Archives for posts with tag: self care

The first time that I learned the importance of pacing, I was pregnant. The fatigue was really challenging. I was keenly aware of myself as a limited resource. I prioritized. I still ended up doing a lot but it was stressful and work was unsatisfying in many ways. Then I became a mother and it all became too much for me. I became clinically depressed, got treatment, and took a good look at my life. I was no longer depressed and with time, my energy increased and I was able to do more work than I had previously.

In 2012, my daughter was a teen and did not need my constant attention. I was working a lot at my private practice. I worked hours that I thought I “should” even though I was working more than full time hours during most weeks. I was working at a hard pace and if I am completely honest with myself, enjoying making decent money for the first time in my life.

Later in that year, I was diagnosed with breast cancer. I learned how quickly daily work schedules can be changed when they have to be. It was incredibly hard. Two years later, when I was done, I was still wiped out, though slowly regaining energy,  not to full strength, but to a higher level than before. I have not returned to full-time work since that time. I work about 80% of full time to allow for self-care.

Lately, I have been literally pacing myself. I am in training for a big hike. I am not naming it because it is a kind of hike and not really a specific hike. I want to increase my ability to hike uphill. I really enjoy hiking but I have avoided certain hikes for decades because I had trouble with elevation gain either due to injury or lack of fitness. I also had a fancy cardio test a few months ago and learned that although my aerobic capacity is better than average, my anaerobic capacity is less than average. I start building up lactic acid earlier than most. I wonder if this has always been true. It may explain why as a kid who was athletic, I hated running long distance and sports like soccer, which seemed like non-stop running. I am from Seattle and as you may have noticed, it is surrounded by mountains. There are a lot of steep hikes.

I am hiking a lot, gradually increasing the elevation of the hikes. I take photos, an activity I love to do, which also provides little breaks along the way. I am learning to hike at my own pace instead of trying to match the pace of others. Uphill, I am slow, but steady.

The frequency of the hiking is higher than before. I am going out 1-2 times a week to hiking areas. Sometimes I hike alone and other times I don’t. I am enjoying it immensely.

I do notice that it is a big difference in my level of outdoor activity. It reminded me of the second summer after my cancer diagnosis. I spent the first summer in surgeries, one after another, three total until the margins were finally clear with a right side mastectomy. At the end of the summer, I started one of many reconstructive surgeries. I had lost a summer of outdoor opportunities living in a place that has some of the nicest summers you will ever experience. By the next summer, I was bound and determined to live outdoors as much as I could, considering that I was still in treatment. We had a ball.

Two years ago, I was recovering from a SCAD induced heart attack and traveling to the Mayo Clinic. Last year, we were caring for my dad, who died in July.

At this moment, I am healthy and energetic, thanks to luck, exercise, healthy eating, yoga, and meditation. I am enjoying what I am able to do with this body of mine, which has been through a lot, and will be through more.  At this point, this pace is right for me.

April was wet but beautiful.



May has been filled with splendid views and wildflowers!


Some animals, like bees, are eusocial. They live in highly organized social groups, each with a job to do, and all for the survival of the group. Adult bees are drones, workers, and for one unlucky female, the Queen.

This would all seem so complicated except for one thing. Bees have tiny brains and they don’t live very long. In other words, it is unlikely that more than the tiniest bit of learning goes into this process and I’d say it’s safe to say that no thinking goes into it. Bees follow instinct. They do their jobs, they don’t change roles, and when they communicate, they send messages that are easy for everyone to understand.

People are also social animals but from an evolutionary standpoint, we are driven for individual survival, not group survival, a quality the ethologist Richard Dawkins called the “selfish gene“. Evolution is not everything. There are other forces at work and some of them even motivate us to get along with one another and nurture each other for the greater good.

But people have big brains and live a long time! We learn to play many roles and carry out many responsibilities. And these roles and responsibilities are not predetermined at birth. Unlike bees, we are not born into an inflexible caste.

Living in a group is really complicated. We communicate with our words and other behaviors. We don’t always say what we mean. We don’t always know what we mean. Our roles overlap and our goals may be at cross purposes.

Bees have very organized relationships. However, they don’t have intimate relationships. People bump and scrap with each other all of the time. We protect ourselves from real and perceived slights. Most of us put a lot of energy into individual survival as well as to helping our loved ones.

