Sunday, January 25, 2015

caregiving or codependency

We first met Trish on these pages in March of this year when she described how her husband Rick was in an automobile accident and paralyzed from the shoulders down needing extraordinary care. Contrary to doctors’ recommendations, she took him home instead of placing him in a nursing home. Now she works full time, cares for her husband and is raising their children.

caregiving or codependency

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We first met Trish on these pages in March of this year when she described how her husband Rick was in an automobile accident and paralyzed from the shoulders down needing extraordinary care. Contrary to doctors’ recommendations, she took him home instead of placing him in a nursing home.  Now she works full time, cares for her husband and is raising their children.

In her first letter, she said she was angry at almost everybody.  In addition to all of her jobs, she still had to battle with the health care system, nursing agencies and her insurance company.  Trish had been in crisis mode for years and was exhausted but felt she had no options.  Mostly she was worried about her ability to do all of her jobs effectively.

I recently heard from Trish again, but this time she is not just looking outside to understand her suffering.

Dan,

You mentioned earlier that I must feel so very alone in this process.  I do.  And now I am beginning to wonder if my husband and I have sort of a drug addict/enabler relationship.  My husband doesn't have to deal with anything.  If his battery charger stops working, it's my job to figure out a solution.  He sits back and says: "Trish, what are you going to do?"  Since the first day of the accident, I made all the medical and legal decisions because he was unable to.  I hired a contractor and had our house remodeled, I hired, trained and supervised caregivers, I found his doctors and his medical suppliers.  At some point I wanted him to help manage his life, but that has never fully happened and maybe I don't allow it.  If he doesn't do something that is required, I immediately swoop in and make it happen because I worry something serious will happen if I don't.

Today he was going to a new doctor.  He screwed around all day yesterday playing on the computer, reading and watching movies while I worked at my "away job" and then came home and did my home job.  After I got him to bed, he has the nerve to ask me to type up a medication list for his new doctor.

I was a little angry and a little tired but did I do it?  Of course I did because I wanted the doctor to have the right information.  Am I an enabler?  I want to stop.  I want him to take care of the things he can, but he never does so there I am doing it.

Talk about feeling alone.  I feel like I am the only one worrying about this stuff.

When we were growing up, I saw how my mom made my dad so helpless.  To this day he can't (or won't) make a sandwich for himself because he is so used to my mom doing everything for him.  He owned a large manufacturing company until he was 70 but he can't use a microwave, a washer or a stove.  Except for the fact that he can walk in use his arms, he is nearly as paralyzed as my husband.

So now I am thinking I have turned into my mother, but how do you change things now? 

Trish,

Dear Trish,

 This is issue arises in almost every caregiving relationship.  Of course you know the answer or else you wouldn't have concluded your letter the way you did.  But before I answer your question about what can be done, I want you to answer mine.  Are you willing to change?  Please don't read anymore until you think about that question for a few minutes.

If you are able to answer that question with clarity and integrity, you will probably feel better.  Even if you are not willing to change, or too scared to change, then make a conscious choice to continue things as they are for now.  That choice doesn't change anything on the outside, but it does change your relationship to your life.  By making a choice, you are taking a more powerful position than feeling like a victim of his spinal cord injury, your mother's genetics or your own neurosis.  You've made a difficult choice.

But genuine willingness to change is also a difficult choice because then you have to confront many of your greatest fears.  Clearly one of the fears is whether your husband could survive if you gave up control.  I also wonder if this role of caretaker or "the responsible one" has become part of your identity. I have a sneaking suspicion that you have been doing this to a certain extent much of your life. 

Change is difficult and takes two things: devotion in practice.  

You must be devoted to the process regardless of your anxiety or how long it takes.  In my work, I find that is the single most important factor in whether couples stay together or people improve -- a heartfelt devotion to getting through it no matter what. 

Now let's talk about practice.  We know that some of what keeps you stuck where the demands of your outside life.  But the other thing that keeps you stuck is your "habit" of self-sacrifice and being the responsible one.  So here is what I ask to begin your practice.  Take 20 minutes every morning, sit comfortably in an erect position with eyes closed. Once you have settled, track your breath.  Just notice every in breath and every out breath, best you can. Your mind will race away frequently because that's what minds do.  But when it does, gently bring it back to the breath.  And here is how this practice is a wonderful way to begin to change your habits.  Every time you bring your mind back to your breath, you let go of something.  It could be thoughts or emotions or stories you are telling yourself about what needs to be done etc., but whatever it is the moment you come back to your breath you are letting go of your narrative.

We will talk more about first steps in setting boundaries with your husband, help to deepen this practice of letting go, and other ways to care for yourself.  But for now, 20 minutes a day to simply breathe and let go of your thoughts and a devoted to the well-being of the person you are. 

Dan Gottlieb
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About this blog
Dan Gottlieb is a psychologist and marital therapist and has been in practice nearly 40 years. His career started in community mental health and substance abuse until his accident in 1979 made him a quadriplegic.

Since that time, he has been in private practice. Since 1985, he has been hosting a radio show called "Voices in the Family" on WHYY FM, Philadelphia's NPR affiliate. He was a regular columnist for the Philadelphia Inquirer from 1994 until 2008. He is also the author of four books.

www.drdangottlieb.com

Voices In The Family on WHYY

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