An Early Lesson in Self-Care, by B. Imei Hsu, RN, LMHC

As I sat alone at my desk in my psychotherapy office on a cold and grey Monday morning, I hung up the phone, looked for the waste paper basket, and threw up. Then, I sobbed.

It had only been a few months since I took a second job working as a counselor for an Eating Disorders outpatient treatment center. While building a private practice a young patient with an Eating Disorder had been assigned to me for her first session, a transfer from another clinic. The hospital had promised a large stack of photocopied records would arrive before the following Monday morning, so the first session was this green therapist going in blind with a quiet, gaunt, and guarded teen who did not believe anyone could, or would help her. She made an appointment to see me again in three days. I will never forget how she smiled briefly as she left the room.

The voice over the phone notified me that this patient of but a fifty- minute session had taken her life. Over the next few hours, I watched myself grow numb as I learned more details — the missing photocopies of her medical records that was on its way to the office — about why she had taken her own life. Wave after wave of nausea hit me. I barely slept the next couple of days, and somehow stumbled through the rest of the week’s sessions with others.

Later in the month, I caught myself in the reflection of the window, staring absent-mindedly across a pond and the greenery of the grounds outside the office park. A mother duck and her babies swam in a straight line, and I admired both their beauty and simplicity of the life cycle: birth, reproduction, growth, adulthood, death. Suddenly, I noticed I was breathing, not my usual shallow, pained breath as of the previous weeks, but deep, full breaths, ones that went all the way into my belly and came back up into my clavicle bones. I put my hand on my neck, and I felt the air fill my lungs again.

It sounds crazy, but it was a moment where I recognized I had survived deep trauma, shock, and sadness. Because of  confidentiality surrounding my patient work as a therapist, I had few people I could talk to. No one suggested I talk to someone about the kind of vicarious traumatization I experienced in witnessing a young teenager stage the beginning of her exodus from the pain and suffering of a horribly abusive home life. Unlike family and friends, I wasn’t a part of her life to have been invited to the funeral to pay respects, and my grief did not have a sense of closure.  I had swallowed all of it in the pages of those records, in the police investigation that followed, and in the quavering voice of her parent over the phone. I felt haunted.

I began to question myself. If I was saddened to the point of practically forgetting to breathe because of the suicide of a client who was my client for one hour, what business did I have believing I could be of help to people who would be entrusting me with their stories for many more hours, months, or perhaps years? I wondered if I had what it took to be the kind of counselor that people could rely upon to care, yet have strong boundaries, and a resilient core.

I’d be lying if I told you there was some magic formula or ritual I did that made it all better. Yet I can say that everything I had learned about practicing self-care came into play. If I needed to feel sad, I felt sad. If I needed to take a walk, I took a walk. When it was time to eat, I ate. I did my best to get in bed on time and at least close my eyes to try to get some sleep. I journaled, spent time with friends, tried to look for things in life to feel grateful. Over time, I could see myself pulling away from the sadness that bound me to this young girl, the absence and the horror, her helplessness, and the violence in her life.

Nearly seventeen years later, I can look back at my career and the many people I’ve had the privilege to help, and I understand that one thing has not changed. I continue to use “Relentless Self-care”, my own program of activities, space, breathing, meditation, and movement to help me stay strong and resilient as I work with people going through some of the most vulnerable, scary, and tumultuous events of their lives. I’ve also taken on becoming an Ironman and an Ultrarunner, spending hours swimming, biking, running, and hiking, as I find that these activities allow my mind to do what it needs to do to hold that space for questioning, for embracing pain and uncertainty, for challenging the mind to hold onto itself when the body has long since tried to give up.

Self-care routines remind me that I don’t need perfection to do my job. I am human, just as my clients are; I hurt like them, I need patience like them, and I need time to heal, just as they do. When I’m catching my breath after a hard run, I remember it’s hard for everyone; no one escapes the work! And when I am constantly reminded that we never get away from the same routines to take care of our bodies and minds, we are in closer connection with one another; that is, we are reminded that we have an, “I – Thou”  relationship, no matter the apparent differences that separate us from bosses, our clients, our friends, or our family members.

For example, when I am feeding myself a plate of food, I remember that my clients are struggling to do the same, sometimes with meager incomes or in unstable homes or relationships. When I lay my head on the pillow and fall asleep almost instantly, I am also aware that some of my patients don’t sleep well because of the stress in their lives. It’s our humanity — even our bodily needs! — that help me understand why I’ve been a counselor for almost 18 years, and in healthcare for nearly 26 years.

When I take the time to care for myself, I find I can do my best work with people. The kind of care and compassion I can show myself is just as easily translated into the care and compassion I can encourage and teach my clients to show themselves. It’s not magic juju. It just feels like it, from the client’s side.

Imei Hsu is an active retired RN and Licensed Mental Health Counselor in the State of Washington. She recently transitioned her practice from an office to telemental health and works from her home that she shares with her husband and one extra fluffy Applehead Siamese cat. She enjoys yoga, dance, hiking, Ironman, and ultrarunning, and never seem to be without a book in hand. In her spare time, she’s all about making food fun again for people with Autoimmune Disease, Food Allergies, and Chronic Illness.,


5,007 Replies to “An Early Lesson in Self-Care, by B. Imei Hsu, RN, LMHC”

  1. Hello there, I discovered your blog via Google even as searching for a related topic, your
    website came up, it appears great. I’ve bookmarked it in my google bookmarks.

