Rituals, community-care, and women’s mental health

Guest: Beth Ricanati
Every year, one in five women in the United States struggles with mental health. Income disparities, caregiving responsibilities, higher rates of poverty and violence are just a few of the risk factors that leave women especially susceptible to chronic stress. Dr. Beth Ricanati is no stranger to burnout. She was the mother of three children and a physician working full time when she realized she needed to prioritize self-care. At the recommendation of a friend, she turned to baking bread as a way to build ritual and community into her weekly routine. Dr. Ricanati joins Sabrina to discuss: The mental health crisis in America and why women are more likely to experience chronic stress than men Why creating meaningful rituals with our hands can benefit mental health The need to shift away from self-care toward community care to address the underlying causes of women’s mental health issues
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Beth Ricanati Transcript

Sabrina Merage Naim
Hey Kassia!

Kassia Binkowski
Hello, lady!

Sabrina Merage Naim
I got to sit down for this episode with Dr. Beth Ricanati to talk about something that may be a little bit different and unusual. And what I really appreciated about this episode is that at different points, it was kind of a palate cleanser for me given how heavy a lot of our topics can be, and I will say, we also did talk about a heavy issue, which is the mental health crisis in this country.

Kassia Binkowski
So give us the landscape here. We're talking about mental health. We're talking about women. We're also talking about bread.

Sabrina Merage Naim
Yes. Specifically, challah.

Kassia Binkowski
The best kind.

Sabrina Merage Naim
Yeah, which is absolutely the best kind. And for those of you who have never had challah, please do yourself a favor, do your tastebuds a favor. So Dr. Beth Ricanati is a physician who has trained and practiced at Columbia Center for Women's Health at the Women's Health Center in Cleveland, and today practices at a clinic in Venice, California. And a lot of what she does, she's an internist, right. She's a doctor that deals with all kinds of medical issues. But what she talks about is at some point, she experienced what a lot of people experience. In her field, it was specifically physician burnout, she was raising three kids, she was juggling too much she wasn't taking care of herself. And then one day, she baked challah for the first time.

Kassia Binkowski
Ahhh! Here are the angels singing.

Sabrina Merage Naim
It may sound a little silly, but it really changed her life. And it really reminds me of during the pandemic, you know, we were hearing so much about people who are baking sourdough bread, there was this huge sourdough trend.

Kassia Binkowski
Can I tell you, just pause real quick. One time when I was maybe 23, my boyfriend at the time now husband, was growing yeast to make his own sourdough under our bed in our dirty apartment. And I found the jar of the growing yeast bubbling over and it was almost the end of our relationship.

Sabrina Merage Naim
Oh, that's disgusting.

Kassia Binkowski
What is this? And why is it here?

Sabrina Merage Naim
Yeah.

Kassia Binkowski
But the sourdough that results is really good.

Sabrina Merage Naim
Right? I will say the whole, mother yeast thing I don't know, is a very strange concept to me. But regardless, that was a huge trend during the pandemic. And at some point, you're like, "Okay, everyone shut up about the sourdough." But when you really think about it, this was rooted in science, right? What was happening is we were all so crazy overwhelmed, and feeling just gutted by everything that was going on around us. And this was a huge coping mechanism. Right?

Kassia Binkowski
It was the need for something tangible and physical and to use our hands and take it out of our heads.

Sabrina Merage Naim
I cannot wait to take a listen.