I try to live a peaceful life. I try to be a helpful and nurturing person. I try to belong to the community of humanity and to contribute to its health. But I often fail to do so and sometimes spectacularly so.

I am a nice person but I am not always nice. I am a caring person but sometimes I try to protect myself at the expense of others. Sometimes, I use my intellect to come up with fancy justifications for my behavior when in my heart of hearts, I know that I am doing wrong. I am a happy person but sometimes I am irritable and sometimes I lose my temper and yell at the very people that in my hearts of hearts, I love the most.

Almost every time this happens it is because I have neglected my self-care. I have pushed myself too hard, worked too many hours, not eaten well, not taken time to myself, and not exercised. When I think of myself last, it is because I am looking outward to what I think my family needs, ignoring cues from myself that a good deal of my distress is simply because I am not caring for myself.

It is at the times I make these seemingly altruistic sacrifices, I am most prone to behaving selfishly.

I am not perfect. That is okay. Expecting myself to have no needs is not okay. Being selfish is not okay.  I am not perfect. That is okay.


I was a young mother of a toddler and it was my birthday. My husband handed me an envelope. It was a gift certificate for Fauntleroy Massage.

I had never gotten a full body massage before. I didn’t even know what the types of massage were. I talked to some friends at work. I remember that Wendy ran down the modalities for me, Swedish, deep tissue, Shiatsu, and the last, Lomi Lomi, which she described as “good but kind of woo woo because it’s spiritual rather than just therapeutic.”

I was not very “woo woo” at the time. I was a scientist.

I called Fauntleroy Massage and was greeted, “Aloha, this is Jann.” I spoke with Jann, who was and still is a practitioner of Lomi Lomi. Yes, I was a scientist but I was also feeling the need to get my life more in balance and expose myself to different beliefs. So I made an appointment.

“You lie there and let me do all of the work. I will take care of you,” said Jann at the beginning of that first massage and many that were to come, at least a couple of hundred of them with Jann over the past 13 years.

I remember having to concentrate on not doing work.

Not doing work is a lot of work. I wanted to bend my leg instead of letting her bend it for me, for example. It took some time to get used to but once I did, it opened up opportunities for different kinds of work, the work of timing my breathing with the tense and release of massage strokes to help unclench muscles. In this way, massage is both meditative and mechanical.

Massage can also be like a dance. Jann is extremely intuitive and strong. She massages with her eyes closed. It is a meditative practice for her, as well. She massages with her whole body. She is conscious of the way she stands, uses her legs, and when her hands aren’t strong enough, she uses her elbows to massage. And I only know this because she’s told me. Jann coordinates her breathing with her exertion and when I am really in tune with her, I do, too. It is a very special experience, which also contributes to a better massage.

All of my messages have been relaxing and they knocked out the chronic pain issues I had for 12 years prior to having my first massage. But not all of my massages are great. The great ones are when I surrender to the massage.

As I mentioned, I have had an increase in energy and stamina. I am extremely happy about this. I have also done a lot of entertaining and taking care of other people. I have not let go of my self care and I have also let my husband take care of me. But I felt guilty about it. His work has been particularly stressful and further, during the summer, he drives Zoe everywhere.

Today I woke up in a fog. I have been tired for a number of days. I took today off for the holidays. I didn’t have to do anything. So I did nothing.

Sometimes doing nothing is nice. But sometimes doing nothing doesn’t do anything to fill me up. Because the nothing is really mindless stuff rather than mindful stillness.

This afternoon, I drug my tired butt to a massage. I was thinking, “I am too tired to go to a massage.” Really. That’s how brain dead I was feeling. I was having to summon the motivation to drive a half mile to Jann’s office and get a MASSAGE.

It happened about half way through the massage. I surrendered. And it filled me up.

Today is Sunday. It is half past noon. There’s bluegrass playing on the radio and my husband is in the kitchen doing dishes. The kittens are wrestling happily on the floor. It’s a pleasant scene. I am completely exhausted.

John and I used to have frequent dinner parties. We entertained a lot. It is one of the things we had to give up for awhile after my cancer diagnosis.

In time, I was energetic enough to host family gatherings, first our daughter’s 15th birthday and later, Thanksgiving. Then we had a party for John’s co-workers.

This morning I realized that I have cooked a major meal every weekend for the past three weekends. First was Father’s Day, then hosting our friends Kurt, Linda, and their kids. Last night our friend, Robin and her son’s Michael and Nate visited from North Carolina. Robin is our daughter’s godmother. Michael, who is almost 22 years old, is our god son. We haven’t seen them in about 8 years. The visit was a big deal.

