PERSONAL GROWTH

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Self-care *isn't* just yoga and green juice in mason jars.

MENTAL HEALTH & WELLNESS • September 2, 2018

Self-care *isn’t* just yoga and green juice in mason jars.

Bubble baths, mani/pedi’s, Sunday brunch with your girlfriends, candlelit yoga, green juice in mason jars, all of this is wonderful and probably helpful to you and your well-being at multiple levels

I’ll be the first to admit I love all of the above!

But, and I realize this is perhaps a little controversial to say, in my personal and professional opinion, this is not what fundamental self-care really is.

To learn what I do think actually counts as fundamental self-care, keep reading.

Think of yourself as a house.

I think it can be quite helpful to think of ourselves and our psyches – the human soul or spirit – as a proverbial house.

When imagining this house, I invite you to envision multiple levels, let’s say three – a basement, a first floor, and a second floor.

These floors represent various aspects of you. The house is reflective of yourself, your own personality. And how you care for your self.

Now, let’s imagine for instance, that you moved into this actual, real multi-level house.

But let’s also imagine you wanted to spend all of your time and energy decorating the first and second floor, painting the walls creamy colors and ordering furniture to make your space pretty.

You had no interest in investigating or spending time in the basement or even really knowing what’s going on down there.

You, instead, prefer to focus on the prettier, more tangible things upstairs.

But let’s also imagine the basement of your house had a cracked and leaking foundation, sump pump problems, some mold, and maybe even a growing family of rats who has taken up residence down there.

Those are some pretty big problems!

But if you never went into the basement to check it out and invest the time, energy, and yes, even finances, into resolving those issues, how liveable do you think the other floors of your house are going to be in the long-term?

You know as well as I do that all the pretty paint and furniture can’t make up for a house that’s structurally unsound or unsafe.

So why am I bringing up fundamental self-care?

Because often I think that self-care gets co-opted to look like all the activities and actions we take to “decorate” the liveable floors – the mani/pedis, the bubble baths, etc. – when really, these activities should come secondary to the self-care work that’s truly needed which is making sure the foundation and structure of our proverbial “house” is safe and whole and strong.

So what does make our foundation solid and strong?

In my personal and professional opinion, fundamental self-care is an investment we make in getting to know and support ourselves and living that awareness out in congruence in the world through career, boundaries, self-expression, and other life choices that support our most fundamental well-being and integrity.

Fundamental self-care, in my opinion, may look like doing the often “unsexy,” often unglamorous “basic” work of confronting your personal psychological history and healing from any unprocessed traumas or grief you may have avoided so that you are not “owned” or “run” by your past.

Fundamental self-care may look learning the necessary developmental life and relational tasks and skills you may have never learned.

Like knowing how to hold firm and appropriate boundaries. Or what a healthy, functional relationship looks like. So that you can create more healthy, fulfilling relationships in your life.

Fundamental self-care may look like investing in a career path that truly fits and fulfills you. (Versus one which you think you “should” take. And investing the time, energy, and even finances into achieving this.

Fundamental self-care may look like removing yourself from toxic, painful people in your life. (Even and maybe especially if they are family-of-origin members!) And, instead, surrounding yourself with people who are truly good to you. Who can show up in functional and appropriate ways.

Fundamental self-care may look like not tolerating disrespect. Not acting or contorting yourself in ways to make others more comfortable, and, instead, showing up authentically as you are and requiring respect and dignity when people interact with you.

Fundamental self-care may look like finally learning how to manage your money responsibly so that you can ensure a strong financial future for yourself.

Fundamental self-care may look like facing the reality of your withering romantic relationship, the professional dead-end you are encountering at work, the numbers on the blood pressure cuff, the unopened mail from the IRS, the little voice at the back of your mind which, despite your efforts to silence it, says, “something is not right here!”

In my work with clients, I see this pattern constantly: driven women who have mastered every professional skill imaginable but who were never given a roadmap for the internal, relational, and emotional competencies that make life actually liveable. The developmental skills that should have been transmitted in childhood — how to identify and name your feelings, how to ask for what you need, how to repair ruptures in relationships, how to hold a firm and loving boundary simultaneously — these aren’t innate. They’re learned. And when they’re not taught, the absence doesn’t announce itself. It shows up as chronic relationship difficulty, a persistent feeling that something is missing despite external success, or a tendency to either over-function in relationships or disappear from them entirely.

Priya is a 41-year-old fintech executive in San Francisco. She manages a team of thirty, negotiates multimillion-dollar partnerships, and never misses a deadline. In our work together, she recognized that she had absolutely no template for what a healthy conflict resolution looked like. Her parents never modeled disagreement that ended in repair — arguments in her house either escalated into silence or were swept under the rug entirely. So Priya learned, very early, that conflict meant rupture. That disagreement meant the end of connection. This belief ran every important relationship she had — with partners, with her team, with herself. Fundamental self-care for Priya didn’t mean finding a better meditation app. It meant, slowly and painstakingly, learning that conflict could be a bridge instead of a wall. (Name and details have been changed.)

