For the last week, I have been recovering from surgery. The surgery was planned and, thankfully, I've had an easy recovery with little discomfort. However, I have felt physically and emotionally drained in a way that I had not expected. It makes sense if you consider that a surgical procedure involves injuring the body. Our systems respond to surgical injury in much the same way they respond to any other kind of injury: the sympathetic nervous system is activated and our endocrine system responds with hormonal changes, most notably increasing our levels of the stress hormone cortisol. We have no memory of the injury as we are not cognitively aware when it takes place but our bodies remember. My body remembered and needed lots of rest and quiet, along with good food, gentle movement and human company. I am not going to tell you that I have cared for myself over this last week in an exemplary way. Self care is a prominent term in my therapist lexicon but a practice that I and many others struggle with.

Unfortunately, self care has become an ideology- one which dovetails with the neo-liberal ideology of self-interest that permeates our culture. The emphasis on self care implies that well-being is a strictly personal problem. The belief that the individual is solely responsible for their well-being gives a free pass to systems that exploit human beings and the exclusive emphasis on personal wellness mitigates the need for collaborative engagement and interdependence. If it were enough to “be the change you want to see in the world” (bumper sticker wisdom often misattributed to Gandhi), then the virtues of a juice cleanse should preclude any need for meaningful action to effect social and political change. Self care can feel self-indulgent. And selfish. It can feel hard to justify things like massage and aromatherapy when there is so much suffering and injustice around us. When we are hurt, scared or vulnerable, whether contending with the sequelae of psychological or physical trauma or just the vicissitudes of daily life, self care becomes an imperative. The poet and activist Audre Lorde wrote that self care: “is not self-indulgence—it is self-preservation, and that is an act of political warfare.” Following the Orlando nightclub massacre, LGBTQ peopleposted selfies under the hashtag #queerselflove, reframing self love as a radical act of solidarity in a world that is almost never loving or kind to them.

Self care is more than a concept. It is a practice. It involves action and it is not always easy. Many of us believe deeply that we are not worth care. When we practice self care, we communicate to ourselves that we are worthy and lovable. That can be a powerful, if unsettling message, stirring up some cognitive dissonance. My suggestion: do it anyway. Keep practicing and it will feel less weird; the dissonance will quiet down. Just practice.

1. Take care of your body. Attend to your health needs. If you are ill, rest. If you are tired, sleep. If you are hungry, eat. Pay attention to what makes you feel good and what makes you feel not so good. Adjust accordingly.

2. Move your body in a way that feels good. Walk. Stretch. Practice yoga. Or Aqua Zumba (yes, that is a thing!). It doesn't matter what, as long as you move mindfully.

3. Touch and be touched. Allow someone to hug you and hug back. Hold someone’s hand. Feel, if just for a moment, that you are not alone.

4. Spend time with a non-human animal. Look into their eyes. Smell their breath. Touch their fur (or feathers or scales).

5. Use your senses - see, hear, taste, touch, smell something lovely. I love a hot shower with a nice smelling soap. Right now I am using a Swedish sea salt soap and it smells delicious.

6. Unplug. From your email, Facebook, Instagram- whatever sucks your time and energy. Turn it off for a little while.

7. Get outside. Feel the sun on your face or your hands in the dirt.

8. Take a brief vacation. Put it all on a shelf for a few hours, or even a day. Most worries and problems can wait a little while and may in fact benefit from a post self-care perspective.

9.  Refrain from self-judgment. Give that shit a rest.

10. Remember the words of trans activist Kate Bornstein: “ Do whatever it takes to make your life more worth living. Just don’t be mean.

Sometimes the task is to love ourselves and practice self care when we feel the absolute worst, the most broken and unlovable. Self care is the hard daily work of nurturing ourselves when we don’t really feel like it- when we feel mean, tired, that the world sucks and nothing is fair. It is a practice that requires discipline and determination. Self care does not imply a denial of reality; it requires an acceptance of reality in the current moment and a conscious response to that reality. Finally, self care it is not an abdication of our collective responsibilities to our fellow beings. If anything, self care should strengthen and reinforce the ethical imperative to care for others. It helps us to face the world with an open heart and to stay aware and involved.

Julia Levine, LCSW, specializes in recovery support, self-harm behaviors, high conflict relationships and parenting teens.