TL;DR: Starting today, you can expect twice-weekly posts from me on Tuesdays and Fridays, including essays, real takeaways from my therapy room, answers to your questions in my Dear Pooja column, and short, actionable practices to help you take an idea we’re exploring and bring it quickly into your life. All subscribers will have access to all posts in September. Thank you for being here!

Hi folks,

One of the most durable myths of modern life is the promise that, no matter what is happening around you, with the right plan, the right habits, or the right mindset, you can engineer your way into a better version of yourself.

That story, at best, misrepresents how life actually works. And, at worst, when life becomes messy, slow, or just more confusing than we expect it to, it causes intelligent, thoughtful people to assume that it’s evidence that they are doing something wrong. In reality, they are living through something that cannot be optimized away, that won’t respond to fixing, and that requires new types of thinking and feeling.

Here’s the truth: Life is not always supposed to lead up and to the right.

I’m Dr. Pooja Lakshmin, a psychiatrist and writer. Over the past two decades of my training and clinical practice, I’ve spent thousands of hours sitting with people during the moments when their lives — and who they thought they were — stop making sense.

I was trained inside a medical system that often pathologizes these experiences, and I bring clinical rigor to questions the wellness world treats as vibes, and structural honesty to questions medicine too often treats as individual deficits.

Some of you have been here for years. Others found me through my book, Real Self-Care, my writing for The New York Times, or a post someone sent you. And some of you are brand new.

So: Hi! I’m glad you’re here.

This newsletter is where I think out loud about how identity-level change actually happens, and what it asks of us in a culture that insists our lives should keep getting better, no matter the cost.

Each week, I want to give you language for what you feel but cannot yet name, perspective on why this era makes change so difficult, and a clearer sense of how to move forward when the old frameworks no longer fit.

Why I’m investing more deeply here

Over the past year, I was writing my next book, Quantum Shifts, as I was postpartum with twins. I knew I was living through my own transitional space and growing into a career that had become increasingly public. As I wrote the book, something became increasingly clear to me: writing is my happy place.

I loved the hours I spent reading, thinking, following an idea, and trying to put language around experiences that are difficult to explain. I kept finding moments of flow and ease in the work. And, when I imagined what I wanted more of in the next chapter of my career, the answer was surprisingly simple: more time to read, write, think, and be in conversation with you.

As I was thinking about making this newsletter my intellectual home, I remembered that this is not actually my first regular writerly dispatch. In middle school, a friend and I started a zine called Snickerdoodle. It was part celebrity gossip, part chronicle of what was happening in our lives, and part doodles about whatever had captured our attention that week. (I am now determined to find an old copy in my parents’ basement in Reading, PA).

Apparently, I have always wanted a place of my own, a place to collect what I’m noticing, make sense of it, and send it out into the world. At one point that was my Instagram, but in these times, I understand that my work needs a much more stable home.

On top of existential and creative reasons to write more here, there is also a more practical one. My twin girls turned one last month, and my son is four, which means I now have three very young children at home. I’ve also been coming to terms with the reality that I don’t want to build a career that requires me to be on a plane every month for a speaking engagement. I want to be more present in the life I have.

So I’m investing more deeply in this newsletter.

This newsletter will be my intellectual home: a place where the big ideas and the realities of actual life can meet. A place where we can, together, name what is happening, think seriously about why, and practice living more honestly within it.

I’m putting my stake in the sand and betting that I can make this happen. And you told me you want this, too. (Nearly 300 of you spent an average of 25 minutes on the reader survey I shared earlier this year! You’ll hear more about that in the coming weeks.)

What you can expect

Beginning this month, I’ll be publishing twice a week, typically on Tuesdays and Fridays.

There will be substantial essays, relatable takeaways from my real-life therapy room, and answers to your questions in my Dear Pooja column. Twice a month you’ll get a short, actionable practice to help you take an idea we’re exploring and bring it quickly into your life. I’ll also occasionally share the books, conversations, and cultural ideas shaping my thinking.

This fall, we’ll talk about:

• The strange grief of getting what you wanted

• The experience of doing everything “right” yet no longer feeling at home in your own life

• How to set a boundary when saying no carries a real cost

• What happens when the calendar says you should be over something, but your psyche is moving on a different timeline

• And much more about the big transitions of our lives during uncertain times

You’ll learn new language, consider alternative perspectives, and, at least twice a month, get one small, actionable practice to try.

