When Caregiver Guilt is Excessive

In an earlier post I wrote about guilt felt by caregivers.  I noted that feelings of guilt are appropriate when they result from having done harm or failing to meet one’s responsibilities.  In many cases, though, feelings of guilt aren’t connected to an actual offense, or are much stronger than the offense warrants.  In my psychology practice, I’ve often dealt with clients tormented by such feelings.  This post discusses some of the reasons that people who take care of others have disproportionate feelings of guilt.

Excessive guilt when caring for others can be the result of thoughts or feelings that are different from what the caregiver thinks they should have.  Thus, a client who had been abused by her father regularly visited him years later when he was in a nursing home but  didn’t feel any warmth toward him.  She commented, “It’s pretty terrible that I don’t have more feelings for my own father.”  It was difficult for her to recognize that it was her father’s past behavior, not any deficiency on her part, that had quenched her affection.  Similarly, some grown children feel guilty for still having anger at a parent, sibling, or mate who years before had harmed them.

Excessive guilt can come from a childhood of being held responsible for the welfare of others.  A friend’s mother had been chronically depressed and blamed her children for her misery.  My friend took this to heart; throughout life, whenever anyone she knows is suffering in any way, she has felt guilt, thinking, “If I was more helpful to them they wouldn’t feel so bad.”

The friend mentioned above also shows another tendency that guilt-prone caregivers have–an exaggerated idea of how much difference they can make in someone else’s life.  After a lifetime of trying and failing to fix the lives of those around them, clients typically feel relief when they realize that making others happy is not within their power.

Another idea that can lead to excessive guilt is that it is wrong to laugh, enjoy oneself, or even to have time to oneself if someone else is suffering.  One client refuses to go on vacation while her brother, who has no family but her, suffers from a disabling medical condition that is likely to last years.  “It’s wrong to go and have fun when life is so difficult for him,” she reasons.  It’s even possible to feel guilt over having received benefits while caring for another, as did this mom who realizes that she experienced gains as well as losses during the sickness and death of her son.

Guilt is closely related to self-blame, and self-blame often comes from the strong drive we have to make sense of events, to find an explanation for why they occurred.   Often, the suffering, struggle, or disability of the one who needs care is so profound that we yearn to find someone or something to hold accountable. This urge to blame often takes an inward turn; many caregivers put themselves high on the list of suspected culprits.  Thus, in a letter she wrote to herself, a blogger who calls herself “Mrboosmum” struggled to understand her son’s premature birth and brain damage.   She wrote “It’s not your fault,” but at the same time acknowledged that in part she still thinks she’s to blame.

Another reason for excessive guilt is that many caregivers are caught between conflicting demands.  This is the essence of being in the “sandwich generation,” having responsibilities towards both growing children and aging parents, often along with work responsibilities and other time commitments.  There is no way to do it all, and the caregiver focuses on what doesn’t get done while ignoring what has been accomplished.  Such guilt stems from thinking that one should be able to do the impossible.

Painting by Mark Bowers/Ann Nathan Gallery

Painting by Mark Bowers/Ann Nathan Gallery

So there are myriad ways in which guilt, a helpful emotion when channeled to legitimate duties and commitments, can overflow its banks and flood the psyche with toxic, unrealistic dictates.  As a therapist, I have asked literally hundreds of clients drowning in guilt to reflect on whether their expectations for themselves were realistic and healthy.  Often, the question that helped the most was, “Would you hold someone else to the same standard that you’re holding yourself to?”  In many cases, this process of exploration resulted either in the realization that there was no reason at all to feel guilty or in the reduction of guilt to a much-diminished and well-bounded sense of having fallen short, with this sense usually then leading to appropriate remedial actions.  I encourage all caregivers burdened by feelings of guilt to talk to a pastor, therapist, or wise friend who can help them assess the legitimacy of their feelings.

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About bobritzema

I am a fourth-generation American of Dutch ancestry and am trained as a clinical psychologist. In 2012, I retired from Methodist University in North Carolina to return to my parents' home and provide them with assistance. I maintain part-time therapy practices in Grand Rapids, Michigan, and Fayetteville, North Carolina. I currently worship at Square Inch Community Church in Grand Rapids. I can be reached at bobritzema@hotmail.com.
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