Shame Hits Caregivers Hard

Those who devote enormous attention to caring for a loved one at home often are subject to intense shame.

For those who care for an elderly, ill, or incapacitated significant other at home, shame can be a frequent and devastating burden. There are special reasons for this.

Shame impacts caregivers especially hard due to the influence of so many others involved. Surrounding the patient and caregiver are extended family members, friends, neighbors, church members, work colleagues, aides, service providers, healthcare providers, and more. Whether they’re located near or far, or whether or not they have much involvement with the patient, all of them are aware of the large role that the caregiver has taken on.

Most of these others experience some degree of shame about this. They may feel ashamed about not being there enough for the patient; shame about not contributing enough; shame about not knowing how to help; shame about not being willing to help; shame that they’re repulsed by the nursing duties involved; shame that they’re not relieving the caregiver; or shame that they’re disrespecting the patient by not showing their love or pitching in. They may feel shame that the patient is suffering instead of them. And, finally, they feel shame if they’ve been critical of the caregiver and all the caregiver is doing, even if they’re unaware they're having such feelings.

What happens to all this shame? There are two options. First, some members of this surrounding circle may hold their shame inside and feel worse and worse about themselves. If so, they usually mistakenly call it guilt and say, “I feel guilty for not helping out more" when they’re really feeling ashamed. (See Chapter 15 of How Shame Runs the World to understand the difference between shame and guilt.)

Second, members of this surrounding circle may aim their shame outward. This is a very common reaction to feeling ashamed. They hurl their own shame like a toxic arrow toward the caregiver. When this happens, the caregiver feels criticized, insulted, put down, ignored, excluded, or belittled. Or, she is suddenly expected to function perfectly. For instance, if you're the caregiver, you may find that others do not return your calls or answer your requests in a timely manner. They may find fault and say that you should be doing things differently or better. They may act contemptuously toward you or the patient. They may cut the caregiver out of decisions that are made. Any act that leaves a caregiver feeling controlled, manipulated, violated, ignored, censored, devalued, or erased is most likely an act of shaming. Someone in the extended circle around the patient is trying to get rid of their own shame by foisting it onto the person who’s taking on most of the work. I call this corrosive shame–shame used only to hurt or harm.

Ironically, the better a caregiver does her job, the more likely others are to shame her, making her feel worse! This is because when others’ efforts pale in comparison to the amount of work the caregiver is doing, they feel more shame about their lack of assistance and then try to get rid of it by dumping it onto the caregiver.

If you, as caregiver, take in all this shame and believe it, the amount of shame you carry inside will grow. You’ll gradually feel increasingly bad about yourself. It’s not unusual for these bad feelings to turn into resentment. You can start resenting the patient as well as those others surrounding you.

Another possibility is that rather than others shaming you as the caregiver, you will shame yourself, aiming corrosive shame your own way and feeling increasingly bad. This is more likely to occur if you’ve been raised with a lot of shame as a child, or if you hold standards for your performance that are too high for you to reasonably meet.

Interestingly, as caregiver, you also can suffer by unconsciously projecting your own shame onto others. In this case, you will find fault with others when they’re doing nothing wrong, or you’ll believe others are finding fault with you when they really are not. When you project your own shame onto someone else, you’re offloading it onto them because it’s so painful to face in yourself. Understanding shame can be complicated!

There is a different use for shame that is not corrosive. I call this prosocial shame. Prosocial shame is used to teach a valuable lesson that’s important to pay attention to. For example, if you feel ashamed of yourself for neglecting to schedule your annual checkup with your physician, the shame you’re feeling is there to teach a constructive lesson. Pay attention to this shame and schedule a checkup. Afterward, ditch leftover feelings of shame because they’re irrelevant now.

Relieve the Pain and Burden of Shame

Nothing undermines our health and happiness like shame. For caregivers, the pain and burden of shame can feel excruciating and unrelenting–whether it’s shame that’s been loaded onto you by someone else or by yourself, or whether you shame others inappropriately as a result of all the shame you carry inside. 

A caregiver can permanently relieve herself of this burden of shame. The steps to take are those I describe in Chapter 14 of How Shame Runs the World. You can learn to heal shame. It takes practice. You may want to access a professional counselor to help you. It will be well worth the effort! You’ll feel immense relief. You’ll feel confident and much more empowered to be your authentic self and to lead a more balanced life as a caregiver.

A Balanced Life Can Save Your Life

When life is out of balance, there’s always shame at the base. This is because shame, by definition, is an experience of feeling distant from or lesser than others. When life’s scale is off balance, you feel excluded or inferior to people around you and alienated from yourself. In this unbalanced situation, others seem to somehow deserve more, get more, or don’t have to sacrifice as much as you do.

Shame is at the root of an unbalanced life, and shame can make you sick. In How Shame Runs the World, I show an illustration of a U.S. public health poster that encourages people not to let shame prevent them from seeking out needed healthcare. It reads: “Shame May Be Fatal.” 

Yes, shame can make us sick. Shame can even kill. At the very least, it makes our lives miserable. If, as caregiver, you give up too much of yourself and your own wellbeing to care for someone else, your life will become out of balance. Correcting such an imbalance makes all the difference, and this requires healing your internal shame. When you resolve shame, you will come to respect your own needs as much as the patient’s needs. Only then will you take as good care of yourself as your patient. This is the path to a balanced life, unhampered by shame.