Subscribe now

The core of my work is not changing — the goal was never to become a smoother, more optimized version of yourself. The goal is to interrogate and understand yourself, to feel clear about your decisions and the reasons you are making them, and to understand how forces larger than you are impacting the choices that are available to you, and the risks that are required.

I will raise the paid newsletter subscription price a month from now. But first, I’m giving all of my subscribers full access to everything I post in September. If you want to lock in the current paid subscription price for life ($7/month or $70/year), be sure to upgrade before October.

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A juice cleanse and a bubble bath were never going to save you. But an honest conversation with yourself — one that finally matches the complexity of what you are actually moving through — might.

That is real self-care for our times.

I’m so glad you’re here.

xo,
Pooja

You are reading Real Self-Care, a newsletter written by psychiatrist and bestselling author Dr. Pooja Lakshmin MD.

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Remember: A juice cleanse won’t save you, but an honest conversation with yourself might.

About a year ago I stumbled on an entire genre of YouTube videos devoted to children playing with toy cars for an audience of other children. The so-called entertainment is watching another child play with their toys.

The first time my son saw one of these videos, he was transfixed.

In self-directed play, children take an action, see what happens, and discover what they do next. They learn to tolerate uncertainty, revise the plan, and experience themselves as capable of affecting their environment. Decades of research have linked play with the development of executive function, self-regulation capacity, the development of creativity and learning social skills.

Viewing content of another child playing with their toys is arguably the polar opposite of self-directed childhood play. In this form of entertainment, the child is a pure spectator. If I’m being brutally honest, it feels pretty dystopian that this is a (wildly popular) genre of vlogging.

As a psychiatrist, I understand how important play is not only for childhood development, but also for adult development. During periods of change or uncertainty, adults also need to experiment, act spontaneously and tolerate not knowing how things will turn out before we can know who we are becoming. We learn who we are partly by acting upon the world and paying attention to what happens next.

When I found out that Dolly Parton had passed away earlier this week, I unexpectedly found myself thinking about those damn toy car videos.

At first it didn’t make sense — and then I realized the connection.

I’ve long understood Dolly partly through Tressie McMillan Cottom’s The Dolly Moment essay which I first read years ago. If you have not read it, please do— it’s a Tressie classic.

Dolly belongs to a rare category of people. Despite the weight and scrutiny of her unfathomable fame, even at 80, we can see a continuous thread connecting 80-year-old Dolly back to who she was as five-year-old Dolly, who wrote songs while her mother recorded them.

Dolly, as far as I can tell, was the same person she was at 70 that she was at 7.

By “same” I don’t mean that she didn’t grow or evolve. I mean that she remained connected to the essence of herself, and her identity, even as she changed — that she continued to experience herself as an actor in her own life rather than primarily through the eyes of an audience.

What’s so fascinating to me as a psychiatrist is that fame usually works against that. Being watched by millions (in Dolly’s case, probably hundreds of millions) typically distorts one’s perception of what belongs to their authentic selves and what is put on for the show. We don’t see celebrities reach the height that Dolly did and maintain such psychological cohesion very often.

How did Dolly do it?

To be clear, we cannot know for sure what it felt like to be Dolly Parton from the inside. But from the outside, her life offered a nearly singular picture of a person who continued to act upon the world even as the world watched her. One of Dolly’s most famous statements, which she talked about in a 2025 interview, was, “Find out who you are and do it on purpose.” But she also described the task as one of protection: “You’ve got to find out who that person is, and you’ve got to protect that little person.”

From a young age, she was writing and singing. She went on to build Dollywood and create the Imagination Library, which has since gifted 300 million books to children. Throughout her life, she kept her agency: writing, performing, building, giving and deciding what came next. Even under extraordinary scrutiny, she never appeared to become a spectator of her own life.

Which brings me back to the YouTube car videos. Today, many children encounter that sequence in reverse. Before they have had enough time to discover what they want to make or who they want to become, they can spend hundreds of hours watching other people perform neatly packaged lives on a tiny screen. We have spent years asking whether screens are making young people more anxious, depressed, or distracted. It’s a valid question but there is another developmental question I think we should also be asking: What happens when children spend the years in which they should be learning to live their own lives watching strangers live theirs instead? And, what happens when this scenario carries over into adulthood as well?

We can hypothesize: they lose opportunities to generate firsthand information about themselves: what draws them in, what feels frustrating to them, what fills them with a sense of fulfillment. Crucially, that need does not disappear at 18. Adults maintain psychological continuity in much the same way: by continuing to experiment and act, especially when an old version of life no longer fits.

