Caring for the Caregivers - Part 2 "Who Are We - A Time for Introspection"

In last Sunday's blog, we discussed how caregiving and stress are usually synonymous. "The reason why we say this is because reactions to stress are usually brought on by the caretaker's neglect of their own needs," states certified elder law Attorney RJ Connelly III. "Everyone is subject to stress, no matter how well-balanced we may be, however, there are some people who are more susceptible to becoming physically and emotionally ill from it. There are several factors that play into this problem and the seeds of susceptibility may have been planted long before a person takes on the caregiving role."

Why do I feel this way?

But wait a minute? Are we saying that it is your fault that you have stress? Is caring for someone with dementia not stressful? Not at all, it's incredibly stressful, but it is survivable and can be extremely rewarding!

What's important is that you prepare yourself for this task, including understanding who you are and where your vulnerable points are. We all have them, and it's important to identify them - the earlier the better. This blog will be about understanding who you are, why you may be reacting the way you are, and providing some tools to deal with this. What we are going to look at is how to take a rational approach to this task and the issues associated with it. Once you begin to understand "why" you can begin the process of learning to make better choices when it comes to self-care. Let's get started.

Irrational Thought Processes

In a perfect world, the past should never interfere with the present, but the world is neither perfect nor are we. There is an Orwellian quote that says, "who controls the past controls the future", so if you own your past and understand your past, the future is in your hands. For many of us, however, the past becomes a prison from which we refuse to escape (even though the keys are available, there exists comfort in things familiar, no matter how painful they may be). Therefore, the 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 end well. It is simple - our irrational thoughts create irrational emotions resulting in bad choices, choices that fuel the overwhelming stress that consumes us. Yes, simple to explain but difficult to change.

Thoughts are just that -- thoughts, we owe them nothing.

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. 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 traumas could have been a sick or abusive parent, exposure to substance abusers, witnessing domestic violence, or any event that could trigger a fight or flight response within an individual.

"Those who have experienced certain traumas or negative situations while growing up tend to have higher perceptive senses than others."

For those with sensory sensitivities, every sight, sound, smell, taste, and touch can transport them back to the events and emotions that set the stage for the development of irrational thought processes. Paradoxically, these individuals often tend to become caregivers because they subconsciously seek control in their life and becoming care providers can meet those needs, and as we discussed last week, in control, there is the perception of safety.

Is that strange or 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, most people who are counselors and clinicians in the "helping profession" are motivated to do this by some personal experience.

But the difference is, those of us who are personally and professionally healthy 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 these situations, usually not of their own choice.

So, what do they do when they become 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 doing so, they continue to ride, and ride, and ride - and get more frustrated, tired, and feeling unappreciated.

Everything crashes and burns without maintenance

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 guilty or even worse, worrying about what others will think of them or a combination of all three? This is the irrational thought process that fuels the stress and burn-out process. And eventually, the roller coaster will derail, crash and burn. Because people, like mechanical rides, need maintenance and care on a regular basis.

I have spoken with caregivers who told me that their stress has 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.

"Because people, like mechanical rides, need maintenance and care on a regular basis."

Corralling the Emotions

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 ton of work, work that is never done. Soon, anxiety arises as you check and double-check each new repair to your fences as the old ones break down again. You become paralyzed by decision-making and emotionally disabled by the process of trying to control irrational emotions and the fences you built as a futile attempt to keep those irrational emotions in check. This process is 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.

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 and self 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.

"...distorted perceptions lead to unrealistic expectations of others and self that result in anxiety, emotional upset, and goal blocking."

Once this happens, a 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 lofty 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 others’ "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 (not respond) 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.

Our Belief System

Although most of our beliefs serve us well, those that are self-defeating can set off a chain of events leading to false conclusions and poor choices. So, if you believe that “you must succeed at everything you do or that 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, in which:

  • Reality becomes distorted and events around you are often misinterpreted.

  • You will not achieve the goals and purposes you set out for yourself.

  • Your beliefs create extreme emotions that end up causing distress and a “frozen state” in which you accomplish nothing and can actually go backward.

  • 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 begin thinking rationally, your outcomes could not be more different.

Using Rational Thought

Rational thinking is:

  • Based on 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 present 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 equate rational thinking to positive thinking. There is an enormous difference.

Many in caretaker roles are told to “think positive” when stressed, it sounds nice but positive thinking can be unproductive and even worse, 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.

"Many in caretaker roles are told to 'think positive' when stressed, it sounds nice but positive thinking can be unproductive and even worse, lead to unfulfilled expectations and failure."

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 and make a budget. 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 putting contingencies in place and with that, comes those positive outcomes. So, we want to think rationally, it's the best way to go!

According to a type of cognitive-behavioral therapy called rational emotive behavioral training (REBT), 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 internal demands, and these demands create 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.

The Power of Words

Now, we looked at three irrational beliefs, it’s time to expand on this and look at four ways you can make yourself feel bad by using specific words. And when you feel bad, your choices become limited. 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 believe the worst 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 just put our rational mind to it and stand up for ourselves?

I Can't Stand-It-itis

"If my family doesn’t see what I’m doing here, it makes me crazy, in fact, I can't stand it, and 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 of irrational thinking because it's comfortable for you. 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 similar synonym? "People should see how much I give of myself and sacrifice for dad; they are freaking stupid if they don't!"

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 tell ourselves repeatedly. These “should” and “shouldn’t” statements leave us feeling bad about ourselves because they set up standards that neither we nor others can realistically meet. They also leave us feeling frustrated and hurt by others when they inevitably fail to fulfill our expectations.

People Rating

Labeling or rating yourself against others. “I’m so stinking stupid. Look at Jill, she is 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, rating yourself. In the above case, Jill is being positively rated, and although it sounds good, what you are doing is diminishing your own self-worth. We need to learn to rate actions and not people.

"...Jill is being positively rated, and although it sounds good, what you are doing is diminishing your own self-worth. We need to learn to rate actions and not people."

The Power of Rational Thought

So, does this mean that if you learn to be more rational, dispute your 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 need 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 may even be sad, but it's a task that needs to be done in order to establish a healthy balance once again and stand up for your own needs. 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.

Rational Acceptance

There are three kinds of acceptance that will serve you well if you learn them:

  • Unconditional self-acceptance - USA

  • Unconditional other acceptanceUOA

  • Unconditional life acceptanceULA

Each of these acceptances has 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 obligations 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 more rational thought versus irrational thinking.

Next Sunday:

Understanding Family Dynamics and How to Use Rational Thinking in Difficult Situations