Heather Krantz, MD
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Integrative Self-Care

5/1/2015

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Integrative self-care is a term I coined to describe elements of self-care with an integrative medicine twist.  In order to adequately explain this, I address the “integrative” and the “self-care” terms separately. 

Self-care is about learning to ‘put your own oxygen mask on first.’  We all see the diagram in the seat pocket on the airplane when we fly somewhere.  It reminds us to put our oxygen mask on first before helping others.  I think this is a somewhat counterintuitive concept, especially for mothers.  It is our nature to protect our loved ones before ourselves.  Of course if we pass out from lack of oxygen first, no one survives.  Self-care is about taking care of all the important aspects of ourselves—mind, body, and spirit, as well as health and well being.
 We all live in a stressful world.  There are numerous demands on us coming from all different directions.  We can feel like a hamster on a wheel until we just run out of gas eventually.  The way to keep this from occurring is to realize that “we cannot nurture others from a dry well.  We need to take care of our own needs first, then we can give from our surplus, our abundance.”  (from Jennifer Louden)  Self-care about giving attention to the physical self, the spiritual self, the mental/emotional self, relationships and lifestyle.  It’s about finding equilibrium.  The biggest challenge facing most of us is how to live a balanced life.  This does not mean a life containing no ups and downs, but one with resilience to change.  Resilient people are better able to gather their strength and resources in the face of adversity.  We are most able to do this when we are physically, emotionally, spiritually, and interpersonally supported and nourished.  This is where the “integrative” part enters the picture.

The “integrative” mindset comes from integrative medicine (IM) where the orientation is toward wellness rather than disease or illness.  IM focuses on the body’s natural healing capacity and aims to enhance mind, body, and spirit.  This is really about looking at the whole picture.  It’s about taking a holistic (and I don’t mean just natural or alternative) approach toward health.  It’s about looking at the whole person, in all their uniqueness and complexity, not just their diagnoses.  This leads to the question:  what is health?

The word health comes from the Old English root word hal, which means heal, healthy, whole.  It is interesting that in Western culture and medicine, this is not how we define health.  The Oxford Dictionary defines health as “the state of being free from illness or injury.”  There is a more global and inclusive definition that comes from the World Health Organization.  The WHO defines health as “a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.”  According to this more integrative view, we begin to see a bigger picture—that health is about wellness, well being, thriving, flourishing.  It’s about wholeness—however that is defined by the individual.  This inspires the ultimate question—what make’s you whole?
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The integrative mindset offers a very different way of seeing health and wellness that can impact your life in a profound way.  It bespeaks that healing can be found in the way we live our lives.  Balance is truly the foundation for wholeness.  It emphasizes addressing all the components of our life; they are all important, interconnected and interdependent.  The Wheel of Health from Duke Integrative Medicine illustrates this well.  It shows how integrative medicine attends to health issues, nutrition, exercise and movement, sleep and rest, lifestyle, the physical environment, relationships and communication, spirituality, and the mind-body connection.  At the center is mindful awareness, which involves mindfulness and self-compassion.  Mindful awareness is the core element upon which everything else is built.


The word health comes from the Old English root word hal, which means heal, healthy, whole.  It is interesting that in Western culture and medicine, this is not how we define health.  The Oxford defines health as “the state of being free from illness or injury.” There is a more global and inclusive definition that comes from the World Health Organization.  The WHO defines health as “a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.”  According to this more integrative view, we begin to see a bigger picture—that health is about wellness, well being, thriving, flourishing.  It’s about wholeness—however that is defined by the individual.  This inspires the ultimate question—what make’s you whole? The integrative mindset offers a very different way of seeing health and wellness that can impact your life in a profound way.  It bespeaks that healing can be found in the way we live our lives.  Balance is truly the foundation for wholeness.  It emphasizes addressing all the components of our life; they are all important, interconnected and interdependent.  The Wheel of Health from Duke Integrative Medicine illustrates this well.  It shows how integrative medicine attends to health issues, nutrition, exercise and movement, sleep and rest, lifestyle, the physical environment, relationships and communication, spirituality, and the mind-body connection.  At the center is mindful awareness, which involves mindfulness and self-compassion.  Mindful awareness is the core element upon which everything else is built.

Mindfulness is defined by Jon Kabat-Zinn as paying attention in a particular way:  on purpose, in the present moment, and non-judgmentally.  Mindfulness  is about knowing what you are doing while you are doing it.  It’s about seeing that good stuff and bad stuff come and go in life without necessarily reacting or letting it take control of your life.  It’s about being able to take a step back and put some space between you and your thoughts and feelings.    It is a mindset that allows you to find pause and equanimity among the waves of life.

 Self-compassion is comprised of mindfulness plus self-kindness and a sense of common humanity, according to Kristin Neff, PhD.  Compassion is an inherent human response to suffering that is not often directed toward oneself.  We all share suffering as part of normal human experience.  Being able to direct kindness toward oneself as well as others is fundamental to well being. Being kind to yourself in all the aspects of health and wellness, not just emotionally, is true self-compassion.  Self-compassion and self-care are really flip sides of the same coin.  Understanding this leads to a more integrative holistic view of life where all the parts are important and necessary to make up the multifaceted whole. 

There was a time in childhood when we understood this in a very fundamental way.  Young children have no qualms about kissing their own reflection, hugging themselves, or demanding care for a ‘boo boo”.  We love ourselves unconditionally as children and receive compassion from both others and ourselves.  This changes as we grow older.  We lose that sense of self-kindness.  Regaining this sense of self-compassion is true self-care.   We can best care for others if we care for ourselves first.  We need to put our own oxygen mask on first.
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Heather Krantz, M.D.
Mailing Address:  P.O. Box 6913                               Office Address:  1012 SW Emkay Drive
                               Bend, OR 97708                                                       Bend, OR 97702
(541) 241-2226
HeatherKrantzMD@bendbroadband.com

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