Advanced Parenting, page 24
Are You Burnt-Out?
Psychological research indicates three main dimensions to burnout: exhaustion, detachment, and a sense of ineffectiveness. Symptoms include:
Physical manifestations of exhaustion
• Headaches
• Poor sleep
• Stomachaches
Emotional manifestations
• Drained of energy and creativity
• Unable to cope with minor stressors
Detachment or depersonalization symptoms
• Cynicism or irritability
• Feeling ineffective
• Unable to concentrate
• Feeling hopeless
If you find that you have some or all of these symptoms, please seek help to address your burnout. Many burnt-out parents lose the perspective to see that things can improve, but for many it’s a question of identifying the right resource.
If you sought this book out, I can imagine it’s been a difficult time for you and your family. The most common reason I see parents struggle is because the caregiving duties crowd out everything else. We’re so focused on achieving our child’s developmental milestones that we forget to smile, laugh, and just be present with our child. We’re so frustrated by our lack of progress or the barriers to care that sap our time and energy that we disconnect from who we were prior to the challenges we encountered. Parents are often so spent from the demands, they don’t have any energy left to attend to their needs, their friends, creative outlets, hobbies, recreation, and all the things that make them who they are.
If you see this happening to you, there are ways to break this cycle. As a parent, you have an essential and unavoidable job in helping your family through a challenge, but you are also at high risk for burning out.
Parental Burnout
The World Health Organization defines burnout as having three dimensions—reduced professional efficiency, exhaustion, and feelings of negativity or cynicism related to one’s job. While much of the literature focuses on burnout due to work, specifically paid work outside of the home, parental burnout due to unpaid work within the home is increasingly being recognized. In 2010, a study found nearly 20 percent of parents met criteria for burnout. Looking specifically at parents of children with type 1 diabetes or inflammatory bowel disease, 36 percent—nearly twice as many—reported burnout.9 Though my perspective is biased toward the sickest families, I feel most parents at times take on impossible loads and face excessive stress that can lead to burnout.
The pandemic brought this into focus as most parents had excessive demands on their time. Parenting and working from home while schools were closed is a good proxy for what many parents of children with chronic illness face all the time. A parent is calming the fears, reading the books, keeping the schedule, doing the laundry, serving the meals, and promoting development and learning. On top of this, caregiving parents have appointments, extra homework, additional research, equipment and medication, and school accommodations to manage. It’s no wonder these parents experience higher levels of burnout.
So many parents may think, “I may be burnt-out, but it’s just the way it has to be.” Culturally, many parents feel to be a good parent they must tolerate excessive demands with insufficient resources. With time, I hope our society evolves to provide parents with more support (e.g., paid leave, reliable and accessible childcare). Additionally, I hope we can reduce the pressure to be a perfect and relentlessly positive parent, as these unrealistically high standards further increase perceived demands. Parental wellness—the absence of burnout—is valuable because parents’ needs matter.
In my experience, most parents agree with this. When their friends suffer from burnout, they are quick to say they deserve better and support their friends in changes to improve their balance. However, the same parents often tolerate burnout themselves because of their desire to do what’s best for their child. We can lose perspective easily, but burnout has unintended consequences.
Workplaces have found that burnout is associated with worsening performance. Many forward-thinking companies in the technology and banking fields have begun to give employees unlimited vacation days or require employees to take vacation for this reason. Not because of their desire to win workplace awards, but because they know that employees who are rested are more productive. Similarly, burnt-out parents can see how their exhaustion can lead to reduced efficiency as they are unable to focus or complete the necessary tasks due to fatigue.
With parenting, burnout’s impact on families has the potential to be more toxic than what we observe in the workplace. Imagine how feelings of detachment might impair our close connections with our family and our support system. Instinctively we know that when we feel hopeful, optimistic, or positive about our future, we’re more likely to set higher goals and work more energetically toward positive outcomes.
Harriet was a three-year-old girl who had survived prematurity and congenital heart disease. She had not yet walked or learned to talk, but we had reasons to be optimistic about her future acquisition of these skills given her recent improvements—her heart was now fixed and her strength and stamina to work toward gaining new skills improved. Her family had been through a terrible time—dozens of hospitalizations, multiple near-death experiences, and she had been suspected to have had a stroke more than once. Feeling overwhelmed by all the intrusions on their time, her family decided to opt out of all of her therapies. This was not a break—they wanted to be done.
