Caregivers, Let’s Talk About Caring for Yourself

As the caregiver of a loved one with chronic pain, you may experience painful emotions like grief, anger, or feeling stuck. Christiane Wolf explores how you can create the space to extend compassion to yourself, while building resilience to meet the challenges you face.

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Suffering from chronic pain isn’t hard for just the person going through it; it’s also a huge challenge for anyone in a close relationship with them. If a close friend or family member has chronic pain, it will naturally have an effect on their emotional state and on your relationship. It will change your relationship. The closer the person is to the pain sufferer, the more strongly they will be affected. If they are both the life partner/close family member and also the caregiver, they may even be hit harder than the person in pain. Studies suggest that the partner of someone with chronic pain who is also the caregiver is even worse off than the one they are taking care of! The pain can affect all areas of their life, just as it does for the person in pain.

When it comes to day-to-day activities, a partner often takes over the previously shared responsibilities, like household chores and childcare. It may be that the sick partner can no longer contribute financially. This leads to a higher workload and less leisure time for the healthy partner and maybe causes them to give up on hobbies. The couple might not be able to travel as much or share other activities they previously enjoyed together. Chronic pain also tends to wreak havoc on a couple’s sex life. Because the sick partner often can’t join (or predict if they will be capable of joining) a social activity, the couple will go out less often and will spend less time with friends. Over time, they’ll be invited to fewer events, as others start to expect that they won’t attend. Isolation is real for both partners—partly because of mere exhaustion and partly because of loyalty on the part of the healthy partner.

Emotions such as sadness, grief, anger, overwhelm, depression, hopelessness, and feeling stuck are often suppressed as the healthy partner feels that they shouldn’t complain, since they’re not the one with chronic pain.

Then there is the emotional burden. Seeing your loved one in so much pain and not being able to help causes many feelings: sadness, grief, anger, overwhelm, depression, hopelessness, and feeling stuck. These are often suppressed as the healthy partner feels that they shouldn’t complain, since they’re not the one with chronic pain. Caregivers who are also life partners have a higher risk of burnout than other caregivers because they’re never able to take a break and get some internal (and external) distance.

Mindfulness and self-compassion can become trusted allies under these circumstances, too. Bringing kind awareness to these complex situations helps us to see more clearly what might be needed to reduce the stress and suffering of the dynamic.

Who Cares for the Caregiver?

All of the ways to work with emotional pain, overwhelm, and the loss of the anticipated present and future are just the same for the loved one as for the one suffering from pain. Self-care is important—even more so for those who are caretakers. All kinds of self-care activities are helpful, especially meditation. Mindfulness (or present-moment awareness) can make other self-care activities—a workout, coffee with a friend, time out in the garden—even more effective and enhance our enjoyment of them by helping us be present and remember them clearly. The problem with self-care, though, is that it takes time. Chances are, with all the extra

responsibilities that a caregiver carries, there won’t be much time—or any time at all—for these wonderful activities. Massages? Nature walks? Dinner with friends? Yoga classes? Going to a game?

By all means do what you can, but know that this is not all you can do. Here is where mindfulness and compassion come in handy: We can practice in any moment during our day, no matter what’s going on. We don’t have to say, “I’ll drive you to urgent care when I come back from yoga.”

Mindfulness is always available, even during caretaking. You can be aware of what’s going on with both your partner and yourself at the same time. You can see both that your partner is in pain and what that does to your own feelings. You can be compassionate with your partner and toward yourself, too. In any moment that feels right, check in with yourself: How are you feeling? How is your body feeling? Is there anything you can do right now to support yourself, like releasing the shoulders or a clenched jaw? Can you offer yourself words of kindness, like “You are doing the best you can,” or acknowledge to yourself how hard this moment is: “This is a difficult moment”?

Mindfulness is always available, even during caretaking. You can be aware of what’s going on with both your partner and yourself at the same time.

Mindfulness allows us to become aware of an emotion instead of pretending we don’t have it and to acknowledge it with compassion: “A part of me feels really frustrated right now” or “There is nothing wrong with feeling the way I feel right now. This is what people feel like in this kind of situation.” You are not disloyal by acknowledging how hard it is on you to follow your loved one’s pain journey. When you take care of yourself in this way, you’ll notice that it becomes easier to keep showing up for your partner.