There’s something else that happened this week that makes this all more interesting. Yesterday, news outlets reported that Meta has agreed to pay up to $16.68 billion to states that brought charges against it and change how Facebook and Instagram operate for minors. The case against Meta centered on kid’s safety and mental health (Meta settled the claims and denied wrongdoing). But it also points toward a developmental question that is harder to quantify: What happens to a child’s sense of agency toward their own life when watching displaces doing? (To be fair, that displacement cannot be blamed simply on screens or on parenting; this change is occurring in a culture that has made safe, affordable, independent play unattainable for many families, while screens become ubiquitous.)

Dolly Parton became someone the world wanted to watch. But she never appeared to become a spectator of her own life. Perhaps that is the thing she modeled best, and why we will most miss her.

Tell me, how are you thinking about Dolly’s legacy? How are you feeling about her passing? I’d love to hear from you in the comments.

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You are reading Real Self-Care, the email newsletter written by psychiatrist and bestselling author Dr. Pooja Lakshmin MD.

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📚 Order my book, Real Self-Care, as an e-book, hardcover, or audiobook.

💬 Hire me for a keynote by sending a message on my website.

📲 For more on tech and child development, check out my conversation with Dr. Dana Suskind about her book Human Raised in What Kids Need that AI Can’t Give Them.

The pace you’re keeping was never built with your actual life in mind.

A few years ago, I ended up in the ER with an angry gallbladder. Two weeks later, I was back with a kidney stone. Yes, you read that right. I ended up in the ER twice in two weeks. How rude.

My body was going through it, but the real wake-up call was how glorious it felt to be stuck in that hospital bed.

I was burned out from moving at a delusional pace after bringing a new baby and a new book into the world, combined with the sincere belief that I could just rest and bounce back. Even as a psychiatrist and author of a book called Real Self-Care, I’m still guilty of dismissing my needs and only stopping when I’m staring down a picture of my chronically inflamed gallbladder.

Sheepishly, I’m also not surprised. The story running underneath all of it is one most of us absorbed so early; life should always be up and to the right. Take a break? You’ll just fall behind. Rest? LOL yeah right.

“That’s just life!” you say with an exhausted shrug or slightly unhinged laugh, depending on the day.

Your default is white-knuckling through life at an ungodly pace. That’s the story I want to interrupt for you today before it takes you all the way down.

We think of burnout as a willpower problem when it’s actually a result of what happens when your real, complicated life keeps running into a system that was never built to accommodate it — the childcare gaps, the caregiving demands, the workplaces that treat rest like a personality flaw.

It’s not burnout, it’s betrayal.

If you’re like me, you probably struggle with slowing down. Believe me, I need to remind myself to slow the F down at least once a week (okay once a day!).

Real Self-Care is where you get language for what you feel but can’t yet name, perspective on why this modern era makes change harder, and a clearer sense of how to move forward when the old frameworks no longer fit.

The system isn’t changing today, but here’s what you can actually do in the meantime.

What I’ve learned the hard way, apparently twice, is this: You don’t need a medical emergency to sanction your rest. You can sanction it yourself.

I put together a free practice based on what I did — and what I’ve seen work with my patients — to help you slow the f down.

Step 1 — Identify the Delusion.

Before you can slow down, it’s important to understand the structural forces that shape your reality. An inflexible workplace. Caregiving constraints. Childcare needs. Financial limitations. A culture that treats rest like a personality flaw. These often invisible forces are exactly what make your to-do-list delusional, assuming you have unlimited time, resources, and capacity. Name what sounds true to you. That’s where the personal failure story starts to lose its grip.

Step 2 — Give Yourself Permission to Stop.

It’s unrealistic to light your to-do list on fire, so start by identifying one thing you can pull back on this week by 25% and notice what happens. Did someone’s life depend on it? Probably not. Did you feel a little lighter? Probably.

Note: when you complete this step, you will likely feel a bit nauseous and like you are making the biggest mistake of your life. As I like to tell my patients, Guilt Does Not Need to be Your Moral Compass…Keep going anyway.

Step 3 — Do the Hell Yes Things.

Faux self-care tells you to treat yourself. Real self-care tells you to fuel yourself. In order to feel well, you have to keep doing the things that made you feel well in the first place. Your Hell Yes thing should be something that’s uniquely yours. Start by asking yourself: What gives me energy vs what drains me? The best Hell Yes things are oddly specific, not generic.

