Psychiatrist and Real Self-Care author Pooja Lakshmin joins us to discuss her experiences with faux self-care and toxic wellness culture, her definition of real self-care and how it can fit into your life, the importance of setting boundaries (and what that actually looks like), how to tell if you need self-care or professional help, and more.
Dr. Pooja Lakshmin MD is a psychiatrist and author, the founder of the women’s mental health platform Gemma, and a contributor to The New York Times. Her new book, REAL SELF-CARE (Crystals, Cleanses, and Bubble-Baths Not Included), a national bestseller, has been featured by Good Morning America, NPR’s Code Switch, The New York Times, Vox, The Guardian, and translated into 8 languages. Pooja serves as a clinical assistant professor of psychiatry at George Washington University School of Medicine, and maintains an active private practice where she treats women struggling with burnout, perfectionism, and disillusionment, as well as clinical conditions like depression, anxiety and ADHD. She frequently speaks, advises and consults for organizations on mental health, well-being, and real self-care for employee wellness and for brand social impact initiatives. Her clients include Peloton, LinkedIn, TheNew York Times, 23andMe, Edelman, Pearson, McKinsey, Memorial Sloan Kettering and more. Learn more about her work at poojalakshmin.com, and subscribe to her fabulous Therapy Takeaway newsletter on Substack.
Resources and References
Pooja’s book, Real Self-Care
Pooja’s Therapy Takeaway newsletter on Substack
Christy’s latest book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses and Find Your True Well-Being
Subscribe on Substack for bonus episodes and more
Christy’s online course, Intuitive Eating Fundamentals
Transcript
Disclaimer: The below transcription is primarily rendered by AI, so errors may have occurred. The original audio file is available above.
Christy Harrison: Welcome to Rethinking Wellness, a podcast exploring the diet culture, disinformation, dubious diagnoses, and disordered eating that are so pervasive in contemporary wellness culture--and how to avoid falling into these traps so that you can find your own true well-being.
I’m your host Christy Harrison and I’m a registered dietitian, certified intuitive eating counselor, journalist, and author of the books Anti-Diet, which was published in 2019, and The Wellness Trap, which came out on April 25th and is now available wherever books are sold. You can learn more and order it now at christyharrison.com/thewellnesstrap.
Hey there! Welcome back to Rethinking Wellness. I’m Christy, and my guest today is psychiatrist and Real Self-Care author Pooja Lakshmin, who joins me to discuss her experiences with faux self-care and toxic wellness culture, her definition of real self-care and how it can fit into your life, the importance of setting boundaries (and what that actually looks like), how to tell if you need self-care or professional help, and more.
It's a great conversation. It's especially relevant because as I'm recording this, I'm in the midst of childcare limbo and my schedule is totally thrown out of whack and Pooja and I talk about the issues with the lack of paid childcare in this country and how that affects people and the stress that it causes, and I'm living that right now and feeling so low energy. So apologies if this intro sounds like a bit of a downer, but I think it's a really great conversation that we had and talking about some of the systemic issues for why people feel so burnt out and why faux self-care just isn't the solution. So I can't wait to share the interview with you shortly. Before I do, just a few quick announcements.
This podcast is made possible by my paid subscribers at rethinkingwellness.substack.com. Not only do paid subscriptions help support the show and keep me able to make the best free content I possibly can, daycare snafus notwithstanding, but they also get you great perks like early access to every episode, bonus episodes (including one I did with this week’s guest), biweekly bonus Q&As, subscriber-only comment threads where you can connect with other listeners, and so much more. Just go to rethinkingwellness.substack.com to sign up. That’s rethinkingwellness.substack.com.
This podcast is brought to you by my second book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses and Find Your True Well-Being, which is now available wherever books are sold! It explores so many of the themes we talk about on this podcast, including the connections between diet culture and wellness culture; how the wellness space became overrun with scams, misinformation, and conspiracy theories; why many popular alternative-medicine diagnoses are misleading and harmful—and what we can do instead to create a society that promotes true well-being. Just go to christyharrison.com/thewellnesstrap to learn more and buy the book. That’s christyharrison.com/thewellnesstrap. Or you can just pop into your favorite local bookstore and ask for it there.
Now without any further ado, let's go to my conversation with Pooja Lakshmin. So Pooja, welcome to the show. I'm so happy to have you on Rethinking Wellness.
Pooja Lakshmin: Thank you so much for having me, Christy.