No wonder I’m exhausted! It was not so long ago that I was having trouble having enough stamina to track conversations with people. It was even less long ago that I was needed 12 hours of sleep per night.

I am pretty mindful of my stamina and energy levels. I honor my need for sleep better than most. But I still overdo it and today I need extra rest.

I was thinking that I need to be mindful of these things because I am more limited than I was in the past. However, after seeing a series of old photos of myself over the years taken in the past 15 years, I am starting to wonder.  When I compare them to recent photos I realize that I currently look a lot less tired and that I actually look healthier than I did in my 30’s and early 40’s.

I have some things to think about. I don’t want to go back to the years when I pushed myself to work harder at the sacrifice of my own self-care.

At this point, it’s not so much that I CAN’T do what I used to be able to do.

It’s that I WON’T do it.


As I mentioned in The Hours, taking care of myself as a breast cancer patient is time consuming. For example, I still need 10-12 hours of sleep per night. I walk an hour to an hour and a half nearly every day. My wheat allergy coupled with the diet I eat to help maintain good health means that I eat very little prepared or processed food. Cooking from scratch takes time. I still find myself in health providers offices 2-3 times per week. And I work for a living. Right now, I bill about 18 hours per week. Twenty hours per week is considered full-time for a private practice psychologist. I used to bill nearly twice that much but admittedly, that was pretty unhealthy. The way I explained it to my husband was, “Imagine that you lost four hours of every work day and had 2-3 doctors’ appointments every week.”

And it’s not just trying to find time for work. It’s trying to find time for a social life, to spend time with my husband, and to spend time with my daughter. I have been looking at what I can give up to free up my time. There are some things like blogging and walking that take time but I will not give them up. My blog writing ebbs and flows in frequency. When I have a lot of ideas, it is because I have a lot on my mind to process and it is helpful to write about it.

I stopped seeing my naturopathic oncologist several months ago. I follow continue to follow her recommendations. We had transitioned to a maintenance schedule, anyway. I was also on a maintenance schedule with my acupuncture appointments. I was getting them every three weeks, traveling to a different city to get them. I told her I wanted to see if things continue to go well and check back with her as needed. I have decided that I am done with reconstruction and have no scheduled appointments with my surgeon. This means that I have scaled back to medical oncology appointments every three months, onco-surgery follow-ups every six months, massage every three weeks (I have been doing that for 13 years to manage chronic pain and stress issues), an annual mammogram, an annual MRI, a yearly physical with my internist (I am now one month overdue), psychologist visits every 2-4 weeks, and a trip to the dentist twice per year. I am still figuring out how to work in a dermatology visit as well as a trip to the eye doctor.

I have also opened up more work time by working on the weekends. I don’t work more than an hour or two each day but I don’t really like to do that. Due to logistics, cutting back a little on my practice means cutting back too much, due to the number of hours each of my testing patients requires. So I’m stuck between working a little less than I want to, which is boring and strapping us for cash or to work a little more than I’d like to. I talked to my husband earlier in the week and told him that I wanted to try to build a week off into my schedule every quarter. Because he is awesome, he quickly told me that he thought it was a wonderful idea. So, I’ve already taken off a week for New Orleans and have a vacation coming up in the summer.

I am so grateful to have flexibility in working all of this out and I will keep working on it since my energy level and responsibilities are still somewhat of a moving target.

When I was a girl, my younger brother, Jim frequently rode our bikes. I remember the pumping my legs furiously so that I could coast along for awhile without having to do anything to propel myself. It was exhilarating going down hills and on the flat, it created joyful stretches of ease, moments of effortlessness.

Being a healthy person, having a healthy marriage, and being a good parent are all “works in progress”. When John and I saw a psychologist for marital therapy years ago prompted by family planning issues, I asked her sincerely, “When is the time when we get to coast in marriage?” She promptly responded, “Never.” I remember my shock at her response at the time. It’s kind of funny looking back at my thoughts at that time. I do know that I was quite overwhelmed by my life and about to enter my second episode of major depression. It was a fantasy I had that after all of the hard work I had done in my life, that I would be able to coast. I would have an easy time as a wife, parenting  would get easy.

