Worth a look: Dr Pooja Lakshmin's Real Self-Care
A well-being manifesto that's subversive and deeply useful
Dear community,
In today’s Worth a look column, I’d love to share with you a gem of a book: women’s health-specializing psychiatrist Dr Pooja Lakshmin’s first book, Real Self-Care.
👀 Worth a look. Recommendations for particularly inspiring articles, books, movies, or shows that’ll make you think differently about health and well-being.
You may know Dr Lakshmin’s work already — either here or in her previous role as a New York Times columnist. As some of you know,
,, and together write the weekly Substack newsletter , with actionable, bite-sized psychological pearls — of which I’m a big fan. I’m also lucky to have gotten to know Dr Lakshmin personally this year, as fellow physician-writer-entrepreneurs, and she is as thoughtful and intentional a person in real life as she is in her writing.As is now the case for me with most thought-provoking reads, I read Real Self-Care in fits and starts over a few months — with plenty of time to chew on its nuggets. As a toddler parent whose earlier nighttime reading window is now mostly shot, I find this is how I can get the most out of a book.
On finishing this book, I immediately sent my mother a copy. And I highly recommend it to all of you.
Dr Lakshmin outlines how especially as women, our choices are constrained by multiple intersecting systems of oppression, including capitalism and patriarchy, that exist to keep us small and in our places — and that actually profit off our smallness.
Learning to live in accordance with our own values — enacting real self-care — thus constitutes rebellion. It’s how we can reclaim our own power and agency and when enough of us take this on, that’s how we enact systemic change.
Real self-care involves the hard work of setting boundaries, cultivating our muscles of self-compassion, and getting clear on the values that determine how we want to live — not just on our goals themselves. This allows our “insides to match our outsides.”
Dr Lakshmin contrasts real self-care to faux self-care — sold to us by a $4.4 trillion wellness industry — in the form of quick, externally oriented fixes like wellness retreats and bubble baths, which end up being “empty calories” that are “devoid of substance.” And faux self-care actually keeps us mired in the oppressive regimes that benefit from this — and take us further from our own true needs and values.
“If it’s someone else’s answer, it can never be your solution.”
-Dr Pooja Lakshmin, Real Self-Care
“Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
Audre Lorde, as quoted in Real Self-Care
In her words…
Not only does Dr Lakshmin lead us through approachable exercises to get us to enact the core elements of real self-care, she does so with compassion and a place of deep vulnerability.
In the book, Dr Lakshmin shares her own struggles to find a path of real self-care, detailing her early professional disenchantments (as a psychiatrist, she was taught her patients needed ‘fixing,’ but learned no ways of helping them navigate systemic failures), a divorce and decision to leave her residency program and life behind for a matriarchal orgasmic meditation cult — a chapter that she was later challenged to integrate into her sense of self after claims of darkness within its ranks surfaced.
She details how she emerged from these difficult circumstances and re-engaged psychiatry and her personal life with a new set of perspectives, going on to become a New York Times contributor, author, and entrepreneur — as well as deeply fulfilled personally.
Here is Dr Lakshmin’s own self-care compass, in the domains of career, family life, and herself. Pay attention to the why (‘because what feeds me…’) and the how (the values that apply) wheels: they are more important than the what (the goals) wheels.
Dr Lakshmin teaches us that the way we honor our own needs and values in enacting our goals is more essential to our well-being than are the specific goals we choose.
Here are some particularly beautiful and insightful segments from the book:
“Real self-care… is an assertion of power… It’s having the audacity to say, ‘I exist and I matter.’ These are revolutionary acts.”
“Guilt does not need to be your compass.”
“As women, we are taught that others know better than us, and not to trust our intuition…. Self-compassion is a radical act of subversion of the social structures that are built to keep us quiet and overburdened.”
“The way you move towards your goals influences the mental and physical state you’re in when you arrive [emphasis added].”
