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Information and resources for today's
family caregiver.
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"Positive Self-Talk and Indulgent Actions"
"Life is a series of obstacles, often with me as its chief obstacle."
-- Jack Paar
I have a cousin who hosts a radio show for the blind in which she reads aloud from the funny, the moving and the curious. She frequently shares her sources of inspiration with me, which is how I found out about the book, Mama Gena's School of Womanly Arts by Regina Thomashauer. The focus of the book is women's relationships to men, but the author is an unwitting spokesperson of Powerful Tools for Caregivers. She adamantly believes that what we tell ourselves about ourselves is the key to our physical and mental well-being.
Stress management courses almost always include exercises in positive self-talk. If we tell ourselves, "I blew it; I should have done B instead of A," that may lead to better results the next time the situation comes up. It may also show our emotional maturity when we are willing to take responsibility, apologize and change our behavior. However, if we continue to beat ourselves up for:
- what we didn't do
- what we can't do
- the mistakes we've made
And if we fail to give ourselves credit for what we did do, what we can do, or our successes, we will lose confidence, become depressed and generally be unhappy. There is a saying that "Misery is optional," but Mama Gena puts it another way: "Pleasure is a choice." Too many of us have bought into the mantra, "No pain, no gain," and as a result suffer from "anhedonia" - life without pleasure. She describes a woman, who "every few days would descend into a pit of self-disapproval." That too seems to be true of many caregivers who feel whatever they give to others is never enough. Mama Gena's advice for overcoming this discomfort involves these exercises:
- Stop your "doubt tape. . . Decide that you are always at some level, responding exactly the right way to whatever is happening. Notice your genius and approve of it." Try checking in with yourself hourly for an entire day, and praise yourself for what you are doing.
- Put together a grateful list. Make a habit of being thankful for everything possible in your life. Celebrate whatever is happening - even a change in the weather. Becoming aware of the good things in your life, or "counting your blessings," pulls the focus away from the stresses in your life and begins to undo negative thinking.
- Make a list of all the "shoulds" in your life - all the ways you think others expect you to behave or ways you believe you should behave - and question them.
- Form a "bragging group." Find one or more people with whom you can check in weekly to share your accomplishments. The only rule is that you must only brag - no complaining, no putdowns, no comparing oneself to others, and no qualifying or criticizing one's own brag. You are likely to be surprised by how much the members of your bragging group inspire one another.
Another exercise carried out in Powerful Tools for Caregivers classes is to write down samples of our negative self-talk and rewrite them as positive self-talk. Here is an example:
Negative self-talk: Nothing I do pleases my father. I can never do enough.
Positive self-talk: I do many considerate things for my father. He has never found it easy to say thank you, and the physical pain he is in now makes it even harder for him to be grateful.
If you are someone who has made self-doubt a lifelong habit, rewriting your life script with positive self-talk will take constant practice. Sue Bender in Stretching Lessons quotes a friend who says, "Doubting myself is so deeply ingrained; it's like getting layers of paint off an old oak door. Even when it's really well done, there are still a few places where the paint stays. Can you really remove it all?" Probably not, but you can get better at it over time. Pay less attention to your bad habits and concentrate on practicing the good ones.
Among those good habits is adding pleasure in familiar and unfamiliar ways. Psychologist Joseph Campbell is widely quoted for his favorite rule for living: "Follow your bliss." Mama Gena says, "Getting your bliss starts with finding the bliss where you are." Have fun no matter what your circumstances may be. She provides a long list of suggestions including:
- Give yourself a party (prepare with a manicure, sample new foods, dance for no reason, buy new clothes)
- Turn an unpleasant task into something fun (clean house in your bathing suit, take a joke book to the doctor's office)
- Say "yes" to an offer you would normally decline. Go out on a limb. Consider it research so the outcome doesn't matter.
If none of these is appealing, make your own list. Too many of us are better able to express our pains and disappointments than our pleasures. Mama Gena notes that pleasure and fun create the environment where self-esteem can flourish. Relaxed caregivers know that sleeping well, exercising and positive attitude contribute to their health and well-being. But caregivers who truly thrive are as concerned about getting their MDR (minimum daily requirement) for pleasure as they are about taking their daily vitamins.
