Maslow’s Hierarchy of Needs

We’re all individual and cope differently with chronic pain and illness.  Our coping strategies are complex and will depend on our innate personalities, upbringing, beliefs, past life events and current living arrangements.  I sometimes beat myself up that I get fed up, angry, frustrated and tearful about my life where other people with chronic illness seem to “rise above” their situation on a cloud of calm, accepting gratitude. That was, I did beat myself up until I realized that the people who are further along the path to self-actualization to me live very different lives to me.

I learned at school about Malow’s Hierarchy of Needs, which looks at the motivations behind people’s behaviours.  Maslow’s original work proposed 5 stages to reaching self-actualization:

1. Biological and Physiological needs – air, food, drink, shelter, warmth, sex, sleep.

2. Safety needs – protection from elements, security, order, law, limits, stability, freedom from fear.

3. Social Needs – belongingness, affection and love from work group, family, friends, romantic relationships.

4. Esteem needs – achievement, mastery, independence, status, dominance, prestige, self-respect, respect from others.

5. Self-Actualization needs – realizing personal potential, self-fulfillment, seeking personal growth and peak experiences.

Only when our lower level basic needs (eg. food, shelter) are satisfied can we progress to meet higher level growth needs (eg. achievement, status).   And once these needs have been reasonably satisfied we may be able to move on to reach the highest level called self-actualization.

Christopher Reeve, who became quadriplegic following a horse riding accident, was truly inspirational, meeting the challenge of his new life with positivity, determination and a passion to improve the plight of others with spinal injuries.  He had a loving wife of many years, healthy children, a beautiful million dollar home, the best medical advice in the country, hand-picked carers, all the latest equipment to aid his disabilities and support from highly influential friends who helped him fund raise to achieve his goals.  I often wonder how he would have faced the challenge of his new life if his wife had left him, he was broke, lost his home and had to live in a rented house in a poor neighbourhood, had state carers who visited him for 15 minutes a day and who didn’t have time to see to even his most basic needs, had no health insurance, had rubbish doctors and his friends and family abandoned him in droves.

I admit to getting irked with Oprah when she harps on about self-actualization like it’s achieveable for all.  It’s really not.  Oprah had a tough life, but she managed to escape her childhood.  What if she hadn’t?  What if she’d been illiterate and unemployable, or sick and unemployable, and was still living a dirt poor life in the town where she was born?  Would she still be the person she is today under those circumstances?  I’m guessing not.

From comments made on my blog it seems to me that the most important factor in coping well with chronic pain and illness is whether or not you live alone.  The more self-actualized amongst us all appear to be married or living with parents or other care-givers.  Their basic needs are met.  They have food, shelter, love, companionship, care and financial security through another’s ability to work.  They don’t have to worry where their next meal is coming from or the fact they’ve no clean undies because they’ve been too sick to do the laundry (having spent 3 days in the same knickers last week, trust me when I say it’s truly icky).  Having our basic needs met makes the difference between living well with pain and illness and merely existing.

I take my hat off to all those living alone yet still managing to live life with passion, humour, grace, fortitude, determination and empathy for others.  You are stronger than the Oprahs and the Christopher Reeves of the world and I, for one, salute you.

10 thoughts on “Maslow’s Hierarchy of Needs

  1. kneillbc

    Such an excellent observation. None of us exist in a vaccuum. People weren’t meant to live alone. This idea of someone being able to care for oneself independently, without physical, moral and social support is ridiculous. Nobody ‘does it all by themself’. We all need help.


    1. bertieandme Post author

      We do all need help, but sadly many people don’t get the help they need to have good quality of life. When I was bedridden for 10 years I saw my Mum for 1 hour a day and had 4 hours of paid cleaning and shopping done on a Wednesday (all I could afford), and didn’t see a soul the rest of the time. 23 hours a day alone lying staring at the ceiling is quite an isolated existence and I know others with ME who are in similar positions (I went for 6 years without seeing any kind of medical professional). I managed to exist/survive but it wasn’t good quality of life. Many elderly people are also in similar positions x


  2. AllieCats

    Thank you for bringing up this topic. It’s one of the things that frightens me the most. I’ve been sick with EDS, Lupus and Eosinophilia-Myalgia for 25 years and now that I’m in my 60s I find myself alone with little resources. I owned a wholesale floral business and tried to keep it open long past what I was physically able and that caused me to hurt myself financially and with the amount of Medicare I now receive. I couldn’t face the fact that I was disabled and wouldn’t get better so I kept trying until nothing was left.