I was reminded of my wish to coast recently when I realized that after all of my hard work, I had strayed off of Weightwatchers and begun to gain weight. I didn’t gain a lot of weight and I’ve started losing again. It may not seem to be a big deal to you but I have gained and lost weight many times since I was 14 years old. And as I have mentioned, the last two periods of weight gain had put me into the clinically obese range. My breast cancer was highly responsive to estrogen and progesterone. Our adipose tissue (fat and other stuff) has glandular function and increases female hormone production. I know it is important for me to exercise and eat right. I am very lucky to not have physical issues that would interfere with my ability to exercise and to have a life situation that makes it possible for me to work part time. But even knowing these things, my weight has crept up in the past when I stopped paying attention to my habits, when I tried to coast in my life.

I have lived a good bit of my life working at capacity and feeling fairly stressed out. At these times, I have thoughts like, “It will be SO much easier, when ____________” This blank has been completed in many different ways over the years, “when I finish school”, “after the baby starts sleeping through the night”, “after my career is established”, “after my daughter is grown”, “when my husband’s job situation improves”, “after my cancer treatment is done”, “after my energy returns”, “after I start working full time again.”

But the truth of the matter is that although stress ebbs and flows throughout out lives, we are never done with it. And there are always unknowns and unexpected challenges that loom on the horizon.

In my work, I specialize in what for most children are chronic difficulties. And although many of them have loving and very skilled parents, even the most loving and skilled of the parents gets exhausted with the extra work their child or children require. There is also a period of adjustment after diagnosis that can take anywhere from weeks to more regularly, years, and sometimes, never. It is the adjustment to the idea that there will be no coasting as a parent and that one’s children will likely need more support and over a longer number of years, than other children.

I sometimes use an analogy with parents. I tell them, “Raising a child with these challenges is like running a marathon of unknown length and unpredictable terrain, with uphill, downhill, and stretches of flat. It is important to take the cups of water whenever you can.”

If I really think about it, coasting on a bike only lasted so long before I either had to brake because I was going too fast or start pumping my legs again so I could keep going. I have been working hard to take care of myself but also to nurture my relationships and carry out my responsibilities. I will keep working on the rhythm of knowing when to pump and when I can coast so I can keep moving forward and maintain my balance. And if if that little cup of water looks too small to last a lifetime, I will take them when they are offered.


I am often told in the gentlest of ways, how important it is for me to rest and take care of myself. And the people who tell me this are very loving and very correct.

However, there are reasons that it is hard for me to sleep as much as is necessary. I do it but I’m not sure if most people realize the consequences. Or to put exercise into my daily life. And to take time to eat well. I suspect that a good number of cancer patients who are taking care of themselves have a very different life than the “well” people who do not perhaps put as much time into self care as they might.

I didn’t sleep well for 18 months. And the two years prior to my cancer diagnosis consisted of five courses of stress for every meal. Although prior to cancer, I had pretty much slept well, the rest of my self care was lacking.

Now, at typical weeks goes as follows. Whereas,  a year ago used to be able to get up at 6:30 am to exercise, I am not yet able to do that again. The earliest I am able to get out of bed is 8:00 am and that is when I have morning patients or when I have an early healthcare appointment. If I have no scheduled morning obligations, it is very hard for me to get out of bed before 10:00 am and sometimes I am not up until after 11:00 am. This means that in a 24 hour day, I am often in bed more hours than I am out of it.

Six days a week, I go walking right after I get up. Usually it is for an hour but of late I have been extra stressed and I often walk for two hours. But even on days when I walk for an hour, it means that I don’t start the working part of my day until noon on most days of the week. If it is a day when it is my responsibility to cook dinner, that means I have about 5 1/2 hours to work and that includes showering, dressing, and putting on make-up if it is a clinic day for me. I have found that lately, if I don’t need to go into the office, I may skip showing all together in order to save time.The point of this is that due to my increased sleep needs as well as my need to exercise regularly, I have a compressed work day.

But wait, there’s more! I also have an above average number of healthcare appointments each week. I see my psychologist every other week, I still get acupuncture every three weeks, plus I have the normal oncology and every day person dentist visits, annual physicals, etc. Oh yeah, I am also a mom and need to bring my daughter to her healthcare visits. Next week, I have three of my own doctors’ appointments and one for my daughter. There’s no way I’m going to be able to pull this off. So I’m going to need to reschedule my appointments for the dentist as well as for acupuncture. I am keeping my psychologist appointment because I am dealing with a greater amount of stress these days and that is not a ball I want to drop.