Sabrina Merage Naim
Right. So Beth, what she talks about, and now she goes all around, she does these, you know, forums and speaking engagements, where she's actually teaching people how to bake challah, whether it is at a church, or a synagogue, or for medical students, or at companies, she's doing this all over the place. And the point is that she is helping people understand how to create ritual and meditative practices with these tangible practices of using your hands, and how it's so important for your mental health. And as a physician, she saw firsthand, particularly at these women's clinics, and particularly for women who are faced with all kinds of very specific chronic illness, that a lot of these things are very much connected to the mental health issues that we're facing that just go unchecked, whether that's stress, whether that is the overwhelm that we talk about as mothers or as business women or as caretakers, these things that we just do not take care of, and then they turn into physical chronic illnesses. And she talks about the things we can do to change our lifestyles, whether that is creating these rituals and baking challah right, which is her ritual, or food is medicine. And so I really, really just enjoyed and appreciated this conversation as kind of in a moment where we are all feeling so overwhelmed. What is it that we can do to stop outside of that, and create rituals for ourselves, that bring us this peace, this calm that we also desperately need?

Sabrina Merage Naim
Hey, Beth, hello.

Beth Ricanati
Hi!

Sabrina Merage Naim
So good to have you with me. I'm intrigued and excited to have this conversation because we're going to hit on a lot of different topics that maybe don't always feel like they go together. But we're going to talk about why they do and why it's so important. So I'm gonna first lay the foundation a little bit of your story. So you are a mother, you are a physician, and you worked full time while raising three children. And I want to just kind of understand what that period of your life was like for you and for your family.

Beth Ricanati
Oh, my goodness, it was frenetic. So I finished my medical training while pregnant with our first child, and then dove right into practice. We were living in New York City and we had our second child there, then we decided that maybe being closer to family was a good idea. And so we moved back home to Cleveland, Ohio, and I fortuitously joined the Women's Health Center at the Cleveland Clinic, and we had our third child.

Sabrina Merage Naim
Yeah, wow, that's a lot.

Beth Ricanati
It was too much for me, actually. We didn't have the term then, "Physician burnout". Let's just say that I was trying to do it all, I was trying to be a mom and be a clinician and be a wife and a friend. And I somehow lost myself in the process. It was easy to do. I loved being busy like that. I thought that was fantastic to be running around the hospital, and then dashing off to pick up one of the kids, and then try and make dinner and do all these things. And being busy like that was was exciting for me. But what I didn't realize, and I didn't realize this till years, years later, the value of self care and the value of needing to refill my tank, so to speak, to take care of myself, so that I actually could turn around and be the kind of caregiver that I wanted to be to those around me. And it was a very difficult time in hindsight, because I just didn't stop and I paid a price for it. I ultimately had trouble sleeping and I was losing weight and I just wasn't healthy and didn't see it. Didn't see it at all.

Sabrina Merage Naim
What sticks out to me about what you're saying is that, and I think this affects so many of us, is when we are in the middle of it, in the middle of the chaos and the hubbub, we keep busy, and we don't even recognize, often, that we are not taking care of ourselves and that we're not, you know, doing the things that we need to do for ourselves in order to be able to take care of others around us. Right? How often do we get so caught up in the chaos of the machine, that we don't even have that self awareness until so long after the fact? The other acknowledgement that I want to make is that this is all pre-COVID. And so imagine that physician burnout that you're referring to, how compounded it is for physicians, in the last couple of years with everything that we've gone through in terms of COVID and, I mean, just the pandemic in general, but also for female physicians and clinicians who have everything that you just talked about, the needing to be everything to everyone, plus COVID. So just an acknowledgement for those of you out there who are in that position. That it's crazy, that physician burnout is real and it was real before COVID, and it's certainly much more real now. But the overwhelm you experienced is really not uncommon among working mothers, not just even physicians. It's something we talk about a lot in this podcast.

Beth Ricanati
I didn't know how to talk about it, unfortunately, when I was really in the throes of it. Unfortunately, I didn't realize it and I didn't also know how to talk about it with others, and because I really liked my job, it was almost as if, I think, subconsciously, I probably felt a little guilty, like how can I complain? I have this dream job, these wonderful children, a great marriage, like, what? How can I complain that there's there's a problem. And it wasn't until I got off that merry go round and literally pivoted 180 degrees, that I was able to start to reconcile some of these issues.

