Family Caregivers Quotes

You cannot breathe life into someone refusing to inhale." Colleen Songs

But in a home where grief is fresh and patience has long worn thin, making it through another day is often heroic in itself.

We have a mental health system that is dominated by political and hidden forces that keep us stagnated and unable to see real, lasting change.

Balance” is a luxury. Equality is a necessity. When we stop talking about work-life balance and start talking about discrimination against care and caregiving, we see the world differently.

Doctors diagnose, nurses heal, and caregivers make sense of it all.

A Family Caregiver stays when the rest of the world walks out.

A lot of people believe that mental illness does not affect our children within the school system. But the truth is that a lot of bullying stems from untreated or poorly treated mental and behavioral health problems.

In most families, care-giving becomes the woman's responsibility. While care-giving can enrich you, it can also deplete you if you don't have support or make time for self care.

If our primary caregivers are shame-based, they will act shameless and pass their toxic shame onto us. There is no way to teach self-value if one does not value oneself. Toxic shame is multigenerational. It is passed from one generation to the next. Shame-based people find other shame-based people and get married. As each member of a couple carries the shame from his or her own family system, their marriage will be grounded in their shame-core. The major outcome of this will be a lack of intimacy. It’s difficult to let someone get close to you if you feel defective and flawed as a human being. Shame-based couples maintain nonintimacy through poor communication, nonproductive circular fighting, games, manipulation, vying for control, withdrawal, blaming and confluence. Confluence is the agreement never to disagree. Confluence creates pseudointimacy.

The process of reforming the mental health system never includes the complaints that families and caregivers have regarding a need for increased access to resources, treatment, education, and financial support. Reform has continued to ignore the basic needs of families and suffering individuals with severe mental illness and special needs.

Parents, families, and caregivers are a “minority” group in the mental health system. This population is hungry for knowledge, direction, and peace of mind. The first step toward these things is embracing truth about our “fallen” mental health system

Resistance to change in the mental health system comes disguised as protection of civil liberties and freedom of speech. As a result, many parents, families, and caregivers are at a loss and feel defeated by the majority of Americans who strive to maintain the current rules of society.

There is a world of difference between the experience of 'care' – the wiping of a bottom, the bathing of a body: basic biological obligations – and the intimacy that makes us want to live.

One of the most common corruptions of childrearing remains the controlling caregiver’s propensity to shape the child into an object aligned with the caregiver’s own unprocessed trauma. Controlling caregivers have a variety of methods at their disposal to accomplish this, including such “civilized” approaches as manipulating, conditionally loving, withdrawing attention, threatening, isolating, shaming, guilt-tripping, humiliating, and withdrawing resources.

Never having experienced inequality, therefore, the majority of straight white men will be absolutely oblivious to their own advantages – not because they must necessarily be insensitive, sexist, racist, homophobic or unaware of the principles of equality; but because they have been told, over and over again, that there is no inequality left for them – or anyone else – to experience – and everything they have experienced up to that point will only have proved them right. Let the impact of that sink in for a moment. By teaching children and teenagers that equality already exists, we are actively blinding the group that most benefits from inequality – straight white men – to the prospect that it doesn’t. Privilege to them feels indistinguishable from equality, because they’ve been raised to believe that this is how the world behaves for everyone. And because the majority of our popular culture is straight-white-male-dominated, stories that should be windows into empathy for other, less privileged experiences have instead become mirrors, reflecting back at them the one thing they already know: that their lives both are important and free from discrimination. And this hurts men. It hurts them by making them unconsciously perpetrate biases they’ve been actively taught to despise. It hurts them by making them complicit in the distress of others. It hurts them by shoehorning them into a restrictive definition masculinity from which any and all deviation is harshly punished. It hurts them by saying they will always be inferior parents and caregivers, that they must always be active and aggressive even when they long for passivity and quietude, that they must enjoy certain things like sports and beer and cars or else be deemed morally suspect. It hurts them through a process of indoctrination so subtle and pervasive that they never even knew it was happening , and when you’ve been raised to hate inequality, discovering that you’ve actually been its primary beneficiary is horrifying – like learning that the family fortune comes from blood money. Blog post 4/12/2012: Why Teaching Equality Hurts Men

What makes people good communicators is, in essence, an ability not to be fazed by the more problematic or offbeat aspects of their own characters. They can contemplate their anger, their sexuality, and their unpopular, awkward, or unfashionable opinions without losing confidence or collapsing into self-disgust. They can speak clearly because they have managed to develop a priceless sense of their own acceptability. They like themselves well enough to believe that they are worthy of, and can win, the goodwill of others if only they have the wherewithal to present themselves with the right degree of patience and imagination. As children, these good communicators must have been blessed with caregivers who knew how to love their charges without demanding that every last thing about them be agreeable and perfect. Such parents would have been able to live with the idea that their offspring might sometimes—for a while, at least—be odd, violent, angry, mean, peculiar, or sad, and yet still deserve a place within the circle of familial love.

I was involved in hundreds of projects with tight deadlines that probably could have stretched into a few more days. Would that have made a difference to the project? Most of the time, no. Would that have made a difference to my colleagues’ lives at home, as caregivers or as members of their community? I think the answer is a resounding yes.

The presuming social view that mental health is not as serious as the media says it is, blocks progress. This too is political.

Parting One is strong, a child now grown The other weak, a parent aged - The strong once feeble The weak once mighty - Time, the infinity has marked them...

Furthermore, the controlling caregiver possesses poor boundaries, if they have any at all. These poor boundaries set the child up for numerous failures in adult life. The controlled child is like a chess piece or toy soldier who is constantly moved around, picked up, put down, ordered to do this, ordered not to do that, commanded to feel this, and commanded not to feel that.

The child of a controlling caregiver believes that there are always winners and losers in life, and that the winners have all the power and the losers must neglect their own senses, needs, and wants. The result is that they gain a deformed and inaccurate picture of the world—the only world they know.

I remember us saying that we liked small houses, that proximity engendered closeness in a family. That nobody should be raised by a nanny or in day care. I remember us saying that time, not money, was the greatest resource. That everything would be all right. That the universe would provide. That belief was a force more powerful than gravity itself.

A child needs to feel safe and protected, which means that their body, psyche, and belongings are safe and secure from violation. Because a child is helpless and dependent on their caregiver, they need a guardian in this predominantly unknown and sometimes scary and dangerous world. A child’s caregiver is responsible to fit the roles of safe haven and protector.

Where there were once several competing approaches to medicine, there is now only one that matters to most hospitals, insurers, and the vast majority of the public. One that has been shaped to a great degree by the successful development of potent cures that followed the discovery of sulfa drugs. Aspiring caregivers today are chosen as much (or more) for their scientific abilities, their talent for mastering these manifold technological and pharmaceutical advances as for their interpersonal skills. A century ago most physicians were careful, conservative observers who provided comfort to patients and their families. Today they act: They prescribe, they treat, they cure. They routinely perform what were once considered miracles. The result, in the view of some, has been a shift in the profession from caregiver to technician. The powerful new drugs changed how care was given as well as who gave it.

What was your childhood like? What was your relationship like with each parent—and were there other people with whom you were close as a child? Whom were you closest to and why? I’d ask you to give me several words that described your early relationship with each parent or caregiver, and then I’d ask for a few memories that illustrated each of those words. The questions go on: What was it like when you were separated, upset, threatened, or fearful? Did you experience loss as a child—and if so, what was that like for you and for your family? How did your relationships change over time? Why do you think your care-givers behaved as they did? When you think back on all these questions, how do you think your earliest experiences have impacted your development as an adult? And if you have children I’d ask you these questions: How do you think these experiences have affected your parenting? What do you wish for your child in the future? And finally, when your child is twenty-five, what do you hope he or she will say are the most important things he or she learned from you?

