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Vulnerabilities of Caregivers – John J. McGee

“Although our vulnerabilities and the external threats to our wellbeing are in many ways nothing compared to those of the persons whom we serve, it is important that we recognize our own before dealing further with the vulnerabilities of those whom we serve.

We are all vulnerable to breakdowns in our personal values. Sometimes these can be due to how we feel and what we are experiencing within ourselves; at other times we can be part of a system that makes it harder for us to respond to our shared values. If a caregiver is afraid of being hurt, he/she then becomes more likely to use restraint to control violent behaviors. Or, if a caregiver is depressed, then it is extremely hard to bring joy to others. If we are being beaten and de-valued at home, it is hard to bring non-violence into someone else’s home.

John J. McGee’s “Mending Broken Hearts” CPLS Newsletter

Many of our vulnerabilities are worsened by lack of adequate training and hands-on supervision. Some caregivers are quite isolated and seldom have the opportunity to discuss their problems and search for new responses to challenging situations. It is critical that caregivers recognize their weaknesses and find ways to overcome them. Community leaders need to listen to caregivers and find ways to offer support and encouragement.

Caregivers need to find their own self-worth from themselves, talking frequently, sharing their anxieties, and pointing out their goodness. Our own worth has to be generated from within ourselves. We need to form strong communities.

The question of burnout seems to be always present. Some caregivers give up and attribute their burnout to poor supervision, working in violent settings, receiving little guidance, or low pay. Since we are not only teaching feelings of companionship, but also a sense of community, it is important for caregivers to look at themselves, question their reality, and search for ways for themselves to feel safer, more engaged, and more valued. The first step in this is to step back and examine those things that make us vulnerable.

Let us take a moment to reflect on these aspects of our lives — recognizing these will help us understand better the needs of those whom we serve.”

 

~Excerpt from John J. McGee’s “Mending Broken Hearts” — CPLS Newsletter.

 

Mentoring is About…

– Us and all caregivers: mothers, fathers, direct care supporters, clinicians, physicians, and all who advocate for and about those who are forsaken.

– All cultures and our desire and creativity to integrate the centrality of feeling safe and loved into all cultures and faith systems

-A sharp and transcending focus on caregivers and administrators with the assumption that we are the ones who need transformation from within so that we might more lovingly serve others.

– Our day to day life experiences, always linking what is taught with what is done

– A calling to keep our hearts open to building on unconditional love and its meaning in every encounter.

– Human interdependence as the center of the human condition.

– A commitment from agencies to a culture of gentleness that gradually changes policies and procedures so that feeling safe and loved is the central cultural aspect of all forms of care giving.

– Experiencing hands-on interactions with the most forsaken individuals and sharing ideas with caregivers around the kitchen table in a spirit of gentle dialog.

– Developing and carrying out community-centered celebrations that lead to companionship and community.

-John McGee

Developing and carrying out community-centered celebrations that lead to companionship and community

Who The Other Is: Human Vulnerabilities and Gifts

Who the other is: HUMAN VULNERABILITIES AND GIFTS

Caregivers have to be very tuned into the life-story of the person and the significance and impact of inner vulnerabilities; we must also be astute at seeing or even sensing the life-giving gifts of each person such as forgiveness, curiosity, hope, and the slightest hints of a hunger to connect with others.

Vulnerabilities can be caused by a sorrowful, often undefined, vague, but morally defining, memories of years of segregation, loneliness, scorn, institutionalization, racism, sexual abuse, societal prejudice, illiteracy, poverty, imprisonment, neglect, war, dictatorship, torture, the loss of family members, political isolation, and poor health care. These experiences and often vague and ill-defined memories can be worsened by our lack of attunement or empathy for these conditions, ignoring their long-term effects, or taking a “lift yourself up by your bootstraps” attitude. Internal vulnerabilities can come from psychiatric conditions such as schizophrenia, manic-depression, depression or the often condescendingly cited “borderline” personality.  Caregivers frequently fail to recognize or understand the hidden power of past memories and the end result is comments such as knowing better, being manipulative, or attention seeking.