Sabrina Merage Naim
Right. I think I think what's interesting about your position, especially, is that as a, quote unquote, caretaker, you were a caretaker for your children, for your parents, for your spouse, and for your patients. Right? Having that position of caretaker kind of across all categories of your life is already extremely overwhelming. And like you mentioned, you you worked at both Columbia Center for Women's Health and the Women's Health Center at the at the Cleveland Clinic. And what I'm curious about, because at that time, you didn't necessarily recognize it within yourself, but did you see it in others? Tell us about what you saw in your patients, particularly women?

Beth Ricanati
Great point. Yes, I was seeing again, and again, so many patients who might be coming to me with physical ailments, but they weren't just physical stress. Stress is such an important aspect of our lives, it can make us sick, and when we're sick, it can make us it can make it harder to get better. And so many of these women were carrying so many burdens, and didn't necessarily put all the pieces together. Because when we certainly weren't, at that time talking about it, you know, in general, there wasn't that that conversation happening. I'm glad to see that it's at least more acknowledged now and talked about now. But I spent a lot of time just talking about the need to, you know, eat breakfast or the need to find some time for themselves and to figure out maybe how to exercise even for a few minutes a day. When I left the Women's Health Center at the Cleveland Clinic, I stayed for a few years at the clinic before we moved out west and I was in the wellness Institute there, running a program to treat chronic disease through lifestyle. And that is where it really hit home, that the power of food, and the power of exercise and the power of stress management can fundamentally alter our health.

Sabrina Merage Naim
I want to be clear that you are a physician, you are an internist, not a mental health professional, but those lines really get blurry. Because what you're saying is that, oftentimes you would have patients coming into your clinics that were having chronic issues and disease, and were sick, you know, medically, physically ill, and that the underlying issues were mental health issues or stress issues, right, or lifestyle issues.

Beth Ricanati
They certainly were compounded. I mean, diabetes isn't a mental health issue, per se, but if you you have to incorporate both. I am a firm, firm, firm believer in traditional Western medicine and taking medication, and if you need surgery, and all of all of that, but I think it -- and not but -- and I think it works hand in hand with lifestyle modification for lack of a better term. I mean, I think you have to, if you if you have a thyroid condition, or you have depression, or you have diabetes, or you -- pick the condition -- or cancer, God forbid, or you know, an autoimmune disease, there's a role a significant role for traditional medicine, you know, and whether it's taking taking a medication or getting an infusion or having a procedure, and I think it's complemented by thinking about what you eat, and how you approach your life and having some form of stress management, as well as part of that. I think they complement each other so nicely and so effectively.

Sabrina Merage Naim
Yeah, and that philosophy, correct me if I'm wrong, is not necessarily one that comes from medical school or training, right, oftentimes, from what I understand as someone who's not in that field...

Beth Ricanati
Although it's changing.

Sabrina Merage Naim
Okay, great. I like to hear that, but a lot of the training that you were getting was very much the treating your patients through medicine, treating your patients through if, you know, it was surgery or whatever. And it's not a lot of that holistic lifestyle, changing the food, the nutrition, right, that did not come from your training.

Beth Ricanati
No, when I trained, and obviously this was a while ago, but when I trained, there was a clear line in the sand and over here it was you take a pill, or you have a procedure, etc. And then over here, other people on that side might talk to you about acupuncture or breathing or Reiki or some other something.

Sabrina Merage Naim
And it was considered woowoo, right? It was like the woowoo medicine that wasn't legitimate.