And some how during that time I will be working, getting ready for a trip, and getting fittings for the charity fashion show. (Alas, I did not know that I would be wearing multiple outfits, each from a different store in the Greater Seattle area. And there are times I will want to have with my family and friends. And times when I am unable to do much of anything besides surfing on the Internet.

I know that my days of needing 12 hours of sleep a night will likely decrease. I am also hopeful that my healthcare appointment frequency will decrease. But I also know that they could all increase again if and when I have health problems again. It has been nearly two years since my initial diagnosis. I would say that I wish I had known how long of a haul this was going to be but frankly, knowing myself, it was better not to have known ahead of time.

Again, the fact that I need to take care of myself is correct. It is right for me to do what I am doing. But when you tell a cancer patient to “take care of herself”, I want you to know what you are asking her to do. And if you can find a way to magically make more time in the day, you will be her best friend forever.

As a child/adolescent psychologist, I work with a lot of moms. They often express feelings of guilt for their children’s challenges. I often respond by saying, “You have the rest of your life to feel guilty as a mother. Save some for later.”  This statement usually gets a laugh and often the guilt although not gone, is small enough for us to move forward in our conversation. It is often, however, not so easy. People get stuck. Even psychologically solid, reasonable parents can get stuck on guilt. Several years ago, I worked with a wonderful mom of a very young child who was showing signs of significant developmental challenges in multiple areas. She had professional experience working with children and was acutely aware that her son may have handicaps that would greatly change the future possibilities in his life.

Although there was no evidence that she had done anything to contribute to her son’s difficulties and further, it was yet unclear as to whether his difficulties would be short-lived or chronic, she felt guilty. She felt guilty and stuck. During one session I asked, “What do you think you are getting out of this guilt?” She looked at me understandably with a confused expression. I went on, “It may sound backward but sometimes people hang onto guilt because it gives them a sense of control in situations in which they feel totally out of control. We cannot have guilt without a sense of power, even if the power we feel is to harm.”

She was dubious but I had planted a seed. She came back a week or two later and basically told me that she had thought what I had said made no sense but upon careful reflection, it actually made sense. It was a turning point in her grief process.

Guilt is blame turned inward. It can also be turned outward. In Atom Egoyan’s 1997 film, The Sweet Hereafter, a town grieves for the loss of a busload of school children in an accident. Ian Holm plays an attorney who travels to the small town to file a class action law suit against the bus company. He has his own grief back story, which is his adult daughter’s drug addiction. Holm’s character tirelessly pursues blame. Someone must be responsible for the tragedy. That someone must pay. Things don’t just happen. They happen for a reason. He was going to find the reason at all costs. I won’t spoil the ending for you but let’s just say that letting go of blame and accepting the loss of control is a major theme of this film.

As for myself, I have had issues with letting go of anger. There is a release that comes with losing my temper and in the moment, it feels good. But because I am at heart a peacemaker and an empathetic person, I feel regret at having hurt other people, especially my husband. My anger is usually rooted in anxiety, anxiety that a problem can’t be controlled or solved. Anxiety that my house will never be an environment that I can control and make a sanctuary. Fears that my cancer will return. Fears for my family, especially my teenaged daughter. I have fears of not being a good enough psychologist when my patients are having particularly treatment-resistant struggles.

Most people would consider me to be a very disciplined person. One exception to this has been my life long struggle to eat healthfully and to exercise regularly. I love food. I am an excellent home cook and I love good restaurants. I love to eat a large amount of food. The act of eating is an amazing, highly enjoyable, sensory experience. It is also a wonderful social experience. And I know when I am overdoing it and often in my life, I just keep eating. And at these times, it seems too hard to put the time into preparing healthy meals. Quick and easy is convenient but not nutritious.  The rest of my health suffers and I just don’t feel as good during the non meal parts of the day. It also feels good sometimes, not to exercise. “Ah, I can just sit here and rest.” This is particularly true when I let my work and family life burden me. I work too many hours at work and at home, doing things and worrying about people. I am tired and I feel that I deserve to rest even though I know that I deserve the kind of treatment that promotes good health. But like many caretakers, I put my self-care low on the priority list even though I have counseled countless moms to avoid this. But putting my health at lower priority made my daily to-do list shorter. It made it seem like I was juggling fewer balls in the air. It was a false illusion.