They can be made more difficult by physical disabilities such as seizures, sensory disorders, or the side effects of medications. The presence of developmental disabilities can make it more difficult for the person to defend self and reach out to others.

Each person is a unique expression of the human condition

Our human strengths and weaknesses are shared with those whom we serve. Each person is a unique expression of the human condition. Some are more troubled or burdened than others, but we all share the common thread of humanity. Within this fragile thread lie the values that bind us together. In our own personal lives, these vulnerabilities can arise at any time and threaten our well-being.

The question is to what degree does any individual need support when threatened by these and other forces. We need to recognize each person’s vulnerabilities and find ways to reach out to those who are more threatened. They are more than persons with vulnerabilities, mental illness, or behavior problems. They are full human beings with a range of gifts and vulnerabilities, a deep inner life that beseeches and long ago our attention, and longings that call for fulfillment.

While recognizing the need for teaching functional skills, our central caregiving role must focus on teaching each person to feel safe with us and loved by us. Although professional measurement tools to define the degree or absence of functional behaviors can play a useful secondary role in care giving, if the central developmental milestone of feeling safe and loved is not achieved, then any further discussion can be fairly shallow. If the center of the human condition has not been achieved or has been broken, the rest of learning is merely peripheral. If we can help form the center, skills will blossom. The assessment of our companion or becoming-companion is based on the assumption that we must focus on the center and then the periphery will take care of itself.

John J. McGee

Common Situations: Refusal to Participate

Common Situations: Refusal to Participate

If the person refuses to participate,

• Make sure there is a structured flow to the day, not just the emptiness of custodial care.
• Be aware of other caregivers who might be coaxing, cajoling, or bribing the person to participate.
• Bring about minimal participation by doing activities with the person.
• Continue to dialogue.
• Emphasize valuing and elicit it during any movement toward the slightest participation.

We are challenged to enable participation and establish feelings of solidarity

The major challenge in this situation is to make valuing occur, even in settings that contradict it. Many caregivers work in almost hopeless situations: institutions where the mentally ill are herded like animals, nursing homes where the aged are left to fade away, homeless shelters where the poor are warehoused for an evening. Although we need to fight for social justice and establish decent places for people to live, work and play, many caregivers still need to create hope and feelings of companionship where there is none. Thus, if we work alone in a setting that seems to be the antithesis of valuing and engagement, we have a special and difficult role: to bring hope where only despair reigns.

To bring hope where only despair reigns

 

We will often be ridiculed for our idealism and seeming naiveté. Yet we can express valuing and create feelings of companionship even in the midst of hopelessness. Our interactions are what matters. If the person in the most forsaken institutional ward runs from us and falls to the floor, we can keep on teaching the meaning of human engagement. If the person lashes out, spits, or screams at us, we can move toward him or her and continue to bring about engagement and give unconditional valuing. We are challenged to enable participation and establish feelings of solidarity regardless of the hellish reality in which we find those who are marginalized.

-John J. McGee, PhD

Mentors Cannot Give What They Do Not Have

“Mentors cannot give what they do not have. Mentors are not about changing anyone’s behaviours; they are about focusing on others feeling safe with them and loved by them. Nothing more and nothing less. When in situations where there might be opportunities to state what they are against, they merely share what they are for.

Mentors do not devalue, put down or condescend; they lift up, respect, and simply share what they might do. They do not forbid or frown upon those actions that they do not like. They must be embedded in daily hands-on experiences with the most marginalized. They find joy in being among the most forsaken; they reach out to the most abandoned. The Mentor’s work is with caregivers in union with the most marginalized.”

-John McGee

Mentors cannot give what they do not have

We Need To Be The Most Loving During The Worst Moments

“We often see ourselves as better than those whom we serve and express this in talking down to those who are troubled, acting condescendingly, separating ourselves from their lives, and making sure that we are in control instead of dialoguing. Our task as caregivers is companionship and community. Our culture makes it harder because there is an expectation that we must control others by withholding ‘positive attention’ when someone is acting out. Our position is the opposite. We need to be the most loving during the worst moments.