Beth Ricanati
Right. And in fact, I often felt, which probably contributed to some of my burnout, quite frankly, in the last few years of my job at the Cleveland Clinic, when I was talking up the lifestyle modification program that we were running, I often felt that from some of the more established physicians that they thought I had gone off the deep end. And that, you know, all I was preaching was, you know, yoga and blueberries. And that's not really it at all. I mean, in fact, there's a lot of data and this whole idea of epigenetics that look at how the foods you eat, literally play on your genetics and can affect your disease status. So broccoli, for example, actually can turn on and turn off certain genes in your body are impacted from cancer. I mean, there's so much, you know, real scientific really good research in this area that look at both, and you have to just, I think be a little more open minded. And that wasn't the case, you know, when I when I was originally training. Now I'm so grateful to see that so many, both medical schools and, you know, obviously, then research are actually looking at the synergy between what I would have traditionally said is, you know, more Western based medicine, and what I learned and trained, and the more alternative side of things. So I think there's an understanding now and an awareness that when we talk about health, and health and well being, we mean the whole body, our mind and our physical body.

Sabrina Merage Naim
And it makes so much sense.

Beth Ricanati
It's exciting to see.

Sabrina Merage Naim
Right? It just feels so obvious that the fact that it has taken us so long to get here is, is a little bit shocking. But I'm glad to see that things are headed in the right direction. And I want to ask you about some of the trends you are seeing as a physician in terms of mental health differing between women and men. We know, for example, that women are more likely than men to be diagnosed with depression, with eating disorders, with PTSD. What were the things that you were seeing in terms of differing diagnoses and and symptoms there?

Beth Ricanati
One of my areas of concentration when I was at the Cleveland clinic's Women's Health Center was actually, it was eating disorders, for example. So I did see quite a few women with eating disorders. And you're right, lots of depression, lots of anxiety, lots of panic. And I think because studies originally didn't necessarily look at the differences between men and women, the picture got muddled, you know, for example, heart disease presents very differently in women than in men. Heart disease is the number one killer for women. But it's not the classic "Oh, I have an elephant on my chest." That's for men. And it took a long time, and now we know and now there's more awareness. But how the different diseases present, they present differently in men and women. And I think there's more of an awareness now, to look at that and to think about that, and to try and piece together what's going on with somebody that we didn't necessarily have.

Sabrina Merage Naim
But what are some of the underlying issues, like you kind of talked about how we don't want to upset the applecart and I think that's poignant, because it's similar to what you were dealing with when you were in the middle of your chaos, right? You didn't have a moment to stop and think about, okay, is my body alright? Like, I'm dealing with three kids and my patients and my husband, my, you know, everyone around me, am I checking in on my own body? Is it, you know, I have questions around, for example, are men more likely to seek treatment than women? Are they more pathologized? I don't know. You know, what are what are some of the underlying issues that we get into trouble before we actually seek the treatment and the care that we need?

Beth Ricanati
Well, there are certainly well documented barriers to care. You're absolutely right. They fall down along gender lines, they fall down along racial lines, socio economic lines, you can start to look into point at all of these, these issues, and they are really significant. We've certainly seen that with COVID in the last two years, right, that who sometimes has had access to either care or who's essential and who had to go to work versus who who didn't have to, and was able to socially distance, or who gets the vaccines and who doesn't, like how does all of this come come to be? It's difficult, it's really, really difficult, which is why for my own little small sort of space in the world, since I can't solve some of those bigger structural issues, I try and really focus on what I actually can do for me, and obviously, for my patients, and now for the people I make challah with, my family. But you know, I try and control the controllables. And I try and encourage those around me to do that as well. Because some of the structural issues are just... sometimes they seem really overwhelming, and they seem insurmountable. And it's sometimes actually, it's almost easier to just throw your hands up and say, "Oh, well." But actually, I have been so impressed by the changes that I've seen, when somebody really fundamentally does alter their diet, or when they really do fundamentally adopt some kind of physical exercise that they hadn't been doing. I mean, it's incredible what how you can impact your health and wellbeing: you can radically alter your blood pressure or your sugar levels or things like that. It's exciting to see. And I like to encourage people about that, because I can't necessarily do much about some of the bigger structural issues and the very the access and the barriers to care that are there. I mean, you're absolutely right to call attention to it, because they exist.

