Can Self-Care be Painful? The Hard Work of Deep Self-Care

© deagreez / Adobe Stock

The term self-care has become a popular buzz word, usually as encouragement to engage in activities that fill our souls and provide a resting place after a busy day. The term is increasingly appearing on social media, in self-help books, and even advertisements.

As dental professionals, we often hear about physical self-care due to the daily microtraumas caused by the nature of chairside treatment.

Self-care comes in many forms: a hot bath, a lovely glass of red wine on the patio, a new workout program, hiking in the mountains, to name a few. Some companies play on our sensibilities and push that buying their product is self-care because you deserve a nice car or a new pair of luxury Italian leather shoes.

In my opinion, all of these suggestions sound attractive. As a therapist and educator, I often remind my students to participate in self-care. I enjoy a nightly hot bath, an afternoon workout, and making healthy choices about food. As a clinical dental hygienist, frequent massages are a very welcome form of self-care. Each indulgence fills my soul and leaves my body stronger than it was yesterday.

In this pursuit of a “stronger than yesterday” mentality, I challenge myself and students to dig deeper than the physical luxuries that feed the self-improvement or self-care hunger. As I sink into a piping hot bath (lava, as my partner calls it) with my favorite lavender bubble bath and candle, I question the deeper roots of self-care.

What about the dark corners of my mind that need some TLC?

This is where self-care gets painful. Self-care runs deeper than the above-mentioned activities. It is about doing the hard work of the mind and soul that brings us to a new place of self-understanding. I believe that if we go through this life without sitting in the pits of our dysfunction and take responsibility for our part in life’s circumstances, we may never experience real peace or joy. We will continue to flounder about life, wondering where things went wrong.

Four Difficult Self-Care Experiences that are Worth the Hard Work

Inner child work: I will be vulnerable and use myself as an example. Three years ago, I began doing serious inner child work after leaving a relationship where I played out that inner child voice daily. I am a forty-something professional woman. Looking at how the scars of the past haunted my daily life was painful.

Frankly, it was embarrassing. After all, I am a therapist. These answers should have been obvious to me, right?

I could not have been more wrong. The real self-care came with the awareness of how my past played out in my thoughts, words, and behaviors. It took work. It took pause and contemplation. It took feeling the nasty feelings that I so love to avoid. Looking at the unattractive sides of myself was extremely uncomfortable.

I have learned to put this into practice as part of my daily self-care. The pain I used to feel is now simply a self-awareness that allows me to use emotion-regulation strategies for behavior change. This has been an incredibly freeing experience. For example, an angry patient may subconsciously trigger feelings of a childhood connected to an angry father. The exchange that follows between the hygienist and the patient may be reflective of childhood behavior. The hygienist may unknowingly act out old childhood behaviors in defense against the angry patient. The dark corners of the hygienist’s mind sees the patient as dad, and she/he responds accordingly. This leaves the clinician feeling exhausted and, most likely, the issues are unresolved.

Boundaries: Setting boundaries can be very difficult, especially in long-term relationships. Whether it be with a partner or parent, when you draw a new line in the sand, pushback is inevitable. People treat us the way we allow them to treat us.

When I say, “I no longer accept this behavior from you,” the opposing party will throw a tantrum. The tantrum could present in many different forms: passive-aggressive silent treatment, aggressive bulldozing of the new boundary, and using guilt and shame. Setting real boundaries comes with following through with consequences.

For example, I tell my sister that if she continues to drink around my kids, they will no longer be allowed at her house. Most likely, she will challenge this boundary and drink the next time my kids are visiting. If this is a serious boundary and I wish to enforce it, I have to take my children and go. My sister will likely engage in unhealthy behaviors. She will try to guilt and shame me. She will trash me to the rest of the family. She may even act out by drinking more because she “is an adult and can do what she wants.”

Perhaps she can, but not around my kids. If I stand strong, as painful as it may be, hopefully, she will eventually honor my wishes to spend time with her nieces and nephews. Painful, indeed, but worth the struggle if I wish to protect myself and my children.

Another example happened several years ago. A hygienist in my office was ill, and I saw one of her patients. The patient immediately started by saying that I was not his hygienist, and he would “hit me if I hurt him.”

