If you would prefer to listen to a slightly shorter, podcast version of this post, please click here

Welcome to A Carer’s Heart blog, all about carers’ guilt. This is the first in a four-part series covering the four most prominent emotions carers experience throughout their caring journey: guilt, resentment, grief and anger.

Whether you care for a loved one part-time or full-time or if you live with them or care remotely; the role of carer brings with it, a multitude of emotions, both positive and negative but guilt is probably the most common of the four prominent emotions.
The enormity and relentlessness of the role can mean that we can notice the challenging emotions more often, rather than the positive emotions, thoughts and feelings, such as gratitude, humour and joy.

This is particularly true with the emotion of guilt, which can show up multiple times a day, even an hour, and is often in response to situations that are unavoidable, such as providing personal care for a loved one or managing a psychological meltdown. Over time, even the anticipation of the activities can evoke a physical response, even if we don’t notice the emotional response any more.


Like all emotions, guilt is highly complex and I am not able to explore it in its entirety here. So, in this post I will outline:
– The meaning of guilt
– Explore three situations where carers can experience guilt
– Outline three ways to build emotional resilience to help manage the feelings of guilt

The meaning of guilt:

Without getting too ‘Freudian’ about the meaning of guilt, this is the Cambridge Dictionary definition, which is a good place to start in the caring context as it includes a reference to ‘another person’:

Guilt (noun) is “a feeling of worry or unhappiness that you have because you have done something wrong, such as causing harm to another person”

Examples:

  • He suffered such feelings of guilt over leaving his children.
  • She remembered with a pang of guilt that she hadn’t called her mother.

To add even more context, this is the Wikipedia description of guilt:

Guilt is “an emotional experience that occurs when a person believes or realizesaccurately or not—that they have compromised their own standards of conduct or have violated universal moral standards and bear significant responsibility for that violation. Guilt is closely related to the concept of remorse as well as shame.”

In the second definition, I have highlighted three words or phrases that are very relevant in the caring role.

Accurately or not: This is a key phrase because on many occasions, the sense or feeling of guilt can stem from an assumption about something, for example, the outcome of an action you have taken or not taken. Or an inaccurate or irrational thought, such as a negative thought you had about wishing your loved one was not there anymore so that you could do something important to you (this one is a biggie and will be covered in a future post).
When we go on to explore ways to build emotional resilience as carers below, this is a crucial point to remember; that your feeling of guilt may not even be based on fact!

Remorse: Remorse is the ”…feeling of sadness and being sorry for something you have done” and is most often linked to regret. As with the above example, the emotions of remorse or regret that are often evoked following feelings of guilt might not be a factual or rational response to what has happened. So, being able to recognise these emotions when they ‘turn up’ is important in being able to respond to them in a more balanced way and therefore, start to build resilience in the future.

Shame: Shame, in the context of experiencing negative emotions as a carer is, “…an uncomfortable feeling of guilt or of being ashamed because of your own or someone else’s bad behaviour”.
As a caregiver, there are multiple opportunities for shame to show up and in unexpected ways! Firstly, you may experience shame as a response to a feeling of guilt that has arisen from something you did or said. Secondly, as reflected in the second part of the definition; having a sense of shame because of someone else’s behaviour, such as an adult loved one with dementia who has a verbal outburst in the doctor’s surgery, or a child loved one who experiences a meltdown in a public place. The initial emotional response may be shame in these or similar examples, HOWEVER, then comes the double whammy; you then experience an overwhelming sense of guilt for having been, even momentarily, ashamed of them!

All three of the above words or phrases are an integral part of why and how we feel guilt. Although I am not able to dive any deeper into them this time, my workshops do – details are at the end.

How carers experience guilt

There are so many ways in which ‘guilt’ shows up in our lives as caregivers, however, I will outline three that give broad examples of the type of situations and thoughts that are likely to trigger an emotional response of guilt, probably along with other emotions, such as remorse and shame.

