The family that eats together thrives together, says years of social science research. But recurring dinnertime battles nearly ended the three-decade marriage of my former patients Sonia and Tony (not their real names). After a serious car accident left Sonia with a spinal cord injury that limited the use of her hands, she felt envious toward Tony for taking over her duties as chef. Every night, he'd work to please her with his best creations. Every night, she'd respond with loud complaints that the meal was too hot or too salty or the meat was too tough. He'd feel helpless, frustrated and angry, yelling at her for constantly criticizing him. She'd then shout back before tearfully rolling herself away from the table.
On some level, Tony understood that his wife was hurting from her many losses and mishandling her sadness by provoking fights with him. But he was so full of his own sadness and frustration that he had trouble preventing himself from overreacting. He then felt doubly helpless — unable to please her and unable to control his own emotions.
Contentious interactions with their loved ones cause a sense of helplessness for many caregivers. For all the sacrifices they make and the myriad tasks they perform, they worry that they aren't adequately caring for their family members. Such helplessness is associated with caregiver dread, burnout and, ultimately, depression.
In our new book, AARP Meditations for Caregivers: Practical, Emotional and Spiritual Support for You and Your Family (coauthored with my wife, psychologist Julia L. Mayer), we share several stories of caregivers who felt stymied when care recipients ignored, corrected or resented them. We then offer some of the following suggestions for decreasing helplessness and regaining hope that the family will endure through these difficult times:
Beware of Projections
It was clear, in Sonia's case, that she herself felt helpless because she could no longer do the everyday tasks that had once brought her a sense of accomplishment. She then handled her distress by subconsciously projecting her feelings onto her husband — that is, by frustrating Tony enough to make him feel as helpless as she did. This is a common pattern in caregiving relationships. Rather than interpret these attacks as personal, caregivers should try to see them for what they are — signs of unbearable suffering. Only then can they maintain an empathic connection with the loved ones they're caring for.
Help Care Recipients Feel Helpful
Sonia would never compliment Tony's cooking because it was too painful a reminder of her own losses. But by asking her for recipes and advice on cooking techniques, he helped make her feel like a valued expert in her own kitchen. As a consequence, she would soften (a little, anyway) her nightly barbs. When caregivers work to reduce care recipients' feelings of helplessness by appealing to their preserved areas of expertise, they will then alter the relationship dynamic and feel less helpless themselves.
Pat Your Own Back
We all crave acknowledgment for our contributions. But when others, through obliviousness, ingratitude or spite, can't or won't provide it, then we have to give it to ourselves. Tony managed to do this by repeatedly telling himself he was in fact a fair cook and was doing an adequate job, despite Sonia's many pointed criticisms. A fact sheet on "The Emotional Side of Caregiving" recently put out by the Family Caregiver Alliance suggests that caregivers keep journals of their daily accomplishments to better appreciate their otherwise unheralded efforts.
Seek Others' Support
What Sonia wouldn't give her husband, their adult children could. Tony frequently related to them much of what he did for their mother, and they were quick to praise him. When he invited them to dinner at the family home, they made a point of complimenting their father's cooking in front of their mother — while also stating that they missed their favorite dishes their mother had always made. Caregivers who gain support from other family members will feel less helpless and maintain morale.
Accept What Can't Be Helped
There are many difficulties caregivers may face, including their loved ones' physical and emotional limitations. Sometimes all the best caregivers can do is accept those limitations as part of the new family landscape. Though Sonia had always pumped up Tony's ego through much of their marriage, she could no longer do so. If he fought her continuously now, then their marriage would likely end. Instead he wisely accepted her as she now was — adjusting his expectations — and the marriage endured.
Barry J. Jacobs, a clinical psychologist and family therapist, is a member of the AARP Caregiver Expert Panel and coauthor of the new AARP Meditations for Caregivers: Practical, Emotional and Spiritual Support for You and Your Family (Da Capo, July 2016). Follow him on Twitter @drbarryjjacobs and on Facebook.