Christy Harrison: I'll have given listeners a brief bio of you in the introduction, so they'll know at this point that you're a psychiatrist and the author of the book Real Self-Care, but many of us, you've also had a whole journey of your own with faux self-care and toxic wellness culture. I'd love to start there since I know many listeners can relate to that, myself included. I've also heard you say that those experiences really deeply informed the work you do today. I'm curious to hear what aspects of wellness culture you got caught up in and why you think they were appealing to you.
Pooja Lakshmin: Yeah, I love how you asked that question because I think it is actually. So while my story is quite extreme, the seeds of it I think really resonate with everybody in that we all know what it feels like to think that there is some sort of magic answer and to believe that so deeply, and many of us also know what it feels like to kind of be heartbroken by that. So my journey started a little more than a decade ago, so I am now 39, almost 40, but back in my late twenties, I found myself kind of having checked off all the things that I was supposed to do by that time as a good first generation Indian girl, woman, really, I'd been valedictorian of my high school, went to an Ivy League college, got into medical school, got married. So I found myself as a second year psychiatry resident sort of being like, okay, well now I can figure out how to be happy.
I did everything I was supposed to and that didn't work. And at that time I was also going through a grueling psychiatry training and really disillusioned with mainstream allopathic psychiatry and how it was practiced. And to be clear, I've had my own journey with that. I am practicing. I have a private practice now. I am a psychiatrist. Spoiler. Earlier I did go back to medicine, but I was really angry because I had become a doctor and I thought naively that being a doctor meant that I would be able to fix all of my patient's problems. But turned out that that's not true. There's actually lots and lots of problems patients have that I can't fix. I can't get somebody their job back when they've been discriminated against for being pregnant. When I was working in an er, somebody comes in, that's unhoused, I can't get them housing.
There's just so much. So anyway, so I blew up my life. I left my marriage and I found this commune, this group in San Francisco that was very focused on spirituality and meditation and sexuality. It was based on female orgasm, and I dropped out of my residency training program and I spent almost two years with this group. By the end, I realized that the wellness world, the woo woo world has just as many contradictions and hypocrisies as mainstream medicine. There's bad actors everywhere. I made the mistake of believing that there could be one easy, magical solution and came to find that that was not true. And so I left and ultimately I turned 30 in my, I write about this in the book, I turned 30 in my old childhood bedroom, my parents' house. It was a very difficult time, but ultimately kind of coming back and facing my failure and coming back to medicine, finishing my training, graduating from George Washington University, coming on the faculty and really has made me who I am now. Yeah, I guess that's sort of the long and short of it.
Christy Harrison: How has your view changed of wellness culture having gone through that experience?
Pooja Lakshmin: Well, I think on one hand I have a huge amount of compassion for the folks who find themselves in an M l m or who are jumping from the latest juice cleanse to juice cleanse to the essential oils, I guess. I think it's really easy to sort of roll our eyes. If you have a certain level of education and a certain level of privilege, it's really easy to think of those, those people as less than or stupid or foolish. But the reality is that people who get sucked into these types of scams, they're not stupid. And there's a lot missing from mainstream medicine that has folks be vulnerable to the seduction of the easy solutions. I can't remember what your original question was, but hopefully I answered it
Christy Harrison: For sure.
Pooja Lakshmin: And you'll notice I have a tendency to sort of wind around. So
Christy Harrison: Yeah, I love it. I do too, and I feel like that's the best kind of conversation. And it's so interesting to me not only thinking about who gets sucked into these kinds of things, because I also thought a lot about that and writing my book and with my own past experiences of being sucked in, I think of myself as science minded and pretty smart and educated, and I have skepticism about a lot of things. And yet there were certain areas of my life where I didn't have skepticism and things that I just really, I was vulnerable to the messaging. I was vulnerable to false promises because I wasn't getting promises and answers and solutions in the conventional healthcare system. And sometimes people who are really driven and look for answers on their own and sort of like a dog with a bone about a particular issue, which I definitely am, I went down the rabbit hole to try to find answers.
And I think that kind of personality type almost makes people more vulnerable in some cases. And I'm just struck by your background as someone who you said checked all the boxes, valedictorian, ivy league school doctor, all of these things have such prestige in our society and such many of us are conditioned to think of doctors as very Scientific and sort of infallible and arbiters of what's true and real and evidence-based or whatever. And to know that doctors are just as vulnerable as the rest of us, and depending on what's going on in your life, you can be more vulnerable to these sorts of pitches and scams. And as you said in the book, OC Cult really, I think that's just important for people to know and understand that even doctors are people to, in this way, even doctors can be susceptible to this stuff.