1. I have negative thoughts about my loved one”

In one of the carer support groups I belong to, another member mentioned a book ‘The Selfish Pig’s Guide to Caring’ by Hugh Marriott. It sounded light-hearted and at the time I was looking for something to cheer me up, so bought it and started to read it.

Now, at this point, you might be wondering where I am going with this, apart from recommending a book, but bear with me! Marriott suggests that you can read the book from start to finish, or dip in and out of the different chapters as you need them, so the latter is what I decided to do and one of the first chapters I noticed was Chapter 12, “Pushing them down the stairs”!

I bet that got your attention, it certainly got mine!

In addition to being a police officer for over 20 years and trying to protect others, I have always prided myself on my compassion and I have never considered myself a violent or vindictive person. So, when I read the title of that chapter, I had quite a strong response. 
Initially, disbelief, that a carer would even say those words, let alone do anything like that. Then anger, probably for the same reason. BUT then I had an overwhelming sense of guilt, as I realised that while I had immediately judged Marriott just on the title of that chapter, I didn’t have any context around it and then had a nasty suspicion that when I did read it (of course, I was going to read it!), that it would probably relate to me far more than I would have liked it too…and it did!

I won’t spoil the impact of the chapter by repeating it here, (there is a link below if you’d like to read it) but it does nicely ‘break the ice’ on a topic most of us can’t even contemplate thinking about, let alone talk about and that is, at some point, you WILL have dark thoughts as a carer. Hopefully not to the extent of wanting to push your loved one down the stairs or doing any harm to them, but you will have ‘those’ types of thoughts at some point. It might be when you have had a particularly challenging day and you are feeling low, then a thought pops into your head that you wished they weren’t around so you could ‘get on with your life’ or ‘didn’t have to deal with this anymore’.

Then, as you will probably also already know, a nano-second after the thought has popped into your head…whoosh, you’re hit by a tsunami of emotions that follow it, like waves crashing down on you, not giving you time to catch your breath, and right at the front of the pack, is guilt! Guilt for thinking such a cruel and inhumane thought; guilt for the ‘guilt’ of even ‘having had the thought’ in the first place; guilt that you DID have the thought, so you can’t possibly love them; what a hateful person you are, and so it goes on and on…

I can’t even begin to tell you how many times that a thought like that has popped into my head, but probably a couple of times a day and that’s on a good day! I don’t try and stop those thoughts anymore, actually that’s like pushing water up a hill; pointless and tiring. The difference now is that I am building my emotional resilience and psychological flexibility, so when they do turn up, I am practised at dialling them back, sitting with the feeling and then letting it fade until it has gone completely. I will be summarising these techniques in the next section, but just wanted to say here, that if you don’t take anything else away from this blog, please, please, please, know that you are not alone; if you have, or have had thoughts like this, it’s completely normal and there is something you can do to help yourself.

2. “I get angry and say things I regret

Regardless of who you care for or how good your relationship is with them, at one point or another you are going to feel anger and probably say something you later regret. Then, of course, feel guilty about having expressed your anger or frustration in a negative way towards your loved one.

I won’t dive into the emotion of anger today, as this will be covered in the last post of this series, with anger expert, Tanya Heasley, sharing her knowledge about recognising and managing anger and provide some practical tips and exercises.

However, recognising when you are more likely to feel anger as a response to situations or events, will help you to start approaching those triggers in different ways. Such as, if the frustration and anger is focused around mealtimes, then taking some time before these ‘trigger times’ to prepare, will help reduce the risk of anger showing up and then the inevitable guilt! I will outline some activities below that are good for helping to prepare for stressful triggers.

3. “I am not good enough to care for my loved one”

The sense of guilt that comes from believing that you are not good enough to care for your loved one as well as they need it, often stems from setting yourself unrealistically high expectations in the role. Also sometimes referred to as ‘Imposter Syndrome’, whether it is comparing yourself to others who share their caregiving stories in chat rooms or on forums, or from hearing other people talk about how they cope with their caring role, the opportunity to sabotage yourself and almost guarantee you will constantly feel guilty, is huge.

