Should caregivers set boundaries?


If you are in the position of caregiver for someone with a mental illness, you probably think that you have to do absolutely everything you can for as long as you can, for that individual. Why? Because he or she needs so much support and  care. That means that you still do whatever the person wants, whenever he/she wants it and for as long as he/she wants your help because that person is so very needy.

Now this sounds reasonable and even admirable, but it can create problems. A caregiver needs to set boundaries for his or her own good. I know that now, but I was unaware of it while my son was ill with paranoid schizophrenia, and no one pointed it out to me. My husband was even guiltier as he felt that the weakest link in the family needed the most care. As a result, he spent too little time with our other children. Friends? We had little time nor energy to instigate any arrangements and most of our friends shied away, unsure of how to handle the situation and maybe I was to blame because I was so difficult to be with at that stage. I know now that I didn’t have to be around as much because it was to my detriment. My son’s condition did not change whether I was at home listening to his pain for hours on end, or not,  and the result was that we suffered from burnout and utter exhaustion.

I realize now that by identifying too completely with David’s pain and fear, I was in danger of making them my own. I know now that I should have handled my feelings too, but I can’t help wondering whether I would listen to my own advice if I had to do it over again. Psychiatry is soul searching as well as very expensive business, and besides we seldom had the time, nor the energy to seek counseling for ourselves. Every cent went into helping David.

If we’d set limits to the amount of caregiving we could do, maybe other relatives and friends might have been prepared to share the burden with us, although I am not sure about that as the unknown is frightening and most people have their own problems.

Establishing boundaries would have been better for our son. We tried, and I managed better than my husband, who was totally involved with David’s pain and illness. He went to work and then gave his full attention to the problem at hand. He could not accept that David was not going to get better even though we had exhausted the current choice of medications available. In other words there was nothing to do except try one medication after the other. Unfortunately, David proved to be medication resistant.

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