Kabeel Dosani, PhD
Among healthcare practitioners in particular, self-care has become increasingly recognized as an essential tool for managing compassion, fatigue, and burnout. While self-care is vital for all, it has steadily become a buzzword in popular culture that at times has diluted the nuances of self-care to hyper-individualized responsibilities and consumerism. In centering individualized forms of self-care, we tend to place the onus solely on the individual, thereby neglecting structural, environmental, and socio-political factors that play critical roles in shaping wellbeing.
For medical students, striving to take care of oneself is juxtaposed by overwhelming pressures and systemic challenges within the fields they prepare to enter. Although medical students may receive messages from their programs encouraging them to take care of themselves, this messaging is not always echoed in other spaces, in which they may also hear opposing messages insinuating that taking rest makes for a lazy physician. The prevailing culture and demands as they progress through training, amplified by existing systemic issues within healthcare, further present a challenging environment to prioritize individual and community wellbeing. This can ultimately lead to feelings of hopelessness, self-blame, and powerlessness among medical students in navigating their development.
The Radical Healing Framework, conceptualized by French and colleagues (2019) as a tool for addressing racial trauma, offers a helpful model for exploring how we can both recognize larger forms of oppression impacting wellbeing, while also identifying paths towards healing. Per French et al. (2019),
Radical healing is being able to sit in a dialectic and exist in both spaces of resisting oppression and moving toward freedom. Staying in either extreme—the despair of oppression or the imagination of possibilities—could be detrimental. On one end of the spectrum, one could get lost in an overwhelming sense of disempowerment. On the other end, only focusing on dreaming for a better future removes oneself from current reality. We believe it is essential that radical healing includes both acknowledgment of and active resistance from oppression, as well as a vision of possibilities for freedom and wellness. Moreover, the act of being in that dialectic is, in and of itself, a process of healing (p. 24).
This framework further describes radical healing as anchored by critical consciousness, radical hope, strength and resistance, cultural authenticity and self-knowledge, and collectivism. Building critical consciousness involves critically and actively reflecting on the influence of sociopolitical realities and advocating towards change. Radical hope offers the opportunity to envision new possibilities for the future, thus countering hopelessness and disempowerment. Strength and resistance emphasize community resilience and commitment to practicing joy despite forms of oppression. Cultural authenticity and self-knowledge aim to promote cultural knowledge and teachings. Collectivism further recognizes the importance of solidarity and emphasizes the shared influence, responsibility, and accountability we maintain around promoting wellbeing. Although many aspects of our lives, including medical school, encourage competition and independence, embracing collective care ultimately increases community resilience and overall success.
While medical students may continue to explore what taking care of themselves and their communities looks like as they progress through medical school, the radical healing framework may offer a powerful resource to affirm and guide their journey.
Caring for myself is not self-indulgent, it is self-preservation, and that is an act of political warfare.”
- Audre Lorde, A Burst of Light
Dr. Kabeel Dosani is the Assistant Director of Wellness at the University of South Florida Morsani College of Medicine in Tampa, Florida. As a Counseling Psychologist by training, Dr. Dosani is passionate about addressing wellbeing needs through a culturally informed perspective.
References
French, B. H., Lewis, J. A., Mosley, D. V., Adames, H. Y., Chavez-Dueñas, N. Y., Chen, G. A., & Neville, H. A. (2020). Toward a Psychological Framework of Radical Healing in Communities of Color. The Counseling Psychologist, 48(1), 14-46. https://doi.org/10.1177/0011000019843506
Wyatt, J.P., Ampadu, G.G. Reclaiming Self-care: Self-care as a Social Justice Tool for Black Wellness. Community Ment Health J 58, 213–221 (2022). https://doi.org/10.1007/s10597-021-00884-9