-John McGee

Our role as caregivers is to provide community and companionship

Unconditional Value

“Our experiences with Gentle Teaching have taught us that change needs to start with us–our warmth, tolerance and the translation of values into relationships based on companionship. Our interactions need to reflect warm caring and a spirit of oneness in spite of even intense rejection or rebellion. They need to begin to signal feelings of empathy and the understanding that the relationship will evolve into an authentic friendship even though initially it is quite lop-sided.

Our interactions need to centre themselves on love the person with unconditional respect during the best moments and the most difficult ones. We have to care about the other and express the feeling that we are with and for the person. Spit can be running down our face or slaps stinging on our arms, but we need to unconditionally value the other. We are asked to transmit this feeling through dialogue and sharing our life experiences with the other. Our task is to initiate this process in a spirit of human solidarity.

Warmth can be felt

Warmth can be felt in the tone of our voice, the sincerity of our gaze, and the serenity of our movements.

Tolerance is conveyed through patience in the face of aggression, respect in the face of rejection, and perseverance in the face of entrenched rebellion. Our values are the impetus within this process, and they need to be constantly questioned and deepened. It is this spirit that we have learned in our gentle teaching experiences–to break away from emotional homelessness, to rupture the cold grip of loneliness, and to center ourselves  on unconditional love.

The challenge is not to find non-aversive behavioural techniques, but to formulate and put into practise a psychology of interdependence that goes against the grain of modifying the other and asks for mutual change. This presents a major challenge to parents, professionals, and advocates. It requires an awakening of our values and putting them into practice in the most difficult situations.”

 

-John McGee

Defining Empathy

“Empathy is not pity.”

“It is a feeling of being-one-with-the-other. It is trying to understand and sense why a child or adult is acting in a particular way and reflecting on the cumulative impact of each persons life history–years of segregation, submission, and isolation that gnaw away at the spirit. It is a spirit of sharing our common humanity, and the belief that no one exists as a mere individual but that we all exist interdependently…Empathy does not mean over-protection. It comes from our knowledge of the other and ourselves, our reality, our vulnerabilities, and our strengths and weaknesses. It is caring about the others anger, frustrations and rejection instead of whether the other is obeying or producing.

Represent-kindness-serenity-and-peace

We need to represent kindness, serenity and peace. It involves recognition of the personal and social dimensions of what it means to be handicapped, mentally ill, poor or abandoned. It remains steadfast during the good times and bad, at the depths of fury and the heights of joy. Nobody is only a student, a client, a resident, homeless, poor, or powerless. Empathy drives us to uncover the human condition and reveal its fullness, our fragility in the face of life’s vicissitudes, or vulnerability to emotional disruption, and our need for being-with others. We need to consider that we are but one short from homelessness ourselves.”

-John J. McGee

Process of Stretching

“We teach “safe” by placing almost no demands on the person except for being with the person with a sense of just “being.” It is a tremendously important for one human being to teach another it is good to be near you. Nothing more, nothing less. This act of recognizing the brokenhearted person’s existence and goodness is a most powerful teaching-learning experience. At the same time, we need to engage in nurturing and finding relevant ways to express unconditional love without pressuring the person at all. This might seem weird, but the person will learn to feel safe if we lower our demands while increasing our goodness, kindness, and expression of love. We need to avoid putting the horse before the cart. Doing things is not the primary purpose of care giving; being with one another is.

A dimension that is often hard to understand and deal with involves the emergence of self-centeredness, becoming spoiled, after a time of intense nurturing. It is natural to become self-centered as a result of constant nurturing. This creates another important care giving role. We need to slowly begin to focus on stretching the person away from self-centeredness and toward other-centeredness. This stretching process involves reminding the person that he/she is safe and loved while asking a slight degree more—waiting a moment, taking turns, sharing, and other virtues involving others and our relationships. This process is very delicate so we need to keep reminding the person of how safe and loved he/she is.