Sabrina Merage Naim
I want to challenge that perspective, for a minute, because I think, oftentimes, especially on this podcast, we're dealing with really big systemic issues, deeply rooted systemic issues, where I often say it feels so overwhelming, it feels so insurmountable that I want to just put my head down and fall asleep, because I can't even think about it, right? And it feels defeating. But as someone who is part of that system, in one way or another, I do think it is part of your responsibility to do whatever little things that you can do. Right, you are not necessarily going to be the be all end all of fixing the systemic issues that exist in the medical world. But you do have a role here. Right, you do have a responsibility. And I do think you're doing that, right, you're doing that in a really important way. You are challenging the training that you had in medical school, that everything is medicine only or procedure only, you are bringing a completely different perspective to people that otherwise maybe would not have that perspective, and you're giving people an opportunity now, to see how they're able to change their lifestyle. Now, how you might be able to do that, where it gets impacted by the gender lines, the racial lines, the socio economic lines, you know, that's something that I challenge you to kind of look at. But I don't think that saying, you know, it's so big, it exists, it's insurmountable, so I can't do anything about it. I just can't accept that. With all due respect.

Beth Ricanati
Yay! We need more people like you because sometimes I get so overwhelmed, Sabrina. But no, you're absolutely right. So every week at the Venice family clinic, that is what we are trying to do.

Sabrina Merage Naim
So I want to get back to your story. We have now spoken about what it was like for you, that overwhelm that chaos, how you had the physician burnout, how you also saw that around you, right, that there were so many different- I mean, we could sit here and talk about the mental health epidemic among women, the mental health epidemic among teens, it could go on for ages.

Beth Ricanati
Oh gosh, don't get me started. Yes.

Sabrina Merage Naim
It could go on for ages.

Beth Ricanati
Yes.

Sabrina Merage Naim
But I also want to know when was your breaking point?

Beth Ricanati
I was recommended by a girlfriend at the Jewish new year about 15 years ago, to make challah, the bread that we have for Shabbat.

Sabrina Merage Naim
Yeah, wait for those of our audience who don't know what how challah is, please just give a brief overview.

Beth Ricanati
Okay, so challah is this wonderful braided bread, that in the Jewish tradition, it is made every Friday for Shabbat, so for Friday Night Dinner, and then we also make it for various holidays. I knew nobody at that 15 years ago who made challah. I only had it myself a few times a year, I thought it came in a plastic bag from the kosher bakery, you know, where I never went, quite frankly. And I thought it was an insurmountable task to make this bread. Oh and it involves yeast, which I had never touched in my life, so that was terrifying. But my friend Abby said, "No, you can do this. It's a recipe from the JCC in Manhattan from a mommy and me class that I just did with my two or three year old I can't remember. And it's six ingredients, Beth, I think you can handle it." So she convinced me, Sabrina, to try it. And the most amazing thing happened. I literally, I think it absolutely changed my life, I mean, at at the risk of some hyperbole. I began down a completely new path, I mean, I did a 180. So the bread turned out that day. I mean, it wasn't the most beautiful, I've gotten better at the braiding. But the bread turned out. I was amazed, my kids were amazed, and I had so much well, fun is the wrong word. I stood at my kitchen counter, we were in Cleveland, Ohio, then, if you can picture this, I stood at my counter with the ingredients spread out in front of me, and I was focused on them. Like I know, it sounds kind of crazy to say, but I was actually present. Back in the day, I had a Blackberry and a beeper and all these things. I wasn't doing any of that. And I wasn't picking up my kids toys, and I wasn't, you know, signing permission slips, I just was trying to mixed flour, and sugar, and eggs in a bowl. And I felt so good. Because I was just present. And I hadn't realized what that felt like in a really long time.

Sabrina Merage Naim
I want to just interrupt you because I think it's so funny, first of all, that the idea of baking challah which is not, like you said, it's not actually that complicated of a recipe, was the thing that intimidated you, a doctor, who literally has the lives and livelihoods of other people in your hands. But the challah was the thing that was like so intimidating.