Even if you are a trained medical or social care professional (and most of us aren’t), you are not going to know everything about how to care for your loved one every step of the way. You are going to make mistakes…they are going to happen. But they come from a place of love and well-meaning, so when they do happen, once any remedial action has been taken, wait and be ready for the guilt to arrive, because it will, probably even before you have had time to sit and reflect.

As I mentioned earlier, guilt is ever-present and a feeling that you are not good enough to care for your loved one is just another source of the emotion to rise from.
So know, that you are trying your best, with the knowledge you have, right now. You are enough! Just keep an open heart, learn from each situation and don’t fight the emotions.

Before you explore the next section, to make the most of the exercises and activities to help build emotional resilience, it is useful to reflect on the different ways you recognise and feel guilt.
Is it more intense at a particular time of the day?
Do certain tasks activate guilt more often?

Please spend a few minutes thinking about this and you can record your thoughts in this worksheet here before moving onto the last section.

3 ways to build emotional resilience to manage carer’s guilt

In this last section, I am going to explore three different, practical ways to start to build emotional resilience to manage some of the negative thoughts and feelings you can experience as a result of experiencing guilt.

1. Self-compassion

Self-compassion is often confused with self-care, which is also important, however, self-compassion is quite different. It is “showing the same warmth, care and compassion to yourself as you would to someone else” (Neff), such as to those who you love and care for. Self-compassion helps us to get through a situation, such as a long-term caring role or multigenerational caring, which is important, as often there are very few viable options open to us.

Self-compassion is a way to relate to our struggles in a way that helps us to grow. These can be very small actions that we think about and then make small changes; it is important not to judge yourself; not to fall into the drama of something and catastrophise it and it is about having awareness of yourself in that moment. Acknowledging that something is hard and perhaps at times, overwhelming but it’s also about acknowledging it’s not just you who might be struggling; other caregivers around the world will be experiencing those same feelings and emotions. Recognising it is a shared experience that will help you to draw strength from what is a very difficult event. 

There are three main elements to self-compassion and all three need to be present for it to be a useful and stable mindset.
In the ‘COVID & Caring’ blog and podcast on June 17th, I go into more detail about each of the elements.
1. Start to develop a self-compassion routine. You need to be aware that you are struggling but in a balanced way, not getting wrapped up in the emotions.
2. Cultivate a sense of common humanity. The challenge of caring is a difficult one, however, it is a role shared by millions of people around the world, so you are not alone, even though it may feel like it at times. The power comes from accepting that life can be cruel and unfair sometimes and empowering each other to work through the difficult times.
3. The last element of self-compassion is kindness.

Self-compassion is a desire to alleviate your suffering, paradoxically to be able to do that, you have to acknowledge that you are suffering and be motivated to want to help yourself, by accepting that the event is happening and how you can look to the future to heal and to grow.  Kristine Neff, a lead researcher into self-compassion, says to ask yourself this question:

“What can I do differently to make this situation better for me, so I can also help others?

She has developed three short exercises to help you to develop a self-compassion mindset. I have placed all three of them in the notes at the end of this post, both written exercises and MP3 audio of all three, with links to Kristine’s website as well.
So, please do read or listen to that episode and try one or a couple of her exercises, as they have helped so many people who have been able to develop their self-compassion and alleviate some of their stress and anxiety.

2. Meaning

So, let’s get started with the dictionary definition of ‘meaning’:

Meaning (noun): “the end, purpose, or significance of something: Example: What is the meaning of life?

(Dictionary.com)

It is difficult from the above definition to understand how meaning is important to us as individuals and more specifically, why it is such a useful concept for us as carers. To add more context and help with understanding, here are two more enhanced definitions developed by lead researchers in the field of ‘meaning in life’:

Meaning “enables people to interpret and organize their experiences, achieve a sense of their own worth and place, identify the things that matter to them and effectively direct their energies.” (Steger, 2009)

Meaning “is based upon our capacity to perceive order and coherence in our existence, pursue our goals, and feel the fulfilment that follows these achievements. (Reker & Wong, 1988)

I feel these definitions provide a clearer explanation of the different aspects of meaning, which you can then translate into your own words, thoughts and feelings.