Caregivers had to take care of themselves, and part of that meant having a life beyond whatever illness had put them in their role. God knew Ehlena told this to the family members of her chronically sick patients all the time, and the advice was both sound and practical. At least when she gave it to others. Turned on herself, it felt selfish.

It seems like it has been forever. But i getbthe feeling that forever hasn't even started yet.

Toxic stress response can occur when a child experiences strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support. This kind of prolonged activation of the stress-response systems can disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment, well into the adult years.

There’s a painful, uncanny irony that, in the name of familial love and loyalty, child sexual abuse survivors are overtly and covertly encouraged to remain silent. Family members and other caregivers will go to great lengths to deny, discredit, muzzle, medicate, or institutionalize the silence breakers. This must change. We need models of “love with accountability.

I love cheetahs. Every moment of every day is spent in fear of dying a terrible death yet they always carry themselves elegantly, remain loyal to their family, and never complain about anything.

I do not believe you can have it all, or at least not at the same time in life. First of all, having is a possessive word. When we focus on having a baby, having a marriage, having a great and successful job, and having lots of material stuff we have lost touch with the most important part of life: being. Having a successful career and making lots of money that allows you to buy more stuff doesn’t help you to be more present for the ones we love: children, spouses, family, and friends. Intimacy requires time; giving up your role as a primary caregiver comes with sacrificing physical and emotional intimacy with your child.

Children need their caregiver’s presence, interaction, connection, and emotional availability. Not only are these fundamental elements closely related to feelings of safety and security, they are also vital for a child’s healthy development. Since the child’s well-being depends on the bond between themselves and their caregiver, it is their caregiver’s responsibility to be very attentive both to their own selves and to their child.

Crying is the primary way by which infants and small children convey their needs. Their cries can be from hunger, pain, fear, neglect, and many other things. It is the caregiver’s responsibility to correctly decipher these needs and then meet them. It is tragically common, however, that the child’s cries are so often ignored, misunderstood, and even taken as an "attack" on the caregiver, which may result in an active and brutal punishment of the child.

Much of the control exerted by the caregiver is accomplished through being indirect, such as implying expectations. The caregiver may tell the child what the child feels and thinks, particularly when he or she is upset or angry. "You don't really feel that way, do you?" is a phrase heard often in the families of people with a compressed structure. Statements like, "You want to play the piano for Aunt Martha, don't you?" are used to get the child to do what the caregiver wants without directly asking the child what he wants or not leaving the child any room to say no. The caregiver may act in a way that assumes the child feels as the caregiver feels, as if the child were an extension of the caregiver, by saying, for example, "I'm cold, put on your sweater." Children growing up in this situation become so well attuned to the feelings and will of the caregiver that the caregiver may eventually need only to shiver a little for the child to go to get a sweater for both of them.

In 2008, the national Coping with Cancer project published a study showing that terminally ill cancer patients who were put on a mechanical ventilator, given electrical defibrillation or chest compressions, or admitted, near death, to intensive care had a substantially worse quality of life in their last week than those who received no such interventions. And, six months after their death, their caregivers were three times as likely to suffer major depression. Spending one’s final days in an I.C.U. because of terminal illness is for most people a kind of failure. You lie on a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place. The end comes with no chance for you to have said goodbye or “It’s O.K.” or “I’m sorry” or “I love you.” People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The hard question we face, then, is not how we can afford this system’s expense. It is how we can build a health-care system that will actually help dying patients achieve what’s most important to them at the end of their lives.

If David had been diagnosed with diabetes at a young age, members of his family, school, and church would have undoubtedly mobilized support. His caregivers would have communicated his need for dietary changes, exercise, and/or insulin. This was not the case when David exhibited the earliest signs of depression. The myth persists that mental illness is a character flaw. It is my hope that one day disorders of the brain will be treated with as much care, compassion, and tenacity as diseases of any other organs in our bodies.

Further, because you received so little emotional connection from your caregivers and no one showed you appropriate ways to speak or behave—a helpful model called mirroring—you may find it hard to recognize, label, communicate, and express your emotions when asked to describe them.

Caring Across Generations, led jointly by twenty organizations representing caregivers, care consumers, and their families, is a national movement to embrace our changing demographics, particularly the aging of America, and an opportunity to strengthen our intergenerational and caregiving relationships.

CONSENSUS PROPOSED CRITERIA FOR DEVELOPMENTAL TRAUMA DISORDER A. Exposure. The child or adolescent has experienced or witnessed multiple or prolonged adverse events over a period of at least one year beginning in childhood or early adolescence, including: A. 1. Direct experience or witnessing of repeated and severe episodes of interpersonal violence; and A. 2. Significant disruptions of protective caregiving as the result of repeated changes in primary caregiver; repeated separation from the primary caregiver; or exposure to severe and persistent emotional abuse B. Affective and Physiological Dysregulation. The child exhibits impaired normative developmental competencies related to arousal regulation, including at least two of the following: B. 1. Inability to modulate, tolerate, or recover from extreme affect states (e.g., fear, anger, shame), including prolonged and extreme tantrums, or immobilization B. 2. Disturbances in regulation in bodily functions (e.g. persistent disturbances in sleeping, eating, and elimination; over-reactivity or under-reactivity to touch and sounds; disorganization during routine transitions) B. 3. Diminished awareness/dissociation of sensations, emotions and bodily states B. 4. Impaired capacity to describe emotions or bodily states C. Attentional and Behavioral Dysregulation: The child exhibits impaired normative developmental competencies related to sustained attention, learning, or coping with stress, including at least three of the following: C. 1. Preoccupation with threat, or impaired capacity to perceive threat, including misreading of safety and danger cues C. 2. Impaired capacity for self-protection, including extreme risk-taking or thrill-seeking C. 3. Maladaptive attempts at self-soothing (e.g., rocking and other rhythmical movements, compulsive masturbation) C. 4. Habitual (intentional or automatic) or reactive self-harm C. 5. Inability to initiate or sustain goal-directed behavior D. Self and Relational Dysregulation. The child exhibits impaired normative developmental competencies in their sense of personal identity and involvement in relationships, including at least three of the following: D. 1. Intense preoccupation with safety of the caregiver or other loved ones (including precocious caregiving) or difficulty tolerating reunion with them after separation D. 2. Persistent negative sense of self, including self-loathing, helplessness, worthlessness, ineffectiveness, or defectiveness D. 3. Extreme and persistent distrust, defiance or lack of reciprocal behavior in close relationships with adults or peers D. 4. Reactive physical or verbal aggression toward peers, caregivers, or other adults D. 5. Inappropriate (excessive or promiscuous) attempts to get intimate contact (including but not limited to sexual or physical intimacy) or excessive reliance on peers or adults for safety and reassurance D. 6. Impaired capacity to regulate empathic arousal as evidenced by lack of empathy for, or intolerance of, expressions of distress of others, or excessive responsiveness to the distress of others E. Posttraumatic Spectrum Symptoms. The child exhibits at least one symptom in at least two of the three PTSD symptom clusters B, C, & D. F. Duration of disturbance (symptoms in DTD Criteria B, C, D, and E) at least 6 months. G. Functional Impairment. The disturbance causes clinically significant distress or impairment in at least two of the following areas of functioning: Scholastic Familial Peer Group Legal Health Vocational (for youth involved in, seeking or referred for employment, volunteer work or job training)

People with BPD can be dramatic and charismatic, and they are often quite caring and understanding. Nevertheless, caring for someone with BPD is like trying to hold onto the sun: the emotional intensity of a person with BPD can singe and char relationships. Further, people with BPD often become swallowed by grief or sadness, leaving the caregiver or family member in the dark about what to do.