What Bessel van der Kolk, MD, psychiatrist and trauma researcher and author of The Body Keeps the Score, makes clear in his decades of clinical work is that trauma recovery isn’t primarily an intellectual exercise — it’s a physiological and relational one. Fundamental self-care, in this sense, often involves learning to inhabit your own body again. To notice when your chest tightens before a difficult conversation. To recognize the particular quality of the silence in a room that tells you something important is happening. To trust the information your body is giving you, rather than overriding it with performance and productivity.

Fundamental self-care may also look like grieving. Grieving the childhood you didn’t get, the relationships that didn’t work the way you needed them to, the version of yourself who had to become so capable so early. Delayed grief is extraordinarily common in driven women — the mourning gets deferred again and again in favor of the next deadline, the next responsibility. But it doesn’t disappear. It sits in the basement of your house, accumulating, until it finds another way out — through anxiety, through physical symptoms, through the relational patterns that keep repeating no matter how many new partners or workplaces you move through.

At the end of the day, fundamental self-care looks like confronting reality.

And sometimes (or often) making hard choices about what you need to do in order to live your life in a more sane, safe, and fulfilling way.

When we do this level of fundamental self-care work, we are, proverbially, cleaning out the “basement”, repairing the foundation and working on the structural issues holding up our house to ensure that the other floors of our “house” are sustainable in the long term.

If we focus just on decorating the top two floors through a roster of nice-but-not-necessary self-care activities and don’t focus on the basement, we may be ultimately distracting and self-sabotaging ourselves.

And that’s not self-care.

But of course, if you’re working on all levels – doing the deeper psychological and logistical work “basement work” to support your well-being in life AND you are nourishing yourself with yoga, green juice and the like on the “upper levels”, that can be wonderful!

And honestly, those lovely treats can often make the “basement level” work more palatable.

Just remember, until we tackle the basement and foundation of our house, all the bubble baths in the world aren’t going to help you live in a truly, fundamentally self-caring way.

What I see consistently in my practice is that the women who make the most durable, meaningful changes in their lives are not necessarily the ones who work the hardest or try the most things. They are the ones who become willing to look clearly at the gap between the life they’re living and the life they actually need. That gap — between the relationship that isn’t working, the career that stopped fitting years ago, the body that’s been ignored, the financial reality that’s been avoided — is the basement of the house. And no amount of decoration upstairs will change what’s happening down there.

What does confronting reality actually require? It requires, first, a willingness to slow down enough to feel what’s actually true. For driven, ambitious women who have built entire identities around forward momentum, this can feel like the most counterintuitive thing in the world. Slowing down can feel like failure. Sitting with uncertainty can feel like incompetence. But the women I work with who do this — who get genuinely quiet enough to hear what their own nervous system and their own heart are telling them — consistently report that the answers were never the problem. They knew what was true. They’d just been running from it.

Fundamental self-care also looks like building support structures that match the actual weight you’re carrying. It’s not weakness to need therapy. It’s not indulgence to need coaching, community, or genuinely restorative relationships. What I find, in working with driven women, is that they are often incredibly resourceful on behalf of everyone around them — their teams, their families, their clients — and remarkably under-resourced when it comes to their own care. Fundamental self-care is about reversing that equation: investing in yourself at the level you invest in everything else you value.

The cultural water that ambitious women swim in deserves naming explicitly. Joan C. Williams, JD, distinguished professor at UC Hastings College of Law, has documented extensively how women in high-status professions face what she calls the “double bind” — judged harshly when they’re warm (read as not competent enough) and judged harshly when they’re competent (read as not warm enough). Add a relational trauma history to that bind, and the inner monitoring becomes nearly continuous. Healing has to include a clear-eyed look at how much of the exhaustion isn’t yours alone — it’s a load you’ve been carrying for systems that were never designed to hold you.

What moving forward actually looks like — and what it doesn’t.

I hope that you found this post helpful and that, maybe, it even caused you to see the self-care work you do or need to do in your life in a different way.

And now I’d love to hear from you in the comments below:

Leave a message in the comments below so our community of blog readers can benefit from your wisdom.

The path forward starts with an honest assessment of where you are. Not a self-critical inventory of everything you’ve done wrong, but a clear-eyed acknowledgment of what your house looks like right now — which floors are liveable, and what’s genuinely going on in the basement. This kind of assessment is best done with support: a skilled therapist, a coach who understands relational trauma, a community of women who are doing this same work. You don’t have to diagnose your own foundation in isolation.

From there, the work tends to move in three directions simultaneously. First: processing what’s already happened. The unprocessed grief, the old stories, the ways your nervous system learned to protect you that no longer serve. This is therapy work — slow, specific, relational. Second: building new capacities. The skills you didn’t get. Emotional literacy. Healthy boundaries. The ability to stay present in conflict without either collapsing or escalating. The capacity to ask for what you need without it feeling like a dangerous gamble. Third: making changes in your external life that align with your internal reality. The relationship that needs an honest conversation. The career decision you’ve been avoiding. The financial situation that deserves your actual attention.

