Before her 50th birthday, Audre Lorde faced cancer for the second time. The black feminist poet had already lost a breast to the disease, and six years later it doubled back for her liver. Though stunned by pain and fear, she declined medical intervention, and instead embraced her own form of self-care: keeping an appointment to teach in Germany, taking in the first Feminist Book Fair in London, and having fun. “I may be too thin,” she noted in her journal, “but I can still dance.”

Lorde died in 1992, but not before putting self-care on the map with her book of essays, A Burst of Light. In it she wrote: “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.” In one of her journals, she took the idea further: “I wasn’t supposed to exist anyway, not in any meaningful way in this fucked-up whiteboys’ world.” Coming of age during the civil rights movement, she observed that those marginalized by dint of class, sex or race often had to do battle just to get their basic needs met.

Some think of self-care as an hour at the nail salon or a day at the spa. But over the centuries, those who have advanced our understanding of the concept often did so as they tilted toward the blades of what felt like an indifferent world. Facing imminent danger, they gained clarity not just about surviving, but thriving. The personal became political: They sought to show that there is a relationship between self-care and a life well lived.

In the 1960s, the Black Panther Party organized in Oakland, California, specifically to check police abuses against poor black citizens. The group’s membership consisted of recent migrants whose families had fled to Northern and Western cities to escape the Southern racial regime. But when they got there, they were “confronted with new forms of segregation and repression,” according to Donna Murch in her book, Living for the City. As the Panthers patrolled neighborhoods, they witnessed other needs going unmet. They evolved from protecting black bodies to uplifting black lives, and established medical and legal clinics, ambulance services and a program to feed children.

The Panthers’ Free Breakfast for School Children program started in 1969. Initially held at one local church, it went from feeding a few kids to a few hundred to thousands daily in at least 45 locations around the US. “The school principal came down and told us how different the children were,” said a parishioner who helped out in the early days. “[The kids] weren’t falling asleep in class, they weren’t crying with stomach cramps.”

The Panthers’ good deeds did not go unpunished. An armed band of black men and women (even during an open-carry era) did not sit well with American authorities. The FBI labeled the Panthers a hate group, and went after the party’s reputation in part by attacking their community work, claiming the meals they served were infected with disease. They harassed children and parents who participated in the programs, and even destroyed food the night before a program was to open in Chicago. By planting moles to infiltrate the organization and by staging violent raids against it, the FBI ultimately brought about the party’s demise. But the free breakfast program refused to die. It drew attention to the fact that many American children had been going to school hungry. In the early 1970s, the US Department of Agriculture launched its free breakfast program, which has fed tens of millions of children over the years.

After free breakfasts became social welfare policy, other facets of the civil rights movement’s approach to self-care started to be absorbed into the mainstream.

At the Behavioral Wellness Clinic in Mansfield, Connecticut, founder Monnica Williams has witnessed the transformation of self-care from radical political movement to an institutionalized staple of mainstream medicine. Yet she and her staff of therapists still encounter resistance, even when they prescribe what would seem to be enjoyable “homework” to their depressed or anxious patients: “We encourage them to do something in line with their values and goals,” she says. “[But] it’s often easier to get OCD [obsessive compulsive disorder] patients to touch trash cans as a part of their homework assignment than it is to get depressed patients to incorporate things that nurture them in their daily lives.”

Williams admits that she herself wrestles with getting the proper quotient of self-care. An academician who has the whole summer off, she never takes more than a couple of weeks of vacation. That’s not unlike many Americans, who in 2016 left more than 650 million vacation days in the bank. Williams suspects that the mindset of self-denial is a hard one to shake. “It goes back to our Protestant work ethic, when we were on the frontier,” she notes. “But we’re not on the frontier anymore.”

The psychologist’s work dovetails with that of the pioneering researcher Dorothea Orem, an American nurse who, between 1959 and 2001, developed the widely used “self-care deficit nursing theory.” She identified self-care as a human need, and mentored health providers in supporting patients’ desire to be as independent as possible, which improved outcomes in both rehabilitation and primary-care settings.

While self-help literature used to be dominated by authors recommending various techniques for self-improvement, recent years have seen a rise in books asking simply that we learn to care for what we have. Gay Norton Edelman is the author of one of them, The Hungry Ghost: How I Ditched 100 Pounds and Came Fully Alive, and she’s at work on a second, The Well-Fed Ghost.

The writer remembers a difficult period when, as a young mother, she and her husband welcomed their third son. Exhausted by trying to meet the emotional needs of three small children, the stress overtook her. She found herself yelling at the boys for the smallest infraction, and simultaneously eating her way to a 100-pound weight gain. “I turned to food as a form of love,” she recalls. That became a form of self-abuse, and she reached 254 pounds.

“I went to a therapist about it, and she said that what I needed as an antidote to yelling at the children was self-care. I literally didn’t know what she meant,” Norton Edelman recalls. She sought help with a sensible eating plan, and lost the excess weight in 14 months’ time. But keeping it off and achieving a deeper sense of peace required a more mindful form of intervention. She found that her therapist’s prescription of self-care was the right solution, and took simple steps such as taking time to put on lotion after a bath, or embarking on tech-free nature jaunts with her husband in New York’s Adirondack Mountains. She also became more careful about not giving too much of herself away: “I have a magnet on my fridge that says: ‘Somebody please stop me before I volunteer again.’”