He moved into her house allegedly to care for her. Beulah knows he’s just after the house. It’s a highly valuable piece of luxury waterfront property now. Horton is a caregiver, not a carer. Sometimes she wonders if he’s trying to hasten her demise. Horton is Beulah’s big regret in life. She bites into the soggy biscuit and wonders what her boy will do with all the family china when she’s gone.

High-quality and affordable childcare and eldercare • Paid family and medical leave for women and men • A right to request part-time or flexible work • Investment in early education comparable to our investment in elementary and secondary education • Comprehensive job protection for pregnant workers • Higher wages and training for paid caregivers • Community support structures to allow elders to live at home longer • Legal protections against discrimination for part-time workers and flexible workers • Better enforcement of existing laws against age discrimination • Financial and social support for single parents • Reform of elementary and secondary school schedules to meet the needs of a digital rather than an agricultural economy and to take advantage of what we now know about how children learn

As each of us proceeds with personal development, we return again and again to family issues. Little else in life has the same profound impact. In a sense, you carry your original family inside you. Father, mother, and other primary caregivers become internalized and form a permanent part of who you are. Thus to ignore family is to ignore yourself. Understanding your family experience is to understand yourself and move on with your growth.

This first stage of life runs from birth to eighteen months. This is when you learn that either you can trust your parents/caregivers and the larger world around you or you cannot. If the care you receive is consistent, predictable, and reliable, you can develop an innate sense of trust that your critical needs (for being fed, cleaned, held, soothed, protected) will be met. By developing trust in infancy, you also develop the virtue of hope.

Psychologist and mindfulness expert David Richo, Ph.D., has focused on how these healthy connections are formed and what is needed to keep them alive. He describes the “5 A’s” as the qualities and gifts we all naturally seek out from the important people in our lives, including family, friends, and especially partners. What are these 5 A’s? • Attention—genuine interest in you, what you like and dislike, what inspires and motivates you without being overbearing or intrusive. You experience being heard and noticed. • Acceptance—genuinely embracing your interests, desires, activities, and preferences as they are without trying to alter or change them in any way. • Affection—physical comforting as well as compassion. • Appreciation—encouragement and gratitude for who you are, as you are. • Allowing—it is safe to be yourself and express all that you feel, even if it is not entirely polite or socially acceptable. What Richo is describing, in essence, are those genuine needs we have that form the basis of secure, healthy relationships. The 5 A’s are what we all should have received most of the time from our caregivers when we were growing up. They are also what we want in our adult relationships today. In his book How to Be an Adult in Relationships, Richo compares and contrasts the 5 A’s with what happens in unhealthy or unequal relationships.

In one sense the cause of suicide is simple: overwhelming pain. This overwhelming pain, however, is the aggregate of thousands of pains. Any hurt that we have ever suffered, if it remains consciously or unconsciously lodged within us, can contribute to suicide. This may range from being an incest victim 50 years ago, to losing a job 10 years ago, to having a car battery stolen yesterday. The pains come from everywhere: ill-health, family, peers, school, work, community, caregivers. For each suicide there was a finite point at which this aggregate became too much. Although "The straw that broke the back," is frequently an accurate metaphor, no one pain is ever the cause of suicide. Suicidal pain is decomposable into thousands of pains, and nearly all of these pains are decomposable into painful constituents. Sexual abuse, job loss, and personal theft each have numerous painful constituents. The search for the single cause is a fundamentally wrongheaded approach to the understanding and prevention of suicide. It is inaccurate to say simply that pain causes suicide, since a level of pain that is lethal for one person may not be lethal for someone with greater resources. Similarly, deficiency in resources cannot be regarded as the cause of suicide, since two people may have equal resources and unequal pain. Our resources may also come from everywhere; even such trivial distractions as going to a movie can contribute to coping with suicidal pain.

Ambivalence is often intensified by deficiencies outside the family--officials cannot find a missing person or medical experts cannot clearly diagnose or cure a devastating illness. Because of the ambiguity, loved ones can't make sense out of their situation and emotionally are pulled in opposite directions --love and hate for the same person, acceptance and rejection of their caregiving role, affirmation and denial of their loss. Often people feel they must withhold their emotions and control their aggressive feelings... This is the bind...

There are times when we cannot function and we need to withdraw and regroup. There are situations that we know we cannot handle. In spite of all the pushing and urging of friends and family who insist that we will have a wonderful time, the patient senses that it will lead to his mental devastation. If I do not listen to my body and withdraw from the overstimulation, it takes several days for my intellectual abilities to return. This is very frightening because I can’t help wondering each time this happens if I’ve pushed myself totally over the line of no return.

PLACEMENT The Physical Transference of Care and Saying Good-bye "A toddler cannot participate in a discussion of the transition process or be expected o understand a verbal explanation. [They benefit] tremendously by experiencing the physical transference of care, and by witnessing the former caregiver's permission and support for [their new guardians] to assume their role. The toddler pays careful attention to the former caregiver's face and voice, listening and watching as [they talk] to [their new guardians] and invites the [guardians'] assumption of the caregiver's role. The attached toddler is very perceptive of [their] caregiver's emotions and will pick up on nonverbal cues from that person as to how [they] should respond to [their] new family. Children who do not have he chance to exchange good-byes or to receive permission to move on are more likely to have an extended period of grieving and to sustain additional damage to their basic sense of trust and security, to their self-esteem, and to their ability to initiate and sustain strong relationships as they grow up. The younger the child, the more important it is that there be direct contact between parents and past caregiveres. A toddler is going to feel conflicting loyalties if [they] are made to feel on some level that [they] must choose between [their] former caregiver and [their] new guardians ...

When Pétain had announced the armistice terms to the French people, he told them that a “new spirit of sacrifice” was needed. In order to recover from the anguish of defeat, he declared, France must undergo a complete transformation of its society, adhering to the conservative spirit of his government’s new motto—Travail, famille, patrie—rather than to France’s national motto since the French Revolution—Liberté, égalité, fraternité. Obedience to authority and devotion to work, he made clear, must replace the idea of freedom and equality. There must be a return to tradition, to working the land, and to so-called family values, which in his and Vichy’s eyes meant accepting men as the unquestioned authority figures of the family and viewing women solely through the prism of motherhood and caregiving.

Patriarchy creates coercive background conditions for women, and thus patriarchy, not capitalism, is to blame for women’s exploitation under capitalism. Women are exploited under capitalism because they are forced by gendered expectations of women’s place into segregated spaces. In the home, gendered expectations about what women ought to do causes them to devote more time and energy to caring activities. Not only are women expected to be the main source of childcare and domestic labor in the home, they are also the psychic caregivers, coordinating social, spiritual, and emotional efforts for families. Their doing this explains the exploitation of women qua women in capitalism. The best evidence for this claim is that women in other economic systems are also exploited. For example, in the Soviet Union women were exploited for their domestic and sexual labor despite living under a noncapitalist economic system.121 I do not mean to say that there is no economic or material component to women’s condition. Women are stuck in these roles in part for material and economic reasons; they do not have enough bargaining power within heterosexual relationships generally to escape these roles. If women are able to gain an economic foothold, as is possible in an enlightened capitalism that eschews discrimination and gender segregation, then they can begin to work their way into better bargaining positions in their homes. And with better bargaining outcomes in their domestic lives, women can do better in the capitalist economy. Thus, capitalism does not provide an easy escape route, but it does point in the direction of escape from patriarchy.