When I was a resident, I did some crazy procedures. And somehow, opening a packet of yeast was just...

Sabrina Merage Naim
That was the thing that put you over the edge. I think that's really funny. And also for those of you listening, who maybe don't connect so clearly with the challah per se, that this should be the placeholder for the rest of our story. This is the placeholder for that, you know, X thing, right, that really makes you stop, makes you disconnect from all of the normal, you know, chaos that you're involved with. And the your phone and appliances and the kids and the whatever that you have going on. Challah baking was that for Beth. And for Beth, actually, who now does, you do trainings and forums and speaking engagements around it and baking classes, that it ends up being that way for a lot of other people. But it also can be seen as a placeholder for whatever that might be for you, right? That might be knitting, that might be running, or riding a bike, or whatever. But in this case, there was something about working with your hands on a simple task that changed your life. Can you just talk about that a little bit more?

Beth Ricanati
So I ultimately wrote a book about it. And when I was What is it about this bread? That is so therapeutic for me and it's exactly in part what you just said, the actual experience. There's a whole body of research that looks at the Creative Arts, the knitting, which which you mentioned, I'm going to extrapolate and say challah making, but when you're use your hands in a creative pursuit, you feel more grounded. Now you feel present, you feel less anxious, and because I'm grounded right then and there in the dough making challah. It's a phenomenal experience. And as a result, I kept doing it. And I learned so many lessons that I wanted to share it. You know, call it what you will, it's not a routine, you know, there's a difference between rituals and routine for me, making challah is a ritual. It's not a routine, it's not walking my dog or folding laundry, those are routines. This is different.

Sabrina Merage Naim
Yeah, I do want to ask you about that because ritual, to me, sounds so much more meditative than a routine, and just to go back to your book for a second it's called "Braided: A Journey of a Thousand Challahs," and in the book, and since then, you've written a lot about the benefit of meaningful rituals on mental health. And I want to know, how for you this was making call on Fridays with your family, and now doing that in forums with others. What does meaningful ritual mean to you? Can you explain a little bit more, this word that has become very powerful, ritual?

Beth Ricanati
Having a ritual, to me, is having an experience that A) I do repeatedly. So I might have made challah once, 15 years ago, that wouldn't have been a ritual. That would have been an experience. But it's something, first of all, that I come back to again, and again, and again, I come back to it at a set time, in a set way. And I do things throughout the experience of making challah to elevate it. So for example, I always set an intention at the beginning of making challah. And I think when you bring in different behaviors, if you will, that's may not be the best word choice, but to elevate the experience, and you focus and are present there and then, you make it a ritual. You know, I mentioned walking the dog, you know, when I walk our dog, and I adore our dog, as anybody who knows me knows, we spent COVID together, she and I, she on my lap, but I'm just walking her, right? I'm on my phone, I'm looking around, I'm not paying attention. It is not a ritual. It's just a chore. But when I'm making challah, it's a very special experience. I make it on Fridays, sometimes Thursday night, I set an intention, and I'm there.

Sabrina Merage Naim
When you say set an intention, say more. What does that mean for you?

Beth Ricanati
Yeah. So I learned this beautiful concept about setting an intention when you make challah, and it was explained to me originally as you have an opportunity to make challah in the merit of somebody or something. So for example, I haven't yet made my challah this morning, which I will do right after our conversation, and I'm going to make it in the merit of this experience and speaking with you because I find it really thought provoking. Because I think when you set an intention, and you say it out loud, not in your head- whether you're alone, or there are other people around, I don't care, I'm really fervent about this, you have to say it out loud. Because I really do think that when you make it audible, great things actually can can happen. There's something really marvelous about that, I think.

Sabrina Merage Naim
When you say that this changed your life, you're really not exaggerating, because today, a still practicing but much less, and the lion's share of what you do are these workshops. And I'm curious to know, why do people bring you to teach challah workshops? Of all the things that you could be doing or teaching what is it? To be fair, it sounds kind of simple, right? There are a lot of people that make challah but you do it a little differently. Why?

