The problem with "self-management"

If you’re a regular listener of The Rest Room podcast, you may have sensed a little bit of a theme. I’m very interested in exploring tools and techniques to help us learn how to live well with chronic illness. We’ve explored topics like pacing and how to safely and sustainably introduce movement into your life - things that are often lumped into the bucket of “self-management”. To me, self-management has always been thinking about the stuff I have to do myself (often outside of a medical setting) to manage my conditions on a day-to-day basis. But I never really took the time to ask: what are we actually talking about when we say “self-management”? For so many people living with long-term conditions, being told to “self-manage” leaves them feeling neglected and abandoned without appropriate care. It can feel like a cost-saving exercise for an overstretched healthcare system, and patients are often left alone to “manage” as best as they can. It turns out that “self-management” is not just one thing, and that even within the NHS, nobody seems to agree on what it means. Which (obviously) has significant repercussions for patients. And that’s exactly what we’re going to be exploring with our guest, Jackie Walumbe. Jackie is a physiotherapist working for the NHS in England and is the co-chair of the Physiotherapy Pain Association. She’s also working on her PhD, which focuses on the self-management of chronic pain.In today’s episode we do a deep-dive into all things self-management, including:* Why can’t anyone agree on what self-management actually means?* How do we have such a disconnect and what does this mean for patients?* Jackie’s research into self-management * People falling through the gaps and the burden of responsibility on the patient* How should we conceptualise self-management (or should we even be using that term at all?!)* Learning from patients* How can we provide better pain care for patients in the future?…and much more. This was a fascinating conversation, and it made me rethink a lot of things that I just took for granted in the pain space. I hope whether you’re a patient or a clinician, you’ll find it just as fascinating!To listen, you can just click play at the top of this email, or you can listen on Apple, Spotify, Amazon and Google. If you’d rather read the transcript of the episode, I’ve made that available on my blog.Please note: if you receive this email within the first few hours of it being sent out, it might take a few hours for the podcast to filter through to some of the podcast platforms like Amazon or Spotify.A huge thank you to Jackie for sharing her research with us. You can follow Jackie on Twitter and learn more about the Physiotherapy Pain Association.A big thanks to Phlo for supporting this episode. They’re the online pharmacy that makes ordering your medication easy. Visit wearephlo.com or download Phlo on your favourite App Store to manage, track and have your medication delivered at the touch of a button.Thanks to my brilliant producer Philly Guillou at OG Podcasts, to Lucy Dove for the episode art, and to Amit Rai for my intro music.If you want to support The Rest Room, please consider becoming a premium subscriber. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit natashalipman.substack.com