In my 20’s, I gained and lost the same 20 pounds over and over. By my 30’s and 40’s, I have gained and lost the same 40 pounds twice. Right now, I have given up the convenience and the joy of eating to the point of indulgence for healthier foods. Yes, it is work to plan my meals, to make entrees ahead and freeze them in reasonably-sized portions. I take the time to make sure that I always have healthy vegetables on hand. I love vegetables and you know what, eating a large volume of vegetables is actually good for me. And I’ve gotten so that I look forward to my daily 3 mile walks. The key for me was realizing that I was self-employed and could therefore set my own hours! I am better at exercising in the morning and had been trying to add it to the end of long clinic days, which didn’t work at all. So, I just started seeing my first patients at 9:30 am instead of 8:30 am. What a rut I was in to not think of that solution years ago!

Letting go of these things has required patience, which does not come naturally. But I have grown and changed over the years. I have learned to manage my anxiety pretty well and with my mindfulness practice, I am learning to practice acceptance and further, that acceptance is not the same as doing nothing. It is not accepting that can spin me in circles, feeling like I am doing something but getting no where. Endless anxiety and anger can be a trap where you expend so much energy that it feels like you are doing something productive and your are not. And as a person who has been clinically depressed twice in my life, I can tell you that the helplessness and hopelessness of that passive state is one of the loneliest places in the world. I can’t tell you how thankful I am that I have not been near that place for over 10 years.

It can be hard to let go of anger, of grief, of impatience, or anxiety, of sadness, of guilt, at the point when I need to move on. Emotions are vital to our lives, even the “bad” ones. They motivate, protect, and educate us. But they do not always work in a healthy way with our thoughts and behaviors. I know that I will be working and reworking this balance for the rest of my life. I try not to think about how things “should” be in respect to things over which I have little control. I got breast cancer when other people with similar lifestyle and risk factors did not. I got it when people with more risk factors did not. Disease is part of the natural world and it doesn’t make sense to me to be mad at the universe. That just doesn’t work for me and the cost is too high.

We all have to make our own paths in life. In my life, I feel pretty unstuck right now but know that the cost of each day is a different set of gains and losses. Yes, I have lost the illusion of control but I have gained so much. I write this to reflect. I write this to remember the peace I have in my life at this moment.

I let go to gain freedom. I let go to go on.

I had a great first day back at work yesterday. I’m so glad that I took off extra time to recover from this surgery. I have two more full clinic days and then I have Th and Fri as paperwork/healthcare visit days.  

That’s actually a full-time schedule, which was not the plan. The was a scheduling mishap by either a parent or myself, which I resolved by scheduling a full day of testing with a teen on Weds.

Now before you start wagging your finger at me, keep in mind that next week, I have no one scheduled! I had cancellations and did not fill in the spots. And although the schedule snafu family could have come in next week, they have already waited 4 months to see me and the mom says they’ve been ‘marking the days off on the calendar’ until their appointment, which they had thought was yesterday when I was scheduled to see someone else. Fortunately, the snafu was discovered last week. It meant a lot to the mom to only have to wait an additional two days instead of seven.  

My popularity, while good for business can be stressful. There is a shortage of specialists in my area coupled with high demand. But I love my job and after all, I got three hugs yesterday!

This post was inspired by the Health Activist Writers’ challenge for the month of April. I write “inspired by” because I have yet to use one of their suggested daily writing prompts.

As a child psychologist, I am often advising the mothers of my patients to take more time for self-care. A frequent response is, “I know, but I just don’t have time,” to which I reply, “If you feel you have no time for this than you have been without time for yourself for far too long and this is even more reason to do it!”

I know I am asking a lot of moms who are already taxed with parenting, work, and household responsibilities. I have struggled with the same life balance issue myself over the years, especially since becoming a mom 14 1/2 years ago. One of the valuable lessons I am continuing to learn as a breast cancer patient is to take care of myself, I mean REALLY take care of myself. It’s not that I was living a martyr’s life but I was not taking sufficient care of my health. To do this properly, takes time.