Step 4 — Get Curious From the Inside Out.

Name the real things in your life that would get more of you if you loosened your grip a little. Naming it moves you from the abstract to the specific, and it becomes something you can actually move toward.

For me, it’s so I don’t spend every weekend working. So I have more time with my kids. So I can actually take care of my mental and physical health instead of just writing about it. So I can get my next book edited and out into the world, and give this newsletter community the attention it deserves.

The system hasn’t set you up to do this easily, but you aren’t powerless. You can choose how to direct your attention and energy. That choice, practiced over time, is what makes your nervous system feel a little less like it’s on fire.

Paid subscribers get the complete Slow the F Down Resource with reflection prompts and experiments to help you figure out what slowing down actually looks like inside your life, with your constraints.

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Hi folks,

I submitted my final round of revisions for my next book, Quantum Shifts, last Friday and went into the weekend with the book completely off my desk. It will now go into production, which includes copy-editing, setting it into pages, and all that fun stuff. I also received proofs of the cover options, which is very exciting. I got to query all of my friends on their favorite cover looks, and I’m really happy with how it is turning out. (Let me know if you are interested in hearing more about how a book cover gets picked because it is quite a process.)

Today, I want to follow up on the thread that we began in my last personal note about how it felt to ask for an editing extension from my editor. Though that was a tough decision for a workaholic like me to make, in the end I delivered a work product that I felt proud of, in a way that didn’t betray my values. I practiced what I preach, which is that sometimes we need to ask for more time. And that’…

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Hi folks,

This week’s letter is coming to you a few days late as I’m still head down in the last of my book edits for Quantum Shifts. But I wanted to make sure to get this note out to you this week because it’s an important one.

Whatever your thoughts on AI are, the conversation takes on a whole new layer of meaning (and complication) when we talk about AI and kids.

Personally, I’m trying to make sense of the flood of new information about AI coming at me at all times as the conversation seems to change and grow week to week. (One newsletter on the topic that I have been reading and find valuable is ’s Mind and Iron. ) I’m trying to imagine what the next decade of education will look like for my kids (my son will enter public Pre-K4 next month). There’s so much uncertainty about how AI will affect learning and development and parenting — and we’re only at the very beginning of the conversation. Practically speaking, elementary school age ki…

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Hi folks,

Those of you who have been here for a bit know I’ve had quite the year. I gave birth to twin girls almost exactly one year ago (Mira and Anya will turn one this weekend!). I took three months off last year after having them via C-section, then got right back to my private practice and keynote speaking work. And I wrote the first draft of my second book, QUANTUM SHIFTS.

It was, ummm, a lot.

Last month I was in the messy middle of first-round edits for the book. I was supposed to deliver the edited manuscript by mid-June. I had a ton of deep work to do in order to hit my deadline. But there was also my son Kiran’s 4th birthday (successfully hosted a party for 20 pre-schoolers!), Father’s Day, and Justin’s birthday, all as my parents were in town visiting us.

Before I had kids, I would put my work before…pretty much everything. When I was younger, I had an attitude of, “My work is so important, probably more important than yours, and therefore I d…

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Listen Now

Hi folks!

The arrival of the summer season hasn’t meant much of a reprieve for me so far. Right now, I’m deep in making second-round edits for my book, QUANTUM SHIFTS, plus traveling for speaking engagements (Boston and Winnipeg!).

For many of us, summer means a jam-packed schedule and a disruption of routines, which can make us feel off-kilter and stressed. So it’s a great time for me to remind us all of how and where we can take back personal power in our lives.

This week, I’m sharing a post all about POWER, and how to reclaim yours within yourself and your community. This post completes a collection of all four real-self-care principles from my first book. Check them all out below. These 101 posts are meant to be helpful resources for you whenever you need them, and they will always remain free to read.

I hope these reminders can be a support system as you shift into whatever mode this season has in store for you.

xo,

Pooja

Power 101

In my book, Real Self-Care, I write about four self-care principles:

1. Boundaries

2. Compassion

3. Values

4. Power

Today, I want to help you claim what’s yours.

In our current state of affairs, it is easy to fall into feelings of powerlessness. With government controlling our access to health care, media controlling our information, and billionaires controlling so many of our public services, each of us is up against a lot.

And that’s how power wants us to feel. Systems of oppression beat us down and strip us of meaning and hope — that way, we’re easier to control, less troublesome.

That’s where our work comes in. We are never powerless, individually or collectively. We can always return our focus to where we do have power, and we can implement change: ourselves, our relationships, our workplaces, and our systems.