In attunement, it is the infant who leads and the mother who follows. “Where their roles differ is in the timing of their responses,” writes John Bowlby, one of the century’s great psychiatric researchers. The infant initiates the interaction or withdraws from it according to his own rhythms, Bowlby found, while the “mother regulates her behaviour so that it meshes with his... Thus she lets him call the tune and by a skillful interweaving of her own responses with his creates a dialogue.” The tense or depressed mothering adult will not be able to accompany the infant into relaxed, happy spaces. He may also not fully pick up signs of the infant’s emotional distress, or may not be able to respond to them as effectively as he would wish. The ADD child’s difficulty reading social cues likely originates from her relationship cues not being read by the nurturing adult, who was distracted by stress. In the attunement interaction, not only does the mother follow the child, but she also permits the child to temporarily interrupt contact. When the interaction reaches a certain stage of intensity for the infant, he will look away to avoid an uncomfortably high level of arousal. Another interaction will then begin. A mother who is anxious may react with alarm when the infant breaks off contact, may try to stimulate him, to draw him back into the interaction. Then the infant’s nervous system is not allowed to “cool down,” and the attunement relationship is hampered. Infants whose caregivers were too stressed, for whatever reason, to give them the necessary attunement contact will grow up with a chronic tendency to feel alone with their emotions, to have a sense — rightly or wrongly — that no one can share how they feel, that no one can “understand.” Attunement is the quintessential component of a larger process, called attachment. Attachment is simply our need to be close to somebody. It represents the absolute need of the utterly and helplessly vulnerable human infant for secure closeness with at least one nourishing, protective and constantly available parenting figure. Essential for survival, the drive for attachment is part of the very nature of warm-blooded animals in infancy, especially. of mammals. In human beings, attachment is a driving force of behavior for longer than in any other animal. For most of us it is present throughout our lives, although we may transfer our attachment need from one person — our parent — to another — say, a spouse or even a child. We may also attempt to satisfy the lack of the human contact we crave by various other means, such as addictions, for example, or perhaps fanatical religiosity or the virtual reality of the Internet. Much of popular culture, from novels to movies to rock or country music, expresses nothing but the joys or the sorrows flowing from satisfactions or disappointments in our attachment relationships. Most parents extend to their children some mixture of loving and hurtful behavior, of wise parenting and unskillful, clumsy parenting. The proportions vary from family to family, from parent to parent. Those ADD children whose needs for warm parental contact are most frustrated grow up to be adults with the most severe cases of ADD. Already at only a few months of age, an infant will register by facial expression his dejection at the mother’s unconscious emotional withdrawal, despite the mother’s continued physical presence. “(The infant) takes delight in Mommy’s attention,” writes Stanley Greenspan, “and knows when that source of delight is missing. If Mom becomes preoccupied or distracted while playing with the baby, sadness or dismay settles in on the little face.

I’ll say it: I am lucky enough to not have to work, in the sense that Jesse and I could change how we organize our life to live on one income. I work because I like to. I love my kids! They are amazing. But I wouldn’t be happy staying home with them. I’ve figured out that my happiness-maximizing allocation is something like eight hours of work and three hours of kids a day. It isn’t that I like my job more than my kids overall—if I had to pick, the kids would win every time. But the “marginal value” of time with my kids declines fast. In part, this is because kids are exhausting. The first hour with them is amazing, the second less good, and by hour four I’m ready for a glass of wine or, even better, some time with my research. My job doesn’t have this feature. Yes, the eighth hour is less fun than the seventh, but the highs are not as high and the lows are not as low. The physical and emotional challenges of work pale in comparison to the physical and emotional challenges of being an on-scene parent. The eighth hour at my job is better than the fifth hour with the kids on a typical day. And that is why I have a job. Because I like it. It should be okay to say this. Just like it should be okay to say that you stay home with your kids because that is what you want to do. I’m well aware that many people don’t want to be an economist for eight hours a day. We shouldn’t have to say we’re staying home for children’s optimal development, or at least, that shouldn’t be the only factor in the decision. “This is the lifestyle I prefer” or “This is what works for my family” are both okay reasons to make choices! So before you even get into reading what the evidence says is “best” for your child or thinking about the family budget, you—and your partner, or any other caregiving adults in the house—should think about what you would really like to do.

Allegations of multi-perpetrator and multi-victim sexual abuse emerged to public awareness in the early 1980s contemporaneously with the denials of the accused and their supporters. Multi-perpetrator sexual offences are typically more sadistic than solo offences and organised sexual abuse is no exception. Adults and children with histories of organised abuse have described lives marked by torturous and sometimes ritualistic sexual abuse arranged by family members and other care-givers and authority figures. It is widely acknowledged, at least in theory, that sexual abuse can take severe forms, but when disclosures of such abuse occur, they are routinely subject to contestation and challenge. People accused of organised, sadistic or ritualistic abuse have protested that their accusers are liars and fantasists, or else innocents led astray by overly zealous investigators. This was an argument that many journalists and academics have found more convincing than the testimony of alleged victims.

For women who spend all their hours doing unpaid work, the chores of the day kill the dreams of a lifetime. What do I mean by unpaid work? It’s work performed in the home, like childcare or other forms of caregiving, cooking, cleaning, shopping, and errands, done by a family member who’s not being paid. In many countries, when communities don’t have electricity or running water, unpaid work is also the time and labor women and girls spend collecting water and gathering wood. This is reality for millions of women, especially in poorer countries, where women do a much higher share of the unpaid work that makes a household run. On average, women around the world spend more than twice as many hours as men on unpaid work, but the range of the disparity is wide. In India, women spend 6 hours a day doing unpaid work, while men spend less than 1. In the US, women average more than 4 hours of unpaid work every day; men average just 2.5. In Norway, women spend 3.5 hours a day on unpaid work, while men spend about 3. There is no country where the gap is zero. This means that, on average, women do seven years more of unpaid work than men over their lifetimes. That’s about the time it takes to complete a bachelor’s and a master’s degree.

Many of us juggle multiple life factors including businesses to run, work to go to, children to take care of, our physical bodies to tend to, homes and cars that need maintenance, friends and family to keep up with, groups and communities to stay active with, emails to respond to and an online presence to maintain. Not to mention the time needed for self-care, exercise, play, personal growth, meditation practice, shows to binge or simple quiet time in nature. Economic times have also changed. For many, a single income is barely enough to support a single person, let alone a family. As I enumerate all of these life factors, I’m actually surprised anyone has time for even one securely attached relationship. Secure attachment takes time, both to establish and to maintain. Research shows that it takes babies up to seven months for their attachment to their caregivers to become securely established, and for adults, a securely attached romantic relationship takes approximately two years to really solidify.60 So, while you might feel an instant resonance or connection with someone, building an actual relationship based on trust, seeing each other in multiple contexts, deeply understanding each other and relating in securely attached ways requires time.

