Issues Treated in Therapy:

Self-Care

One meaning of self-care is the ability to take care of basic, daily needs (sometimes called activities of daily living, or “ADL’s”) such as feeding oneself, showering or bathing, brushing one’s teeth, dressing in clean clothes, and attending to medical problems. Having difficulty with this kind of self-care can stem from several different areas of concern.

Depression can bring with it a total lack of care for one’s condition, a loss of appetite or motivation, a lack of energy, or a sense of self-loathing, all of which can impair the ability to care for one’s self
Cognitive declines associated with dementia can impair self-care skills
Psychosis – a split from reality that may include hallucinations or delusions – impairs self-care skills

An extended failure to care for one’s self is a serious concern to therapist, and can even result in hospitalization.

Life Problems Caused by Lack of Self-Care
How Psychotherapy Can Help with Self-Care
Self-Care to Cope with Grief

Life Problems Caused by Lack of Self-Care

Another meaning of self-care can be the ability to care for one's emotional needs, manage anxiety, anger, sadness and other feelings, set boundaries with people, and generally attend to one's more complex needs, even when other people's actions or demands make this difficult. family members, employers, children, friends or society at large may have expectations of us that, as we attempt to meet them and to please or care for others, can interfere with our own well-being and our ability to care for ourselves. People with an anxiety disorder, dependent personality disorder, or depression, as well as codependent people, may fail to care for themselves in this way .

How Psychotherapy Can Help with Self-Care

Therapy can uncover the root of a failure to care for one’s self. If depression is the cause, therapy can help improve one’s mood thus leading to functional self-care. If dementia is occurring, therapy can help in the early stages by teaching new coping and communication skills, and can help families learn to cope with having a loved one with dementia, however it can significantly alter the course of this biological conditions. If psychosis is present, therapy alone can do more harm than good. A high level of care – such as daily group activities at a hospital or community mental health center, and/or a residential placement, unless family members are available and capable to provide consistent care – along with medication is usually the appropriate course, and can significantly improve self-care skills. The failure to care for oneself due to wanting to please or care for others, such as in a codependent relationship, or in the case of overly demanding family members, can indicate some difficulty with self-image and/or with setting boundaries.

Self-Care to Cope with Grief

Jennifer, 32, comes to therapy wearing the same clothes several sessions in a row. She originally came to therapy to deal with marriage issues, and since her marriage ended she has been very depressed. Her lack of self-care is a sign that the depression is worsening. Upon questioning, she reports she has no energy and sees no need to care for herself since “he’s gone.” Her therapist encourages her to care for herself even when she doesn’t feel like it. She demurs. The therapist asks about suicidal thoughts, noting how severely her mood has worsened. Jennifer admits to some passing thoughts. The therapist recommends hospitalization, and Jennifer accepts this intervention passively. Inpatient, she is given medications and attends groups, which begin to turn her mood around slightly and slowly. Returning home and restarting therapy, she is able to begin working through her grief and caring for herself, though it is a great struggle for several months.

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