Beth Ricanati
I do it a little differently. Exactly. So because I'm a physician, not really a baker, I look at this whole experience very differently. It's an act of mindful meditation. So when I make challah I like to talk about intention, I like to talk about being present. I like to talk about taking a breath taking a beat as you mentioned, I like to talk about helping others and I like to talk about the ingredients themselves. I am really obsessed with this idea of food as medicine. And I have been profoundly impacted both myself and we have chronic Disease in my immediate family, and then also obviously, with my patients, it actually really matters what you eat. It really does. So I love to talk about that when I'm making challah. And particularly when here I am a physician standing in front of people with, you know, white flour all over me. And I like to explain that these are six ingredients I can pronounce, let's just start with that, I actually know what they are, as opposed to when you go to the grocery store, and walk down the bread aisle and pull out some random loaf of bread and you turn it around and you read the ingredient list that's a mile long, and I don't even know what half of that stuff is. I want people to eat real food. And I want them to think about the quality of that food.

Sabrina Merage Naim
You are now leading workshops in companies, and for medical students, and at churches and synagogues and kind of across the board. And a lot of what you're saying that you talk about is the importance of food as medicine, the importance of stress reduction, and bringing ritual into your life and these meditative practices. And all of this is wrapped up in self care. And I want to talk about self care for a second. Because right now, especially, there is so much screaming at women, for the need to bring self care into their lives, that it almost starts feeling like a burden, honestly, like people are just shouting at us that we need to care for ourselves more. And for for years, women of color, in particular have been advocating for a shift away from self care to community care, you know, because it just feels like "okay, well, who the hell is going to be doing all the things that I'm supposed to be doing if I am now caring for all of these things that I need to do for myself," it feels like there's a disconnect here because we do not have the resources. And in particular, this stems from a woman named Nikita Valeria, who posted on Facebook in the wake of the Christchurch mosque shootings in New Zealand, "shouting self care at people who actually need community care is how we fail people," which was so poignant and spread like wildfire. So where is self care limiting? And when does it go from being helpful to being toxic? When should we start acknowledging the need for community care, and how is that involved in what you're talking about as well?

Beth Ricanati
When I think about self care, you need to take care of yourself too, in some capacity, so that you can turn around and take care of others. So for example, I love the analogy of the oxygen mask on an airplane and how the flight attendant says, "in case of an emergency, and the mask will drop, be sure to put the oxygen mask on yourself first, so that you can take care of others." A) I like it because yes, you need to take care of yourself first, literally, so that you can take care of others, you need to make sure your oxygen mask is on. But also, that's a quick action, right, I'm not advocating that we all go and abdicate in our sort of regular lives, and instead, you know, just go and indulge taking care of ourselves all day long instead. It's not an either or.

Sabrina Merage Naim
I couldn't agree more. And I think it goes back to what you were saying at the beginning of the conversation, which is that you weren't taking care of yourself and therefore you could not be the kind of caretaker for those around you that they deserved and that they needed from you. And it's true of our family and it's true of our broader community. If we neglect ourselves, then we cannot be part of this community care that we so desperately need. But I like the distinction, also, that, you know, there was this thing going around social media where it was like, you know, "women stop doing the laundry and stop, you know, cooking every night and stop doing this and that and just care for yourself." And the response is, "well then who the fuck is going to do it?" Right? I like the word abdicating. We're not abdicating our responsibilities and what we need to do in our lives to care for others. We are including those things, those rituals, as part of that, as an essential part of that in order to more fully be able to care for those around us. And so I really agree, I think it's so true that community care only can happen after self care.

Beth Ricanati
I think I would say that self care is part of community care. To provide community care we need to nourish ourselves and, AND not or, and we need to nourish those around us we need to take care of all of us.

Kassia Binkowski
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