Pooja Lakshmin: And I think that that's become a big part of my line of thinking and exploration in the years since that time of my life bringing humanism back to medicine. And that was one of the reasons that I got on social media to begin with. I was kind of Burnt out in my academic job and wanted a place to get my voice out. And so I started on Instagram kind of micro-blogging, maybe you could call it, and that was a way for me to just be Pooja. And that's taken me to lots of different places, writing for The, New, York, Times, writing a book. And I'm still kind of continuing to figure out how to navigate that because I am Dr. Lachman to my patients, but I'm also just Pooja. So I think it'll be kind of a lifelong journey as it were. But I think one of the things that you said that really stands out to me, Christy, is that word answer, wanting to know the answer and really sort of believing that there is one answer when in fact, for so much of, if we're just talking about health for so much of health and wellbeing, there are many answers.
And it's certainly true that there are some bad and wrong answers for sure. This is not to say that everything is gray. There are things that we know are not good for you, but the spectrum of what might work is never just one thing. And I think that when you're dealing with any type of life stressor, whether that's divorce, whether that's losing a job, whether that's a loved one who is sick, you're just so much more vulnerable to wanting control and just wanting to know and really believing that it can be that simple.
Christy Harrison: Totally. Well, I'd love to talk a little bit about the terms you define in your book and how this relates to that because you talk in the book about faux self-care versus real self-care. Obviously the title of the book is real. How do you distinguish those terms and what do you see as the reasons that people turn to faux self-care get sucked in?
Pooja Lakshmin: Yeah, so the sub subtitle of the book is Crystals cleanses and Bubble Baths Not Included, which my agent thought of actually, I thought it was brilliant. It's a little cheeky, but I think that I wanted something to signal upfront as soon as people picked up the book that we were going to a different place. And so I use the word or the term faux self-care to describe the commercial oriented ways that we've come to think about. So that's like the scented candle, the essential oils, the bubble bath, the juice cleanse, something that you purchase, usually something that you're doing or buying. It usually keeps the status quo in your relationships. It doesn't require you to think more deeply and change the way that you engage in your marriage, your parenting, your workplace, your community. It comes from outside of you. It's something that you're doing or buying.
It's not that it's bad, it's that it's a tool. And I reframe this as real self-care is a principle. So a tool is something that serves you for a certain period of time and a certain circumstance, whereas a principle can be applied widely and a principle is something that is internal. And so I came up with these four core principles of real self-care. And this is coming from not only what I see in working with patients, but also in the concept of onic wellbeing, which we can talk about. And so the four principles are boundaries, compassion, values, and power. And those are all processes that you do on the inside in order to get to a tool. So it's not that the bubble bath is wrong because there's plenty of people out there that are like, wait, wait, wait, Pooja, I love yoga, and there's lots of evidence for meditation. I'm not knocking anyone's meditation practice. It's that it's actually real. Self-care is about the internal process you take to get to the thing. It's not the thing because over the course of your life, the things are always changing, and when you just make it a concrete form of a thing, you're actually not doing all of that internal work.
Christy Harrison: So when you're like, I have to meditate to let off steam or something, or it's like a release valve almost from an unsustainable life, that's not necessarily real self-care when you're like, let me clear space for meditation or let me clear space in my life to take care of myself. And then meditation is the thing you want to do with that space. That's a whole different orientation towards it.
Pooja Lakshmin: Exactly, exactly. Real self-care can never be just taking 15 minutes out of your day to check mark box one thing that you heard on a podcast that you're supposed to do. And so now you're going to do it for a week and feel really good about yourself, but then two weeks later, life is going to get busy and you're going to fall off. So real self-care is actually working through those principles about how do I set boundaries, how do I talk to myself with more compassion, really figuring out what matters most to me, and then understanding that this is all the way that you exert power over a system that is not designed for you. That whole process is then threaded through your whole life and all of your decisions.
Christy Harrison: Let's talk a little bit more about that systemic aspect of it. What do you think some of the systemic issues are that people are using fo self-care as a release valve for maybe a bandaid for, and what are some genuine ways of addressing those issues?
Pooja Lakshmin: So my clinical practice, my private practice is focused on perinatal psychiatry. So most of my patients are pregnant and postpartum women. So issue social issues like paid parental leave, federally mandated paid parental leave, which we still don't have in the United States, which I'm sure everybody that listens to your show knows that by now because we're all screaming about it. Affordable childcare, universal pre-k, accessible, affordable health insurance that actually covers mental health. So all of these sort of what we think of as social safety net programs, our government, our society has collectively devalued all of that resource and put the burden of wellbeing on the individual. And one of the things that I often say is you can't meditate your way out of a 40 hour work week with no childcare. That's not the answer. That's not how wellness should work. Now, you could say that the answer is solely top down, that this is all about changing our laws and funding programs, and that's not incorrect.
