Self-Care is Not a Solipsistic Trap: A Reply to Critics

Abstract

This paper is an answer to criticism of the self-care, self-help movement in health recently advanced by Robert Crawford and other writers. The authors review the multiple and varied origins, motivations, and ideologies associated with self-care developments. It is maintained that the self-care movement embodies a broad, popular social resistance to the ills, inequities, and iatrogenic elements in highly technological health care systems. Empirical examination of specific programs and formulations of this movement reveals that it cannot be fitted into a simplistic "victim-blaming" ideology, but instead operates to decrease dependence and heighten individual and political/social awareness of hazards to health.

Self-Care in Health

“…self, family, commu nity, professional). The "self-care debate" is, of course, more than a prob lem of definitional confusion; but such clarifi cation could help move attention to the role of self-care and self-help in improving the quality of care and extending its benefi ts (89,90). Below are several questions that seem to dominate the literature about the role of self-care.…”

“…This hypothe sis assumes that participants in lay self-care development, presumably in cluding members of mutual aid groups and lay voluntary programs, are different from people with political interests in health and health care. There is presently insufficient data to characterize the political values and awareness of participants in organized self-care activities; indeed, the his tory of mutual aid groups would suggest a contrary hypothesis (90,120). Data on the nascent self-care education programs are too meager to judge the ultimate direction of their influence on participant awareness and politi cal action.…”

Why self-care fails: Implementing policy at a low-income sickle cell clinic

“…Some simply describe various types of self-care practices such as self-diagnosis and self-medication (e.g., Dean 1986, Demers 1980, Freer 1980, Roghmann & Haggerty 1972. Still another group concerns itself with debating the relative merits and pitfalls of self-care as health policy (Crawford 1977, Deria 1981, Katz & Levin 1980, Kickbusch 1981, Kronenfeld 1979, Levin 1981. Despite the diversity of approaches to studying selfcare, there remain three deficiencies in the literature that I will address with my research.…”

“…Most regard self-care as originating in the women's health and consumer movements of the 1960's and 1970's (cf. DeFriese 1982, Green 1977, Katz & Levin 1980, Levin 1981, Fleming & Anderson 1976, Sehnert 1981. According to these accounts, self-care is a progressive grass-roots response to increasing dissatisfaction with the problems of the health care system--its impersonality, its excessive cost, the increasing medicalization of everyday life, and the authoritarian nature of doctor-patient relations.…”

Mental health and public health: Strengthening a working relationship

“…An affinity prevails between these values and the desire to cut costs by reducing the use of professionals. This financial motive, along with associated victim blaming ideologies, have been used as a justification for fostering SH/ SC (Crawford, 1977;Katz and Levin, 1980). SH/SC are an omnipresent source of care for physical ailments and distress.…”