Carers and Self-Care: A Selfish or Selfless Act?

Carers and Self-Care: A Selfish of Selfless Act?

Quite often I work with carers and when I do I’m deeply moved by their selfless acts of love, compassion, care and devotion and their generous giving in support of the needs of loved ones: family members, relatives and others. However, it seems the giving often comes at the expense of their own health and well-being. Why might that be so, I often wonder? Is it a conscious choice or is it something done without thought or question? Are selfless acts of care-giving an expectation of society or do they arise from personal beliefs about caring for loved ones?

My mind wanders and I reflect on some of the self-management groups I’ve delivered. It’s something I really enjoy, we usually have lots of fun while we learn and sometimes, because of the topic and the issues it raises, things can get pretty challenging. There’s something about running such groups that can open up a whole can of worms, from the issue of personal responsibility through to whether or not the ‘healthcare’ system does in fact provide health care. Whatever worms surface every group has taught me something new, all of them have been very rewarding, and without question the topics we cover have had a positive impact upon the lives of people present.

Many years ago I was taught about the importance of rapport and wherever I go and whoever I’m working with I’ve come to recognise that it’s the foundation of any relationship. In fact I’ve heard it argued that rapport is everything. Sometimes though, once I think I have it, I have to risk breaking it in order to create a space for discussion. A space in which to get people thinking about how things could be different. That make sense?

Anyway, there I was one evening with a lively group of carers and after introductions, a gentle warm-up exercise and some playful banter, things seemed to be going great. We’d be together for up to eight weeks so it was important to make a good start. I asked how things were going and if everyone was okay. They said they were.

Time, I decided, for the potential rapport breaking moment.

So I said ‘I need to share something early on to avoid it being a problem later. That okay?’

A nodding of heads, in a sea of smiling faces, suggested it was.

‘Well the thing is…I’m not sure we can do the self-management stuff because the trouble with you people – carers – is that you seem to have real problems with two tiny words. You also have another problem in that you’re really selfish.’ (please note: saying ‘you people’ always has the potential to break rapport.)

‘Huh!?!’ Came the response. ‘What do you mean?’

‘You seem to have real problems with ‘I’ and ‘no’. And on top of that you’re all really selfish.’

‘Are you serious?’

‘Sure, never been more so. It’s just an observation of course but you lot seem to have real trouble with considering your own needs and a real problem in saying no to any demands from others. And you’re really selfish’

– Some of the comments they threw back at me:

‘How can we possibly be really selfish if we spend so much of our time caring for others? How can we possibly consider our own needs when the people we care for are unwell and for the same reason how can we say no? Wouldn’t we be really selfish if we were putting our own needs first?’

‘Exactly, really selfish.’

‘What are you talking about?’

‘Well, are you telling me that caring is important?’


‘And are you telling me that the people you care for are important?’


‘Does caring for your loved ones make a big difference?’


You want the care you provide to be for the foreseeable future, if not forever, or at least for as long as possible. A life-time perhaps?’


‘And…are you telling me that without you the people you care for would be, erm, in a bit of a pickle?’


‘Well there you go then. I rest my case, ample evidence of your selfishness…’

Now let me tell you, over the years I’ve been on a few training courses aimed at helping me understand people better. (Actually, I really went to try and understand myself better but that’s a whole other story…) What I’ve learned is that apparently when people look at you in a certain way it can mean a certain thing, and what they say and how they say it can provide clues as to how they might be feeling. Sometimes it’s easy to pick up that for example they’re happy with you (this wasn’t the case here) and sometimes it’s easy to pick up something else. Looking out at the group I would say quite a few facial expressions suggested confusion, others a little anger, and I got an overall a sense of rising tension in the room.

Fab, so I continued…

‘Let me ask you something. If you continually made withdrawals from your bank account and made no deposits what’s the likely outcome?’

‘We’d be in debt.’

‘Exactly. So you recognise you cannot spend what you haven’t got? And of course the deeper we get into debt the harder it can be to get out of it. In fact often it becomes so difficult it can lead to all kinds of other problems such as anxiety and stress and depression. A downward spiral.’

‘And if the people you loved and cared for depended on there being funds in the account would you spend it all?’


‘And how helpful would it be if you not only spent it all but you spent more than you had?’

‘Not helpful at all, probably a bit foolish really.’

Sometimes I’ve been known to go off at a tangent and start to share stories and at this point I decided to share one. It’s actually relevant though because it’s a lovely analogy about self-care and also illustrates, beautifully, how something that could be perceived as a selfish act is actually vital to the survival of others. Perhaps you’ve heard it before?

If you’ve ever flown anywhere, with any airline, you’ll know there’s always a pre-flight safety presentation. Part of it includes the air hostess telling you (and demonstrating) that in the event of the air pressure in the cabin falling oxygen masks will automatically drop down from above each seat. Before fitting the mask over anyone else, even the people who are completely unable to care for themselves, you must always, always fit your own mask first.

Why is that? (I know you’re already telling me, but just in case…)

Because if you don’t take care of your own needs first you’ll very quickly be in a position where you’re completely unable to take care of anyone else’s. Actually, perhaps I need to be blunt. You’ll be dead.

So if the people you care for are so important to you how is it that you’re not doing everything in your power to ensure you can continue to be there for them in the long term? I’m accusing you of being really, really selfish for NOT loving, nurturing, and caring for the NUMBER ONE most important person in your life, and theirs. YOU

By not taking the time to consider and support your own health and wellbeing – your account balance or your oxygen – you leave yourself less capable, and perhaps completely unable, to care for others. Doesn’t matter how much you love them, or how much they need you, you’ll be unable.

Really, really selfish…

‘But it still feels wrong to put our own needs before the needs of others. It seems selfish, I feel guilty.’

‘How about feeling guilty about not taking care of yourself? How about feeling selfish for not taking care of yourself enough to ensure you can care for those you love for as long as you possibly can? If you want to do the BIG guilty and selfish trip how about thinking about how you’d feel if you were gone and their care was left to someone else. Someone who, despite how much they were paid and despite how much they cared about people would never care for them in the way that you do and as well as you do?


Time to move on and talk about wellbeing and keeping well. About the little things we can do every day to support our own health and wellbeing AND so that we can then be in a better place to support others.

It really is okay to do that.

Selfish is not the opposite of selfless, particularly so in the context of caring for others. It doesn’t mean putting your own needs first at the expense of others, it means putting your own needs first for the benefit of others. Selfish is the interdependent partner of selfless.

Carers not only contribute a huge amount to the lives of so many others, in doing so they also make an enormous contribution to society, not least by reducing the pressure on an already pressured health care system.

Whilst carers may have a responsibility to care for themselves, society has a responsibility to recognise and acknowledge the contribution carers make. And with that a responsibility to find ways to support them with their own health and wellbeing needs. Recently someone pointed out that because there are costs associated with doing that, in the current economic climate it probably won’t happen, because we cannot afford to.

Really? Well perhaps it would be helpful to consider a different perspective. That we cannot afford not to. That perhaps instead of seeing carer health and wellbeing as a ‘cost’ we consider it an investment and in doing so recognise not only the contribution carers make but also the savings society benefits from.

“When I loved myself enough…I learned to meet my own needs and not call it selfish.”

Kim McMillen