The Blue Mind Rx Statement Our wild waters provide vast cognitive, emotional, physical, psychological, social, and spiritual values for people from birth, through adolescence, adulthood, older age, and in death; wild waters provide a useful, widely available, and affordable range of treatments healthcare practitioners can incorporate into treatment plans. The world ocean and all waterways, including lakes, rivers, and wetlands (collectively, blue space), cover over 71% of our planet. Keeping them healthy, clean, accessible, and biodiverse is critical to human health and well-being. In addition to fostering more widely documented ecological, economic, and cultural diversities, our mental well-being, emotional diversity, and resiliency also rely on the global ecological integrity of our waters. Blue space gives us half of our oxygen, provides billions of people with jobs and food, holds the majority of Earth's biodiversity including species and ecosystems, drives climate and weather, regulates temperature, and is the sole source of hydration and hygiene for humanity throughout history. Neuroscientists and psychologists add that the ocean and wild waterways are a wellspring of happiness and relaxation, sociality and romance, peace and freedom, play and creativity, learning and memory, innovation and insight, elation and nostalgia, confidence and solitude, wonder and awe, empathy and compassion, reverence and beauty — and help manage trauma, anxiety, sleep, autism, addiction, fitness, attention/focus, stress, grief, PTSD, build personal resilience, and much more. Chronic stress and anxiety cause or intensify a range of physical and mental afflictions, including depression, ulcers, colitis, heart disease, and more. Being on, in, and near water can be among the most cost-effective ways of reducing stress and anxiety. We encourage healthcare professionals and advocates for the ocean, seas, lakes, and rivers to go deeper and incorporate the latest findings, research, and insights into their treatment plans, communications, reports, mission statements, strategies, grant proposals, media, exhibits, keynotes, and educational programs and to consider the following simple talking points: •Water is the essence of life: The ocean, healthy rivers, lakes, and wetlands are good for our minds and bodies. •Research shows that nature is therapeutic, promotes general health and well-being, and blue space in both urban and rural settings further enhances and broadens cognitive, emotional, psychological, social, physical, and spiritual benefits. •All people should have safe access to salubrious, wild, biodiverse waters for well-being, healing, and therapy. •Aquatic biodiversity has been directly correlated with the therapeutic potency of blue space. Immersive human interactions with healthy aquatic ecosystems can benefit both. •Wild waters can serve as medicine for caregivers, patient families, and all who are part of patients’ circles of support. •Realization of the full range and potential magnitude of ecological, economic, physical, intrinsic, and emotional values of wild places requires us to understand, appreciate, maintain, and improve the integrity and purity of one of our most vital of medicines — water.

Type II trauma also often occurs within a closed context - such as a family, a religious group, a workplace, a chain of command, or a battle group - usually perpetrated by someone related or known to the victim. As such, it often involves fundamental betrayal of the relationship between the victim and the perpetrator and within the community (Freyd, 1994). It may also involve the betrayal of a particular role and the responsibility associated with the relationship (i.e., parent-child, family member-child, therapist-client, teacher-student, clergy-child/adult congregant, supervisor-employee, military officer-enlisted man or woman). Relational dynamics of this sort have the effect of further complicating the victim's survival adaptations, especially when a superficially caring, loving or seductive relationship is cultivated with the victim (e.g., by an adult mentor such as a priest, coach, or teacher; by an adult who offers a child special favors for compliance; by a superior who acts as a protector or who can offer special favors and career advancement). In a process labelled "selection and grooming", potential abusers seek out as potential victims those who appear insecure, are needy and without resources, and are isolated from others or are obviously neglected by caregivers or those who are in crisis or distress for which they are seeking assistance. This status is then used against the victim to seduce, coerce, and exploit. Such a scenario can lead to trauma bonding between victim and perpetrator (i.e., the development of an attachment bond based on the traumatic relationship and the physical and social contact), creating additional distress and confusion for the victim who takes on the responsibility and guilt for what transpired, often with the encouragement or insinuation of the perpetrator(s) to do so.

Central to any understanding of stress, health and disease is the concept of adaptiveness. Adaptiveness is the capacity to respond to external stressors without rigidity, with flexibility and creativity, without excessive anxiety and without being overwhelmed by emotion. People who are not adaptive may seem to function well as long as nothing is disturbing them, but they will react with various levels of frustration and helplessness when confronted by loss or by difficulty. They will blame themselves or blame others. A person’s adaptiveness depends very much on the degree of differentiation and adaptiveness of previous generations in his family and also on what external stressors may have acted on the family. The Great Depression, for example, was a difficult time for millions of people. The multigenerational history of particular families enabled some to adapt and cope, while other families, facing the same economic scarcities, were psychologically devastated. “Highly adaptive people and families, on the average, have fewer physical illnesses, and those illnesses that do occur tend to be mild to moderate in severity,” writes Dr. Michael Kerr. Since one important variable in the development of physical illness is the degree of adaptiveness of an individual, and since the degree of adaptiveness is determined by the multigenerational emotional process, physical illness, like emotional illness, is a symptom of a relationship process that extends beyond the boundaries of the individual “patient.” Physical illness, in other words, is a disorder of the family emotional system [which includes] present and past generations. Children who become their parents’ caregivers are prepared for a lifetime of repression. And these roles children are assigned have to do with the parents’ own unmet childhood needs — and so on down the generations. “Children do not need to be beaten to be compromised,” researchers at McGill University have pointed out. Inappropriate symbiosis between parent and child is the source of much pathology.

In Separation, the second volume of his great trilogy on attachment, John Bowlby described what had been observed when ten small children in residential nurseries were reunited with their mothers after separations lasting from twelve days to twenty-one weeks. The separations were in every case due to family emergencies and the absence of other caregivers, and in no case due to any intent on the parents’ part to abandon the child. In the first few days following the mother's departure the children were anxious, looking everywhere for the missing parent. That phase was followed by apparent resignation, even depression on the part of the child, to be replaced by what seemed like the return of normalcy. The children would begin to play, react to caregivers, accept food and other nurturing. The true emotional cost of the trauma of loss became evident only when the mothers returned. On meeting the mother for the first time after the days or weeks away, every one of the ten children showed significant alienation. Two seemed not to recognize their mothers. The other eight turned away or even walked away from her. Most of them either cried or came close to tears; a number alternated between a tearful and an expressionless face. The withdrawal dynamic has been called “detachment” by John Bowlby. Such detachment has a defensive purpose. It has one meaning: so hurtful was it for me to experience your absence that to avoid such pain again, I will encase myself in a shell of hardened emotion, impervious to love — and therefore to pain. I never want to feel that hurt again. Bowlby also pointed out that the parent may be physically present but emotionally absent owing to stress, anxiety, depression, or preoccupation with other matters. From the point of view of the child, it hardly matters. His encoded reactions will be the same, because for him the real issue is not merely the parent's physical presence but her or his emotional accessibility. A child who suffers much insecurity in his relationship with his parents will adopt the invulnerability of defensive detachment as his primary way of being. When parents are the child's working attachment, their love and sense of responsibility will usually ensure that they do not force the child into adopting such desperate measures. Peers have no such awareness, no such compunctions, and no such responsibility. The threat of abandonment is ever present in peer-oriented interactions, and it is with emotional detachment that children automatically respond. No wonder, then, that cool is the governing ethic in peer culture, the ultimate virtue. Although the word cool has many meanings, it predominately connotes an air of invulnerability. Where peer orientation is intense, there is no sign of vulnerability in the talk, in the walk, in the dress, or in the attitudes.

