Although this article was not written for the Dominant submissive (D/s) or Master slave (M/s) Lifestyle, a true Dominant or Master can easily be considered a "care giver". To that extent, many Dominants may find this article quite appropriate to spend time reading.

In this article we will look at how caregivers cope with the emotional stresses that may come with being a caregiver to a loved one with a chronic condition.

The emotional facet of our being coexists with our intellectual, physical and spiritual facets. Our emotional reactions begin when we are infants which, at that time, are quite undifferentiated – alarm when basic needs are not met, and contentment when needs are satisfied. Gradually, over time, emotions become differentiated until they evolve into the emotions we experience as adults – joy, anxiety, fear, frustration, passion, anger, depression and so forth.

As we mature, we each develop an individual style of dealing with our emotions. Our personal style becomes set fairly early on, so that, without even thinking, we react to various emotional stimuli in our own particular way. For example, the person who, when frustrated goes into a rage, versus the person who keeps his frustration inside and develops a headache.

We learn our emotional reactions by example, by being taught and by experience, that is, finding out what works for us. This is not necessarily a conscious, cognitive process. For many of us, we would have to stop and think, " Well, what do I do when I am afraid, frustrated, etc." Our emotional response then is automatic, not necessarily rational and not always adequate. With that as a foundation, the caregiver comes to the role more or less prepared to deal with emotions, although she is almost never prepared enough for the enormous emotional challenges that will be encountered.

It therefore serves us well to take a more concrete, problem solving approach to caregiver emotional reactions, rather than assuming that our usual way of coping with negative emotions will suffice.

Coping When Things Don’t Go Smoothly

A previous article (Understanding and Acknowledging Negative Emotions) described the emotions caregivers experience – fear, anxiety, frustration, anger and depression. We also looked at how unrealistic expectations can set the caregiver up for disappointment, frustration and anxiety. Logically then a good starting point is an accurate assessment of what one can expect when caring for someone who is chronically ill, and what the caregiver can expect of herself in terms of her contribution.

What is the goal? If you set unrealistic expectations of cure, or expect to turn back the clock, you will sink before you begin. However, even assuming you have accurately assessed these two factors, it is still helpful to take a problem solving approach to the emotions you may feel.

Let us first look at how we learn to deal with emotions. As noted above, early on we develop our own style. As part of that style, we use psychological defenses in order to deal with feelings, especially unacceptable or threatening feelings. We develop preferred defensive styles when we are young.

Defenses, despite their bad rap, are not necessarily negative. They prevent us from being overwhelmed by emotions since they can give us time to regroup. For example, when a family hears the diagnosis of Alzheimer’s Disease in a loved one, they may initially respond with denial – " It’s not Alzheimer’s Disease. He’s just getting older and having some memory problems." Denial here gives time for a breather and a gathering of resources. Denial, like other psychological defenses only becomes a problem when it goes on and on and interferes with coping and problem solving.

Another defense, rationalization, is an attempt to justify something that is not reasonable in order to make it acceptable. For example, the caregiver who is depressed by the restrictions of taking care of a loved one, rationalizes that no one else can do the job as well and therefore continues feeling trapped and overworked. Psychological defenses are used to deal with emotions but too often do not provide enough of an answer.

Overcoming Caregiver Stress

Practically, the obvious first recommendation for overcoming caregiver stress, whether it is physical, emotional, or time limitations, is to take care of yourself. Caregivers hear this often. It is not a new idea. It’s just that caregivers don’t take time because they’re too busy to figure out what this means for them. Taking time to meet your needs has tremendous payoff in terms of your ability to deal with emotional stress. This means making sure you have adequate rest, nutrition, and exercise. More specifically it may be helpful to take time for one of the relaxation techniques such as yoga or mediation.

To successfully use any activity for stress reduction, however, one must plan and set up a specific realistic time when it can be done. Similarly, time away at an activity, which brings pleasure, must be planned. Whether the activity is a brief extended venture, it won’t happen by just saying you should do it. You must make a definite plan and follow through.

Develop a support system, that is a community of friends, relatives, and professionals who will be resources for you. Make a list of people:

on whom you can rely on for specific tasks and assistance,

on whom you can share your feelings,

who can help with transportation,

who can stay with your loved one for a while,

with whom can you go out and have a good time, and

to whom you can go when you need professional help.

To deal with emotions more specifically, you must become proactive so that the same emotional stress does not repeatedly wear you down. Usually it is certain situations with an impaired loved one that are the trigger for upsetting emotional reactions. You won’t always be prepared and in control but being aware and planning ahead can help a lot.

There are also steps that are useful in understanding and dealing with your feelings.

Identify the feeling. You must first know what it is that you feel. Anxiety, anger, depression are qualitatively different and have different antecedents.

Admit that you have the feeling even though it is unpleasant and accept that it is yours.

Take a step back and gain some distance from the situation. Go to the next room. Take a walk.

Analyze. Use the time to figure out what triggers the feeling. What it is about a situation that makes you feel a certain way? How do you react? What does the situation mean to you?

Talk about your feelings with someone who you trust, or write them down to express them. Sometimes writing helps one to understand, and begins the problem solving process. Talk to a professional if you are getting overwhelmed.

Make a plan. Figure out what you can do differently when you recognize that feeling again. Make the plan very concrete. It’s like dieting. You can’t just say I’m going to start tomorrow. You have to know specifically what you will change and how.

Remember there must be a balance between your needs and those of your loved one. Be comfortable with your limits. This means accepting what you are realistically able to do. Remember to be a good caregiver and to go beyond care giving, your life must continue and be meaningful.

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