Self-Care: Why Some People Find It So Hard and How Counselling Can Help

"I know I should look after myself. But the moment I stop, I feel guilty."

Many people describe it this way: everyone else's needs come before their own, family, work, friends, students, clients; when they rest, their mind is on what is still undone; asked "what do you want," they cannot answer; the body has been sending signals for a long time, but it is always "once this busy patch is over." Some are caregivers, some work in helping professions, some simply learned as children never to be a burden.

Self-care is coming up more and more in counselling, but it is not spa days or holidays. It is a way of treating yourself. This page explains what self-care is, why some people find it especially hard, how counselling can help, and when it may be time to reach out.

What is self-care?

Self-care is consciously noticing and responding to your own needs: physical, emotional, relational, spiritual. It includes very basic things, such as sleep, food, rest and exercise, and less obvious ones, such as allowing yourself to say no, having someone you can be honest with, and being a little kind to yourself when you have done badly. It is not a luxury. It is the foundation on which a person keeps functioning.

Everyone has times when they are too busy to look after themselves, and that is normal. It becomes a problem when "too busy for myself" turns into a permanent state, when your own needs always come last, when rest brings guilt rather than recovery, and when the body's signals are ignored again and again. This state is especially common among caregivers, people in helping professions, parents, and anyone who learned early that they are only worth something when looking after others.

Occasional busyness versus chronic self-neglect

Self-care is not selfishness, and not consumption

Many people react to "self-care" in one of two ways: either it feels selfish, because so many people need them, or they understand it as consumption to reward themselves, such as shopping, holidays or massages. Both understandings make self-care hard to sustain. Selfishness is putting your own needs above everyone else's. Self-care is acknowledging that you have needs too, and making sure you have enough in reserve to keep caring for others. Consumption brings brief relief, but real self-care is mostly ordinary and unglamorous: enough sleep, decent food, boundaries, permission to be imperfect. These cost nothing, yet are harder than a holiday, because they require you to believe you are worth it.

How is self-care related to burnout?

The end result of chronic self-neglect is often burnout: emotional exhaustion, detachment from your work or the people you care for, and a sense that nothing you do makes a difference. Self-care is both the prevention of burnout and the foundation for recovering from it. If you are already in a state of burnout, the burnout page in this section may also be useful. Taiwan's John Tung Foundation mental health site also has resources on stress management and mental health self-help in Chinese.

Why some people find it especially hard to look after themselves

Being unable to look after yourself is rarely about laziness or not knowing how. Most people know they should sleep earlier, rest, say no. What stops them is something deeper at work underneath. These are the most common reasons:

• Learning early that you are only worth something when caring for others:Some people were the family caregiver from childhood: looking after younger siblings, managing an emotionally unstable parent, keeping the peace at home. What they learned is that their value lies in being useful to others, and that their own needs are unimportant, even a nuisance. That belief keeps running in adulthood.
• A culture of "don't be so selfish":In an environment that emphasises filial duty, sacrifice and "the greater good," looking after yourself is easily read as selfish. Many people are not unwilling to rest; they feel they have no right to.
• Busyness as worth:In a society that treats busyness as a badge of honour, stopping feels unsettling, as if you have become useless. Some people are even afraid to stop, because the moment they do, the feelings that busyness has been holding down come up.
• Guilt about rest:While resting, the mind says "there is still so much undone," "everyone else is working while I rest," and rest becomes another drain. This guilt usually comes from a harsh inner voice, and that voice was usually learned many years ago.
• Not knowing what you need:When a person's attention has been on others for decades, the ability to recognise their own needs gradually withers. Being unable to answer "what do you want" is not because there are no needs, but because it has been too long since you listened to yourself.
• Unclear boundaries:Unable to say no, unable to let anyone down, feeling that everyone's problems are your responsibility. A person without boundaries is swamped by everyone's needs, and because they never refuse, the people around them learn not to ask.
• The caregiving role:Caring for ageing parents, an ill partner or a child with special needs. These roles are real, and often no one shares them. The most common trap for caregivers is treating themselves as the only resource, then feeling guilty when they run out.
• Consumption in place of care:Because real rest brings guilt, some people "reward" themselves with consumption instead: shopping, eating, scrolling until late at night. These bring brief relief but do not replenish what has actually been used up, and often bring more guilt.

So working on self-care is usually not about "how to find time for one more thing," but about looking together at why you feel you do not deserve care, where those "musts" come from, where your boundaries give way, and how you can relearn to listen to yourself.

Common signs of chronic self-neglect

Chronic self-neglect is more than "being tired." It shows up in the body, emotions, thoughts and behaviour at the same time. Some common signs include:

In Hong Kong, self-care is often seen as something for "when there is time" or "something rich people do." A culture of long hours, high demands and efficiency treats rest as laziness and stopping as waste. From childhood, people are taught to work hard, endure and think of their family, but rarely taught that they may also look after themselves.

An ageing population means more and more people are becoming caregivers, and caregivers in Hong Kong are usually expected to cope alone. Chronic depletion in the helping professions, parents' boundless giving to children, and cramped living spaces that leave no corner for solitude all make self-care especially hard here. When a person has never been permitted to look after themselves, they do not know how long they have been running on empty.

How counselling can help

Counselling is not about adding "self-care" to an already overflowing schedule, and not about teaching you to book a spa or a holiday. It is about looking together at why you feel you do not deserve care, and relearning to listen and respond to yourself. Depending on your situation and your counsellor's approach, the work may include:

• Relearning to recognise your needs: starting with very small questions, such as "what does my body feel right now" and "what do I want at this moment," and slowly practising turning attention back toward yourself. This is a skill that can be relearned.
• Working through guilt about rest: recognising the voice that says "you shouldn't" whenever you rest, tracing where it came from, and learning to respond to it differently.
• Examining the "musts" and "shoulds": for example, through CBT, laying out the beliefs that keep you from stopping: "I have to do everything well," "my needs don't matter," "refusing people is selfish," and finding views that fit reality better.
• Learning to set boundaries: practising saying no, expressing needs, letting people down, and discovering that relationships survive boundaries and often become healthier for them.
• Learning self-compassion: for example, through Compassion-Focused Therapy, practising treating yourself as you would a friend when you are exhausted or have done badly, rather than adding another layer of criticism.
• Redistributing time and responsibility: looking at how your time and energy are currently spent, what could be set down or handed over, and how to keep some space for yourself within the life you already have.
• Working on the caregiving role: for example, from a family systems perspective, looking at how you became "the one who looks after everyone" in your family, and how that role could be renegotiated.
• Working on the patterns underneath: if the inability to look after yourself is tied to beliefs learned in childhood, to self-worth or to family experiences, these need proper attention for change to last.

Counselling approaches for self-care

Different counsellors work with self-care difficulties in different ways, and most blend approaches depending on your situation. These are the ones you are most likely to encounter. Open any of them to see how the approach works and what a session looks like.

When to reach out

No one has to wait until they are at breaking point. If several of the following sound like you, it may be worth talking to a counsellor:

• You have been saying "once this busy patch is over" for months or even years
• Rest is full of guilt, or you no longer know how to rest at all
• Asked "what do you want," you cannot answer
• You can hardly refuse anyone, then resent them or yourself for it
• Your body has been sending signals, such as chronic insomnia, headaches or stomach problems, and you keep ignoring them
• You have given up your own interests, friends and private time
• You are a caregiver, and you feel everything can only be done by you
• You have started to feel numb or resentful toward the people around you, then blame yourself for it

Frequently asked questions about self-care

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