But I also think that it's a both and approach that we need this internal process and that individuals do have agency in getting to a place where they can lead to collective action, whether that is the mom who sets a boundary in her home life and that leads to her or her partner getting paid parental leave that perhaps would not have if the individual did not first move through the process of understanding that the problem was outside of them and they needed external help. And then I think there's also the really important background to this, which is that self-care in the political sense was birthed by black queer thinkers. So Audrey Lorde, bell Hooks, no, Audrey Lorde said, self-care is self-preservation. And I quote her three or four times in my book that it's not an accident that's sort of the people that are the most oppressed keep being asked to do the most work. So that means that folks that have more privilege really do need to be examining that privilege, just part of the power principle in real self-care and looking where they can give back and where they can fit in.
Christy Harrison: Related to this distinction that you made about tools versus principles, I'm curious how you see wellness culture approaches fitting in. You touched on that a little bit with meditation, which is evidence-based or yoga, another evidence-based thing. But I'm curious if you think there's a role at all for more woo woo things out there, things maybe that aren't fitting into real self-care and how you'd encourage people to relate to them if they do.
Pooja Lakshmin: Yeah, it's funny that you asked me that because when I was writing the book, I was going through fertility treatments to try and get pregnant, and I was also getting reiki, which is so woowoo, and so I was trying to figure out how do I talk about this in the book? So there's a section that's like, well, what if I really like the woowoo stuff? Because for me, the reiki, it is a way for me to, one, get out of my house. I work from home to be in a nice quiet environment that smells nice with somebody who is putting very compassionate, loving attention on me for an hour, and it gets me out of my mind and into my body. And that, I think if as long as you understand that that is not going to, let's say cure cancer or treat your depression, and I have a history of depression, I take antidepressants, I'm also in therapy. But if you know what the tool is used for and also that you're not spending too much money on it, I think that's okay. I think it's when your expectations are outsized and you are sacrificing too much and you don't have clear boundaries over what this activity or this group can do for you, that's when you run into problems.
Christy Harrison: I like that distinction and that sort of notion of boundaries, again, bringing that into how you relate to these things. Yeah, I think reiki practitioners or Reiki advocates might say, it has all these benefits and here are all the things that it does. And if you really buy into that, then I can see that being problematic and also kind of potentially leading down rabbit holes to other things that are not evidence-based and could be harmful. And if you can relate to it in a way that's like, well, this is just a fun, relaxing, nice thing I'm doing for myself, I think of how I've experienced acupuncture as well. I've only done it a couple of times. But it's funny, I had a friend who swore by it, recommended it to me, and at the time I was like, oh, I think there's an evidence base for this, so I'll give it a try. Didn't look it up or anything. It just went, had a wonderful relaxing first session. And then at the end felt like the back pain that I had been experiencing for weeks was suddenly resolved. And I was like, this is amazing. Let me look at PubMed and see what the acupuncture research says. And was like, oh, oh, interesting. It's very mixed. Not a lot of good evidence, maybe mostly placebo and
Pooja Lakshmin: Placebo's great to be clear.
Christy Harrison: But placebo is great. Yeah, placebo can be really great when it's harnessed in a useful way when it's not duping people out of their money or something like that.
Pooja Lakshmin: And I think that also an important point too, is that you're not using it as a substitute for evidence-based care. So especially when we're talking about mental health, that you're still going to therapy, that if medication is something that is part of your treatment program, you're still taking it, right? That you don't believe that this non-evidence based tool is going to cure whatever condition you're struggling with. And I think maybe part of this is getting back to the both and which is a critical aspect of real self-care both. And the problem is systemic, and there are individual actions that we can implement to buffer ourselves both. And you can perhaps find, you might be somebody who finds some woo woo things to be fun and just generally feel good. It's okay as long as you're doing it mindfully and understanding what you're expecting and how much is costing you. And when I say costing, I mean financially, but also socially, emotionally as well.