Thus polyvictimization or complex trauma are "developmentally adverse interpersonal traumas" (Ford, 2005) because they place the victim at risk not only for recurrent stress and psychophysiological arousal (e.g., PTSD, other anxiety disorders, depression) but also for interruptions and breakdowns in healthy psychobiological, psychological, and social development. Complex trauma not only involves shock, fear, terror, or powerlessness (either short or long term) but also, more fundamentally, constitutes a violation of the immature self and the challenge to the development of a positive and secure self, as major psychic energy is directed toward survival and defense rather than toward learning and personal development (Ford, 2009b, 2009c). Moreover, it may influence the brain's very development, structure, and functioning in both the short and long term (Lanius et al., 2010; Schore, 2009). Complex trauma often forces the child victim to substitute automatic survival tactics for adaptive self-regulation, starting at the most basic level of physical reactions (e.g., intense states of hyperarousal/agitation or hypoarousal/immobility) and behavioral (e.g., aggressive or passive/avoidant responses) that can become so automatic and habitual that the child's emotional and cognitive development are derailed or distorted. What is more, self-integrity is profoundly shaken, as the child victim incorporates the "lessons of abuse" into a view of him or herself as bad, inadequate, disgusting, contaminated and deserving of mistreatment and neglect. Such misattributions and related schema about self and others are some of the most common and robust cognitive and assumptive consequences of chronic childhood abuse (as well as other forms of interpersonal trauma) and are especially debilitating to healthy development and relationships (Cole & Putnam, 1992; McCann & Pearlman, 1992). Because the violation occurs in an interpersonal context that carries profound significance for personal development, relationships become suspect and a source of threat and fear rather than of safety and nurturance. In vulnerable children, complex trauma causes compromised attachment security, self-integrity and ultimately self-regulation. Thus it constitutes a threat not only to physical but also to psychological survival - to the development of the self and the capacity to regulate emotions (Arnold & Fisch, 2011). For example, emotional abuse by an adult caregiver that involves systematic disparagement, blame and shame of a child ("You worthless piece of s-t"; "You shouldn't have been born"; "You are the source of all of my problems"; "I should have aborted you"; "If you don't like what I tell you, you can go hang yourself") but does not involve sexual or physical violation or life threat is nevertheless psychologically damaging. Such bullying and antipathy on the part of a primary caregiver or other family members, in addition to maltreatment and role reversals that are found in many dysfunctional families, lead to severe psychobiological dysregulation and reactivity (Teicher, Samson, Polcari, & McGreenery, 2006).

Kaffman (2009) described childhood victimization as a "silent epidemic", and Finkelhor, Turner, Ormrod, and Hamby (2010) reported that children are the most traumatized class of humans around the globe. The findings of these researchers are at odds with the view that children have protected status in most families, societies, and cultures. Instead, Finkelhor reports that children are prime targets and highly vulnerable, due principally to their small size, their physical and emotional immaturity with its associated lack of control, power and resources; and their related dependency on caregivers. They are subjected to many forms of exploitation on an ongoing basis, imposed on them by individuals with greater power, strength, knowledge, and resources, many of whom are, paradoxically and tragically, responsible for their care and welfare. These traumas are interpersonal in nature and involve personal transgression, violation and exploitation of the child by those who rely on the child's lesser physical abilities, innocence, and immaturity to intimidate, bully, confuse, blackmail, exploit, or otherwise coerce. In the worst-case scenario, a parent or other significant caregiver directly and repeatedly abuses a child or does not respond to or protect a child or other vulnerable individual who is being abused and mistreated and isolates the child from others through threats or with direct violence. Consequently, such an abusive, nonprotective, or malevolently exploitative circumstance (Chefetz has coined the term "attack-ment" to describe these dynamics) has a profound impact on victim's ability to trust others. It also affects the victim's identity and self-concept, usually in negative ways that include self-hatred, low self-worth, and lack of self-confidence. As a result, both relationships, and the individual's sense of self and internal states (feelings, thoughts, and perceptions) can become sources of fear, despair, rage, or other extreme dysphoria or numbed and dissociated reactions. This state of alienation from self and others is further exacerbated when the occurrence of abuse or other victimization involves betrayal and is repeated and becomes chronic, in the process leading the victim to remain in a state of either hyperarousal/anticipation/hypervigilance or hypoarousal/numbing (or to alternate between these two states) and to develop strong protective mechanisms, such as dissociation, in order to endure recurrences. When these additional victimizations recur, they unfortunately tend to escalate in severity and intrusiveness over time, causing additional traumatization (Duckworth & Follette, 2011). In many cases of child maltreatment, emotional or psychological coercion and the use of the adult's authority and dominant power rather than physical force or violence is the fulcrum and weapon used against the child; however, force and violence are common in some settings and in some forms of abuse (sometimes in conjunction with extreme isolation and drugging of the child), as they are used to further control or terrorize the victim into submission. The use of force and violence is more commonplace and prevalent in some families, communities, religions, cultural/ethnic groups, and societies based on the views and values about adult prerogatives with children that are espoused. They may also be based on the sociopathy of the perpetrators.

The traditional hospital practice of excluding parents ignored the importance of attachment relationships as regulators of the child’s emotions, behaviour and physiology. The child’s biological status would be vastly different under the circumstances of parental presence or absence. Her neurochemical output, the electrical activity in her brain’s emotional centres, her heart rate, blood pressure and the serum levels of the various hormones related to stress would all vary significantly. Life is possible only within certain well-defined limits, internal or external. We can no more survive, say, high sugar levels in our bloodstream than we can withstand high levels of radiation emanating from a nuclear explosion. The role of self-regulation, whether emotional or physical, may be likened to that of a thermostat ensuring that the temperature in a home remains constant despite the extremes of weather conditions outside. When the environment becomes too cold, the heating system is switched on. If the air becomes overheated, the air conditioner begins to work. In the animal kingdom, self-regulation is illustrated by the capacity of the warm-blooded creature to exist in a broad range of environments. It can survive more extreme variations of hot and cold without either chilling or overheating than can a coldblooded species. The latter is restricted to a much narrower range of habitats because it does not have the capacity to self-regulate the internal environment. Children and infant animals have virtually no capacity for biological self-regulation; their internal biological states—heart rates, hormone levels, nervous system activity — depend completely on their relationships with caregiving grown-ups. Emotions such as love, fear or anger serve the needs of protecting the self while maintaining essential relationships with parents and other caregivers. Psychological stress is whatever threatens the young creature’s perception of a safe relationship with the adults, because any disruption in the relationship will cause turbulence in the internal milieu. Emotional and social relationships remain important biological influences beyond childhood. “Independent self-regulation may not exist even in adulthood,” Dr. Myron Hofer, then of the Departments of Psychiatry and Neuroscience at Albert Einstein College of Medicine in New York, wrote in 1984. “Social interactions may continue to play an important role in the everyday regulation of internal biologic systems throughout life.” Our biological response to environmental challenge is profoundly influenced by the context and by the set of relationships that connect us with other human beings. As one prominent researcher has expressed it most aptly, “Adaptation does not occur wholly within the individual.” Human beings as a species did not evolve as solitary creatures but as social animals whose survival was contingent on powerful emotional connections with family and tribe. Social and emotional connections are an integral part of our neurological and chemical makeup. We all know this from the daily experience of dramatic physiological shifts in our bodies as we interact with others. “You’ve burnt the toast again,” evokes markedly different bodily responses from us, depending on whether it is shouted in anger or said with a smile. When one considers our evolutionary history and the scientific evidence at hand, it is absurd even to imagine that health and disease could ever be understood in isolation from our psychoemotional networks. “The basic premise is that, like other social animals, human physiologic homeostasis and ultimate health status are influenced not only by the physical environment but also by the social environment.” From such a biopsychosocial perspective, individual biology, psychological functioning and interpersonal and social relationships work together, each influencing the other.

