Updated: Jul 23, 2019
In our last blog, we discussed how care giving and stress are usually synonymous. This type of stress is characterized by physical, mental and emotional exhaustion brought on by neglect of one own’s needs. Everyone is subject to stress, no matter how well-balanced they may be, but why does it seem that some people are more susceptible to becoming sick from stress than others? There are a number of factors that play into this problem and the seeds of this problem may already be planted long before a person takes on the care-giving role.
In this week's blog, we will explore this and ask caregivers to begin the process of introspection. We will also provide some insight into what may fuel irrational stress and hopefully help you understand why it occurs and begin the process of thinking in a more healthy and rational way, mitigating the harmful effects of daily stress. Let's get started.
In a perfect world, as they say, the past should never interfere with the present, but the world is neither perfect nor are we. Unfortunately, our past may very well be the reason we react (not respond) to things the way we do. The choices we make, how we think, and why many of us become slaves to our irrational thought processes never ends well. It rather simple, our irrational thoughts create irrational emotions resulting in bad choices, choices that fuel the overwhelming stress that consume us. Simple to explain but difficult to change.
Where do irrational thoughts come from? In most cases, we need to visit our past and those things we experienced. Those experiences, both positive and negative, result in how we perceive things. And as the saying goes, perception is truth, at least to the person doing the perceiving. Perception not only includes the environment, our actions and the people around us, but how we perceive ourselves as well.
So what does all this mean? Irrational thinking, perception? Just how does this apply to our discussion on caregiver stress and burnout?
Just this – those who have experienced certain traumas or negative situations while growing up tend to have higher perceptive senses than others. These experiences could be a sick parent, exposure to substance abusers, witnessing domestic violence, or any event that could trigger a fight or flight response in an individual.
Every sight, sound, smell, taste and touch can transport these people back to events that created their irrational thought processes. And paradoxically, these people tend to become caregivers because they think that is expected of them, because there is some control in providing care and as we discussed last week, in control there is safety.
Does that make you weird? Not at all. As a person who worked as a licensed clinician for decades, my choice to work with older individuals with addictions and chronic illnesses was fueled by a loved one who struggled with alcoholism. In fact, the overwhelming majority of people who are counselors and clinicians in the "helping profession" are motivated to do this by some personal experience.
But the difference is, we don't let these feelings get in the way of helping others or succumb to the stress caused by the passion we have. Why, because years of training and education help us to know our "stress points" and what emotional "buttons" we have and how to avoid getting them pushed. So through our training we learned how to handle this, unfortunately, most caregivers don't have the luxury of being trained as they are thrust into situations not of their own choosing.
So what do they do after being frustrated, tired and feeling unappreciated? They try to control. But last week we discussed that control is an illusion, so it is a roller coaster of emotions they ride, wanting to get off but feeling guilty for even thinking about that so they continue the ride.
Why do they stay on? Is it because the person they are caring for needs help at that time or is it to avoid feeling guilt or even worse, worrying about what others will think of them? This is an irrational thought process that fuels the stress and burn-out process. And eventually, the roller coaster will derail.
I have spoken with caregivers who told me that their stress reached a point where every sound seems to be coming from a loudspeaker, every taste, smell, and touch resulted in a sensory overload and a shutting down of the senses. But they couldn't let go because their "thinking" wouldn't let them. Imagine that!
But how did they get there?
Let's pretend you are a rancher, but instead of cattle, you need to corral your emotions. Because those emotions are out of control, you build a fence around them to keep them in, but, like cattle, they find a way out. So you build another fence around the first fence. They spill out again and you construct yet another fence...and so on and so on.
But it's not just about building fences and moving on. Any good rancher knows that once a fence is built, it must be maintained. So you start to fix the first fence that the emotions leaked through when the second fence goes down. Now, you are not only corralling emotions but also maintaining a series of fences you constructed to keep the emotions in check.
What started out as a way to protect yourself and keep your emotions under control has turned into a lot of work, which is never done. Soon, anxiety arises as you check and double check each new repair against the old ones. You become paralyzed by decision making and emotionally disabled by the process of trying to control irrational emotions and the fences you built in a futile attempt to control them. This process it tiring, frustrating, anxiety provoking and stress inducing...and a recipe for burnout.
At the root of this problem is the inability to communicate effectively and assertively. In most cases, the lack of communication is the result of a lack of trust and the outcome is a caretaker who feels frozen in a role they have placed themselves into. But why?