Christy Harrison: Yeah, that's such a good point. I often think too about not proselytizing,
Pooja Lakshmin: And I think that when you find folks who are proselytizing, that is a red flag and not all of it is malicious. I think sometimes just as a person who lives in the world, you find something that you really like and really works and you're kind of like, oh my God, guys, this is great. You should really try it. I think that's fairly innocent, but then there's of course people that are making a lot of money off of this stuff,
Christy Harrison: And that's where it becomes,
Pooja Lakshmin: That's different,
Christy Harrison: Problematic or even not necessarily making money, but gaining influence, gaining followers, and becoming known for something that is not actually evidence-based.
Pooja Lakshmin: And I think that comes back to one of the things that's come up a lot with real self-care in these conversations is the issue that real self-care takes time. It's not something that you do in a day, a week, a month, a year. It's something that you're constantly learning and relearning. Whereas with the faux solutions and wellness culture and social media culture, we're just so indoctrinated to believe that there's a quick fix and to get that sugar high of like, oh, okay, I have the answer. I solved this problem. I think we have to really just constantly be, I don't want to say vigilant. I think that that word is maybe a little bit too strong, but I think mindful is the right word that we always have to be mindful that none of this is short term.
Christy Harrison: Yeah, it's a practice. I mean, I definitely understand the feeling of wanting it to be short term, wanting someone to have the solution. And I remember in my days of struggling to get a diagnosis or multiple Diagnoses, that ended up being for what was going on with me, I was like, if it's just gluten and I can just take this out of my diet and feel better, then that'll be amazing. That'll give me exactly what I am seeking and not finding, not that I had this language back then, but in the conventional healthcare system, it was not giving me what I needed. And so the promise that something could come along and be as simple as just changing the carb products you buy or whatever, that felt incredibly appealing and hopeful. So I get wanting to have that quick fix solution, and I think that desire and that hope is so weaponized against us and used to sell things and to rote people into things that are really not in their best interest.
Pooja Lakshmin: Well, I think it capitalizes on the sort of childlike fantasies that we all have, that you can get something for nothing. And I'm just thinking in your book, you have the acronym sift, stop investigate, find better coverage, and then tracing the claims and the quotes and things like that. And I think I would say kind of when we're talking about better coverage, that any source that is just being very dogmatic about this is the one right way and this is the only way should really trigger some spidey hairs on the back of your neck.
Christy Harrison: It's interesting with this day and age of social media and thinking about what sells and what does, well, I wrote in the book about how I was very pulled to this black and white sort of way of speaking and writing and thinking by social media, not that I probably didn't already have that tendency to begin with, but as many of us do. But I think that the things that get rewarded and it sort of incentivizes us to be more strident and less nuanced. And so I think it can be tricky sometimes. I feel like I've seen even people I really admire get sucked into this very strident one right way of thinking, maybe about particular subjects or maybe across the board sometimes. And it's frustrating because even relatively nuanced thinkers can still fall prey to that.
Pooja Lakshmin: And I appreciate you saying that, Christy, because I think totally, and as someone who like you is sort of navigating this media space and having a public role and persona, I try to be nuanced, but certainly there's probably times where I fall into it too, almost about nuance being strident about that. And I think maybe the takeaway there is that it's okay for us to make mistakes and to acknowledge them and to evolve and change, and that to admit, oh, yeah, actually that wasn't the best way to frame this, and I've been thinking about it more and this is what I've come around to. But I think it requires trusting your audience to be able to go there with you. But I think from what I've seen, I think that not to make this a media podcast show, but that's what an audience actually really craves. They want to see that we're thinking through these hard things with them as well, and you're kind of in it alongside them.
Christy Harrison: That's really helpful. Yeah, I think you're right. The incentives of social media and of the attention economy in general are sort of pushing in one direction, but there is an appetite for nuance as well. And I think we see that with Substack too. There's such long form emails and media that I see sometimes people who subscribe to my Substack become paid subscribers. Thank you to everyone who's listening who's done that. I'll see the other ones they've subscribed to. Substack sends you an email and says, also subscribes to such and such, and sometimes it'll be like plus 50 other Substack. And I'm like, wow, that's amazing that people are taking the time to read this in this kind of depth. Not that they're necessarily reading every single one of those 50 every week, but it just shows that there is an appetite for that, I think.
Pooja Lakshmin: Right. And I think that that also in kind of getting back to this vein of what is actually real and sustainable when we're talking about wellbeing and wellness, that on the other side too, that making content that is nuanced and going past the superficial sugar high is what actually stands the test time too. That is much more sustainable. And maybe it's not going to give you the big quick hits and the spikes, but it's going to attract the people who really want to have a thoughtful and long-term conversation,
Christy Harrison: Which is so what I'm here for, that's what I want, and my career. And it seems like. Yeah, for sure.
