The Self-Care Paradox: From Nursing Theory to Neoliberal Subjectivity.

Abstract

Self-care occupies a central, often taken-for-granted and normatively privileged position in contemporary nursing discourse, consistently framed as a marker of empowerment, autonomy and responsible health behaviour. Although critical scholarship has contested this framing through work on relational care, feminist critiques of individualism and the neoliberal responsibilisation of health, the normative work self-care performs within nursing's own conceptual frameworks remains insufficiently examined. This paper offers a theoretical analysis of self-care as a subject-forming discourse. It revisits Orem's Self-Care Deficit Nursing Theory as a conceptual baseline in which vulnerability and dependence are ethically acceptable conditions that legitimately call forth nursing intervention, and traces how neoliberal health discourse has reconfigured self-care from capacity into obligation. Building on existing structural critiques, the paper argues that a further, subjective transformation warrants attention: self-care discourse contributes to the formation of subject positions in which responsibility is internalised, vulnerability experienced as inadequacy and care-seeking as personal failure. These subject positions are unevenly taken up across class, gender, age and health status, and may be resisted or reinterpreted. Drawing on Byung-Chul Han's account of the achievement subject, the paper conceptualises this dynamic here as the self-care paradox and considers what it asks of nursing theory.