After the Orgasmic Meditation Commune, I Had to Fix My Warped Thinking About Wellness
Pooja Lakshmin on Escaping the Self-Care Industrial Complex
A decade ago, while in my late twenties, after spending much of my life up until that point in school to become a physician, I made a drastic decision. To the shock and horror of my family and friends, in the course of a year I blew up my marriage, moved into a wellness commune in San Francisco, and dropped out of my highly competitive psychiatry residency training program. And not just any commune, but one that practiced and taught orgasmic meditation.
Convinced I had found the Answer to life’s problems, I spent nearly two years with this group—living in their intentional community, working for their wellness start-up, and spreading their message with fervor. The group itself was organized like a matriarchy, in which women held and wielded the power. To say this appealed to me was putting it lightly; I was a former women’s studies major but had grown up in a patriarchal South Asian culture and had just gone through a male-dominated academic medical system.
In the introductory class for the group, co-led by an ob-gyn, the group’s leader explained that the reason women felt unsatisfied was because Western culture had indoctrinated us to disconnect from our bodies, and because of that, we never learned to fully live in our power. They offered up orgasmic meditation as a female-focused practice that was akin to sensate focus therapy—it allowed you to drop away from all the noise and chatter in your brain and connect with your body, and in turn, with yourself.
Within a week of that first class, I dove in. It was the first time in my life that I saw women openly asking for what they wanted and getting it. It felt like the one wellness practice—the one feminist utopia—that could fix all of my problems. I spent nearly two years deeply immersed in this group’s world of spiritual practice and Eastern wellness modalities.
How did a type A, perfectionistic physician find herself in a group focusing on female orgasm? In hindsight, I realize I had been simultaneously searching desperately to find myself in new and exciting places while also attempting to lose myself. I was disillusioned with mainstream medicine and psychiatry, which, at the time, I viewed as irredeemably flawed and betraying the people it proposed to help.
As a trainee, I experienced the death of a patient, which crushed me. I started to question what was being taught—I didn’t get much guidance in medical school or residency on what to do when your patient can’t pay for health insurance or when she has lost childcare for the third time in two months and is being fired from her job. Instead, I was taught to prescribe medications or provide psychotherapy for issues that were clearly systemic.
While there is certainly a great need for both of these medical interventions, the lack of attention to the inhumanity of our social policies left me feeling powerless—just like my patients. Personally, I was burned out and teetering on depression, and I felt like my own attempts to get professional help were lacking (despite being a physician myself!). It was in this state—angry and feeling betrayed by our medical system—that I left to find answers in the most unlikely of places.I had tried extreme wellness and I knew the dangers of getting caught up in the self-care industrial complex.
To me, the group I joined was changing the world—breaking stigmas and taboos about women’s sexual wellbeing and fighting loudly for the empowerment of people who are often dismissed by the medical establishment. I met the neuroscientists at the Rutgers fMRI orgasm lab, one of only two labs in the world that studied female orgasm through brain imaging technology. I studied what happens in the brain during female orgasm. It was a period of both personal and academic exploration.
During this time, I became aware of many critics of the group, yet I didn’t have tolerance for them. From my perspective, I was there fully of my own volition, and I looked with pity upon those who couldn’t see how singular this group and its mission were. At the time, I believed in their particular brand of wellness dogma and spirituality—a combination of new age teaching and Silicon Valley–espoused libertarianism. Coincidentally, the dogma fit perfectly with my Hindu upbringing, which leaned heavily on magical thinking, mythology, and gurus.
Unfortunately, what I didn’t realize, and what those who cared about me did, was that as a physician, I offered something invaluable: legitimacy. During the time I was with the group, from 2012 to 2013, I was treated with kid gloves, kept at arm’s length from the inner workings of the higher-ups. At the time, I thought that distance was in place because I was not spiritually actualized enough to be in the inner circle. It was many years later, in 2018 after the news broke about an FBI investigation into this group, that I found out how dark the story had become and I put together the pieces of why I was always shooed away.
I left the group after a little less than two years. As they were reaching new levels of success and opening wellness centers all over the world, I began to notice inconsistencies in their dogma. I wanted to finish my residency training, and I was starting to understand that one wellness practice could not fix all of my problems.
