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Managing the Toll of Caregiver Trauma

A few months ago, a client who is the mother of a child with significant behavioral challenges came to meet with me. We’d been meeting for several months, discussing how the brain works, the ways in which her child’s brain works differently, how those differences are connected to the behaviors her daughter was exhibiting at home and at school, and ways to provide or create accommodations to help calm the chaos her family had been living through for several years.

This mom is a self-described glass-is-half-full type person, and I found her to be just that— optimistic, despite living through heartbreak and periods of despair; hopeful, despite experiencing the massive stress that parenting a child with special needs can bring; in possession of a keen sense of humor, which allows her to make light of situations that many parents might find hard to discuss without breaking into tears.

But the session this day was different.

It had been a long week for her and for her child. She was fielding daily calls from school about her child’s out-of-control aggression towards teachers and other students. School administrators were leveling threats of expulsion— one of my client’s greatest fears, and something she’d worked desperately to avoid since she and her husband are both employed full-time outside the home.

The family had endured full-on rages by her daughter lasting late into the evening. A family keepsake was now broken, along with assorted other objects that happened to be in the eye of the storm.

Tears and yelling and complete exhaustion ensued.

All the while, this mom felt like she was failing to live up to who she believed she should be in these moments. She was not calm. She actively sought to create distance from her child because she could no longer tolerate the verbal abuse and raging behavior. She felt like she was constantly yelling at everyone in her family, all week long.

Upon reflecting on the week during our time together, she noted that if she was “just stronger” and “did what she was supposed to,” her daughter would be “getting better.” Although the week had been particularly difficult, in reality the last two years, overall, had been incredibly difficult. And although she was an optimist at heart, she could not see a way out, a path that might ever truly improve her family’s situation.

I wish this was just one client’s story, but it is the story of many I’ve had the great privilege to journey alongside, and of many more I meet in my work facilitating trainings and workshops. The situations they describe, and the feelings associated with these situations, are those of people who have experienced serious trauma.

I don’t say this lightly, but in parenting their children whose brains work differently, each is separately living through, on a daily basis, a traumatic event. It’s no wonder that these parents frequently describe being depressed, anxious, and on-edge. It is no wonder that they might find themselves physically ill much of the time, with ailments that rarely seem to abate or resolve. It is no wonder that their sleep is disturbed or their relationships might be crumbling. This is what happens when someone’s resiliency has been worn to a nub, when internal reserves are depleted to nearly non-existent levels. Many parents are left wondering how they ended up in such a dark place, and how they might ever extract themselves again.

They feel alone in their experience, that somehow along the way they should have done something to prevent their families from ending up in such a desperate place.

So how do we reach this point? Where does it begin, and what can we do to get ahold of it before it reaches these serious levels?

It’s helpful to realize that, quite often, the spiral begins with relational stress.

Relational Stress is when the relationship between the person and their environment (or other people in their environment) is appraised by the person as exceeding his or her resources and endangering his or her well-being. (Lazarus et al 1984)

When we first begin to experience relational stress, we feel “stressed out.” As the stress continues, we begin to experience more emotional distress and may begin to see physical manifestations such as aches, pains, coughs and colds, or digestive issues that won’t go away. The longer the relational stress remains in place, the more we become habituated in our maladaptive responses, to the point of disturbing our internal or autonomic nervous system balance, leaving these systems in a state from which they are unable to return to normal resting state— to the place where recovery happens.

Chronic stress sets in deep within our physical bodies (the body keeps score!) and our mental psyche. This is often where our relationships begin to suffer, due to an accumulation of symptoms that manifest as: isolation, lashing out, nagging others more often, distrust, feeling resentful, distracted and/or agitated.

A secondary contributor, compassion fatigue (also known as secondary traumatic stress), is defined as a condition characterized by a gradual lessening of compassion over time. It results from an ongoing, snowballing process that occurs in a demanding relationship with a needy individual. In addition to relational stress, compassion fatigue brings with it the weight of frustration, emotional depletion, exhaustion and depression. It also might encompass negative elements driven by concern for the person being cared for, such as hyper-vigilance, avoidance, fear, and intrusive thoughts.

Compassion fatigue can lead to profound shifts in the way we view the world and our loved ones.

We may find ourselves becoming more cynical and resentful, developing a much darker view of the world.