Put Your Own Oxygen Mask On First

Love yourself, for everyone else’s sake!

— Gerald S. Cohen, DHom, DC, FIHI founder of The Center for the Healing Process

Sick and Tired

My typical client is a professional, peri-menopausal woman, who is a mom to two high school-aged kids, a wife to a husband who is pretty supportive but who snores, and a caregiver who manages at least one parent’s health from afar. She gets an average of 5 hours sleep a night, doesn’t exercise much, is bone-tired, and yet she can’t sleep at night. To the casual observer, this woman is highly functioning. She gets things done and people rely on her. She has trouble saying no, because she knows there may not be anyone else willing to pick up the reins and make things happen. Even if she did say no, she is so used to “doing it all” that she doesn’t even consider letting go.

And, oh, by the way, this woman has been diagnosed with at least one autoimmune condition, most typically Hashimoto’s thyroiditis, lupus or multiple sclerosis (MS). She takes thyroid medication, which she thinks may be contributing to her fatigue or hot flashes. And she may be on a low dose of prednisone to address her systemic inflammation. By the time this woman comes to me, she is sick and tired of being sick and tired. She is often resigned that this is the way her life will be, forever. I will come to learn that she takes anti-anxiety medications [only half a pill though, only when I need one] and that she now relies on sleeping pills [but really, how else can you stay asleep?]

Granting Permission

So where do we start? Are these issues related to diet? Toxic overload? Hormonal imbalance? Well, the answer is likely “d) All of the above”. Everything must be addressed, but before we can even get out of the gate, I often find that she first needs me to give her permission to take care of herself before taking care of others, or other responsibilities. And I literally mean that I give her permission first and hold that for her until she is ready to give herself that permission. The fact that she has come to me is an indication that she’s ready to do whatever it takes to feel better, but even while she says “Go,” her actions may indicate that she still has her foot on the brake.

I uncover this when we discuss her sleep habits. She says she’s desperate for a good night sleep, but she can’t imagine wearing earplugs and eye shades in case someone [mom, kids, the dog, etc.] needs her in the middle of the night. That’s when I use the metaphor of putting our own oxygen mask on first, so we can in fact be better prepared and able to help others. She’ll usually laugh and get the visual immediately. But then she’ll say something like, “But they depend on me to [help with homework, make dinner, get to doctor appointments, manage the team, etc.], and I simply don’t have time or energy to do things for myself.”  Then I offer some tough love: Well, of course everyone depends on you. You have been giving everyone every possible indication that you will take care of everything, which has now worn you down to the nub of your own wellbeing and sanity. What is the cost of this to you?

This is usually met with silence and then a lowering and nodding of the head. Yeah, she says, I’m worn out, but honestly, I just expect this will be the way it will be. I just need to get by.

“You cannot serve from an empty vessel.”

– Eleanor Brownn, inspirational writer & speaker

I know more than a little bit about the high-functioning-while-having-an-autoimmune condition profile. While I don’t have kids, I am married, I used to run a sales team, had quarterly revenue targets to beat, sit on boards, and at one point had both parents in hospital beds in the house I grew up in, an hour’s plane flight away. I managed their care from afar, as my father refused to move out of the house or accept more help, even as the downward spiral of events multiplied and it became clear that their level of care was inadequate.

Oh — I forgot to mention that I had MS, and often experienced a worsening of symptoms following stressful events. Because I knew that I had to manage my stress or else suffer the consequences of MS flare-ups, I searched for simple stress management solutions. One of my favorites was a course I took at Stanford University’s Center for Integrative Medicine called (I kid you not) “Love Yourself for Everyone Else’s Sake.” I remember sitting in a circle with about 8 women and ‘fessing up publicly, that the first sentence I ever said, was “I can do it.” My whole being lived into that belief my whole life. I remember feeling understood as every head nodded in empathetic agreement.

The Perils of I Can Do It All

We were guided by the wise and skillful teacher, Mark Abramson, DDS, and founder of Stanford’s Mindfulness-Based Stress Reduction (MBSR) program. Mark knows well the costs of that do-it-all-yourself and give-all-of-yourself personality type, and sees the effects daily in his specialty dental practice. He specializes in addressing TMJ (temporomandibular joint disfunction – the clenched jaw give-away that your stress levels are sky high) and sleep apnea with a blend of integrative therapies that work, like hands-on manipulation, acupuncture and mindfulness.

Mark drew graphic pictures of what was happening inside our bodies during the stress response. We learned that this chronic and unrelenting stress response led to bad outcomes like systemic inflammation and chronic disease. We imagined what could happen to us if we continued down this well-traveled but perilous path. If something really bad happened to us, who would be there to care for everyone else? And then he offered us ways to summon the relaxation response to counter-balance the habitual stress responses. He led us through guided meditations, breathing practices and movement exercises. Mark gave us permission to fill our mind-body-spirits up first.

Give Yourself Permission

By week 6 we had come a long way. Some women admitted that caring for others and caring for ourselves is not an all-or-nothing proposition. Some confessed that before the course they thought it selfish to take time to do things for themselves; by the end they came to the realization that the newfound prioritization and relaxation actually gave them more energy to do their caregiver and daily tasks. Mark initially gave us permission to care for ourselves first, and by the end, I think most of us granted ourselves that permission. I’ve been wearing earplugs and eyeshades every night since that class, and I’ll tell you that the far-greater quality and quantity of my sleep has had a direct impact on my ability to function better in all of my roles. As women, we may resist the idea of caring for ourselves first. But, once we understand the hazards of not putting our own oxygen mask on first, we can embrace opportunities to love ourselves more, which has a profound ripple effect. As Lucille Ball wisely said,

“Love yourself first and everything else falls into line. You really have to love yourself to get anything done in this world.”

What’s your experience? Are you giving yourself permission to care for yourself first?

Take good care!

Image Credit: johnnylemonseed/iStock




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Palmer is a certified Functional Medicine Health Coach who has helped thousands of people reverse autoimmune conditions based on her own two-decade battle to successfully beat multiple sclerosis (MS). She’s the author of the Amazon #1 bestselling book, Beat Autoimmune, which has a powerful foreword by Functional Medicine pioneer, Mark Hyman, MD.

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