Pooja Lakshmin: And I kind of had to struggle with that with real self-care because I never really expected to write a self-help book. And the proposal for this book actually was much more sort of problem focused and more big think systems of oppression and talking about betrayal, not burnout on the vein of my New York Times writing. But then once I got started writing, I was working with an editor who was helping me, a freelance editor, and I got started writing it was writing the drafts of the chapters. What kept coming out actually was prescriptive. It felt like I was talking to my patients and I kept coming up with all these little exercises and things, which seemed like I was like, wait, I don't think of myself that way. But then I realized that that's the way that I could be most helpful because there's only so many patients that I can see. And another way to reach people is through a book that maybe obviously is not the same as therapy or treatment, but can give you the beginnings of a new conversation with yourself
Christy Harrison: And tools to use maybe as an adjunct to treatment as well.
Pooja Lakshmin: Yes. Yeah. Actually, one of the really cool things about the book launch is I've gotten a couple emails from people who are reading the book with their therapist and kind of comparing notes and working through the exercise and things like that, which is really cool.
Christy Harrison: That's so great. Well, that kind of segues into another question I wanted to ask you, which was like, I appreciated in the book that you list some ways people can tell the difference between a situation that requires real self-care and one that requires professional clinical help and that you call that out in specific places. But could you share a few of those distinctions, especially for listeners of this show who might be disillusioned by the conventional healthcare system or mental health system as well, and maybe less inclined to seek out that kind of support?
Pooja Lakshmin: Yeah, it was really important for me to include this, these, I think in every tool oriented chapter, I have a little takeaway box that is sort of like what to look out for, because I feel like self-help actually doesn't do a great job of doing this traditionally. And the gist is that a self-help book can't solve your problems. An Instagram course cannot treat major depressive disorder. You need an actual mental health professional or a physician to do that. So there's lots of different signs that people can be attuned to, but one of the big ones is keeping tabs on your functioning. So if your thinking is so negative, if you are beating yourself up every day so much that you're not able to get to work on time, that it's really hard for you to respond to emails, that it takes you a whole day to craft one email, that means your functioning is impacted.
And I feel like a lot of times we don't, nonclinical people don't make the link to functioning. Functioning means that something when we're talking about mental health functioning means that something going on in your mind, whether it's your thoughts or your feelings, is to the level of volume that it then changes your behavior. So one example in my clinical practice is, for example, like a diagnosis of postpartum O C D. So I had a patient at one point who had such intense intrusive thoughts that when she was up on the second floor of her house of dropping her baby off the banister, and so she changed her behavior when she was alone in the house, she stopped going upstairs. That's a very clear example of how your functioning is impacted, how your behavior changes. So a big part of the book is me talking about boundaries and how to set boundaries and how hard they are, and some tools to work with guilt and things like that. If you're somebody who every time you set a boundary, you feel so guilty and so emotionally dysregulated that you're almost thick, you're nauseous, or if you're always backtracking on boundaries, that could be another sign too.
Christy Harrison: And so if people are experiencing those things to reach out for professional support is probably the best approach rather than just try to muscle through it on their own with a self-help book.
Pooja Lakshmin: Exactly. And I think the way that we've traditionally thought about self-help and clinical care is a bit backwards. So really it's like you should be in treatment with a whole program. It's not just medication, right? It's like therapy. Maybe it's a support group, it's nutrition, it's exercise, maybe it's meds. And when things are going well, when your depression is treated, when your P T S D is treated, then you're able to do real self-care. Then you're able to use these tools to be more compassionate with yourself. Then you're able to use the tools to start setting boundaries with your best friend who's actually toxic. It's not the other way around. And on top of that, you can sort of use real self-care as a barometer to see how you're doing. If you notice that things have been going well for a while, you're able to set boundaries, you're more compassionate, you understand what's important in your life and you're able to make some big decisions, but then maybe in a couple months things change and you're noticing actually you're feeling a lot more conflicted when you're setting boundaries. This negative self-talk has gotten really bad again, and the tools aren't working. That could be a sign that maybe you need to talk to your mental health professional to maybe get back into therapy or maybe change the dose of your medication or tweak something. Right. You can sort of use it as a barometer.
Christy Harrison: Yeah, that's helpful. I'd love to talk a little more about boundaries because that's something you, obviously, it's one of the core principles you discuss, and I really like your approach to boundaries. I feel like it's a flexible approach, which is it's not about being rigid or just saying no all the time, which I think is how a lot of us think about boundaries. So can you explain what positive or healthy boundaries look like to you?
