The Self-Care Paradox
The Self-Care Paradox
It’s no secret that women can feel disregarded by mainstream medicine. High maternal mortality rates persist, particularly among black women. Ignorance and apathy around reproductive issues like endometriosis is common. Doctors dismiss conditions that afflict women, like chronic fatigue syndrome, as little more than hysteria. Decades-long exclusion from research on conditions as fundamental as heart disease and pain have contributed to women’s unnecessary suffering—and even death.
It should come as no surprise, then, that women are turning to nontraditional methods to feel better.
In these wellness spaces — spas, retreat centers, practitioners’ offices, or living rooms — women find a gentle touch and a sympathetic ear. Instead of seven minutes of face time with your doctor (during which they might listen to your concerns for only 11 seconds), you get 60 minutes of undivided attention. Bodywork therapists and energy healers take time for you. They tell you that the pain you have is real. You are seen, as the saying goes. You are heard.
Wellness has become a stand-in for many people who have received unsatisfactory care from the medical establishment. But self-care isn’t health care.
The problem is exacerbated when wellness practitioners make overblown claims about products and treatments, couching their practices in pseudoscientific language. Why does a massage need to release your toxins, boost your immune system, and stimulate your colon? Why can’t it just be something that feels good and is relaxing?
“I don’t think we need empirical evidence to justify the pleasure that surrounds [wellness] activities,” says Timothy Caulfield, a professor of health law and science policy at the University of Alberta and the author of Is Gwyneth Paltrow Wrong About Everything? “But increasingly, because people want it to be part of an industry, they want to be able to market it… [T]hey add these layers of noise around it in order to give it that sense of scientific credibility.”
Wellness has co-opted and commodified both Eastern medicine and spirituality, as well as modern health research. It has repackaged philosophical practices and sensible advice into faux-scientific jargon about alkalis, free radicals, and the microbiome and sells it to people at a steep markup. Wellness—as in the opposite of illness—is no longer a human right but a luxury item, and it has developed into a $4.2 trillion industry.
Through its progression, wellness has become a meaningless term. Is it yoga? Therapy? A charcoal detox? A vaginal steam? Proper heart attack knowledge and prevention? A face cream? There should be a distinction between wellness the concept — a set of behaviors, like nutrition and exercise and sleep, that support health — and Wellness™, the industry that relies on claims of toxins to sell you $400 juicers, $90 vitamins, and rose quartz eggs to put in your vagina.
Much of Wellness™, like detoxes, cleanses, and colonics, also looks suspiciously like the diet and cosmetics industries. Three of the largest wellness markets are personal care, beauty, and anti-aging ($1,083 billion); healthy eating, nutrition, and weight loss ($702 billion); and fitness and mind-body ($595 billion). And the movement’s marketing often recycles images and slogans from weight-loss and anti-aging propaganda: Instagram posts of thin, young, Gwyneth Paltrow–esque women tagged with #cleanliving, #fitness, and #motivation.
“We’re under constant pressure to be constantly improving. And a lot of the pressure is on women,” Caulfield says. “It’s almost like you have this moral imperative — if you’re not trying to improve, you’re failing at some level.”
Wellness has become both nurturing and exploitative. It offers a kind of attentive care that many people need and desire. But it’s also a capitalistic system. Advertising exists to convince us that there is always something in our lives that can be enhanced. With Wellness™, the thing that should be upgraded is us. And now, in addition to the old “problems” of extra weight and wrinkles, Wellness™ has convinced people that they have new ailments, like inflammation or a pH imbalance or a blocked colon, that can only be healed by a special massage or diet or crystal.
This doesn’t mean that all of wellness (small w) is without value. Western medicine would do well to return to some of the fundamental principles of wellness, starting with seeing a person as a whole being, not a collection of organs. Taking a holistic approach to improving a person’s quality of life through exercise, nutrition, reduced stress, and a good night’s sleep is also science-backed and effective.
Doctors can also learn from wellness practitioners, most notably when it comes to emotional intelligence and better communication. Online reviews of clinicians rarely mention if the patient was cured or not; rather, they talk about how the doctor made them feel — if they paid attention and listened to their problems. Physicians rightfully assume they know more about the human body than the person they’re examining, but the patient arguably has more expertise about their own body. Doctors need to hear them and believe them when they say something is wrong. That is the first step on a path toward true wellness.
The Self-Care Paradox
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