Carers

CRAIG HASSED: One of the most challenging kinds of relationships that we can have, especially in our personal life, is that of being a carer. Now, of course, it can impact on health professionals as well who are in caring roles, or indeed, teachers caring for children. But when those relationships are most close to us, being a carer can really be a big challenge in itself. And it can be associated with the poorer mental and physical health because of the stress associated with that very often. And so how can mindfulness help us with that? One of the really key things that we need to develop if we’re in a caring situation is to develop self-care.

And that’s very different to self-indulgence or to being selfish. And sometimes, we don’t get that distinction, perhaps, right. We think that if I take time to look after myself, then that’s a selfish thing. But self-indulgence is when we’re not looking after our duties because we’re selfishly looking after something else that we’d rather do. But to actually be so compassionate and caring for ourselves means to make sure we take the time, perhaps, for refreshing ourselves, time for mindfulness, time for being physically active if we can, some time to have a little bit of space in the day.

But that space in the day is really important, because very often, even where we might have an hour or two where we’re not actually actively caring for somebody, we can still be mentally preoccupied about it. So this space is not just having the time in the day, it’s creating the mental space to actually be present in those moments that we have that are down time, to just be able to leave what’s been going on so far in the day, to not be racing ahead to what might be happening later on in the day. But just to enjoy those simple moments.

Just walking down the street can just be walking down the street, rather than walking and worrying about how much we might have to do still in the day to come. Sometimes we might, of course, disappoint ourselves or feel that we haven’t been as patient as we might like. And it’s very important to, perhaps, just acknowledge it. But also to be able to be kind enough to ourselves to notice we are all human. We all have failings and foibles. And we all have our moments where we just feel a bit overwhelmed, and just to be able to be compassionate and forgiving enough to ourselves, and then to move on.

Now if we can do all that for ourselves, it makes it easier, of course, to be a little bit more compassionate and forgiving for others who might be in a situation where their mental or physical health is under some significant stress. It may not always be, perhaps, responding to others in the way that they might like. So the person who’s got the illness themselves will often be experiencing a lot of stress as well. So to be forgiving to ourselves, to be self-compassionate also is a foundation on which we can be more compassionate and forgiving for others.

If we’ve got a very full day, and there might be thousands of things that we need to do in the course of the day, then it’s very helpful to just be doing one thing at a time. Now this, of course, has been said before. But if we’re doing one thing and we’re thinking, I’ve got another 100 to do, then we feel like we’ve done a 100 days work at the end of the day, rather than just the one. So just one moment, one step, one job at a time. And then that makes each thing in itself a lot more doable.

Whereas that sense of feeling pressured can be accentuated enormously by being preoccupied or concerned about what might still be done in the day, what might still be required to do in the wake, or perhaps for the rest of the year for that matter. So one step, one moment, one job at a time. Another really important topic in being a carer is how to deal with the vicarious stress or vicarious distress. When somebody is stressed, if we, for example are in a state of distress, it could be physical pain or emotional pain. As has been previously mentioned, the amygdala, the brain’s stress centre fires off. And so it activates the fight or flight response.

But if we are distressed by somebody else’s distress, as a carer, then even though we are not the person experiencing, perhaps, the physical pain or emotional pain, we do experience a kind of distress ourselves. So our own stress centres, our own amygdala can be firing off as well. And this, if it’s happening every day, that the carer is stressed, taking on the distress of others, it’s happening, and if it’s significant, then that can accumulate over time, and sometimes leads to what’s called a carer burn out or carer fatigue.

And that sort of burn out, one of the key elements of that is depersonalisation, not really caring in the way that we might like to, not really listening, not really being emotionally engaged. So we need to learn to perhaps deal with this a little bit better. And so one of the things that, when we practise our mindfulness meditation, is sitting in the chair, we are often sitting in the presence of our own distress. We might have anxieties and worries from the day. We might have our own physical discomfort.

But if we can learn to sit with our own distress, learn to be a little bit more at peace with it, learning to embrace it with a little bit more compassion, for example, learning to be less reactive to it, then it makes it easier when we get out of the chair and back into our day to day life to be less reactive to the distress of others, to be able to be more patient in the presence of somebody else’s distress, a very important way in which we can learn to care better, but also care in a more sustainable way.

One of the things about having responsibilities of any sort, at home or at work, and especially for being a carer, is that we sometimes feel like I’ve got to be able to do everything all of the time, be all things to all people. And that’s a tremendous load to expect and to put on our own shoulders. So knowing when we need to stop, but also knowing when we need to ask for some help, offer some support, that’s a very important thing to do. So sometimes that might be asking for help from colleagues or from other family members or from friends, and sometimes, of course, there are support services that can be provided within, say, a health care system.

But that knowing when to ask for help is not necessarily a sign of weakness. It’s just recognising that there are certain ways that we need to just pace ourselves and to be able to give ourselves some space to renew and refresh.