    I have no family in the US and the friends I had are long gone mostly because I needed to be alone to deal with all my health issues and discomfort. I’m also drug intolerant and there’s no escape from the constant misery. I seldom go to doctors anymore unless it’s life-threatening, like internal bleeding, because they don’t understand the complexity or the severity of my condition. I’m so tired of them profiling me as soon as I walk in the door as depressed and thinking that’s my major problem. I always try to look my best and not appear poor. Any little break I get lifts my spirits but it’s hard not to feel down when your life is so fragile. I only have myself to depend on and at times it’s very difficult. I rent a small studio that I’m able to afford on the measly social security I get (my savings is long gone) and if I ever have to leave here I’ll most likely be homeless. Terrifying!! I fall through the cracks and there are no social services or housing I qualify for. I can’t stand in lines at food banks and can’t take public transportation. Thank heaven’s for Amazon and eBay!

    I’ve isolated myself because of the shame and fear of judgment. I’m a college graduate and was a business owner, how did I end up here? I feel like doctors look at me like I have no value, especially when they find out I have no one helping me. With the new Medicare cutbacks to doctors I can’t find a rheumatologist in my area that will even take me. Although I don’t know what good it would do anyway since I can’t take most drugs. The EDS is progressing rapidly and I’m losing a lot of my mobility which is very frightening.

    My dog and cat are the reason I keep going…they need me and I need them. When I started this post I didn’t realize it would end up with me spilling my guts. It started with me wanting to share that it could be worse and be grateful for the people you have in your life and the money to buy the things you need to give you comfort. Thanks for letting me vent here.


    1. bertieandme Post author

      I hear you loud and clear AllieCats. Even my healthy single friends worry about getting older and how they’ll manage alone, and the prospect for those of us already with serious illness is really scary. I’m brutally honest in this blog about what living with chronic illness is like – it’s the only place I get to do that, because I hide how I really feel from everyone in my ‘real’ life (we are conditioned to put on a brave face to the world).

      Single people face huge challenges when it comes to living with illness and disability and this simply isn’t recognised enough by a population which is dominated by families/couples. And don’t get me started on how the medical profession see us sad, sick singletons – you were spot on with that observation :-/

      Sending big hugs to you,

      Jak x


  3. playingthehandiwasdealt

    I couldn’t agree more with your post. I have EDS (classical/type II), and now a subsequent corneal disease related to it, but it wasn’t diagnosed until I connected the dots 12 years after getting sick. I’ve lost everything to this disease: career, grad school, sustainable income, permanent housing, all friends/almost all family, etc., and I tried my hardest to keep pushing through it all, but in the end the disease(s) just took it all and per the unrelenting pain, I can’t take narcotics either and it’s like living in a torture chamber 24/7. I really don’t believe even the EDS community understands what it’s like to deal with this nightmare all alone and with limited resources, and never mind the loneliness. It’s just such an abnormal existence: I lived a full life before getting sick and now I’m technically one step away from living in my car. :/

    While I do have a good, EDS friend on WP who’s married, I find that I just don’t fit in with the online support groups, etc. as I can’t do anything, have no one to do anything that I can’t do with, and have no money to do so anyway and as that depresses me, I’d rather not have to chat with the supported-types who have so much to gripe about while commenting on their iPads from their hot tubs in their big homes purchased by their spouses. 🙂 Boy, I sure hope that weird sentence made sense!

    I’ll bookmark your blog as I’m visually impaired and it’s too hard to follow everyone as my reading time is limited, but I do check back! Hang in there…


    1. bertieandme Post author

      Sorry to hear you’re in a similar position to me. The sheer loneliness gets to me the most I think and that’s the bit many sufferers who are part of a couple can’t possibly understand. I don’t think I’ve been touched by another person for 8 years now and as a species we’re not designed for that level of isolation. Hugs x


  4. AllieCats

    It’s been a long time since I’ve been touched, too, although not as long as you two. When I first saw my allergist several years ago she touched me all over and I broke down in tears. I’ve never had a doctor touch me with such compassion and I didn’t know how to respond.


    1. playingthehandiwasdealt

      I hear you, AllieCats (guess I was following this thread here). My so-called EDS doc never touches me, which I find rather odd due to my EDS. So, my PT does and while I haven’t cried, I think it keeps me a little more sane. It’s just not normal for us to not be touched and live like recluses! Argh!

      Take care,
      A 🙂


  5. Pingback: Getting Really Real About Chronic Debilitating Illness: Sometimes We Need Help – One Sick Vet

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