These roles are learned and as a result, irrational beliefs and perceptions develop resulting in a distorted sense of reality. These distorted perceptions lead to unrealistic expectations of others that result in anxiety, emotional upset and goal blocking. For those who allow themselves to be shut down by other family members or friends without communicating their needs will develop unnatural patterns of relating to others.
Once this happens, the caretaker's behaviors begin to take a decidedly negative tone as they:
Cannot talk about their problems for fear of negative reactions
Feel uncomfortable about expressing feelings
Communicate using passive aggressive behaviors forcing others to “guess” at what is troubling them
Have high expectations of everyone and if let down, develop resentments
Have no idea how to have fun and if they do, they feel overwhelming guilt
Are afraid to challenge other’s "rules" even if they make no sense
This pattern of communication, or more appropriately miscommunication, further solidifies a belief system that does not serve the caretaker well. Mostly subconscious, these beliefs determine how we react to life. When an event triggers off a train of thought, what we consciously think depends on the general beliefs we subconsciously apply to the event.
Although most of our beliefs serve us well, those that are self-defeating can set off a chain of events that lead to false conclusions and poor choices. So if you believe that “you must succeed at everything you do or you are not worthwhile”, you may end up not asking for help or you allow others to take advantage of you because you view yourself as “less than”.
Self-defeating (irrational) beliefs can lead to how we perceive the world, and:
Reality becomes distorted and events around you are often misinterpreted
You will not achieve goals and purposes you set out for yourself
They create extreme emotions that end up causing distress and a “frozen state” in which you accomplish nothing and can actually go backwards
You develop behaviors that harm you, others and your quality of life
Obviously, irrational thinking is not good and we know what it can do to you. Our goal is to develop a rational thought process. Rational thinking presents a stark contrast to an irrational thought and belief process. When you think rationally, your outcomes could not be more different.
Rational thinking is:
Based in reality, it sees things as they really are, keeps the good and the bad in perspective with an understanding that everything may not be the way we want it to be but that’s the reality of life
A way to actually achieve goals and purposes
A way to keep emotions in check and appropriate to the presenting situation
A way to develop behaviors that lead to healthy outcomes
But I want to take time here to discuss something that has come up more than a few times while working with families. Many mistake, or equate, rational thinking to positive thinking. There is a huge difference.
Many in caretaker roles are told to “think positive” when stressed, it sounds nice but positive thinking is really unproductive and even worse, can lead to unfulfilled expectations and failure. Positive thinking in many cases is wishful thinking, a type of thinking filled with hopes and desires but no realistic ways to accomplish a goal. Rational thinking is goal oriented and realistic, with plans in place and goals that can be achieved.
As an example, a positive thinker will buy a lottery ticket and hope to win so he can pay the rent while the rational thinker will find a job. A caretaker who “thinks” things will get better and waits for that to happen will crash while one who plans rationally will find ways to take care of themselves through thoughtful planning and contingencies in place. So we want to think rationally!
According to a type of cognitive behavioral therapy called rational emotive behavioral training, most of our upsets in this world are the result of three major irrational beliefs. Read below and see if any of these apply to you. Our graphics below also show you irrational versus rational self talk and the consequences of irrational beliefs.
Do you recognize yourself in any of these? These beliefs have demands and these demands create the problems. The goal is to be less demanding and more flexible, which can lead to healthier emotions and outcomes. We will look more at these “demands” later when we begin to put all this together.
Now, we looked at three irrational beliefs, it’s time to expand on them and look at four ways you can make yourself feel bad by engaging in certain thinking and using specific words. And when you feel bad, your choices are made through that type of thinking. Feeling bad leads to bad choices.
Using words like awful, horrible, catastrophic or disastrous to describe an event that is merely uncomfortable or displeasing leads you to belief the worse and in turn, an emotion follows. For example, “My sister seems to think that caring for our dad is easy. After months of trying to change her mind, it’s horrible what has happened to us.”
So let's think rationally. Is anything really awful? Yes, many things we do or handle as caretakers or helpers can be frustrating, uncomfortable and even make us anxious but is it really awful or unbearable? Aren't there things we can do to make things better if we put our mind to it or stand up for ourselves?
I Can't Stand-It-itis
‘If my family don’t see what I’m doing here, I won’t be able to stand it. Not getting their support is unbearable!"
