Do you care for a child or adult with challenging behaviours? Have you felt exhausted, overwhelmed, or helpless at times? It’s important to know you are not alone. Having the responsibility for caring for a dependent with a disability or mental illness can be really tough.
I’ve complied my top tips for managing stress and burnout recommended to me by my clients who are caregivers or the disability staff I have managed as a senior practitioner. I’ve also road tested these strategies myself, and I can attest that they can help, but the trick is to practice…big time. Please don’t expect to read this article and instantly master all these techniques, these are the sorts of skills you may consider learning over time.
Have a game plan – It’s not realistic to expect yourself to be OK all or even most of the time. When you feel overwhelmed, you need to enact your plan. This may mean you have to physically remove yourself from the room to calm down, call a friend, or take a deep breath. Basically, when it all gets too much, try using an ‘unhooking skill’ when you catch yourself caught in an intense emotion or powerful thought. By this I mean things like disputation, acknowledging your suffering, and being your own compassionate-parent.
Disputation – this involves trying to step back and think a bit more rationally about the situation and catch your brain using biased thinking such as over-generalization, black and white thinking, or catastrophizing. I.e., Your brain might have got hooked on “Yet again! He always punches his sister”, but a disputation of this might be “I’ve noticed when his sister uses her outdoor voice too close to Brian he reacts with violence 70% of the time”. Basically, the goal is to step backwards from the thought, and then replace it with sometime a bit more balanced. A word from experience though, disputation is hard to do when you are feeling a very intense emotion – my psychologist colleagues tell me this is because we go into ‘fight or flight’ mode and activity in our frontal lobe is inhibited, which is the part of our brains we use for logical reasoning. Disputation is easier to do once we have calmed down a little bit. Sometimes disputation is the last thing you need a friend or partner to suggest you try doing when you are feeling super stressed though!
Acknowledge your suffering – This is my go-to strategy when feeling super overwhelmed by an unpleasant emotion or thought. Often when an intense, unpleasant emotion surfaces, we try to jump into problem solving mode, or push away or ignore the emotion that has surfaced. Men in particular are often accused of doing this, especially if it’s our partner who is the one feeling overwhelmed. Sometimes, when supporting ourselves or a fellow caregiver, before problem solving mode it’s better to acknowledge the emotion first. When you catch yourself having a strong feeling, you may have the thought “I’m really feeling overwhelmed right now - This feeling is really intense”. The next step after you acknowledge your suffering, is to take a deep breath and take a moment.
So I know you might be thinking ‘what help would that be’, or maybe you’re thinking ‘I’m well aware of my suffering, thanks very much!’ But are you really? Is it possible that when an intense, uncomfortable emotion shows up you try to push it away, ignore it, or numb yourself from it? Sometimes that helps in the short-term but leads to issues if used too much (think of emotional eating for a classic example). To paraphrase Russ Harris, there is such a thing as raw discomfort and dirty discomfort, meaning that sometimes the actual experience of feeling overwhelmed in the first place is not as ‘bad’ as the feeling of recrimination when you’ve scoffed the entire cheese-cake. Sometimes, if we just take a moment to pause and ‘breath into’ our suffering, it helps to give us the mental space we need to choose a different action.
Be your own compassionate parent – Self-Compassion is actually not what you might think it is on the surface - It is actually quite a complex construct, and I probably cannot do it justice here but I’ll give it a go. If I were to summarize, I would say that, at a high level, it involves being nurturing with yourself rather than judgmental, being soft when you need softness, and being firm when you need firmness. People may hear the term ‘self-compassion’ and think this mean self-indulgence, weakness, or letting yourself off the hook: It’s not – people who relate to themselves in a compassionate way are more likely to take responsibility for their actions, set-high goals but bounce back rather than pointlessly recriminate if they fail, have better health behaviours and experience better wellbeing (sold yet?). Wait there is more: Self-compassionate people motivate themselves, don’t exaggerate their suffering, and they don’t pity-themselves. In fact, I’ve been told that Self-Compassion research is getting boring – it always comes out on top.
My take on this situation is that by getting rid of unhelpful, judgmental thinking, self-compassionate thinkers are taking the wind out of their secret “you’re not lovable/you’re a failure/you’re not good enough” story. These sorts of stories tend to actually cause people to engage in poor coping choices just to get by, but this ultimately takes them further away from the life they really want to live deep down. Honestly, has beating yourself up ever helped you in the long run?
When you’re being self-compassionate, you might recognize you need time out and allocate money for a massage – sometimes caregivers feel guilty for taking care of themselves, worrying that they are being selfish but self-care is VERY important and you deserve it. But if you were to get a massage every night and not be able to pay the family bills, well then that would be self-indulgent.
Similarly, you might recognize that you are profoundly exhausted and identify that the best thing you need to do is to get some sleep. But you also just want a bit more time on the couch, on your phone, watching Nexflix, having what feels like a well-deserved glass or wine… When you are being your own ‘self-compassionate parent’ you know you need to disconnect from the devices, and start your bedtime routine. Soft when you need softness, firm when you need firmness. I’ll endeavor to write more on Self-Compassion in future blogs. It’s multi-dimensional, simple yet also complex, and not easy to do without practice!
Lastly, I recommend trying to take the time to sit down with a support person and calmly map out your long-term plan for managing your health. Please ask us if you would like caregiver’s wellbeing to also be part your child’s Positive Behavioural Support Plan.
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