    Hi there, just turned into alert to your blog
    thru Google, and found that it is really informative.
    I’m gonna be careful for brussels. I will be grateful when you proceed this in future.
    A lot of people will likely be benefited from your writing.

  2. Hey there! Do you know if they make any plugins to assist with Search Engine Optimization? I’m
    trying to get my blog to rank for some targeted keywords but I’m
    not seeing very good gains. If you know of any please share.
    Thank you!

  3. Hi! I know this is somewhat off topic but I was wondering which blog platform are you using for this site? I’m getting tired of WordPress because I’ve had issues with hackers and I’m looking at alternatives for another platform. I would be great if you could point me in the direction of a good platform.

  4. I think that is one of the most significant info for me.
    And i am happy reading your article. But want to remark on few general issues,
    The site taste is wonderful, the articles is truly great : D.

    Good activity, cheers

  5. Interesting blog post. Some tipls i would like to bring up is
    that computer system memory should be purchased but if your computer can no longer coope with
    that which you do by using it. One can set up two RAM boatds
    containing 1GB each, by wway of example,
    but not one of 1GB aand one having 2GB. One should look for the manufacturer’s documentation for
    thhe PC to make certain what type of memory
    it can take.

  6. I truly love your website.. Excellent colors & theme.
    Did you make this site yourself? Please reply back as I’m wanting to create my own personal website
    and would love to find out where you got this from or what
    the theme is named. Appreciate it!

  7. Excellent beat ! I wish to apprentice whilst you amend your site, how could i
    subscribe for a weblog website? The account aided me a acceptable deal.
    I were tiny bit acquainted of this your broadcast offered brilliant clear concept

  8. I tuly wanted to send a simple comment to be able to thank you for
    all the remarkable items you are placing at this site.
    My particularly long internet investigation has finally been rewarded with excellent content to
    write about woth my great friends. I ‘d declare that many of us website visitors actually are rather fortunate to exist in a fine place with very many outstanding individuals with good guidelines.

    I feel really fortunate to have discovered the site and look forward to plenty of more
    entertaining minutes reading here. Thanks a lot once again for a lot of things.

  9. They were honest in their inspection of our roof telling us our roof was in great shape and there was no
    need for a replacement at this time.
    excellent from start to finish. Very professional from the evaluation process through project completion. Completed our project in one day.
    Highly recommend.
    Once it was determined we needed a new roof, the
    crew was quickly scheduled and got the job done in 1 day.
    The crew was quick, neat and thorough.
    you guys just rocks! thanks for all of your hard work…very happy with
    my new roof!
    This guys are awesome…They completed the job in just 3 days- too fast if you compare
    it with the quality of my new roof, my home looks awesome now.
    They also built it with special materials for make it
    stronger…We are very satisfied with them
    Great work…..Outstanding service from this crew.

    They showed up on time, got the job done quickly and I haven not any single problem after.

  10. Another issue is that video gamihg became one of
    the all-time greatest forms of entertainment for people of all ages.Kids enjoy video games,
    and also adults do, too. The actual XBox 360 is probably the favorite video games systems
    for majy who love to have a huge variety of video games available to
    them, and who like to learn live with some otyers all
    over the world. Thanks for sharing your ideas.

  11. I used to be more than happy to search out this net-site.I wiszhed to thanks in your time for this glorious read!!
    I undoubtedly having fun with very little little bit of it and I have you bookmarked to check out new stuff you blog post.

  12. I do agree with all the ideas you have presented on your post.

    They are very convincing and will certainly work. Nonetheless,
    the posts are very short for beginners. May you please prolong them a bit from subsequent time?
    Thank you for the post.

  13. Hi I am so thrilled I found your weblog, I really found you by error, while I was searching on Yahoo for something else,
    Anyways I am here now and would just like to say
    thanks for a tremendous post and a all round thrilling blog (I also love the theme/design),
    I don’t have time to read through it all at the minute
    but I have bookmarked it and also included your RSS feeds, so when I have time I will be back to read
    a great deal more, Please do keep up the awesome jo.

  14. Hi, Neat post. There’s an issue along with your site in internet explorer,
    could check this? IE nonetheless is the market leader and a good
    element of other people will pass over your magnificent writing
    because of this problem.

  15. Terrific article! This is the kind of information that should be shared around the net.
    Shame on Google for not positioning this put up higher!
    Come on over and visit my web site . Thank you =)

  16. Undeniably believe that that you stated. Your favourite reason seemed to be at the web the simplest factor to keep in mind of.
    I say to you, I certainly get annoyed at the same time as folks consider issues
    that they plainly do not realize about. You controlled to hit the nail upon the top and outlined
    out the whole thing with no need side effect , other people
    could take a signal. Will probably be again to get more.

  17. My spouse and I absolutely love your blog and find most of your post’s to be
    just what I’m looking for. Would you offer guest writers to write content to
    suit your needs? I wouldn’t mind writing a post
    or elaborating on a lot of the subjects you write with regards to here.
    Again, awesome website!

  18. Hey There. I found your blog the usage of msn. This is a really well written article.
    I’ll make sure to bookmark it and return to learn more
    of your useful information. Thank you for the post.
    I will definitely return.

  19. I don’t even know the way I ended up here, but I assumed this put up was
    once good. I do not understand who you are however certainly you’re going to a famous blogger should you aren’t already.

  20. of course like your website however you have
    to check the spelling on several of your posts. Many of them are rife with spelling problems and I find
    it very troublesome to tell the truth however I’ll definitely come back again.

Leave a Reply

Your email address will not be published. Required fields are marked *