Pooja Lakshmin: Yeah, so in the book, I share a story, sort of my aha moment with boundaries, and this was in 2016. I had just graduated from residency at George Washington University, and I have landed my dream academic job as a supervisor in our women's mental health clinic. And my mentor took me out for lunch and she gave me one piece of advice that was very surprising. She said, Pooja, you don't need to answer your phone. You can let it go to voicemail, listen to what they want, and then decide how to respond. And that was really kind of revolutionary for me at the time, because I had been a med student and a resident where we had pagers at that time, and the pager would go off and you'd have this like P T S D response to call back right away. And I was like, oh, okay.
So the boundary is the pause and then you decide yes, no, or negotiate a boundary isn't always no, because there's always a cost to no. There's always a consequence whether it's financial, emotional, social, physical, and if you're in a marginalized group, if you're a woman of color, if you're a black woman in corporate America, the cost is going to be higher. So you can't always say no, but the pause is always accessible. So for me, at that time in my life, it was sort of like, oh, okay. I let it go to voicemail. Sometimes it's the front desk and they have a bunch of insurance paperwork for me to sign, and I can call them back and say, Hey, I'll come by at the end of the day after I'm done with my patients. But maybe it is a patient who I know if she misses a day of her A D H D medication, she literally might get into a car accident. So I'm going to put that refill in right away. I use my discretion, I use my decision-making. Again, there are situations where you can't say no. In that case, what you do is you make a mental note for yourself and you say, you know what? I, six months from now or one year from now, I want to be in a place where no is more accessible to me than it is right now.
Christy Harrison: I really like that planning for because it requires also looking at your life, looking at your values, how things are set up, and trying to align things more with the values you want to live.
Pooja Lakshmin: Exactly, exactly.
Christy Harrison: So this podcast is called Rethinking Wellness, and I've been asking all my guests, how are you rethinking or how have you rethought wellness in light of your work, in light of your experiences and everything you've been through in wellness culture?
Pooja Lakshmin: I love this question. I have been deeply thinking about it in relation to real self-care because I wrote this book, it came out in March, and I had not anticipated how brutal a book launch would be for my mental health. And I've been writing on my Substack and on social media about how I Burnt out after the book launch, and I felt a lot of shame. I just wrote a book called Real Self-Care, and I'm a psychiatrist and my whole platform, it's real, but it also was very much aligned to my message, which is that real self-care never ends. And in every new season of your life, every new role you have to relearn it. And giving myself grace that I've never written a book before, I've never launched a book or promoted a book or been on so many podcasts, and I also understand world small silent, geez, like, okay, people want to talk to me about buying book, but I've had to really look at what are my values?
How do I want to spend my time professionally, what is most important to me and what really fills me up? And those are hard questions that I don't know the answers to yet. So I'm letting myself have some time to be slow and grapple with these questions and play around and investigate and go internal, because that's the whole thing with real wellness, that it has to come from you. So I think to answer your question of rethinking, I don't think I'll ever even have the answer. I'll always even be proving myself wrong and having to come up with new answers for myself.
Christy Harrison: Yeah. Well, I mean, it really goes back to something you say in the book about how real self-care is an action, that it's a process.
Pooja Lakshmin: It's not a tool, it's not one thing, and so you don't check it off the list and call it a day.
Christy Harrison: You have to keep doing it. It's like showing up again and again for yourself and asking the tough questions, and I really appreciate what you've been sharing on your Substack about it, because I also have experienced varying levels of burnout multiple times throughout my career, but I think especially with the launch of having my first book launch, getting a second book deal, having the pandemic hit, getting pregnant through IVF also, which was a lot of,
Pooja Lakshmin: Oh, so we have very similar journeys. I didn't realize that.
Christy Harrison: Yeah, yeah, totally. I know, and I wanted to get into that maybe for our bonus episode, we can talk a little bit about the IVF stuff and then having a second book come out and having to all the promotion with that, I've just been exhausted and too little childcare trying to juggle and make it work and up against those systemic issues we were talking about and just trying to feel like, what is going to fill my cup? What is going to energize me and what do I love doing? What do I want more of in my work life? What do I want less of? What can I sort of work towards, even if I can't say no to things right now, what can I work towards changing in the future
Pooja Lakshmin: And sort of distinguishing which things are the sugar highs and which are the actual nourishing calories? There are so many sugar highs with book launches
Christy Harrison: For sure. Yeah, they're big time. I mean, as an anti-diet person, I'm always like, well, I don't know if I distinguish between sugar highs and nutrition, but I get your point for sure that it's the quick energy. Yes. In the anti-diet framing, I do say sugar or carbs might be a quicker acting source of energy, which is what you want sometimes, but also sometimes is not the most sustainable or satisfying in the long run. If you want something that's going to really keep you full for a while because you're going into a long meeting or whatever it is, you're probably going to choose a full meal rather than just a candy bar or something.
