Reframing Ambivalence in Caregiving

Regardless of how we became a caregiver, whether we chose the role or were assumed into it, most of us can agree on several things:

1. Our responsibilities have shifted, and we are often asked to handle tasks far outside our comfort zone.
2. The work is both physically and emotionally exhausting.
3. It is not always clear where we are headed or what we can expect.
4. The role involves so many emotions, emotions that are often considered taboo, and we rarely even let ourselves think about them.

The reality is that caregivers experience a wide range of emotions, from ambivalence and resentment to anxiety, grief, loneliness, fear, and even joy—often within the same day. We are conditioned to believe, as one family caregiver so eloquently stated, that we “must always smile and never complain… It feels that if [we] complain, [we]’re inadequate or [want] to give up, which is never the case at all” (Cori Carl, What do you wish other people understood about caregiving? The Caregiver Space, 10/8/2017). Yet these emotions are normal and healthy; we must find ways to name, feel, and express them.

Caregiving Ambivalence

Let’s start with ambivalence. Sometimes, caregiving feels like a blessing. We are honored to share this intimate experience with a loved one and cherish our added time together. At other times, though, caregiving may feel like a never-ending ordeal. These ambivalent feelings are a sign that we recognize the reality of our situation and our mind’s way of acknowledging all of the conflicting emotions we are trying to process.

Ambivalence in caregiving is simultaneously having positive and negative emotions about the experience. For example, a caregiver might want to be doing what they are doing, but on bad days, they might wish they didn’t have to be there.

Ambivalence can arise from many situations, including:

• Changes in the relationship between the caregiver and the care recipient
• Conflicts due to multiple commitments or roles
• A difficult relationship with the care recipient before the onset of dementia
• Conflicting cultural or personal norms and values regarding care

Ambivalence can take a toll on a caregiver’s mental and emotional health, leading to burnout, anxiety, depression, or insomnia. Do not try to bury these conflicting feelings. Confront them so you can make peace with your life as a caregiver.

Tips for Managing Ambivalence

1. Accept the Range of Emotions: Caregiving can elicit many emotions. Feelings of stress, anger, pride, and tiredness are normal. Allow yourself to feel and acknowledge them without self-punishment.
2. Accept Ambivalent Feelings About Your Loved One: Every relationship, including the most loving ones, has ups and downs. On some days, caregiving can stir up old negative feelings, while intense love might emerge on other days. Allow negative emotions to pass without altering your behavior or falling into self-recrimination.
3. Let Emotions Guide You: Sometimes, conflicting emotions can become insurmountable. Recognize when you’re feeling stressed, angry, or fatigued. These emotions are signs you need to practice mindfulness, find an emotional outlet, or develop better sleeping habits. Accept your emotions and let them guide you toward a less ambivalent life. Family caregivers who need a break should consider professional in-home care.
4. Make Necessary Changes: Accept your deeply felt and conflicting emotions and make necessary changes. If you need more support, enlist the help of family members or hire an in-home caregiver. Rearrange your schedule to get more rest. If you’re experiencing persistent feelings of anxiety, try yoga or therapy. Find the source of the ambivalence and seek relief.

Reframing Ambivalent Emotions and Thoughts

Reframing ambivalent emotions and thoughts during caregiving situations can help manage stress and improve the overall caregiving experience. Here are four examples:

1. From Resentment to Compassion
   • Original Thought: “I feel resentful that I have to spend so much time caring for my parent when I have other responsibilities.”
   • Reframed Thought: “I am grateful to have the opportunity to care for my parent and show them the love and support they need during this time.”
2. From Guilt to Acceptance
   • Original Thought: “I feel guilty that I can’t always be there for my loved one.”
   • Reframed Thought: “It’s okay to take time for myself and acknowledge that I am doing the best I can with the resources and time I have.”
3. From Overwhelm to Focus
   • Original Thought: “I am overwhelmed by the endless tasks and responsibilities of caregiving.”
   • Reframed Thought: “I will focus on one task at a time and recognize my accomplishments, no matter how small.”
4. From Frustration to Patience
   • Original Thought: “I get frustrated when my loved one doesn’t cooperate or understand what I’m trying to do.”
   • Reframed Thought: “I understand that my loved one is struggling and that patience and calm communication can help us better manage the situation.”