This is not me asking you to bypass the very real difficulties of the world and embrace toxic positivity. I am not an optimist, but I am hopeful. Optimism is the sense that everything will be okay. Hope is different — it’s understanding that things may not be okay, but knowing you still have the agency to improve things for yourself and those around you.

Systems change only when many individuals show up to do things differently. Small changes, both internally and externally, can eventually add up to real, wider change. That’s why each one of us, even the marginalized among us, has the capacity to fight back in systems that are stacked against us.

Here’s your quick Power Program:

• Embrace both/and as opposed to either/or to stay connected to your power.

• You must acknowledge bad feelings to practice hope and gain power.

• It’s not your job to change the whole system. It is your job to stay in touch with your agency. Acknowledging the complexity of yourself and others will help you retain power.

• Giving back when you have power generates more power for everyone else.

• Hope is not something you have or don’t have. It’s a skill to build.

Lean Into Both/And

For a long time after I had left the wellness community and was returning to the medical world, I had a lot of deep questions about my character. Did I fall for a scam and ruin my life? Or had I been courageous to question the status quo and follow my interests?

A psychoanalyst mentor had an important answer (really, another question) for me: “Is the knight on a chessboard a small, lifeless wooden object, or is he a powerful player that can change the stakes of the game?” The answer, of course, is both.

Each and every one of us are both. A living, breathing paradox. Many experiences, talents, and flaws, all in one bundle. I eventually came to terms with my past and accepted myself in the present. Yes, I did all of those things, and I was making different choices and building a solid future for myself now. I saw my chessboard for what it was, and I also saw the game was not over.

When we look at ourselves in our situations from the lens of both/and, we give ourselves the benefit of perspective. We recognize that there is rarely just one story, and we’re able to see that more than one truth can be possible at the same time.

Turn Up Your Complexity

Our culture has a way of flattening people’s existence (especially women’s) and of viewing complexity and contradiction as a threat.

It can be tempting to take our big losses, mistakes, and failures and turn those into our whole identities or the entire lens we tackle life from. When we use both/and to better see and reflect on all sides of our stories, we empower ourselves.

Each of us has a complex story. That’s okay. What we’ve overcome and how we’ve changed is part of our agency and power.

When we don’t flatten ourselves or others, or immediately label people as someone different than we are, that’s powerful. It’s one way to push back against our society’s expectation that people should conform to one stereotype or narrative.

Trade Cynicism for Agency

Practicing real self-care requires taking ownership of yourself back from the system that has held you down. Those systems can include your family, your workplace, society, or all of the above.

Revolution first requires changing our internal landscape — that’s what real self-care is all about. Once we change ourselves, we can go forth and exert power and agency in the outside world.

I think of this as planting seeds of revolution. We are seeding the future for ourselves and for the next generation as well. Remember, this work is ongoing and blossoms in unexpected ways.

Establish Hope as a Practice

In order to cultivate hope, people need to activate one or more of four different types of coping skills:

1. Problem-solving
   Jumping to a task or action that helps you move forward tangibly

2. Emotion regulation
   Reducing your in-the-moment stress level or feelings of discomfort.

3. Activating a core identity
   Connecting with an individual or collective identity.

4. Relational coping
   Connecting with mentors or important people in your life.

Each of those coping mechanisms can help you get back in touch with your personal power and find hope exactly where you are.

Exercise: Identify your hope-building skills

1. Think of a recent bad experience. Why did the situation make you feel so bad? Remember the feelings that you experienced at the time.

2. What actions did you take immediately after this event happened? Think about what you did in the hours, days, and weeks that followed. How did you cope? Did you move into problem-solving (specific actions like researching or collecting more information), or did you immediately reach out to a trusted friend or colleague (relational coping)?

3. Get granular. Which coping skills do you tend to reach for? Which did and didn’t work for you? Keep in mind we often use a mix of all four coping skills in order to build hope for ourselves. There may be two that come most naturally to us, but remember that all of these tools are available to you in times of distress.

Remember: in the face of so many systemic failures, the practice of hope is the ultimate source of resistance, because it’s always available for us to practice.

Pay it Forward

I believe that community care (another way to say paying it forward) is a byproduct of real self-care. Real self-care builds power, and with power comes responsibility.

Ultimately, the work of real self-care is about changing our relationships with ourselves. What naturally follows such deep internal change is a reorganizing of larger systems.

