Hey friends, I hope you’re happy and healthy today. I’m watching a soft snowfall and hoping it doesn’t stick to the Earth. I don’t much like driving in it or shoveling it but I sure like watching it. I’ve been seeing more family dynamics play out than usual because of the holidays and all of the people I see who are the primary caregiver for an ill family member. November was National Family Caregiver month so we missed the mark by a bit, but it’s an important topic any time of the year.

Contempt

Being that “contempt” is in the title of this article, let’s start by defining it. Contempt is one of the Gottman (relationship therapist guru) four horseman that ruin relationships. It’s really about assuming that someone has bad intentions or is doing something to make your life miserable. Think about a husband getting upset that his wife moved the umbrella. Getting frustrated that it’s not where he left it is normal. Assuming that she moved it because she knew it was supposed to rain that day and she wanted to punish him is contempt. The biggest problem with contempt is that once it’s there, we can’t say or do anything right anymore. Everything can be taken as an insult.

Struggle

How I see this play out in caregiving is most often between siblings who are struggling to meet the needs of an ill parent. Often a sibling calls the other sibling to ask something simple like “Are you planning on being with mom on Christmas?” and the sibling being asked hears “You’re an awful daughter, far worse than I am and don’t take mom’s feelings into account so that I have to plan all of the care for her. Look how much better I am than you”. Ouch.

However, if the other sibling doesn’t call to ask, the person we’re discussing assumes that she’s being left out and feels hurt that way, too. This hurt can come out during the most mundane conversations because they make us feel like our worth and lovability is on the line. If the story in your head is that you’re only a worthy, loveable human being if you’re the best adult child ever, you’re lining up to get hurt when you’re responsible for the care of a parent. Discussing caregiving schedules, opinions on treatment options, and obligations for caregiving can all be sore subjects. Parental relationships bring up old wounds. We love our parents before we love anyone else so it’s often more important to us that we please and honor them than anyone else. If we have doubts about our own worthiness, they’ll pop out as insecurities that challenge our relationships when our parents are ill. But it doesn’t have to be a sibling relationship that causes contempt while caregiving.

Fix it mentality

Any relationship where we’re using our ability to “fix it” or “make it better” as a guide for our worthiness can build contempt. We start to feel like nothing we can do for the other person is enough and it’s their fault for just being difficult or high maintenance. I see this with spouses where one person is ill. The healthy spouse is used to being able to fix and save and make their partner happy. You can’t fix a terminal diagnosis. Or chronic pain. They sometimes take it personally that they can’t make their partner happy and when they get frustrated enough, the story in their head becomes “I’m trying so hard and it’s not helping. They don’t even appreciate it (let’s be real here- sometimes they can’t appreciate it due to mental status) and are impossible to please”. I’d be angry, too!

Examples

Today we’ve given some examples of how hard it is to keep contempt out of the relationship when two people are trying their best to make a sad situation survivable. This has been about healthy people who are truly just dealing with their own wounds. Imagine (some of you already know) trying to take care of a toxic person or sharing caregiving responsibility with an abusive person. Let’s talk about some tips for being a caregiver, whether you’re dealing with “normal” struggles or the difficulty that comes with having to work with someone who’s abusive.

  1. Take your worth out of the equation. The really really cool things about you, your strengths, the beautiful things about you…you never have to force them. If being a caring person is something about yourself that you love and feel is important, you do it naturally. You don’t have to push it, force it, or talk yourself into it. It’s who you are. You don’t have to prove that you can do it at 100% all of the time, without any limits to be good at it and have it be awesome about you. You are worthy whether you live with the person you’re caregiving for or you have them live somewhere else to maintain the relationship with them. There is no trophy for forcing yourself to do more than you can do in healthy way. Once your worth isn’t being proved by how hard you can push yourself, you can get honest about what you really can give to the person without getting resentful for everything that is being expected of you. Choose what you give based on what you have available, not based on what you think it says about your worth.
  2. Practice empathy when you can. What might this person be going through? I’ve had people come in devastated because they’re losing a loved one and a sibling, relative or close friend says something ridiculously insensitive (for example, “at least….” or “if you think that’s bad…”). Most often, I suspect that the friend or relative feels helpless and doesn’t like that so they change the topic or try to make it better with a clumsy effort. What might it feel like to be facing death? What might be important to you? Even when mom is obsessed with something that seems silly, remember there’s a reason and try to assume that the other person (the person you’re caregiving for or the person you’re caregiving with) is doing the best they can.
  3. Ask yourself what positive or neutral intention the person might have had even when it sounded hurtful to you (note: if this person has a history of being toxic/abusive with you, skip this step. Don’t question and gaslight yourself when you’re dealing with someone that you know doesn’t have your best interest in mind).
  4. Take time for yourself/Ask for help. Please please please only give what you really can. Not what you think you should or what needs to be done. Call for help. The area on aging can be a great resource. Don’t shoulder it all alone. I know it can be a lot of work to reach out and explain what you need but it’s worth it. You will still be a worthy, loveable human being. I promise.

I hope this is helpful, friends. Reach out if you need help. Be well and I’ll see you next time!

Kayla Valley is a Licensed Master of Social Work (LMSW) who works at the Highland location of Perspectives Therapy Services. She became a therapist to help people struggle with the depression and anxiety that she understands intimately. She loves being a Michigander and is an avid sewist who loves spending time with her cats and sugar gliders.

Perspectives Therapy Services is a multi-site mental and relationship health practice with clinic locations in Brighton, Lansing, Highland and Fenton, Michigan. Our clinical teams include experienced, compassionate and creative therapists with backgrounds in psychology, marriage and family therapy, professional counseling, and social work. Additionally, we offer psychiatric care in the form of evaluations and medication management. Our practice prides itself on providing extraordinary care. We offer a customized matching process to prospective clients whereby an intake specialist carefully assesses which of our providers would be the very best fit for the incoming client. We treat a wide range of concerns that impact a person's mental health including depression, anxiety, relationship problems, grief, low self-worth, life transitions, and childhood and adolescent difficulties.