Pooja Lakshmin: And neither one is bad too, that you just want to understand the proportions of which and how you're using them.
Christy Harrison: Exactly. And sort of knowing what feels good in your body or your life as it were. And it's complicated too, right? I mean, I think actually this is an interesting metaphor because with sugar for people who've been deprived, I work with people with disordered eating primarily. So it's like people's relationship with sugar, there will be such a guilt infused one, and there's so much push pull and it's off limits, and so then it becomes this sort of forbidden fruit that tastes the sweetest and people then eat it and then feel guilty and sometimes binge eat or eat in this sort of rebound way and then feel physically bad too. And then it's sort of the cycle continues. It's back to deprivation and guilt, and with that, I think it's sort of the sugar becomes this unattainable thing that you have to have, whereas when you're not in that push-pull relationship with it, when you're like, yep, I could have that if I want, or it could have anything else, and it's all kind of morally neutral, then it becomes like, what do I actually want right now? And like, oh yeah, I can have that and maybe I'll have that along with a meal, or I'll have it later. Right now what I really want is something else. You just have so much more choice and agency with what to choose
Pooja Lakshmin: And you can actually feel your preferences.
Christy Harrison: Exactly. Yeah, I think that's an interesting metaphor with real self-care too, because like you said, some of those tools or methods are things that might be the quick fix or whatever, but it could actually become part of your real self-care if it's approached in a different way, if everything's on the table and you actually have space in your life for the more sustainable real self-care stuff.
Pooja Lakshmin: Right, right. The inner work.
Christy Harrison: Yeah. That's really interesting.
Pooja Lakshmin: Yeah, I love that. I'm learning so much.
Christy Harrison: Love it. Well, let's continue the conversation for a couple more bonus questions, but in the meantime, can you let people know where they can find you and your book and learn more about your work?
Pooja Lakshmin: Yeah, absolutely. So my website is poojalakshmin.com. You can find my book there. It's called Real Self-Care Crystals, cleanses and Bubble Baths, not Included. I also recorded an audio book that I narrate, so if you like to listen to your books, that is a great option. And I also have a Substack newsletter that is called Therapy Takeaway, and I've started doing more speaking. So if you work for an organization or a company that wants to learn more about real self-care or bring me there, you can reach out through my website too.
Christy Harrison: I love it. We'll put links to that in the show notes and make sure people can find you through that as well. Thank you so much for being here. It's really a pleasure to talk with you.
Pooja Lakshmin: Thank you, Christy, so much for having me. It's been a pleasure.
Christy Harrison: So that's our show! Thanks so much to our amazing guest, and to you for tuning in. If you've enjoyed this conversation, I’d be so grateful if you could take a moment to subscribe, rate, and review the podcast on Apple Podcasts, Spotify, or wherever you’re listening. You can also support the show by becoming a paid subscriber for just a few bucks a month. With a paid subscription, you unlock great perks like bonus episodes, subscriber-only Q&As, early access to regular episodes, and much more. Sign up now at rethinkingwellness.substack.com.
Got burning questions about wellness trends, diet fads, or anything else we cover on the show? Send them my way at christyharrison.com/wellnessquestions for a chance to have them answered in the Rethinking Wellness newsletter or even on a future podcast episode.
This episode was brought to you by my new book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses and Find Your True Well-Being, which is now available wherever books are sold! Just go to christyharrison.com/thewellnesstrap to learn more and buy the book or just go into your favorite local bookstore and ask for it there.
If you’re looking to heal your relationship with food and break free from diet and wellness culture, I'd love for you to check out my online course, Intuitive Eating Fundamentals. Learn more and enroll now at christyharrison.com/course. That's christyharrison.com/course.
Rethinking Wellness is executive produced and hosted by me, Christy Harrison. Mike Lalonde is our audio editor and sound engineer, and administrative support is provided by Julianne Wotasik and her team at A-Team virtual. Our album art is by Tara Jacoby, and our theme song is written and performed by Carolyn Pennypacker Riggs.
Thanks again for listening! Take Care.
Real Self-Care and Breaking Free from Wellness Culture with Pooja Lakshmin