If you feel your partner’s pain a lot, challenge yourself to consider the following: Is your pain helping your partner?

That’s not to be callous—of course you will be affected by the pain your loved one is in, especially if you are a highly empathic person. But think of a person who is drowning. They don’t need another person crying out in despair and jumping into the pool and drowning with them. They need someone who is compassionate and clear thinking and who will throw them a lifesaver.

Now imagine yourself in the same situation. Would you want your partner to suffer from your pain? Or would that only add to your burden? It’s OK to let go of any guilt and loyalty you might be feeling. And yes, it’s OK for you to feel happy and peaceful even if your partner might not. 

An Alternative to Empathy Fatigue

What your partner needs from you, more than empathy, is compassionate presence. But, you may wonder, aren’t empathy and compassion the same thing? Not really, according to recent research. Empathy is an emotion that alerts you to how the other person is feeling (“I feel your pain”). You feel empathy when certain pain circuits are activated in your own brain. Compassion, on the other hand, is when you feel the pain and simultaneously experience the positive emotion of love or care, which buffers the sharp edges of the pain. Compassion becomes stronger the more we train it.

Compassion does not require the pain to disappear—although that is what we wish for—but simply arises as a natural response to pain. Compassion also carries the knowledge that there are many factors at play in someone’s pain that are beyond our control. We know we can’t simply make the pain go away. This understanding is further deepened in the following practice in which we cultivate equanimity, or seeing the big picture, for another person.

This practice will help us keep the big picture in view when it comes to another person with whom we are enmeshed, whose well-being we are invested in out of love, and which causes us pain as a result. It is time that we open to the (often uncomfortable and painful) truth that we cannot make another person happy or pain free, no matter how much we want that. The words and phrases of the meditation below are helpful to use throughout your day (repeating them softly to yourself ), as a reminder and “kindness anchor.”

An Equanimity Meditation for Caregivers

Start by finding a comfortable position.

Pause.

Take a moment to connect with the ground under your feet or the chair or whatever your body is resting on. Let yourself feel the support of that surface.

Pause.

If you’d like, connect with the feeling of the breath.

Pause.

How is the body feeling right now?

Pause.

Take your time to settle into this practice.

Pause.

When you’re ready, bring your loved one to mind. If you’d like, picture them sitting across from you, looking at you.

Pause.

Allow yourself to feel how much you are affected by their struggle and pain.

Pause.

Now let yourself consider that every person—including your loved one and yourself—is on their own life’s journey, and we cannot make another person’s pain go away, despite our heartfelt wish.

Pause.

Slowly and silently repeat the following phrases to yourself: “Everyone is on their own life’s journey” or “You are on your own life’s journey.”

Pause.

“I am not the cause of your struggle and suffering.”

Pause.

“It isn’t in my power to end your suffering, although I would like to if I could.”

Pause.

“Moments like this are hard to endure and yet I will continue to try to help, when and where I can.”

Breathe softly.

Place a hand on your chest if that comforts you.

Pause.

And repeat these phrases:

“Everyone is on their own life’s journey.”

Pause.

“I am not the cause of your struggle and suffering.”

Pause.

“It isn’t in my power to end your suffering, although I would like to if I could.”

Pause.

“Moments like this are hard to endure and yet I will continue to try to help, when and where I can.”

Pause.

Now, when you are ready, let go of the phrases. Rest back into a bigger space of awareness, feeling the breath but with space around you, as if you could breathe beyond yourself and your

loved one into the wide-open space that allows all feelings to arise and pass away.

Take a long pause.

Now come to an end of this meditation, invite movement back into the body, stretch if you like, open your eyes if you had them closed, and move on with your day.

Excerpt from Outsmart Your Pain: Mindfulness and Self-Compassion to Help You Leave Chronic Pain Behind by Christiane Wolf and Daniel J. Siegel © 2021 by Christiane Wolf, MD, PhD. Reprinted by permission of the publisher, The Experiment, LLC. Available everywhere books are sold. experimentpublishing.com

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