When I asked them why and tried to see things from their perspective, I learned that in some ways they had given up on her. In the past, they had been through cycles of having hope only to see a setback occur. Their love for her was unconditional, and they didn’t expect that she would learn more skills. Their acceptance of the status quo was a coping mechanism, but this learned negativity acquired from recurrent trauma was leading them to close off doors to interventions that might help. Even if the goals of therapy were not to acquire these milestones, therapy still could benefit her by preventing complications from her disability, like pain. We ended up negotiating a break with minimal therapies. Once the parents saw her stable and improving, we made plans for her to go to school and get all the services she needed.
While cynicism can be a way to protect ourselves from further disappointments, research has shown it to be a health hazard.10 While the research on this topic for now consists mostly of small observational studies, you can imagine that optimistic perspectives would open doors to opportunities or help families find more resources and more support. Theoretically, this parental optimism could enable children to achieve better outcomes. Parental burnout and the related hopelessness and exhaustion would instead reduce a parent’s ability to optimally care for their children.
How to Break the Burnout Cycle
It feels trite to encourage self-care to parents who already have so much on their plate—because the demands on you are fixed due to your child’s needs, and because of the way the health and educational systems are constructed. Pooja Lakshmin, a psychiatrist and women’s mental health advocate, may have put it best when she spoke of stress loads reflecting societal betrayal, not personal burnout.11 Burnout in many ways is not a problem you can fix as a parent. Caregiver burnout is a systemic problem. Our society undervalues the work of caregivers and assumes that parents should handle all caregiving on their own without outside help. But even when systemic change seems unlikely in the short-term, it still helps for us to find ways we can promote our coping and prioritize well-being.
Prioritizing Your Own Wellness
Parents are often the best advocates for their children’s health care. But as we’ve discussed, there is only so much time, so much energy, and so many resources. When families devote it all to the children, sometimes parents end up relatively neglected.
However, your needs matter, especially basic needs like sleep, exercise, and regular meals. If you don’t attend to these basic needs, you risk compromising your health and happiness. You may be more irritable or have worse judgment. Anxiety will be heightened. In the short-term, we feel like we can power through, but in the longer term the cost of neglecting these basic needs will become more significant and your health may be compromised.
You are really too important to your family to be neglected.
It’s essential that you’re in the best mental and emotional state you can be. Many have heard the caregiving analogy that parents need to put on their own oxygen mask first, so to speak, on airplanes and in life. This advice may lead some of you to roll your eyes, but it’s also a reality that a caregiver who is sleeping, eating regular meals, and keeping an active social life will be better prepared to show up for their child when it matters.
In addition to these basic needs, increasing positive emotions in your life helps to promote resilience. Creative outlets like dance, art, poetry, photography, or crafting can reduce feelings of burnout and promote feelings of self-efficacy. Connecting with people or activities you love can also help tip the balance toward positive feelings crowding out the negative. Helping others—such as advocating and mentoring other families in your position—can make you feel good and help you to find meaning. Gratitude—savoring these positive experiences—can further magnify the perception of positivity in your life.
When you are dealing with a system that doesn’t seem to work for you and your family, you need to remember that you can advocate for your own needs. Parents have a tendency to martyr themselves for their children. But despite societal messaging to the contrary, it doesn’t make you a less loving or considerate parent if you spend time and energy prioritizing yourself. In fact, it may make you a better parent.
Set and Defend Your Limits
One essential way to make time and space and reclaim energy for yourself as a parent is to set limits. You are allowed to say, “No,” “That won’t work,” or, “It’s too much.” You can say no to your child even if it’s something they really want. You can say no to something the school asks you to do. You can say no to something your doctor recommends. If ever a request doesn’t make sense to you or feels excessive, you have rights. No one knows your family like you do and you may know that sometimes not doing more may be what’s in your best interest.
Perhaps your child is having speech difficulties and you’ve been referred for a hearing test and to start therapy. That’s all fine, but you are going to have a new baby any day and have limited bandwidth for extra issues. For some children, like a child who is having severe tantrums and significantly stalled speech development, having a timely hearing test and starting the process sooner may be essential. If your two-year-old isn’t speaking and you learn there is a fixable cause of hearing loss, addressing it promptly will help promote language development and reduce your family stress level, even amidst the busyness of planning for birth.
But in other situations, like a five-year-old with a slight speech impairment, delaying starting therapy for six months may be no big deal if it will be easier for you logistically at that time. This goes back to the priorities and big picture we discussed earlier in Chapter 2. While these examples are relatively obvious, most situations fall somewhere in the middle, and often I find the most important part of my discussions with parents is the part where I clarify how the issues fit in the context of the rest of their lives.