Author John Crawford says he once lost an entire decade to anxiety. Over time, he found the ability to say “no” an important tool in not allowing himself to become overburdened. “One aspect of my own self-care, which I do hold incredibly important, is a commitment to not overdoing it in terms of working on things that exhaust me,” says the author of Anxiety Relief: A Thorough Self-Care Manual for Anxiety, Stress, and Panic. “I am very mindful of my energetic limitations and extremely strict with ensuring that I don’t overstep them.” He arrived at this understanding after a psychotic episode upended his sanity. The UK-based therapist fell in love with a woman from the US. But after they married, they encountered financial, mental and emotional hurdles in securing her residency in England. Crawford buckled under the strain. “As I paddled my way back to land, I learned about the ocean and mapped the territory,” he writes. Along the way, he transformed from anxiety sufferer, to anxiety expert, to author who writes often on the subject as a way to aid others and spare them the agony he endured.

Crawford’s rocky journey impressed upon him the value of sitting with difficult emotions. “It’s quite natural to want to run away from horrible feelings,” he explains. “Unfortunately, the act of trying to run away from them creates more tension within the body, which is what creates anxiety and depression in the first place.” By attending to one’s emotional pain with a degree of empathy and compassion, he’s found that feelings can soften and even dissolve over time.

The current elevation of taking care of one’s self has many historical precedents. The Ancient Greeks embraced philautia, or “love of self.” Aristotle suggested that “all friendly feelings for others are an extension of man’s feelings for himself,” while his countryman Socrates posited, “a man should not attempt political leadership until he had attended to himself.”

What also becomes clear, whether we look back to history or around at our contemporaries, is that self-care has always been closely linked to the existence of power imbalances. Gandhi, who staged numerous hunger strikes to protest oppression under colonial rule, understood that the body was a battleground. When setting out his 12-point plan for India’s independence from Great Britain, he included discussion of health and hygiene alongside his more famous doctrine of nonviolence. He also advocated disciplined self-preservation. “A ‘no’ uttered from the deepest conviction,” he said, “is better than a ‘yes’ uttered merely to please, or worse, to avoid trouble.”

His understanding of the body as a site of political power anticipated the work of French philosopher Michel Foucault. Foucault explored the structures of discipline and control within society, and offered his own insights into le souci de soi (concern for one’s self). Foucault said that successfully fulfilling one’s own needs requires reflection, meditation and practices that lead toward an ideal state of being. “To care for one’s self is to know one’s self,” he asserted.

Sisters Nadia Narain and Katia Narain Phillips published Self-Care for the Real World in late 2017 because, Nadia says, “it was needed, especially at this time politically and socially.” (In fact, the day after Donald Trump became president, Google searches on the subject of self-care shot up by 500 percent.) Nadia explains, “It starts with taking care of ourselves, our families, our street, our communities and allowing that to spread wider.”

She is one of London’s leading yoga teachers, while Katia is a body worker who started London’s first raw food café in 2000. The two have been incorporating self-care into their teachings and retreats for a while. Over the years, though, they saw that while people were doing a lot of the right things for their health, they seemed to do so out of a sense of obligation. “It was restrictive and rigid. We were like that too… trying to purge ourselves in some way. It took us some time to recognize that we were being really tough on ourselves, but really nice to other people,” says Nadia.

Some people view self-care, itself, as narcissistic. In a 2016 Commentary article on the subject, Christine Rosen points to Instagram posts that feature “people relaxing in bubble baths and performing other rigorous acts of wellness” as reductive, commercially driven understandings of the movement. For advocates of self-care, she goes on, “recovery doesn’t mean bouncing back from a serious drug addiction or major surgery. They’re recovering from having to navigate the realities of adulthood—experiences that previous generations understood as part of life’s sometimes unpleasant facts, like having to save money.” She suggests that people who spend an inordinate amount of time reacting to stress by journaling their “feeling words” won’t develop the mettle to handle “the challenges of what is likely to be a long battle against global terrorism or economic and political upheaval.”

But millennials of all stripes have embraced self-care as a lifestyle more than any generation before them. The Pew Research Center reported in 2015 that they spend twice as much as baby boomers on workouts, diets, coaching, therapy and well-being apps. Brianna Wiest, who was born in the 1990s and is a sought-after speaker and author of the poetry book Salt Water, offers insights as to why:

“Millennials were raised with a sense of self-worth and value that other generations weren’t. They were told that they could be anything,” she says.

At the same time, Wiest urges that people not fool themselves by going for self-care lite—soft, pampering strokes that fail to get down into the deep tissues where the real work must be done. “If you find yourself having to regularly indulge in consumer self-care, it’s because you’re disconnected from actual self-care,” Wiest says. She advises increasing one’s capacity to delay gratification, stepping outside of the comfort zone, and taking on the less glossy tasks that are required to grow in meaningful ways.

A self-care regimen based on who we are and what we need can steady us for those times when the blades of life tilt toward us and draw blood: traumas such breakups, job losses or the death of a loved one. In the case of Audre Lorde, her self-prescribed self-care helped her live more fully even as death was imminent, allowing her to peer through a philosophical lens to observe that, though cancer would win this battle, it would not win the war.

“For the first time I really feel that my writing has a substance and stature that will survive me,” she wrote in a journal. “We all have to die at least once. Making that death useful would be winning for me.”