It wasn’t until I left and started doing my own healing that I recognized how much my time in the group had warped my thinking. I struggled to make sense of what had happened. I fell into a deep depression and wondered if I could keep living. I no longer had the group, and in the process of joining it I had torched my old life.
I had to rebuild my life, and myself, largely from scratch.
My parents let me crash at their place, rent-free. I turned 30 in my old childhood bedroom, wrung out and bingeing reruns of Law & Order: Special Victims Unit, texting with the few close friends who stuck with me. I was fortunate to have mental health professionals to turn to who helped me work through my experiences and make meaning of them. Others who left the group didn’t have that luxury and suffered much more than I did. And I had to grapple with the knowledge that I helped legitimize this group—a cult—as a physician and a professional who spoke publicly on their behalf while I was deeply entrenched in their philosophy.
It was understandable—like many of you, I dove into a wellness practice because the thought had not occurred to me that the solutions needed to come from inside myself. While the practice of orgasmic meditation had helped me personally, I had been seduced by the fantasy that an external solution—this shiny wellness practice—could fix all of the problems in my life.
Instead, I learned the hard way that self-care is an inside job.
Going on to face the real world by returning to my medical training was both the hardest thing I’ve done and the thing that’s given me the most strength. In many ways, it was leaving the cult, not joining it, that has made me the person I am now. I learned to set boundaries, came to understand my values, and ultimately found my voice and started speaking up for myself—separate from my family, the medical system, and the cult. In short, I learned how to practice real self-care.When my patients began coming in talking about self‑care and wellness solutions like vaginal jade eggs and turmeric face masks, I was worried.
In the decade since then, I’ve come to understand that real self-care is not only a more authentic and sustainable solution—it’s also self-determined. It involves the internal process of setting boundaries, learning to treat yourself with compassion, making choices that bring you closer to yourself, and living a life aligned with your values. It’s hard work, but not only can it be achieved, it can be maintained internally, unlike an off-the-shelf product or the lessons of a self-help guru.
And, as you’ll come to understand if you read my book, it has the potential to shift our relationships, our workplace culture, and even our social systems, thus impacting the collective injustices that are the root of women’s problems. I ultimately graduated psychiatry residency and joined the faculty at George Washington University School of Medicine, then went on to start my own private practice focused on women’s mental health.
You won’t be surprised to learn that when my patients began coming in talking about self-care and wellness solutions like vaginal jade eggs and turmeric face masks, I was worried. On one hand, I understood that my patients, who were at their wit’s end from demanding family lives and nonstop careers, were understandably looking to these solutions for a bit of solace.
Yet I had tried extreme wellness and I knew the dangers of getting caught up in the self-care industrial complex. Now I not only had the credentials and the professional expertise to set the record straight, I also had this profound personal experience of what happens when wellness goes very wrong. And even more than that, I knew there was an alternative that was self-driven and sourced from the inside.
So, I did what any reasonable geriatric millennial would do— I started a blog and an Instagram account. Soon after, in 2018, I published an essay for Doximity—“We Don’t Need Self-Care; We Need Boundaries.” Aimed at an audience of women physicians, the piece was an attempt to shed light on the problematic nature of self-care as a solution for health-care worker burnout. Like in many industries, hospitals and medical groups were offering up “resilience training” as a solution to the burnout epidemic in clinicians.
But despite these perks, there was no mention of paid time off, childcare subsidies, or real policy changes to support workers. In the weeks after the publication of my essay, I received message after message from women across the country telling me they felt like I was describing their exact plight. Subsequently, in 2019, The New York Times asked me to adapt the essay to speak more broadly to a non-medical audience, and I went on to become a regular contributor, writing about gender justice, women’s mental health, and the societal structures that prevent women from being able to build emotional wellbeing.
Whether it’s a full-fledged cult, a diet, or the latest fitness program, the answer to your problems is never going to be someone else telling you what to do, myself included. The answers can only come from inside you. I don’t prescribe a lot of rules to follow, but rather encourage you to ask tough questions and make hard decisions. This is deliberate—from what I know, personally and professionally, real self-care has to come from within you. What I’m providing is a guide to hold space for your own self-reflection, and productive questions to ask yourself, so that ultimately, you can create your own path for meaningful and long-term real self-care.
From Real Self-Care by Pooja Lakshmin, MD, published by Penguin Life, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright © 2023 by Pooja Lakshmin.