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"Grappling with Guilt"
By Daniel Kuhn, MSW, Mather LifeWays Institute on Aging,
Evanston, Illinois
"Guilt is the gift that keeps on giving." -- Erma Bombeck
Caring for someone with a chronic medical condition can bring out the best or the worst in the human personality. Compassion, concern, and loyalty are just a few of the positive characteristics that may emerge. Family caregivers also may experience feelings of frustration, depression, and guilt. These bad feelings are inevitable in the face of too much stress. Guilt or self-reproach seems to stand out as the feeling most difficult to overcome.
Some people are prone to guilt and another person's chronic disease may simply intensify it. Even those without this tendency may begin to feel its effects after awhile. There is plenty of room for feeling guilty, particularly if the one you care for gets worse in spite of your best efforts. This is a terrible burden to bear alone. Guilt drains away personal energy that is needed for carrying out many responsibilities for yourself and others.
Although countless situations may breed guilt, a few common examples point out the dilemmas involved:
- The daughter of a woman with a disabling stroke works a full-time job in addition to raising her children. She spends every Saturday helping her mother but whenever she leaves, her mother pleads for her to stay a bit longer. She feels guilty for not being more available to her mother as well as her own children.
- One day a man begins to argue with his mother who has Alzheimer's disease who is acting irrationally and he suddenly yells and curses at her. He immediately realizes that she cannot control her behavior and he should have controlled his anger. He feels guilty for making a bad situation even worse.
- A husband arranges for his wife with Parkinson's disease to attend a local adult day program. In her absence, he is unable to relax and worries if she is missing him. He wonders if he has made a mistake in making the arrangement.
- The wife of a man with dementia promised him that she would never place him in a nursing home. After several years of home care, she feels completely worn out and moves him to a nearby facility. Instead of feeling relieved, she feels overwhelmed guilt.
In some cases, it can be argued that guilt may serve a useful function. It can motivate reflection upon one's mistakes and lead to a positive change in behavior. However, persistent guilt can become a crippling problem. Such guilt usually stems from high expectations put upon oneself that cannot be met. Failure to meet these self-imposed standards leads to more guilt and a vicious cycle develops. It is easy to get caught in a trap of thinking that one should or ought to be able to feel or act in prescribed ways. However, when guilt replaces a freely made commitment as a dominant motive, especially in relation to providing care to someone, it is a clear sign that something is amiss. Change is indicated and some form of personal help is needed.
Guilt may be impossible to dismiss altogether but at least it can be put into a proper perspective. The following are some "guilt guidelines":
- Acknowledge that you are in a no-win situation in regard to improving the health of someone with a chronic medical condition. At best, his or her health will stay the same and may indeed get worse. His or her poor illness is simply not your fault. Your focus is not on finding a medical cure but instead aimed at providing comfort and a good quality of life.
- Set realistic goals with respect to the one who needs care. For example, you alone cannot fulfill all needs at all times. You can take pride in making a positive difference in the life of someone who counts on you for help.
- Accept your shortcomings. Perfectionists are bound to be disappointed over and over again. Seek forgiveness whenever possible.
- Do not take yourself or your role too seriously. Remember that laughter is good medicine without any bad side effects.
- Take a break on a regular basis by enlisting the help of others to provide substitute care.
- Attend a support group for caregivers to learn that you are not alone in feeling or acting the way you do when distressed. Other members of a group can share ways to cope more effectively.
- Share your thoughts and feelings with a compassionate listener. If a close friend or relative
is unavailable, seek counseling through a local church, synagogue or mental health agency.
Guilt can become a crippling problem that chips away at self-esteem and makes life burdensome.
Burnout may be the end result of guilt that lingers. The person you care for may seldom express appreciation so find others who will remind you of the good job you are doing. Rather than focus on your shortcomings, other people can give help give you a better perspective about your strengths. It is first essential to acknowledge guilt and then take active steps to move beyond it in order to remain emotionally healthy. After all, one of the chief needs of a person with a chronic medical condition is an emotionally healthy caregiver.
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"Daily Affirmations for Caregivers"
by Bernie Siegel, M.D.
- I love myself.
- I respect my own needs.
- I am able to ask for what I need.
- I am open to receiving.
- I can ask for help and support.
- I am kind and gentle with myself.
- I deserve care.
- I know how to nurture myself.
- I replenish my energy by eating healthy foods.
- I take the time to exercise daily.
- I have all the energy I need.
- I am compassionate with myself and with others.
- I am able to feel and express all of my emotions.
- I forgive myself and others.
- I am able to renew and refresh myself.
- I take time for fun.
- I love and trust in the process of life.
- I am whole and alive.
- I am at peace with myself.
- I trust that I am doing the best that I can.
- I am enough.
- I am loved.
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