None of this is linear. None of it is fast. But it’s the only kind of self-care that actually builds a foundation instead of painting over one that’s crumbling. And that’s what I want for you — not just a prettier surface, but a life that can actually hold the weight of everything you’re carrying. If you’re ready to begin that work, schedule a conversation here.

Here’s to healing relational trauma and creating thriving lives on solid foundations.

Warmly,

Annie

Frequently Asked Questions

This is part of our comprehensive guide on this topic. For the full picture, read: The Complete Guide to Relational Trauma.

You deserve a life that feels as good as it looks. Let’s work on that together.

References

• Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. Norton Series on Interpersonal Neurobiology.
• van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books.
• Siegel, D. J. (2012). The developing mind: How relationships and the brain interact to shape who we are. Guilford Press.
• Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books.
• Cozolino, L. (2016). The neuroscience of human relationships: Attachment and the developing social brain. W. W. Norton & Company.
• Brown, B. (2012). Daring greatly: How the courage to be vulnerable transforms the way we live, love, parent, and lead. Gotham Books.
• Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. Basic Books.

Camille is a 36-year-old emergency medicine physician in Boston. She arrived at therapy having read everything — the research on burnout, the polyvagal theory, the literature on compassion fatigue. She’d done the yoga. She’d taken the weekend retreat. She’d started the gratitude journal. And she was still lying awake at 2 a.m., unable to turn off the clinical review that ran in her head like a background program she couldn’t close. What she hadn’t done — what all the wellness culture around her had never told her to do — was address the psychological material underneath the exhaustion. Fundamental self-care, she came to understand, begins where the yoga mat ends. (Name and details have been changed.)

Both/And: You Can Be in Recovery and Still Have Hard Days

Driven women often approach healing the way they approach everything else: with goals, timelines, and measurable benchmarks. They want to know how long therapy will take, what “done” looks like, and whether they’re doing it right. I understand the impulse — it’s the same competence that built their careers. But healing from relational trauma doesn’t follow a project management timeline, and treating it like one can become its own form of avoidance. (PMID: 9384857)

Elena is a corporate attorney who, after eight months of therapy, told me she was frustrated with her progress. “I still got triggered last week,” she said, as though a single difficult moment erased months of genuine change. What Elena hadn’t noticed — because she was measuring against perfection — was that the trigger resolved in hours instead of days, that she reached out for support instead of isolating, and that she could name what happened in her body instead of just pushing through.

Both/And means Elena can be making real, measurable progress and still have moments where the old patterns surface. It means healing isn’t a straight line, and a setback doesn’t erase the foundation she’s built. For driven women, this is perhaps the most radical reframe: that effectiveness in recovery isn’t about eliminating hard days. It’s about changing your relationship to them when they come.

The Systemic Lens: The Structural Barriers to Real Healing

The wellness and self-improvement industries generate billions of dollars annually by selling driven women solutions to problems those industries have no interest in solving. Heal your trauma — but not so thoroughly that you stop buying products. Practice self-care — within the narrow window your 60-hour work week allows. Find balance — in a system designed to extract maximum output from every waking hour.

For driven women pursuing genuine healing, the systemic barriers are real. Therapy is expensive, and many of the most effective trauma treatments require multiple sessions per week — a financial and logistical impossibility for many. Insurance covers a fraction of what’s needed, and the most skilled trauma therapists rarely accept insurance at all. Workplace cultures punish vulnerability, making it difficult to prioritize mental health without career risk. Even the language of healing has been co-opted: “boundaries” becomes a buzzword stripped of its clinical meaning, and “doing the work” becomes a social media aesthetic rather than the slow, unglamorous process it actually is.

In my practice, I name these systemic barriers because pretending they don’t exist places an unfair burden on the woman doing the healing. Your recovery isn’t happening in a supportive cultural container. It’s happening despite a culture that simultaneously tells you to heal and makes it structurally difficult to do so. Acknowledging that isn’t defeatism — it’s realism, and it’s the starting point for building a recovery plan that accounts for the actual conditions of your life.

If what you’ve read here resonates, I want you to know that individual therapy and executive coaching are available for driven women ready to do this work. You can also explore my self-paced recovery courses or schedule a complimentary consultation to find the right fit.

What I see consistently in my work with driven, ambitious women is that the body holds the truth long before the mind catches up. By the time a client lands in my office describing what isn’t working, her nervous system has been signaling for months — sometimes years. The tightness in her jaw at 3 a.m., the way her shoulders climb toward her ears during certain conversations, the unexplained fatigue that no amount of sleep seems to touch. These aren’t separate problems. They’re a single integrated story the body is telling about an emotional terrain the conscious mind hasn’t been able to face yet.

Medical Disclaimer