After several threats on my personal safety, I sat him up, took off all PPE, and told him to leave. I told him that I would not stand for physical threats. Luckily, he quieted and let me finish treatment.

The powerful piece of my statement to him was following through on my stance. In this case, he respected my wishes for the remainder of the appointment. If he had not, it would have been my obligation to move forward with dismissal. If I had not, my words would have turned to empty threats, giving him permission to behave poorly.

Saying goodbye: In my late 20s, I went on what I called a “turkey shoot.” I ended relationships with every person that I perceived as a taker or a bad influence. I woke up one morning and thought about the reciprocators versus the vampires in my life. I pondered the list, and essentially ghosted everyone who was draining my energy. Although ghosting may not have been the most mature decision, it served its purpose, and I proceeded with spending time with only those that gave back as much as they took from the relationship.

Perhaps saying goodbye to someone toxic would be the hardest thing you have ever done and the most empowering and loving act you could do for yourself right now. Walking away from someone that drains the soul can be extremely painful and difficult. You may deeply care for that person and live on the hope that they will change and once again reemerge as the person you once thought he/she to be.

Before walking away, have a plan. Whether it be someone in which you make a slow fade or someone significant that will require a dramatic life step, plan ahead. Know how and when you will exit. Rally your support system by calling on friends and family to walk through the process with you. If you are in an unsafe situation, create a safe plan of escape with the help of friends or a professional counselor. Ridding our lives of toxic people is a huge step in self-care.

This can also apply to professional relationships. Many times, walking away from a toxic office that is not supportive, not aligned with our philosophy, or does not take steps to keep us safe is necessary. Being unhappy at work may stem from poor boundaries or even abusive bosses. If proper boundaries have been set and the toxic environment remains, perhaps it is time to say goodbye.

Living within your means:  If the item or service you are purchasing will create debt of any amount, consider if this is true self-care. For many, budgeting is not a common practice, and marketers are experts at convincing us that a product will be life-changing. Taking part in activities such as vacations, trips to the salon, a Saturday night on the town, or a new pair of the latest jeans when the funds are not available is a stress-and-worry trap.

Even though getting my nails done every two weeks sounds like amazing self-care, if I cannot afford it, I have traded an hour of feeling good for months of headaches. As I pay the credit card bill and accrued interest, I wonder if the pedicure was worth it. Instead, I could purchase the supplies and give myself a mani/pedi deluxe combo. Although I may not feel as pampered as when visiting the salon, I have bought myself financial peace of mind when the credit card bill is due.

Consider how you budget or lack thereof is holding you back from true self-care. Is instant gratification creating future headaches?

I encourage the simple self-care ways of life and believe they are a necessity. I challenge each person to look beyond the typical and dig into the hard aspects of self-care. Doing the painful work now can lead to mental, emotional, and financial freedom later, both in your personal and professional life.

Need CE? Check Out the Self-Study CE Courses from Today’s RDH!

Listen to the Today’s RDH Dental Hygiene Podcast Below:

Previous articleDental Hygienists on Father’s Day: Give the Ideal Oral Health Gift
Next articleResearch Analysis: The Risk of Dental Professionals Contracting COVID-19
Kandice Swarthout, RDH, LPC
Kandice Swarthout, RDH, LPC, is a Licensed Professional Counselor and Registered Dental Hygienist. She is a full-time dental hygiene educator in Texas, where she teaches community dentistry and research. Kandice is the owner of Inspired Education & Wellness, where she is a speaker, writer, and private practice therapist. Her unique blend of clinical expertise in both dental hygiene and mental health equips her to assist fellow healthcare professionals in recognizing not only their patients’ needs but also their own, fostering deeper connections with the healthcare community. Kandice’s dedication extends to her role as an approved provider for Texas Health and Human Services, specializing in human trafficking training for healthcare providers. Additionally, Kandice brings a touch of fun and camaraderie to the dental community as the co-owner of Muffins & Mimosas Dental Study Club. She offers engaging, in-person dental continuing education that creates a warm and welcoming environment for friends and colleagues to come together to learn. Read her articles in Today’s RDH column, Mental Health Spotlight. Contact Kandice through her website at or on social media @The Counselor Hygienist.