In order for this reorganization to be equitable for those of us who are most disadvantaged, those of us who hold privilege must share the power we build through real self-care. This might mean giving up some of the things our own privileges afford us — such as opportunities, convenience, status, etc. — so that those resources can be distributed to those who have less power than we do.

Ask yourself:
What privileges do I hold?
What is easier for me than others?
How can I be generous in my personal and professional life?
What am I willing to give up?
How can I give back some of my power right now?

Then take real steps to pay it forward.

Remembering your power is, ultimately, about reclaiming your agency in a world that is constantly telling you that you have none. While the places where you can exert your agency may feel small or few and far between, the act of remembering and deploying your power is, in itself, what builds power. The goal is not to fix everything — it’s to be able to see and act on what you can fix.

You are reading Real Self-Care, the email newsletter written by psychiatrist and bestselling author Dr. Pooja Lakshmin MD.

Share

📚 Order my book, Real Self-Care, as an e-book, hardcover, or audiobook.

💬 Hire me for a real self-care keynote by sending a message on my website.

📲 Find me on Instagram or LinkedIn.

Hi folks! Let’s talk about uncertainty.

We’ve all got problems, and one thing people are always going to do is try to sell you easy solutions. “Join _____ for the answer you seek!” “Buy _____ to find what you’ve been looking for!” As if there is one product or service that can DEFINITELY solve all of your issues.

As a culture, we are addicted to certainty — and we’re willing to pay for it. But, deep down, I think we all know certainty is one thing money can’t buy. Plus, it’s simply not possible in most aspects of our lives. The more elusive certainty becomes, the more people try to grasp onto it in any way they can. People are always trying to solve for uncertainty.

While I was writing my next book, QUANTUM SHIFTS, the concept of certainty kept coming up. When my patients are in the depths of unhappiness and questioning an aspect of their lives, they often have this fantasy that there’s going to be one new thing that’s going to make everything okay — a new pa…

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Hi folks!

In my Dear Pooja column, I answer readers’ real questions about real self-care. Read on for my real talk about why self-care is harder for those with mental health diagnoses — and how to tackle that truth head on.

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Hi folks,

I handed in the first draft of my next book last month, and I’m sitting with some mixed feelings. On one hand, I’m relieved that it’s on someone else’s desk now, but, on the other hand, my mind is now zooming ahead to my book launch. QUANTUM SHIFTS will come out next spring, which, objectively, is so far away — but in real-life time will be here before I know it.

My mind is jumping ahead to a jumble of: This is what I’ll do differently this time (my first book, Real Self-Care, came out in 2023). What kind of support do I need (PR, more admin help). How much will it cost? How can I get organized? Who will I want to ask to blurb, to be in conversation with, etc.?

The business of launching a book is complex, heavy, and not for the faint of heart. But this time, I want to try to do it differently. I want to grow up a bit and act like the accomplished author I actually am.

Throughout my life, I’ve gotten feedback about how I “hide” behind messiness o…

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Hi, folks!

Coming off of the high of turning in the first draft of my second book, QUANTUM SHIFTS, I immediately dipped into a low: I’ve been diagnosed with shingles. For those who aren’t familiar, anyone who had the chicken pox can get shingles — except shingles is much more painful. (There is a vaccine recommended for those 50+; look into it.) Shingles can often be brought on by high stress, which, at least I know exactly how my body reacted to months spent head down writing a book right after having twins. But, luckily, I caught it early, and I’m recovering now.

While I’m taking it a bit easy, I thought I’d share some answers to some of your AMAs on how to get through challenging times — because world news, tough employment conditions, and everything else we’re dealing with is still going on, even when we’re sick or sick of it.

xo,

Pooja

Q: Am I a bad citizen if I take a vacation from the news? It stresses me out so much. 😢 How do you balance preserving mental health vs. reading the news when the world’s on 🔥?

So many of you have asked me this question. It’s a work in progress for all of us.

We are not meant to be sponges absorbing every trauma that comes through day after day (and they do, and they will). It is important to take care of yourself, prioritize, and continue to find joy, meaning, and hope through it all. That in itself is a form of resistance.

You can’t be in the news cycle 24/7; it’s not good for your mental health. You have to figure out the right system and cadence for you to dip into news and stay informed about topics you care about.

Some things I’m trying and working on:

• I have stopped reading the news and listening to NPR as ambient noise (I still love public radio, though). However, that doesn’t mean I’m uninformed. I subscribe to a curated handful of newsletters where I find out the latest terrible thing. But I only look when I’m in the mood and have the bandwidth. That’s about once per day.

