The Great Debate: Self-Care vs. Community Care vs. Systemic Change

In the health care world, whenever someone mentions self-care as a response to improving one’s health, the great debate ensues: self-care vs community care or self-care vs systemic change. Many people believe that self-care is individualistic and goes against collectivist cultures that center the community. Others believe that self-care puts the onus on individuals to change when corrupt systems are the reason people are burnt out, anxious and sick. When I first heard this side of the argument, part of me agreed but I also had a visceral response. Telling people to ignore or disregard self-care will never sit right with me. Self-care is not an extra thing you do to feel good about yourself. Self-care is necessary. To make sure we’re on the same page, let’s break down what each of these concepts mean:

Self-care is anything that you do to care for your self; mind, body, soul. Eating, drinking water, and getting adequate sleep is self-care. Getting medicine when you’re sick is self-care. Spending quality time with loved ones is self-care, too. The list goes on.

Community care is when “the people” help and support each other. This may look like community members supporting single mothers by offering to pick up groceries for her and her kids, neighbors looking out for each other’s children, visiting elderly, donating to small businesses, etc. When I think about community care, I imagine regular people doing small (or big) things to look out for the people in close proximity to them.

Systemic change is when there is a shift or transformation in the infrastructure or networks that govern and support our lives. On the micro level, systems may include our relationships with our partner, family, or organizations. On a macro-level it can include industries, societies and economies. People often speak about systems such as the criminal justice system, welfare system, or healthcare system. Zooming out even further, capitalism is an economic system and patriarchy is a social system. Systems can be difficult to understand because they include policies, values, relationships, structures, and rules that dictate the way people interact within them. When it comes to systems like patriarchy, it is a system itself and it permeates other political, social (i.e.marriage) and economic (i.e. pay gap) systems.

As you can see, all of these things are interconnected and they are all important. If you’ve lived long enough, you know that life is rarely black and white. Life is nuanced and thus, requires a shift in thinking from either/or to both/and. In this case, the argument should never be self-care versus systemic change or self-care vs community care, it should be self-care AND community care AND systemic change. For this reason, even when working with clients individually, I approach self-care from a systems-based approach. I incorporate relationship systems (partners, families, communities, and work teams) as a part of a holistic self-care plan.

Although self-care is often focused on “self”, it is not a solo experience. In order for a busy mom to go to the gym before work on a weekday, her partner, kids, or other members of her support system must support this practice in some way. While they may not like it, some type of compromise or support is necessary to make it work sustainably. 

Another key system that impacts our well-being is the workplace. The culture of an organization or team has a signficant impact on our mental and physical health. When working with clients 1:1, they often share that their family and job are the two greatest contributors to stress and burn out. Lack of boundaries or inability to implement boundaries without negative consequences is often at the root of the problem. This is another reason why a both/and approach is necessary. What good is self-care in a toxic environment when an individual may experience more distress by trying to go against the grain.

I realized this when I was burnt out at my prior job and tried to turn down unnecessary meetings, block time on my calendar for focused work and advocate for myself, only to be met with rigidity and lack of understanding. The team’s culture was client and profit-centered, with disregard for the employee. The organization was extremely reactive and only made changes after the damage was done — after people got sick, quit, or lost business. At the time, I was too burnt out to fight the system and by the time my clients find me, they are too. That is where I come in, to advocate for “the people”. Organizations benefit when their employees are well. I understand the importance of meeting revenue goals, but reaching the company’s KPIs do not need to happen at the expense of the very people that keep things afloat. Implementing corporate wellness and shifting corporate systems is an integral part in supporting individual wellness. 

So yes, systemic change is necessary AND self-care and community-care are just as critical. It is my hope that more health care providers, mental health practitioners, and healers collectively work together to address “systemic care”, which is a term that I think I just made up, but that (in my mind at least) integrates self-care, community-care, and systemic change.