In reality, you can stand it, you just choose not to. You would make changes if you could but you don't. Maybe because you don't have the tools to do so or you keep yourself a prisoner to irrational thinking. But you can stand it and the good news is, you can also change it if you want to learn how.
Do you emotionally disturb yourself by making perfectionistic demands of yourself, others, and/or the world by using the term “must” or “should,” or a synonym? "People must see how much I give of myself, they are freaking stupid!" Why must they?
Demanding behaviors nearly always end without satisfaction. Making demands of others is another attempt to control what you cannot control. In fact, psychologist Albert Ellis calls this "musterbation" (yes, that's what I wrote). Musterbation describes the phenomenon whereby people live by a set of absolute and unrealistic demands that they place on themselves, others and the world. For most of us, these rules come out in a series of should statements that we repeat to ourselves over and over again. These “should” and “shouldn’t” statements leave us feeling bad about ourselves because they set up standards that we, nor others, can't realistically meet. They also leave us feeling frustrated and hurt by others when they inevitably fail to fulfill our expectations.
Labeling or rating yourself against others. “I’m so stupid. Look at Jill, she seems to be able to handle anything and I can't even balance two different tasks."
Think about what this is, instead of rating actions, you are rating a person (and in some cases, rating yourself). In the above case, Jill is being positively rated, and although it sounds good, what you are doing in actuality is diminishing your own self-worth. We need to learn to rate actions and not people.
So, does this mean that if I learn to be more rational, dispute my irrational belief system and take a more realistic view towards life, it really will be a bowl of cherries? The answer is NO, because we are human and imperfect and we will all think irrationally from time to time. The goal, however is to reduce how often this happens, how long it lasts, and how intense these beliefs and emotions are that lead us to poor choices and bad outcomes -- and accept who we are, no more or less worthy than anyone else!
To begin the process, review these three insights about ourselves and life in general:
Others don’t get us upset, we upset ourselves by being inflexible in the beliefs that we hold;
No matter when and how we start upsetting ourselves, we continue to feel upset because we refuse to let go of our irrational beliefs;
The only way to feel better is to work hard at changing these beliefs. This means you have to challenge yourself and practice, practice, practice.
Part of developing these insights is to begin to accept reality. Accepting reality is hard, at times unpleasant, and even sad. Let's wrap up this week's blog by looking at three forms of acceptance that, if they become a part of how you live your life, will reduce your upsets and start the process of changing your irrational belief system.
There are three kinds of acceptance that will serve you well if you learn them:
Unconditional self acceptance - USA
Unconditional other acceptance – UOA
Unconditional life acceptance – ULA
Each of these acceptances have three core beliefs that, if learned will become part of your rational thinking, and can have an amazing effect on how you view yourself and those around you. We are on the way to rational thought and as a result, emotions that are more realistic. We will discuss this more next week.
Remember, the goal of this blog is not to change your situation. The person you are taking care of will have dementia and need care, there will be legal and financial things that need to be done and there will be difficult emotional decisions to make. Our goal here is to help you learn to better understand and process your emotions using rational thought versus irrational thinking.
Understanding Family Dynamics and How to Use Rational Thinking in Difficult Situations
Don Drake oversees Connelly Law's Community Education Programming. He is a retired licensed clinician in the Commonwealth of Massachusetts with over three decades of experience working with older adults diagnosed with HIV/AIDS, substance abuse disorders, chronic homeless and mental illness. Prior to his retirement, he was the director of a unique treatment program for older adults with histories of mental illness, cognitive disabilities, and addiction at Shattuck Hospital in Boston. He was also a director at Steppingstone, Inc. in Fall River, Massachusetts where he was the clinical trainer, program and curriculum developer for the agency and oversaw treatment programming for older adults. He has over 40 years of human service and law enforcement experience and has worked as an administrator at programs in Boston, Hartford, Providence and Philadelphia, helping to structure, hire and train staff in providing behavioral and addictions treatments to adolescent and adult clients. Drake also worked as a trainer for the Massachusetts Department of Public Health presenting training on QPR, a suicide prevention curriculum for lay people, the Massachusetts Council for Problem Gambling and the Crisis Prevention Institute, an international training organization that specializes in the safe management of disruptive and assaultive behaviors. He is also a retired professional wrestler who is in the New England Professional Wrestling Hall of Fame. Drake can be reached at Connelly Law Offices, Ltd. at firstname.lastname@example.org