• My writing and speaking and advocacy work is how I exert my agency. It’s a balm for me. Find your balm; it could be your kids’ school board or at your church. It’s different for everyone.

• All of us need to “check out” from time to time. That’s OKAY. There is a big difference between saying, “I don’t follow politics” and saying, “For my own sanity, I cannot keep up with every latest terrible thing, I need to protect my attention.”

Q: What are your tips for keeping positive when work is having another “restructuring” (but you are thankfully safe)?

I don’t love ‘staying positive’ when the reality is that this is tough time for so many. We are seeing layoffs all over, and it’s taking a long time to land the next job. I think it’s actually more about being prepared. Start activating your network. Now is the time to get coffees, make sure your LinkedIn is updated, start thinking of where you’d go if you need. Being prepared is your best mental balm. It’s never for nothing because your existing network will become stronger for this outreach. And if during the next restructuring you are hit, you’ll have a head start.

Q: How do you find the joy in the daily grind of parenting, work, chores, etc.?

I struggle with this, too. When it feels like everything is a chore, that means I need to go back to my boundaries. So, I will block off time to look at my schedule and assess what I can cut out in work, parenting, personal time, etc. My post on Boundaries 101 lists everything I tell my patients about how to set (and keep) boundaries.

I come back to my boundaries once every three months or so, and sometimes even more frequently. It’s the type of thing you just have to keep coming back to as life keeps changing; that’s normal. There is this fallacy that you learn boundaries once and then you’re good. NO! Our lives are so complex and constantly moving, and in every new context or situation, you will have to relearn your boundaries. That doesn’t mean you are doing it wrong. It means you are human, and you have a full life.

✸✸✸

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You are reading Real Self-Care, the email newsletter written by psychiatrist and bestselling author Dr. Pooja Lakshmin MD.

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Thank you so much for being part of this community!

Initially, this newsletter started as a place for me to keep up with my writing practice. After the success of my first book, Real Self-Care, it became a place to extend that conversation and bring real self-care into your lives on a more regular basis.

I feel strongly that newsletters are not static, and they need to evolve and grow with the author. Now, as I’m about a year away from the release of my second book, I’m figuring out what the next version of this newsletter is.

I’m thrilled to share that big things are on the horizon for this space. As this newsletter evolves, I want to intentionally center you—who you are, why you’re here, and what keeps you coming back—so I can create resources that actually feel useful.

So, I’d love to hear directly from you.

I invite you to take this short survey (5-10 minutes) and share a little about yourself with me.

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As a thank you, I’ll randomly select six individuals to receive a $100 V…

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Hi folks!

Welp, at 11pm last night I submitted the first draft of my second book, QUANTUM SHIFTS, to my editor at Penguin Life. It’s officially Spring. And the President has not started a nuclear war (yet).

We’re all entering a new season, and I hope that feels a bit refreshing for you.

A big part of authorship is supporting your fellow authors, and accepting their support in return. So, in celebration of my own book that will come out next year, I want to share some of my top picks for books coming out this Spring by authors I admire. These books cover many of the topics I often dedicate space to here, including parenting through polycrisis, dealing with prolonged uncertainty, and choosing to do less rather than more.

I hope you find a book on my list that will help support you with wherever you’re at now. And I’d love to hear: What are you most looking forward to reading/watching/doing this spring? Share in the comments!

Leave a comment

xo,

Pooja

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Hi, folks!

Welcome to the newcomers who heard me speak at SXSW. I’m glad you’re here.

Earlier this month I was on NPR 1A talking about something I don't think we discuss honestly enough: what happens after the big mistake. Not the mistake itself, but the aftermath of it.

The most damaging part of a big mistake isn’t the screw up — it’s what you make it mean about you afterward.

As an author who writes openly about her life (especially here), I’ve made some very public mistakes of my own: leaving medicine, getting involved in a cult, having to rebuild my career and my life.

Here's what I know to be true, both personally and clinically: the mistake is survivable. The shame is what takes people down.

We’ve all made mistakes and suffered the consequences, but we make things even worse when we refuse to talk about them or stay swimming inside of our own shame.

So today, I want to shed some light on why making mistakes is not only human, but counter-intui…

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Hi folks,

I took the twins to physical therapy on Friday. They’re 8.5 months old (6.5 adjusted), and they’re working on rolling over more confidently and learning to sit up.

