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Self-management is a way of living and being in the world. It's a lifelong process that involves seeing ourselves as empowered individuals—with unique needs, desires and responsibilities—within the context of our environment.
We might imagine "self management" means "taking charge" by carefully following instructions laid out by health professionals to help us manage a chronic illness such as heart disease, diabetes or mental illness. We may believe in following these instructions we are helping ourselves while saving time at the doctor's office. We might even think we are helping create an efficient healthcare system.
Beyond that, self-management means knowing that as human beings we have the right to make choices about our health and well-being. It means honouring our innate ability to sense what is right for us. It means taking responsibility and directing our own lives. We are, after all, "experts" on ourselves.
Self-management also means recognizing our limits as individuals living among others. As individuals, we have rights and freedoms. These rights and freedoms are not however, more important than others' rights and freedoms. Our right to smoke cannabis or cigarettes, for example, is not more important than a non-smoker's right to avoid second-hand smoke.
Our interests, experiences and histories help shape who we are as individuals. So too do our responsibilities to our families, jobs, and communities. As humans, we are constantly moving back and forth between our need for autonomy and need for community. Bruce Alexander describes this beautifully as our need to "feel free and still belong."
Self-management, then, is about recognizing that we are responsible for our lives, within limits. Some limitations are personal, others systemic or institutional. We can adapt to or navigate some limits with ease. Other limits may be harder to accept or change.
Each of us has the right to live our own life, even if others do not agree with our choices. Managing our health and wellness, including making health-related decisions, helps us live our lives with authenticity and dignity.
Managing our health does not mean ignoring the expertise or advice of health care professionals, family members, or friends. We may need help in figuring out what is going on when something doesn’t feel right. Yet, believing or expecting others to know everything is a mistake. Even though they may have a certain education or level of experience, they can be wrong or misinformed. And they may not know or acknowledge important factors affecting our well-being. Health care professionals spend limited time with us, making it impossible for them to appreciate the larger picture of our lives. Family or friends may spend a lot of time with us, but they may lack expertise on an issue affecting us.
Taking responsibility for our well-being can also increase our capacity for health. Part of self-management involves developing the skills to make decisions that best fit our needs. Doing what genuinely feels right to us is important for long-lasting improvements in our well-being. Being the driver rather than a passenger on our life journey is empowering. This often results in a greater sense of control over our lives and improves our relationship with the rest of the world.
We are all individuals linked to a larger world. Each of our individual worlds has key elements: where we live, the kind of housing we live in, what we do for work, our income, level of education, ethnicity, gender, and the health and community services we use.
The larger world is filled with people, processes and systems that we influence and that influence us. This includes our family, friends, schoolmates and coworkers as well as our loop of past and present opportunities and experiences. Often, we have little control over these aspects of our lives. Personal and social supports (or lack of supports) impact our opportunities and shape our choices. Our choices, in turn, shape our experiences and influence our opportunities.
Access to basic elements—education, skills, income, and support from family and friends—can help us achieve much of what we wish for in life. Without these elements, we struggle to achieve our goals. Remarkably, many of us live without adequate access to the essentials of life. We struggle with respect to housing, food, access to community services, and other things we need to feel free and have a place in the world.
We are all connected. Our choices shape the choices and experiences of others just as their choices shape us. Just by "being," living our daily lives, we affect one another. We need to be able to make choices that work for us, demonstrate care for one another, and live together.
As John Donne said, "No man is an island entire of itself; every man is a piece of the continent, a part of the main...any man's death diminishes me, because I am involved in mankind."
We all want to feel good, in our minds and bodies and in our relationships with others and the world. Taking responsibility for ourselves is often not easy. Sometimes the stories we tell ourselves about who we are, what we can do or cannot do, and how others see us can get in our way. Reflecting on and reframing our stories on a regular basis can help us feel better inside and be better citizens of the world. Each of us can grow, change, and support wellbeing, affecting individuals, families, and communities.
What can we do to feel good and keep our stories from getting too heavy or hopeless? How can we help others monitor their inner dialogues for messages that are negative or unhelpful? How can we contribute to health and well-being for all?
Choose activities where belonging and connectedness are key:
Join a walking group, a reading club, or a music or theatre troupe
Get to know your neighbours by hosting a block party or starting a local project
Volunteer at your local school or favourite service agency
Believe in yourself, your instincts and right to ask questions (be respectful in your delivery):
Learn how to keep yourself healthy (physically, mentally, emotionally, spiritually), and encourage children and others to learn what works best for them too
Be open and curious about new things, observe and listen to others, ask meaningful questions
Engage in real dialogue (conversations where we question our own assumptions and ideas and help others reflect on theirs)
Don't be afraid to ask questions when people in positions of authority or power give you information
Take 'health for all' to heart, and beyond:
Involve children in the process of setting rules for the family or classroom
Work with others to solve an issue by drawing on local knowledge, resources, and capacities
Stand up for those who are marginalized by encouraging others to examine any negative attitudes they express towards them
Start a learning group at your local library or community center—the topic could be a social justice issue such as poverty in your community, or a topic you wish to learn more about such as waste management or the federal government's role in developing healthy citizens!
About the author
The Canadian Institute for Substance Use Research, formerly CARBC, is a member of the BC Partners for Mental Health and Addictions Information. The institute is dedicated to the study of substance use in support of community-wide efforts aimed at providing all people with access to healthier lives, whether using substances or not. For more, visit www.cisur.ca.