Thursday, June 26, 2014

Thick Line in the Sand (Part 1)

This post is the second in a series on self-care for care-givers. Physicians, nurses, mommas, pastors, teachers and unsung care-givers of every stripe, I hope you find something restorative here. Post 1, Caregiver, Love Thyself

The guy was dying in agony. An ill-informed physician and his lengthy drug history added up to inadequate pain medication. He'd scream and curse and spread filth everywhere. Some days his wife was sober. Some days she wove down the hall like someone slowly dodging bullets.

I became one with this family. I was the only nurse who would care for them repeatedly. Shift in, shift out. I read his wife's mood changes fairly well (although she yelled at me plenty). I spent all the patience I had at his bedside, tending the wounds he made worse.

I called to check on them after my shift, asking the current nurse about labs, or subtle changes. And nightmares -- I heard his screams in my sleep. I dreaded caring for them, and feeling guilty for that, tried harder and harder to be more and more, until his wife yelled at me for addressing her intoxication and kicked me out of the room. I realized I was in too deep and with tears streaming down my face, and great gasps for air, informed my manager I could not care for them any more.

He died several days later. I never worked far enough away to not hear his screams.

I wish I could talk to that young, passionate, and utterly broken nurse and tell her leaving this family in other hands was just that -- letting other people do their job. It wasn't a moral failing. And it was utterly brave to do something so counter to her culture.

Years, and many cases of over-involvement later, I learned the term "boundaries" and came to understand the lack of them allowed and reinforced patterns of losing my identity in other people's troubles. This process starts very early for most of us.

In a conversation today I connected with someone over the sense that we felt like glue for our families of origin. Even as a small girl I felt responsible for being the binding between my sometimes disparate family members. My friend experienced this in high definition. When alcoholism and other mental illnesses enter the narrative, a child stretches beyond their natural capacity and maturity to hold together the impossible -- they become tiny adults with all the responsibility, little of the insight, and none of the self-determination.

The thing about glue is, it bonds with things it holds together on a molecular level. No one ever talks about a composite and says, "Man, that's some glue." They talk about the composite, or the more interesting pieces the glue holds together.

Glue gets lost in the whole. It may be unseen. It gets absorbed into what it contacts.

I became a sort of glue for that family, and many others. I lost all sense of myself in the effort to hold together a giant, unwieldy mess.

Have you experienced this? You lost sight of where you start and stop in someone else's needs or problems? Maybe you can't leave your responsibilities to care for your child, and let someone else have a go for a few hours. Pastor/chaplain type, you frequently leave your family sitting without you at the dinner table to tend to a lost sheep. Medical type, you can't get that patient off your mind, and follow up past your shift. AA sponsor, you start out to help, but become so entangled you find you enabled. Teacher, one student draws more of your time and energy than you have to give.

Do you see a pattern here? Boundaries are the lines that tell me where my identity stops, and yours starts. Where my responsibility stops and yours starts. People who struggle with boundaries have a hard time believing anyone else can do the job they do. Frankly, some manipulative people are more than happy to exploit a person strong in love, but weak in boundaries, for their own ends. And, because we're used to finding our identities in others, when the world praises our hard work, we see it as confirmation we're doing a good thing.

We're not. We're killing ourselves, living our lives for others. And, we isolate ourselves from our potentially healthy relationships -- like family and loves -- because we spend all we had elsewhere. It's a good, good instinct to love the unlovely, and tend to the broken, and raise the fragile. But, even a good instinct, taken past its usefulness is a breaking thing. If we get lost in every case, there's nothing left of us for our primary responsibilities: self and loved ones. I prioritize self here, because I believe good other care starts with good self care -- not because I'm trying to raise an army of self-absorbed egoists.

Caregiving culture also happily exploits this problem. It's cost-effective from an overly-simplistic view, to have people who will give everything (the more nuanced understanding shows that broken caregivers are costly caregivers). Plus, we work with other people who share the same blind spot. Our group mentality resists calling attention to the deficit.

The first step to change is to recognize the need. That's actually an undervalued piece of the process. We sometimes push so quickly past it to get to change that we miss the fullness of our struggle's impact on us. I suspect it also leads to hasty solutions -- like creating the type of rigid boundaries that allow NO one in, and serve to isolate us from the real love we possess and real need to receive love.

In the next post, I'll explore more of my journey with learning boundaries, but for now, if something here struck a chord with your experiences -- breathe. Be grateful for your big, big heart. Love yourself well. Indulge yourself in something that makes you happy (not something that numbs you). Come back for the next post on finding and enacting healthy boundaries.

No comments:

Post a Comment