“Somewhat paradoxically, when you start shifting your decision-making to align with your values, you might become less productive and no loner able to meet the needs of those around you with the same timeliness or concern… Yet, in the long run, you’ll be doing fewer of the things that matter most to other people (or to society) and more of the things that matter most to you [emphasis added]”
“Real self-care is a radical and necessary practice for people of marginalized identities — it’s a strategy for taking power away from predatory systems, bringing it back to yourself, and ultimately enacting change.”
Five things that resonated most
In my own life, I’ve learned to live according to my values only in the last two years — with authenticity, boldness, and deep self-compassion.
Before that, I was beholden to expectations and ‘shoulds’ — my own and others’. I’d routinely work overtime to deliver a promised output on time, upholding a perfectionism and toxic productivity mindset that was unhealthy; I’d skip the things that I knew I needed to stay whole and healthy in order to show up as the perfect worker. In short, I conducted myself in ways that promoted burnout and overwhelm.
Unexpectedly, going back to work after having a baby and knowing that my time before and after the workday was not my own any longer made me invest in real self-care — approaching work and my life in a new way: maintaining my own energy and passion for work while staying balanced and healthy.
I am learning to let go of perfectionistic, black-and-white thinking (this workbook is helping a lot) — becoming comfortable speaking back to my inner critic and telling her when she is wrong — and building self-compassion. I write more about this here:
Most tangibly, when I went back to work, I started putting emphasis on protecting my energy and time, including scheduling in time for therapy, walks (usually to/from daycare), and to decompress after energetically intense work like giving a keynote or writing an article.
And after stepping down as Acting California Surgeon General last year, in this most current career phase, I made sure that I said ‘yes’ only to what deeply resonated with my values and that I could afford energetically and financially: from one-off invitations to speak or do an interview to more long-term commitments like advisory work. I acknowledge the deep privilege that allowed me to take this approach.
I am now fortunate to have built a portfolio of wonderful, part-time engagements in which I am able to leverage my previous learnings and build new expertise around systems work to enhance equity and resilience — while having time to build this community, work on my podcast, the Brainstorm documentary, and to spend meaningful time with loved ones.
In other words, my insides now match my outsides, to use Dr Lakshmin’s words.
My work on real self-care in the last two years meant that much of what I read in this book resonated deeply — giving words to the often imlicit internal work that I have been putting in.
But I think that no matter who you are and where you are on your journey, you are likely to find something new and of value in Dr Lakshmin’s formulation of real self-care.
For me, the nuggets that most popped out during this reading were:
Do not over-explain a boundary. You don’t need to seek permission from anyone for a boundary but yourself.
A boundary arises in putting a ‘pause’ in place between a stimulus and response (such as before responding to an ask made via email).
Most others benefit from our staying small and continually self-sacrificing — and the systems we live in are fundamentally interested in keeping us this way. The person who does not benefit — and, in fact, is harmed by the status quo — is us.
Realizing this and understanding what real self-care can enable is pivotal: Real self-care allows us to regain ownership over our well-being in a fundamental way.
Hope is something that can specifically and systematically be cultivated.
Thank you for writing this deeply helpful and subversive book, Dr Lakshmin!
Wishing you all light,
Dr Devika Bhushan
“Faux self-care keeps us treading water—worn down, tired, and hopeless.
Real self-care is your life raft.
And when enough of us internalize real self-care, the tide finally shifts, and we wake up to the power that’s possible.”
-Dr Pooja Lakshmin, Real Self-Care
This was a great read! Thank you. As I reflect on aligning my life with my values, I realize that it is most important to get clarity on my values. Grinding in the system for so long and aligning with what the system tells me to be aligned with has robbed me of my own internal compass. But with self-compassion, I hope to take the journey of returning to myself. I suppose this is one of my highest values, returning to Self! 🙂. So I can say yes to what creates space for that and no to what doesn't. It will be a journey.