In 2002, I was laid off from my very first job following the completion of my post-doc. To make a long story short, the job was ugly. It was the first time in my life that I was treated like I was incompetent. Down deep I knew that I wasn’t incompetent but to be treated this way for nearly three years in my first “real job” and right after becoming a mom was a major blow. The lay off itself was done in a fairly nasty and unfair fashion. It was toward the end of that job that I had my first of two incidences of Major Depression. (The second incidence occurred a couple of years later but only lasted 2 weeks because I got back into treatment immediately after recognizing that I was not myself). It was BAD. It wasn’t just sadness, which is what a lot of people mean when they say, “I’m depressed.” I had no appetite. Food was flavorless. I lost 10 pounds in a week. My sleep was messed up and I had to will myself through each day to have enough energy to parent Zoey who was a toddler at the time. She has always been an empathetic girl and at the time, was learning to read facial expressions. I remember feeling heartbreaking guilt and sadness one day. She was sitting in my lap, looked up at my face, used her fingers to push my mouth into a smile while anxiously asking, “Mama happy?”

Being laid off and depressed was a major wake up call for taking care of myself. And since I was laid off and able to collect unemployment for a few months, I was able to make use of the time to figure out what to do with my life professionally. At that point, I decided that I would never rely on one source of salary again if I could help it. So in 2002, I applied and tested for my psychology license in Washington state and in 2003, started my private practice. Meanwhile, I was writing research grants and ended up being employed through two of them, the longer one landing me on the research staff of the Social Development Research Group at the University of Washington. I worked there until 2007 until the research money ran out. I was unable to secure funding for more grants. As the money ran out, I expanded my practice and then by the time I left U.W. in April of 2007, I was able to build up my practice to full time. Although being in private practice had not previously been an aspiration of mine, it ended up being the perfect job for me.

So although I would not have taken that job had I known what it was going to be like, I got some very positive life lessons out of it. Also, I made a number of friends at that crazy job including my dear friends, Jennie and Lisa, whom I’ve mentioned in my blog. Hmm, taking the opportunities afforded by crappy life circumstances to glean important life lessons? Gee, that kind of sounds like my breast cancer experience thus far.

Fortunately, I was able to use some of those life lessons from my crappy job experience to cope with my breast cancer better and to avoid getting depressed again. Sorry, I hate being depressed. And yes I have grief, but healthy grief and clinical depression are not the same thing.

So having breast cancer and especially the time off after my major surgeries, has given me some time to revise my life plan so that I am a happier and healthier person. As I mentioned previously, taking care of myself takes time and emotional space. I will not always need this much time and this much emotional space but right now I do. At first, this was a hard adjustment for my husband because healing has meant my being more emotionally distant than usual. (And no, I don’t just mean less sex.) We had to develop different ways of spending time together, for example, John started accompanying me on my walks on the weekends. He also eats all of the healthy dinners I make ahead of time in reasonable dinner-sized portions and freeze. The walking and the diet change have been part of the reason that John has lost 22 pounds. My taking care of myself has also meant that John had to take on more responsibility and learn how to take care of me after surgeries. It has also meant John taking care of some of his own health issues better.

For Zoey, my cancer has meant worrying about a parent’s mortality at an earlier age than average. It has meant seeing me less energetic and weaker at times. But overall, I am very happy to report that Zoey has more than risen to the challenge. She fairly quickly snapped out of the angry, eye rolling teen stuff that she was directing toward me and started treating me much more respectfully and affectionately. She is often there with a glass of ice water when she sees me fanning myself during a hot flash and she secretly changed my screen saver to a banner that reads, “I love you, Mom,” just because. Sure we have our moments and she is still able to be disrespectful and her eye rolling muscles aren’t totally lax. And having a mom who is a breast cancer patient when she is a 14 year-old girl makes her life harder. I wish she didn’t have to go through this. But she has grown enormously.

Finally, by taking care of myself, ultimately, I will take better care of my patients. Some of them are feeling a little anxious and impatient because I am off work again for an extended time. But if I don’t take care of myself, I will not have enough energy to do a good job. And as my dear friend, Nancy points out, by taking care of myself and coping positively with a major life stressor, I am modeling valuable skills for the families I see.

So even though the villagers were not initially happy with my changing my life to have a stronger focus on self-care, ultimately, my self-care is reaping benefits for the villagers.

I do believe that there is more than one good solution to every problem but perhaps this lesson could be helpful to some of you readers out there.


Art, Science, Heart ❥

journals of a mature student nurse

Heart Sisters

For women living with heart disease

George Lakoff

George Lakoff has retired as Distinguished Professor of Cognitive Science and Linguistics at the University of California at Berkeley. He is now Director of the Center for the Neural Mind & Society (


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