Rethinking self-care through an Indigenous lens—the importance of community

Abstract

Insights from Indigenous health systems in Australia show why relational self-care is important for the wellbeing of people, communities, and the planet, argue Pat Dudgeon and colleagues

Western self-care tends to centre on practices that are aimed at supporting the health of individuals. Activities such as self-medication, rehabilitation, and accessing healthcare services are all generally focused on preventing disease and managing health in an individual. Indigenous self-care, on the other hand, includes these practices but also engages in a continuum of healing that supports the collective wellbeing of communities and the environment. The holistic, collective, and relational approach to health and wellbeing that underpins Indigenous self-care can enrich the understanding of self-care taught by mainstream medicine and improve public and environmental health.

Relational self-care is a practice that aligns with the Indigenous ethical principle of collective flourishing or “living well.” To take one example, the Yawuru people of west Kimberley, Australia use the health and wellbeing term “mabu liyan,” which refers to “relationships beyond the individual” and “is a model of living well in connection with country, culture, and others as well as with oneself.”¹ For many Indigenous peoples, reciprocity, respect, and responsibility towards all life are core values of relational health and wellbeing. To understand more fully Indigenous relational self-care, we have to consider how Indigenous conceptions of health and wellbeing differ from more individualistic ideas in western biomedical models.

Social and emotional wellbeing is a prominent holistic model of Indigenous relational health.² This Indigenous paradigm of relational health recognises that the physical, emotional, and mental health of the individual is profoundly contextual. Composed of seven interconnected domains of health and wellbeing—mind and emotions, body, family and kin, community, culture, Country, and spirituality—relational health is achieved by having harmonious connections to all these overlapping domains.³

The term “Country” refers to Indigenous cultural and spiritual understanding of the land as sentient kin. Indigenous Australians have long recognised that the health of the land and people are entangled and many Indigenous relational self-care interventions in Australia are centred on strengthening cultural and spiritual connections to Country.⁴ This includes learning Indigenous languages, traditional land management practices and food gathering, and practising cultural activities that strengthen people’s stewardship relationships with Country.⁵ Indeed, culturally specific self-care practices that are aligned to cultural values are important to Indigenous people.⁶

Cultural reclamation

Although many of these connections have been disrupted by colonisation, Indigenous relational health systems have adapted in response and numerous relational self-care interventions based on the social and emotional wellbeing model of health have been implemented across Australia. For example, since 2012 one of us (PD) has directed a nationwide Indigenous relational self-care intervention called the National Empowerment Project.^{4 7}

Responding to high levels of psychological distress and suicide in Indigenous communities, the National Empowerment Project has provided communities with culturally safe tools that support social and emotional wellbeing. These relational self-care tools include cultural reclamation activities, collective truth telling about colonisation, goal setting, conflict resolution, critical thinking, connecting with Elders, and strengthening family and community relationships. Independent evaluations and qualitative evaluations of this intervention have consistently found that participants report improved social and emotional wellbeing, strengthened resilience, and decreased psychological distress.^{8 9 10}

By transforming people’s collective lived experience of colonisation into healing strategies, the National Empowerment Project has supported individuals, families, and communities to take agency over their health. The benefits of relational self-care include the strengthening of sustainable health practices, inter-generational healing, health and wellbeing literacy, and increased self-determination over individual and collective health.¹⁰ Relational self-care also supports Indigenous human rights by advancing decolonisation and supporting communities in their search for truth and empowerment, while nurturing the knowledge of collective resilience and a desire for an equitable future.

It is becoming increasingly clear to western health systems that all life is connected and that planetary and human health are linked, but this idea has been the foundation of Indigenous health systems for millennia. As the public health importance of collective self-care and caring for the environment become increasingly urgent, we should look to insights from the world’s oldest and most resilient health systems. Indigenous relational self-care is a collective healing practice that can move us beyond historically recent, individualistic biomedical models of self-care, allowing us to embrace a more culturally mature understanding of holistic health.