Another source to help with understanding how meaning is an integral part of the role of caring is one of the most powerful and studied speakers about ‘Meaning of Life’, Viktor Frankl. In his book, which recounts his experiences as a prisoner of war in concentration camps during the Second World War, he refers to ‘Man’s Search for Meaning’ and I feel that this paragraph provides relevancy to our understanding of meaning so far and wanted to share it with you.

For the meaning of life differs from man to man, from day to day and from hour to hour. What matters, therefore, is not the meaning of life in general but rather the specific meaning of a person’s life at a given moment.” (Frankl, V, 1963)

That ‘moment’ for us, is living the life of a carer/caregiver and understanding how we can support ourselves throughout the caring journey, from the early days when we take on the role as a carer to when active caring ends and beyond.

There are several different exercises to discover the presence of meaning in your life as a caregiver, or to create meaning
This is one that I feel fits in well with self-compassion above, self-acceptance.

For this exercise, try to make space in a day to quietly reflect on the quote below. Think about your relationship with your loved one or cared-for-person; think about the different sources of meaning mentioned and how you can find meaning or can create meaning, in either these or other ways that would work well for you.

“Learning self-acceptance provides you with a foundation for personal meaning in life. It is easier to experience meaning when you are comfortable with the person you are.”

(Wong, 1998)

These are some of the ‘self-acceptance’ sources of meaning for carers:

  • Accepting that sudden, significant and unpredictable changes are likely to happen; they may feel overwhelming and might change how you see yourself and your role as a carer but you may grow as a result.
  • Accepting that there is no such thing as a ‘perfect carer’. Embracing who you are, accepting that you will make mistakes; there will be emotions such as, guilt and regret, but you are doing your best and you are enough.
  • Accepting that asking and receiving support from others is not a weakness but a strength and will help you to provide the best care for your loved one.

It is helpful to make a note of your thoughts, so you can reflect on them in the future, so please use this worksheet to help record your thoughts.

In the posts on the 19th and 26th August, I expand on the ‘meaning of meaning’ and outline other exercises which you might find useful, so please do read those as well.

3. 7-11 Mindful Breath Technique

The last activity is to learn how to quickly be present in your life, to give you time to better notice and respond to the feelings, that guilt can leave you with. Jon Kabat-Zinn is the lead in developing the mindfulness-based stress reduction programme and his definition of mindfulness is:

Paying attention in a particular way, on purpose, in the present moment and non-judgmentally.

The last part of that definition, which is highlighted, is really important in exploring how mindfulness can help when you experience guilt and how it can help you to move forward.

The main power guilt has on us, is if we get ‘hooked’ by it and allow it to consume our thoughts and influence our actions, which can be exhausting when you are experiencing them often. We have already acknowledged that guilt is a part of your life as a carer, even when the active part of caring has ended, so judging yourself for having a guilt response and trying to ‘fight’ it, isn’t a sustainable way forward.

A quick and easy technique to ground yourself and start to manage negative emotions, such as guilt, is to use the 7-11 Mindful Breath Technique. I use it regularly and it helps me to take back control when I can feel my mind starting to get clogged up with emotions and I can’t think straight.

  • For this technique you are breathing in through your nose (if you can) for the count of 7, holding that breath for 1 second and then slowly breathing out through your mouth for 11 seconds, really pushing deep when you get to those last few seconds of breathing out and then just breathing in normally.
  • Breathing out for 11 seconds might seem like quite a long time but what you are doing is getting rid of all the stale air that sits around in your lungs and doesn’t get changed or used and replacing it with freshly oxygenated air.
  • As you are going to be taking in quite a lot of extra air into your lungs, particularly the first couple of times you practice this technique, it can make you slightly lightheaded. So, do not ever do this while you are driving or carrying out any activity that requires your absolute attention and ability to respond.
  • If an event suddenly occurs, then as soon as you can do so safely, stop, sit or stand in a safe environment and complete the 7-11 Mindful Breath Technique, as above.
  • If you feel like you need to do another one, that is fine but usually one is enough to ground you and give you precious time to think about what you need to do next.

