with our families. At a recent DBT Family Skills workshop, we considered to what degree our relationships are in a working balance, in terms of family interdependence and family flexibility. First, we examine family interdependence as the balance of finding the dialectic between independence or individual development versus family closeness and connection. On the extremes, a family might suffer if it becomes extremely disconnected or extremely enmeshed. Second, we consider family flexibility as the system’s ability to effectively change its (power) structure and role relationships in response to developmental stages. Here the extremes that bring suffering, on one pole there is an excessive rigidity and resisting of change while on the other pole there is very little structure and ongoing chaos. The balance will be unique for each family, as well as unique to particular times of family life, such as times of great stress. The focus is on returning to a working balance that is healthy for all members of the family. And that is a challenge for most of us!
    John Mader

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