Caregiver Guilt

Rabbi Azriel Hauptman

Yehuda and Devorah have been married for fifty years and together they raised a beautiful family. Recently, Yehuda developed a medical condition that is chronic and requires constant care and attention. Devorah took it upon herself to be her husband’s primary caregiver and she told her children that this is the least she can do out of gratitude for the last fifty years of a wonderful marriage. Whenever any of her children or adult grandchildren offers to take a shift and relieve her for a few hours, she refuses. Her family is concerned that the stress might be unhealthy, but are confused as to why Devorah is so adamant in refusing any help whatsoever. 

One of the possible factors is caregiver guilt. Before we discuss guilt in regard to caregivers, we first must define guilt itself. In a nutshell, guilt is what we feel when our actions are inconsistent with our values. For example, if one damages someone else’s property this might lead to guilty feelings assuming that respecting other people’s property is part of one’s value system.

Guilt has some benefits as it prevents us from acting in ways that are against our morals and values. Knowing how badly we would feel if we would act in a certain way prevents us from doing it in the first place. Furthermore, you might want to conceptualize guilt in the same way as physical pain. Just like physical pain alerts us to an injury and prompts us to seek medical attention, similarly feelings of guilt alert us to a moral injury and spurs us to rectify our wrongdoings and repair any damage that we may have caused to others. 

Sometimes, guilt is unearned and then it can be very destructive. Imagine someone who views themselves as a capable and loving parent. When something happens to their child that is out of their control, they might still hold themselves responsible since what happened is inconsistent with their idealized image of themselves as a good parent. This is as if to say, “If I was really a good parent, this never would have happened.” Since unearned guilt is not based on reality, it has no limits and can cause endless torment to a person’s psyche. All for something that he or she never did!

This brings us to caregiver guilt. When you are the primary caregiver of a loved one, you might feel that any shortcomings in your care reflects on your lack of true dedication. “If I leave his side, that means I do not really care about him.” “If I do not feel his pain all of the time, then I am a callous human being.” “If was a better spouse, I could have prevented this condition from happening in the first place.” And the list goes on. Overtime, this can lead to very elevated levels of stress, and can be a risk factor in the health of the caregiver. As such, you have the ultimate paradox. As a result of baseless feelings of guilt, you overly dedicate yourself to caregiving which then affects your own health and now you no longer have the ability to be that idealized caregiver!

Here are some ideas that can help minimize unearned caregiver guilt.

  • Name the feeling. If you can say to yourself that you feel irrational guilt about leaving the bedside and that is why you refusing help, then the monster has been named and becomes easier to deal with. 
  • Practice self-compassion. If you were talking to your friend, you would surely encourage them and tell them that you are a wonderful caregiver even if you lean on others for help. You can tell yourself the same message. 
  • Examine your self-identity. Sometimes our feelings of guilt come from a grandiose idea of who we are. You are a good person even if you are not Superman. Don’t allow your idealized perspective of yourself get in the way of your own health.

As you have probably noticed, these concepts are often the kinds of discussions that take place in the context of psychotherapy. If the primary caregiver is open to engaging in psychotherapy, this might be the tool that they need to navigate this new experience. Like everything in life, caregiving comes with its own unique set of challenges even though it can be very rewarding. The trick is to achieve the right balance without letting baseless guilt get in the way.

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