• No matter how open we as a society are about formerly private matters, the stigma around our emotional struggles remains formidable. We will talk about almost anyone about our physical health, even our sex lives, but bring depression, anxiety or grief , and the expression on the other person would probably be "get me out of this conversation" • We can distract our feelings with too much wine, food or surfing the internet, • Therapy is far from one-sided; it happens in a parallel process. Everyday patients are opening up questions that we have to think about for ourselves, • "The only way out is through" the only way to get out of the tunnel is to go through, not around it • Study after study shows that the most important factor in the success of your treatment is your relationship with the therapist, your experience of "feeling felt" • Attachment styles are formed early in childhood based on our interactions with our caregivers. Attachment styles are significant because they play out in peoples relationships too, influencing the kind of partners they pick, (stable or less stable), how they behave in a relationship (needy, distant, or volatile) and how the relationship tend to end (wistfully, amiably, or with an explosion) • The presenting problem, the issue somebody comes with, is often just one aspect of a larger problem, if not a red herring entirely. • "Help me understand more about the relationship" Here, here's trying to establish what’s known as a therapeutic alliance, trust that has to develop before any work can get done. • In early sessions is always more important for patients to feel understood than it is for them to gain any insight or make changes. • We can complain for free with a friend or family member, People make faulty narratives to make themselves feel better or look better in the moment, even thought it makes them feel worse over time, and that sometimes they need somebody else to read between the lines. • Here-and-now, it is when we work on what’s happening in the room, rather than focusing on patient's stories. • She didn't call him on his bullshit, which this makes patients feel unsafe, like children's whose parent's don’t hold them accountable • What is this going to feel like to the person I’m speaking to? • Neuroscientists discovered that humans have brain cells called mirror neurons, that cause them to mimic others, and when people are in a heightened state of emotion, a soothing voice can calm their nervous system and help them stay present • Don’t judge your feelings; notice them. Use them as your map. Don’t be afraid of the truth. • The things we protest against the most are often the very things we need to look at • How easy it is, I thought, to break someone’s heart, even when you take great care not to. • The purpose on inquiring about people's parent s is not to join them in blaming, judging or criticizing their parents. In fact it is not about their parents at all. It is solely about understanding how their early experiences informed who they are as adults so that they can separate the past from the present (and not wear psychological clothing that no longer fits) • But personality disorders lie on a spectrum. People with borderline personality disorder are terrified of abandonment, but for some that might mean feeling anxious when their partners don’t respond to texts right away; for others that may mean choosing to stay in volatile, dysfunctional relationships rather than being alone. • In therapy we aim for self compassion (am I a human?) versus self esteem (Am I good or bad: a judgment) • The techniques we use are a bit like the type of brain surgery in which the patient remains awake throughout the procedure, as the surgeons operate, they keep checking in with the patient: can you feel this? can you say this words? They are constantly calibrating how close they are to sensitive regions of the brain, and if they hit one, they back up so as not to damage it.

Beliefs about women and their role in society undergird natural parenting. It seems to me to be more than coincidence that natural childbirth, breastfeeding, and natural parenting share a variety of disturbing characteristics. All impose an inordinate amount of work and pain on women, and all ostensibly exclude fathers and other family members, making women not merely the primary caregivers but the only acceptable caregivers a majority of the time. And by requiring intense around-the-clock effort, they make it nearly impossible for women who want or need something in addition to mothering (a job, a career, free time) to be “good” mothers. It all seems suspiciously like the classic ploy to control and judge women by the performance of their reproductive organs.

We need to be much more vigilant and aware of the risks inherent in touting the importance of family involvement and family care. Too easily, those calls can be reinterpreted to mean that the only care worth supporting is that provided by relatives, inadvertently demonizing and pathologizing the use of paid attendants. This is not to say that family members who provide attendant care for their disabled relatives should not themselves be compensated for their work; indeed, I support consumer-directed attendant services that allow disabled people to hire their own attendants, including family members. But, as Laura Hershey explains, seeing attendant care as something best provided by a family member too easily perpetuates the idea that disability is a private problem concerning the family that has no place in the public sphere. This attitude, in turn, leads to the continued devaluation of caregiving; abysmal wages and working conditions are justified on the basis that family members—almost always women—would be doing this work anyway and therefore any compensation, no matter how meager, is sufficient.

But—and this is all on me—it’s just that sometimes, lying next to him after he’d gone to sleep, I would think that maybe my whole point in life was going to turn out to be a caregiver for people I didn’t really, really, really belong to.

What makes people good communicators is, in essence, an ability not to be fazed by the more problematic or offbeat aspects of their own characters. They can contemplate their anger, their sexuality and their unpopular, awkward or unfashionable opinions without losing confidence or collapsing into self-disgust. They can speak clearly because they have managed to develop a priceless sense of their own acceptability. They like themselves well enough to believe that they are worthy of and can win the goodwill of others, if only they have the wherewithal to present themselves with the right degree of patience and imagination. As children, these good communicatiors must have been blessed with caregivers who knew to love their charges without demanding that every last thing about them be agreeable and perfect. Such parents would have been able to live with the idea that their offsping might sometimes - for a while, at least - be odd, violent, angry, mean, peculiar or sad, and yet still deserve a place within the circle of familial love. The parents would thus have created an invaluable wellspring of courage from which those children would eventually be able to draw to sustain the confessions and direct conversations of adult life.

Things you would not give a new homeowner, such as pet information, party ideas, holiday notes and ideas, travel information, car information, and community activities. The Financial Organizing Binder was created in hindsight after settling my father’s estate. The Financial Organizing Binder houses everything needed for someone to act as financial power of attorney on your behalf or to settle your estate after you pass. This binder has been reviewed by estate lawyers and will save you thousands of dollars and untold hours when needed. The Medical Organizing Binder is designed to house the papers and documentation needed to advocate as a power of healthcare, guardian, or caregiver for an adult. Time after time clients share with me how having a simple binder, with medical information for an ill family member, has saved redundant tests, over billing, and so, so much time.

At no point will both of you feel like things are perfectly fair and equal. Someone will always be adjusting. Someone will always be sacrificing. One person may be up while the other is down; one might bear more of the financial pressures while the other handles caregiving and family obligations. Those choices and the stresses that go along with them are real. I’ve come to realize, though, that life happens in seasons. Your fulfillment—in love, family, and career—rarely happens all at once. In a strong partnership, both people will take their turns at compromise, building that shared sense of home together, there in the in-between.

There is a difference between empathy and sympathy and it is an important distinction for those who work in caregiving. Dr. Nicola Davies writes on her website, “Imagine being at the bottom of a deep, dark hole. Peer up to the top of the hole and you might see some of your friends and family waiting for you, offering words of support and encouragement. This is sympathy; they want to help you out of the pit you have found yourself in. This can assist, but not as much as the person who is standing beside you; the person who is in that hole with you and can see the world from your perspective; this is empathy.

In recent decades, the medical establishment has increasingly outsourced relatively complex at-home care tasks to family caregivers, often with little training.

I once received an Explanation of Benefits statement showing that the billed services for a few weeks in the BMTU were more than $3 million. It seems shocking that the medical system can't spare dollar figures in the thousands to pay for professional in-home care. If a medical professional tells the family that the patient has a medical need for twenty-four hour care attendance, as Dr. T did, it doesn't make sense that that very very attendance is a noncovered expense.