These links will take you to a worksheet and MP3 audio of this exercise and they are also in the notes below.

Using a mindfulness technique, such as the 7-11 Mindful Breath Technique, gives you a breathing space to:

  • Acknowledge the presence of strong emotion.
  • Recognise and name the emotion, such as guilt, although this can work with any emotion.
  • Sometimes you won’t recognise or be able to name a particular feeling or thought and it doesn’t matter. Give it a name that best reflects how it is making you feel. As you practice this mindful exercise you will become more confident in recognising and naming particular emotions, but for now, just giving it a name will start to reduce its power.
  • Go through the 7-11 Mindful Breathing Technique and as you are breathing out, you are ‘unhooking’ yourself from the emotion.
  • With the last part of the out breath, you are letting it go, to drift away to the side of you, above you, wherever you feel comfortable with it sitting for a while.
  • Then once you have sat with the emotion for a short while, reflect on the trigger and make a positive connection with moving forward and leaving the emotion sitting on its own.

It may take more than one cycle of the technique, but as with anything, the more you practice it, the more powerful the benefit of it you will feel, however, once might be enough.

I will be developing short workshops on all of the above exercises and lots more, so if you would like to be notified when these are released, please let me know at enquiries@carershearts.org

All the resources and references in the notes below, so please have a look at those.

The rest of the series will be published over the next few weeks:
Resentment – October 7th
Grief – October 21th
Anger – November 4th

Thank you so much for reading this post, I hope you found it useful. I hope you can join me next time and remember, for a special thing it is that you do.

References and Resources

Resources:

A Liberated Mind – Dr Steven C. Hayes (Affiliate Link)

Jon Kabat-Zinn: Definition of mindfulness video

Kristin Neff – Self-Compassion MP.3 Audio Version

Kristin Neff – Self-Compassion PDF Version

Kristin Neff – Definition of self-compassion

Kristin Neff – YouTube video explaining self-compassion

Man’s Search for Meaning: The classic tribute to hope from the Holocaust  – Viktor Frankl (Affiliate Link) 

Self-compassion – Positive Psychology Today blog and Kristin Neff’s exercises

Seven Ways to Build ResilienceStrengthening your ability to deal with difficult times’ Dr Chris Johnstone (Affiliate Link)

The 7-11 Breathing Technique – Worksheet

The 7-11 Breathing Technique – MP3 Audio

The Positive Power of Negative Emotions ‘How harnessing your darker feelings can help you see a brighter dawn – Dr Tim Lomas (Affiliate Link)

The Selfish Pig’s Guide to Caring –  Hugh Marriott (Affiliate Link)

References:

Frankl, V. E. (1963). Man’s search for meaning: An introduction to logotherapy. New York: Washington Square Press

Reker, G. T., & Wong, P. T. P. (1988). Aging as an individual process: Toward a theory of personal meaning. In J. E. Birren & V. L. Bengtson (Eds.), Emergent theories of aging (p. 214–246). Springer Publishing Company.

Steger, M. F. (2009). Meaning in life. In S. J. Lopez & C. R. Snyder (Eds.), Oxford library of psychology. Oxford handbook of positive psychology (p. 679–687). Oxford University Press.

Guilt – Cambridge Dictionary Definition

Guilt – Wikipedia Description

Meaning – Dictionary.Com Definition

Remorse – Cambridge Dictionary Definition

Shame – Cambridge Dictionary Definition

Wong, P. T. P. (1998). Spirituality, meaning, and successful aging. In P. T. P. Wong & P. S. Fry (Eds.), The human quest for meaning: A handbook of psychological research and clinical applications (p. 359–394). Lawrence Erlbaum Associates Publishers.

Music Composed by Michael Coltham – Black Lab Music

Black Lab  Music