With Father’s Day upon us, I was reflecting on what a spectacular role model my father was to my two brothers. His role as a husband to our mother, father to his three children, and grandfather taught an invaluable lesson that will be handed down from generation to generation, as did my father’s father to him.
There is a song written and recorded by John Mayer that says, “Fathers, be good to your daughters.” The message addresses the importance of fathers treating their daughters with love, respect, kindness, compassion, etc. Why? Because one day these young girls will grow up to become partners, wives, mothers and caregivers, and likewise their sons will one day grow up to become partners, husbands, fathers and caregivers. The role of a father is significant.
When the role is taught by examples of goodness, giving of one’s self and strength, it is a rewarding and proud title to hold. However, in some cases it is self-taught because of years of therapy and/or the passion to make changes for the children of future generations to come—perhaps to protect their own children from negative personal experiences they may have been subject to or witnesses of. One word seems to be flashing at me: “Provider,” defined as: to put at the disposal of, furnish or supply.
Psychotherapist Meghan Lemery says in order to navigate the different seasons and pathways of life successfully, we need to be able to draw from the resources of our childhood role models and mentors. When we lack these resources, it can lead to a breakdown, which for most men is expressed with feelings of overwhelming frustrations or anger. She also says a father’s role in parenting is essential for shaping our self-esteem. When a father fails to provide care, love, attention and respect to their child, the result is an adult who struggles to see their value in themselves and others, therefore becoming paralyzed in fear.
Some caregivers experience symptoms of traumatic-like stress, describing themselves as being haunted by distress long after a relative died. Many caregivers are haunted from witnessing a loved one’s suffering and feeling helpless to do anything about it. They often encountered symptoms similar to those shown by people with post-traumatic stress — intrusive thoughts, disabling anxiety, hypervigilance, avoidance behaviors and more — even though research documenting this reaction is scarce. Improvement with treatment is possible, they say, although a sense of loss may never disappear completely.
Here are a couple of stories about patients to illustrate the therapeutic process. Read them below and you’ll notice common themes. Recovery depends on unearthing the source of psychological distress and facing it directly rather than pushing it away. Learning new ways of thinking can change the tenor of caregiving, in real time or in retrospect, and help someone recover a sense of emotional balance.
Barry Jacobs, a clinical psychologist and author of “The Emotional Survival Guide for Caregivers” (Guilford Press, 2006), was careful to distinguish normal grief associated with caregiving from a traumaticstyle response.
“Nightmares, lingering bereavement or the mild re-experiencing of events that doesn’t send a person into a panic every time is normal” and often resolves with time, he said.
Contrast that with one of his patients, a woman who assisted her elderly parents daily until her father, a retired firefighter, went to the hospital for what doctors thought would be a minor procedure and died there of a heart attack in the middle of the night.
Every night afterward, at exactly 3 a.m., this patient awoke in a panic from a dream in which a phone was ringing. Unable to go back to sleep for hours, she agonized about her father dying alone at that hour.
The guilt was so overwhelming, the woman couldn’t bear to see her mother, talk with her sisters or concentrate at work or at home. Sleep deprived and troubled by anxiety, she went to see her doctor, who works in the same clinic as Dr. Jacobs and referred her to therapy.
The first thing Dr. Jacobs did was to “identify what happened to this patient as traumatic, and tell her acute anxiety was an understandable response.” Then he asked her to “grieve her father’s death” by reaching out to her siblings and her mother and openly expressing her sadness.
Dr. Jacobs also suggested that this patient set aside a time every day to think about her father — not just the end of his life, but also all the things she had loved about him and the good times they’d had together as a family.
Don’t expect your nighttime awakenings to go away immediately, the psychologist told his patient. Instead, plan for how you’re going to respond when these occur.
Seven months later, the patient reported her panic at a “three or four” level instead of a “10” (the highest possible number), Dr. Jacobs said.
“She’ll say, ‘Oh, there’s the nightmare again,’ and she can now go back to sleep fairly quickly,” he continued. “Research about anxiety tells us that the more we face what we fear, the quicker we are to extinguish our fear response and the better able we are to tolerate it.”
Sara Qualls, a professor of psychology at the University of Colorado in Colorado Springs, said it’s natural for caregivers to be disgusted by some of what they have to do—toileting a loved one, for instance—and to be profoundly conflicted when they try to reconcile this feeling with a feeling of devotion. In some circumstances, traumatic-like responses can result.
Her work entails naming the emotion the caregiver is experiencing, letting the person know it is normal, and trying to identify the trigger.
For instance, an older man may come in saying he’s failed his wife with dementia by not doing enough for her. Addressing this man’s guilt, Dr. Qualls may find that he can’t stand being exposed to urine or feces but has to help his wife go to the bathroom. Instead of facing his true feelings, he’s beating up on himself psychologically — a diversion.
Once a conflict of this kind is identified, Dr. Qualls said she can help a person deal with the trigger by using relaxation exercises and problem-solving techniques, or by arranging for someone else to do a task that he or she simply can’t tolerate.
“I think that a piece of the trauma reaction that is so devastating is the intense privacy of it,” Dr. Qualls said. “Our work helps people moderate their emotional reactivity through human contact, sharing and learning strategies to manage their responsiveness.”
Although everyone’s situations are unique, it does not dismiss the feelings you may be experiencing, the overwhelming burdens, fears, anxieties and more. So, going back to the opening of this column, let’s analyze the word “provider.” Fathers are providers of many valuable lessons in our lives. However, once the fathers become overwhelmed with circumstances and responsibilities of caregiving, they must know to utilize other providers to assist them. There is nothing wrong or weak about getting the help you need from different provider resources, whether it’s psychotherapy to help you cope with the decline of your loved one or health care provider to help balance daily duties. Whatever the provider you feel would benefit you most, you need to reach out to or ask for assistance. Caregiver support is a real, necessary thing.
Here’s wishing all fathers a healthy and happy Father’s Day!