The developmental model outlined below is a good guide for us to use to understand the various dimensions of new memories that have to be taught:

• From brokenhearted and lonely, to safe and loved;
• From self-centeredness, to reaching out to others and loving expressing love to them; and,
• From dependence on us, to engagement with us and others.

Doing-things-is-not-the-primary-purpose-of-care-giving-being-with-one-another-is

Our pedagogical process starts with us encountering a brokenhearted person and bringing two simple gifts that we have repeatedly mentioned—the feeling of being safe and loved. We have nothing else to give. These are not a program, a clinical approach, or focused on outcomes. They can, if necessary, be translated into mundane outcomes, but, for the caregiver, they are gifts and these now established feelings need to begin to include being safe with a growing circle of others and becoming a meaningful part of increasing engagement.

This stretching process is a part of normal development. These include learning other moral milestones such as learning to share, a giving up, momentarily, of what is theirs; learning to wait and to take turns; wanting others to feel proud; and, learning when enough is enough—self-control. We all have to learn these milestones. Each requires a grounded stance that assumes that the brokenhearted person has learned to feel safe and loved and is ready for participation in a broader community. After these have been formed in the person’s moral memory, we can then begin focusing on strengthening self-esteem, learning that “I am good!” and self-control, learning when enough is enough!” The person’s world and responsibilities begin to expand.

After an intense dimension involved almost solely with unconditional love, it is natural to enter a phase of self-centeredness. It is then that our role evolves into carefully and delicately stretching the still fragile brokenhearted person from a state of self-centeredness to one of other-centeredness. It is a process in which the person learns that it is good to be with a small circle of others, then it is good to do things with this group, and eventually it is good to do things with a wider circle of friends, and finally it is good to do things for others. This last encompasses a high form of moral maturity.

We also begin to focus on the person’s self-esteem. This milestone emerges when others keep reminding the person, “You are so good!” This begins to occur from the very start when we are teaching that it is good to be together. What happens in this process is that the person begins to feel safe and loved from within. As this occurs, the person begins to see him/herself in a different light and forms a moral memory that says, “I am somebody because my caregivers tell me I am.” As the circle of friends grows, the person’s sense of self-worth also expands and becomes stronger.”

– John J. McGee, PhD

The Caring Moment

In the beginning we must always be in the moment with two bits of knowledge focused on giving a feeling of being safe and loved. We should avoid lengthy case histories and cleanly typed plans. If need be, do these requirements. However, our task is to be in the moment; it is not to change anyone’s behavior, but to teach the person to feel safe with us and loved by us.

The present is a series of moments that tumble into the future. Yet, we should not worry about the future, only the present moment. The here-and-now becomes the future with each ticking second. Our encounters transpire in the moment and then transform the next moment.

The-joy-is-in-the-moments

Whether a mother, father, grandparent, or a person whom we are supporting, the most important variable is the moment, not the future, not a projected plan with outcomes, not behavioral change. No, it is our being present in this very moment and all the person sees, hears, touches, and feels in this mutual coming together. It is the tiniest amount of time, perhaps two or three seconds. Then, these moments are linked together with other moments and it is these moments that become new moments; it is the evolving chain of moments that creates our moral memory in us as well as a memory in the other person.

Caregiving’s simplification involves teaching caregivers to be in the moment:

  • In bad moments this equates with forgiveness rather than control;
  • In all the good moments this involves a series of accidental and intentional encounters throughout the day focused on safe and loved;
  • The accidental encounters are merely brief moments of passing by and encompass a wave, a wink, a smile, a name, a thumbs up, maybe a hug if there is time, a whispering of “You are so good.”
  • The intentional encounters are a bit more planned and involve a chunk of caregiving time—from a minute or two or a half hour or more. The time depends. It should be structured in the day with the only purpose being to give a memory that the person is safe when with us.
  • The key is to stay in the moment. Joy is found in the moment.

Our task is simple, just being in the moment with the gift of helping the person to feel safe and loved:

  • Not a moment before,
  • Not a moment after,
  • Just in the now.”

-John J. McGee, PhD