At the session, I had a little Aha moment that I wanted to share with you. The PT was explaining something I couldn't stop thinking about.

When a baby reaches with their right arm, they need to bend their left leg to shift their weight — and vice versa. It’s called cross-coordination. My girls were doing the opposite, which was throwing them off balance. And when they were on their backs trying to roll over, sometimes they’d just flail because they forgot they could tuck their arm and turn.

Here’s what struck me: they knew how to do it. The PT showed one of them the right pattern once or twice, and she got it immediately. Her whole body reorganized. She reached the toy with her left arm, and shifted her weight to her right leg smoothly.

This is exactly what happens psychologically during stress and transition.

We flail…

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If you joined recently, I wanted to share one more idea I’ve been thinking about since last week’s piece.

A pattern that I’m seeing right now, both clinically and culturally, is this:

When the system stops making sense, we assume the problem is us.

It shows up as a low-grade, constantly questioning. For me, it’s recently looked like comparing myself to other authors or speakers, and wondering if I measure up.

But, when I get curious about my insecurities, I remember the context. I’m a woman of color in an industry that is being gutted (publishing) and in a state of massive transition (AI).

When I zoom out, I remember that much of what I’m responding to is not a personal failure. It’s that the rules themselves have become unstable.

The institutions we used to rely on no longer hold our trust. There’s no clear authority telling us what “good enough” even is anymore, because as soon as you get to the next milestone, you still feel as though it could “poof” disappear at a moment’…

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Hi folks,

The confidence struggle never goes away. It just changes shape. I’m a psychiatrist who wrote the book on self-care — and right now, I am in the spiral.

I’ve been heads-down writing QUANTUM SHIFTS all year. The deadline is in three weeks. And instead of feeling proud, my brain is running worst-case scenarios on loop. What if this book doesn’t land the way the first one did? What if I don’t get booked on the same podcasts? What if I don’t belong here anymore?

Over the years I’ve developed three questions I return to whenever confidence collapses and the “what ifs” take over. Today I’m sharing all three questions with paid subscribers — along with my own answers, right now, in the middle of one of the most high-stakes moments of my career. They’re clinically grounded, field-tested on myself in real time, and they work not by making you feel better but by helping you see clearly.

If you’ve ever needed to show up and weren’t sure you could — this is exactly for you. Today is the day to go paid.

xo, Pooja

Get the 3 questions

I’m submitting the first draft of my next book, QUANTUM SHIFTS, in three weeks. This apparently means that book launch anxiety has decided to clock in a year early (it will be published by Penguin Life in Spring 2027).

I can feel the stress arriving in my body in this specific, familiar way — it feels like getting hit by a bus or a train. (That might sound dramatic, but it feels accurate.) It’s a palpable pressure, an awareness of how visible I am as a public figure, a panic to make sure I’m maximizing every moment of this important step in my career.

I’m coming out of the fun part of book writing — the expansive, protected-from-metrics part — where it was just me and my ideas. In that cocoon, I felt grounded and steady.

Now, my mind jumps into hyperspeed, spinning up hundreds of “what ifs.” What if this book doesn’t do as well as Real Self-Care? What if I don’t get invited back to the same caliber of podcasts? What if I don’t expand my audience?

When this happens, I ask myself three questions.

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Hi folks,

I didn’t watch the State of the Union last night. I hope you didn’t torture yourself with it either. Today, I wanted to share my most recent thoughts on where we are as a country here in the U.S.

Over the past five years or so, every few months I have a moment where I feel convinced that my family needs to flee the U.S. I think about where to move and Google how hard it would be to get a medical license abroad. Most recently I wondered whether 529 funds are usable outside the U.S.

This probably doesn’t come as a surprise to you, and I imagine many of you have had similar moments over the past few years. As Americans, we have become increasingly fluent in the language of crisis. We can name corruption, inequality, authoritarianism, and collapse wit…

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Hello folks,

This year, this newsletter is focused on how we navigate change — not just the big dramatic transitions, but also the ones that affect roles we’ve inhabited for years. Daughtering is one of those roles: inherited, rarely interrogated, and one of the hardest patterns to change.

So, when I heard about ’s new book, Good Daughtering (out Feb. 17; you can preorder now!), I knew I needed to talk to her for this newsletter. Alford is a communication expert, author, and speaker whose work centers on the often invisible roles women play in their families and communities. In her book, she describes the very specific caretaking and kingiving work that daughters take on — and uses psychology to help readers figure out how to take back their agency in this familial role.

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