Identify friends and family who care about you, and try to spend more time with them. When you’re apart, visualize being with them and take in the good feelings. Companionship, even if only imagined, activates the brain’s attachment and social group circuitry. Physical and emotional closeness to caregivers and other members of the band was a necessity for survival during our evolutionary history. Consequently, activating a felt sense of closeness will probably help you feel safer.

According to the Family Caregivers Alliance, 46 percent of caregivers providing "complex chronic care perform medical and nursing tasks." Moreover, a majority felt they had no choice because nobody else would do it and/or insurance wouldn't pay for professional service.

The real question is not how my family could afford care, but how anyone in the US can bear the economic burden of caregiving.

If we want people to bring their whole selves into work, we must make it acceptable for anyone and everyone to talk about and share their family experience—and we must also ensure that people don’t feel judged or excluded if they are neither a caregiver nor a parent.

What would it be like if you had to hide every hint of your femininity or masculinity? Every little bit of unique flair? If every single word, mannerism, or choice of clothing were fraught with the question, “Does this make me seem like the person people want me to be?

Imagine if the only message you got about your identity—about who you are as a person—was this: you are wrong.

But it’s more than an absence of spouses that complicates caregiving and companionship later in life. People are having fewer children, if they have children at all. This, in combination with marriage trends, has increased the number of older adults with no close family ties—a group of people whom sociologists call “elder orphans,” “solo agers,” or “kinless.” Researchers estimate that one in five older adults is an “elder orphan” or at risk of becoming one, a figure that is likely to grow in coming years. Like marriage, having children isn’t a surefire insurance policy for caregiving. Adult children might not live close to their parents, or their kids might not have the capacity to help. Daughters, historically the country’s default caregivers of aging parents, can’t be taken for granted as a source of uncompensated caregiving these days. Far more women are in the paid labor force and would jeopardize their economic security or their family’s if they quit their jobs to take care of their parents. (Nevertheless, on average, daughters spend far more time caring for their aging parents than sons do.) Because Americans are having kids later in life, it’s common for children with aging parents to be raising children of their own at the same time; these are members of the so-called sandwich generation. Unable to manage both forms of care, these adults may focus on their kids and outsource care for their parents.

Self-care isn't so easy. Your work or family role may require you to take care of others' needs first. If that's your situation, self-care might seem selfish to you. But you won't be able to help anyone else if you don't find ways, big and small, to refill your own tank. There's nothing selfish about self-care.

If you choose to try to make a life with another person, you will live by that choice. You’ll find yourself having to choose again and again to remain rather than run. It helps if you enter a committed relationship prepared to work, ready to be humbled, and willing to accept and even enjoy living in that in-between span of a single conversation, sometimes over the course of years. And inside of that choice and those years, you’ll almost certainly come to see that there’s no such thing as a fifty-fifty balance. Instead, it’ll be like beads on an abacus, sliding back and forth—the math rarely tidy, the equation never quite solved. A relationship is dynamic this way, full of change, always evolving. At no point will both of you feel like things are perfectly fair and equal. Someone will always be adjusting. Someone will always be sacrificing. One person may be up while the other person is down, one might bear more financial pressures, while the other person handles household and caregiving responsibilites. Those choices and the stress that goes along with them are real. I’ve come to realize though, that life happens in seasons. Your fulfillment—in love, family and career—rarely happens all at once. In a strong relationship both people will take their turns at compromise, building that shared sense of home together, there in the in-between Regardless of how wildly and deeply in love you are, you will be asked to on board a whole lot of your partners' foibles, you will be required to ignore all sorts of minor irritations and at least a few major ones too trying to assert love and constancy over all of it over all the rough spots and an invisible disruptions you will need to do this as often and as compassionately as you can. And you will need to be doing it with someone who is equally able and willing to create the same latitude and show this same forbearance toward you --to love you despite all the baggage you show up with, despite what you look like and how you behave when you are at your absolute worst.

Sometimes, when you are a child who doesn’t belong in the family, you watch as the primary caregivers offer love and nurturing to everyone except you. And often, you wonder if you are undeserving of love.

One of the things Mom’s journey with dementia has taught me is this: Life is in the small things, like the word “Amen”—a simple agreement, a yes to words prayed, and a statement claiming the promises of God. I’ve cried and begged for Mom not to have to go through this valley of loss, but it has come regardless. Now my one plea is that—in all that she has or will lose—she will never lose the love of God and her family. That is a truth worth saying “Amen” to.

If you are patient in one moment of anger, you will escape a hundred days of sorrow. —Chinese proverb

When we make a conscious effort to be our best selves and to set aside our differences, we encourage our loved ones to do the same. The reward is lasting, loving relationships.

The world is nothing but a school of love. Our relationships with our husband or wife, with our children and parents, with our friends and relatives are the university in which we are meant to learn what love and devotion truly are. —Swami Muktananda

Present your child’s true gender as a fact—and not as an opinion.

When someone you love has dementia, you too experience a form of anticipatory grief, but yours may extend over a longer period of time (for some, as long as 20 years) and be socially unrecognized and surrounded by uncertainty.

I was involved in hundreds of projects with tight deadlines that probably could have stretched into a few more days. Would that have made a difference to the project? Most of the time, no. Would that have made a difference to my colleagues’ lives at home, as caregivers or as members of their community? I think the answer is a resounding yes.

Migration feminized because work feminized: rich countries demanded more caregiving labor, which women disproportionately supply. Agin

Other nannies and caregivers I interviewed had similar stories. Large families relied on female family members to help including young girls and those girls grew up knowing how to take care of children, one black woman in Pennsylvania who had never been a formal nanny but had been handed extra children to take care of into middle age expressed in no uncertain terms the being good at something didn't alleviate the toll and magnitude of the work involved.

Whether or not an individual feels safe with the parent, caregiver, family members, or others during early development might moderate individual differences in vulnerability to trauma.

and diminishes our dignity. So, naturally we don't want to be around when we're dying—behind Allen's punch line lies the bitter truth of pain and suffering.

The significance of living longer is the caregiving never ends.

I'm in awe of people who deal with Alzheimer's, because they have to deal with death 10 times over, year after year.

Developmental trauma can disrupt our ability to form and maintain relationships. Whenever trauma or neglect takes place in the context of our caregiving relationships, there’s a high risk that the neural networks involved in reading and responding to other people will be altered. When these “attachment” capabilities are impaired, there will be difficulties with friendships, school, employment, intimacy, and family; there is even risk for repeating transgenerational patterns of abuse.

We'd become volatile, and we were afraid to tell anyone about it, both of us ashamed to admit that all the stress had unleashed monsters in us. We were supposed to be heroes. Or, at least, that's what everyone was calling us.

In the United States, the typical caregiver in the family suffers from depression, is usually stressed out and exhausted, physically and mentally. The emotional toll on members of the family who take care of husbands or wives, mothers or fathers, or grandparents is always high. Taking for instance in Washington, it was once reported that more than half of the caregivers in that state were found to be extremely depressed. A caregiving expert has opined that family caregivers are possibly the most depressed individuals in the United States.

Doctors and researchers, from local emergency rooms to the Centers for Disease Control (CDC), link the growing use of handheld electronic devices to an alarming increase in injuries to children, especially when parents or caregivers are distracted and fail to properly supervise young children in the moment. The Wall Street Journal, in a roundup of research and interviews with experts on the subject, noted that injuries to children under age five rose 12 percent between 2007 and 2010, after falling for much of the prior decade, according to the most recent data from the CDC.