There can be perceived power imbalances between health care and educational practitioners and parents, such that caregiving parents may hesitate to question recommended care. You don’t want to upset the principal or teachers running the Individualized Education Program meeting, because you need them to help your child. If the doctor is recommending something, you feel it must be important, and you worry that if you question the plan, you may somehow offend them. While these individuals bring experience and knowledge to approaching these decisions, ultimately, as the parent, you know your family and your child best. Professionals in these fields supporting families facing challenges should value your perspective and respect your authority as the decision maker.
Delegate
Thoughtfully doing less may be the most effective way to reduce your stress level. But often you may feel you can’t. If you are feeling overwhelmed by all you have to do, delegation is something to explore; but to be clear, delegation is not a simple solution—it comes with logistic, financial, and emotional costs.
However, in many situations, we imagine the barriers to be larger and more troubling than they are in reality. Some things only a parent can do—making medical decisions, helping a child in extreme distress, and leading a family. But other people can be trained to do many of the day-to-day tasks of a parent with training and effort—meal prep, household management, medication administration, or child transportation. Investing the time and energy into setting up a new workflow can pay off. Sometimes we underestimate how others can step in for us when needed. While a babysitter, relative, or neighbor may not supervise meals or bedtime in the same way you do, if they are doing a fine job and your child is cared for, it should be enough. Essentially, the cost of an imperfect solution may still justify the benefit of a break. Some children are particularly fragile or have very specialized caregiving needs, and you may be especially intimidated to train a babysitter, but in these situations do not forget that you can ask for help from professionals involved with your child to ensure the child’s safety.
We are especially slow to delegate cognitive labor, simply because we care about our children more than anyone else and we can’t imagine that anyone else could be trusted to anticipate and monitor complex situations. But when responsibilities are clearly delineated, often others can be trained to be conscientious.
If your child’s challenge is short-term in nature, you may feel as if you can take on all of the added responsibilities and bulldoze your way through it for a few months. However, stop to consider whether this is really what’s best for your family. Many parents may see that childhood is one challenge after another, particularly if you have multiple children.
If you do take it on by yourself, you may be more likely to experience burnout and be less happy and less effective. Finding a way to share the challenge with your co-parent or support system may make it more manageable for you and may result in improving the big picture plan.
If your child’s challenge is expected to be long-term, burnout—both for you and your child—is something to be mindful of. It’s easy to fall into routines that do not promote our well-being; having limits, adjusting your limits over time, delegating, prioritizing yourself, and taking breaks can help you prevent getting to that burnt-out state.
If you do feel burnt-out, know that it’s possible to work your way out of it. Small changes can add up to big relief over time, and even when it’s not immediately evident how to make things better, recognizing how you feel is the first step to making changes. Big picture, spending the energy to get yourself to a better place will help you and your family.
We’ve just reviewed all the difficult feelings that parents can face when their child has a challenge. In the next section we’ll talk about what to do about it and review ways to feel better.
• If the description of burnout resonates with what you are experiencing, what can you do to change your situation?
• Be honest and reflect on the last few weeks: Have you taken care of yourself?
• Think about your limits. Is there anything you could say no to, to preserve your energy?
• Pick one task that you would really like to delegate and consider: What’s stopping you?
• If you aren’t burnt-out, is your current arrangement sustainable?
What to Do to Feel Better
We started this chapter exploring many of the difficult emotions parents feel—sadness and grief, guilt, fear and anxiety, anger, shame and burnout. Depending on your specific situation, you may relate to a lot of these uncomfortable feelings or only a few. One reason it can be so difficult to have negative feelings about your parenting journey is the mismatch between what you expected and what you face. Many of us expect parenthood to be all “unicorns and rainbows,” and the hard part is not expected or welcome. This can be particularly challenging for parents who find their situation is harder or more complex than a typical parenting journey.
As you reflect on which of these feelings you are experiencing or have experienced in the past, remember: parenting isn’t always easy or fun. Even when things are going well, you may not love every minute—and you don’t have to. When your child faces a challenge, you will experience even more negative feelings. It doesn’t mean that you are a bad parent if the negative emotions outweigh the positive emotions sometimes. You can dislike some parts of parenting but still love your child.
Not only is it okay to give yourself permission to find help, but in the long run finding ways to release these emotions may also help your health and your family relationships. When I talk to parents about these feelings, I hear concerns like these:
• “The feeling is so big it feels like it may overwhelm me.”
• “The feeling is so selfish that I feel ashamed of it.”
• “Sometimes just acknowledging its existence feels like a betrayal.”
Our negative thoughts and feelings are more overwhelming when they are kept to ourselves. When you can open up about them, you can take the first steps to making them feel more manageable and working through them. Remember as you face these difficult feelings that you aren’t alone.
