On March 16, Tsgoyna Tanzman, MA/CCC, speech-language pathologist, life coach, and author of Hope After Stroke for Caregivers and Survivors: The Holistic Guide to Getting Your Life Back, hosted a presentation via Zoom for Stroke Support Association’s caregiver group. Tsgoyna focused on several resources that can help make the caregiving role less stressful and more positive, including Breathwork, Cognitive Behavioral Therapy (CBT), Changing Should to Could, and Emotional Freedom Technique (EFT).
Tsgoyna started the session by leading everyone in a breathing exercise–one deep breath in, hold it at the top, then a long exhalation, repeated two or three times. “Notice where your body is in space,” Tsgoyna suggested during the exercise. “Feel the weight of your body, its presence, and any sensations in your gut and heart and brain.”
“Breath,” Tsgoyna said, “is the single most connective way to stop the stress response. If we can pause the stress response for just a moment, it enables us to create more relaxation and resourcefulness. You’re putting the pause button on reactivity and accessing your inner wisdom.”
II. A MODEL FROM COGNITIVE BEHAVIORAL THERAPY (CBT)
As shown in the graphic below, our actions can be traced back to how we feel and think about our circumstances. “We can’t control our circumstances,” Tsgoyna said, “but we can control how we respond to them.” Easier said than done, especially when feeling overwhelmed by the caregiving role, but that’s where the CBT model can help.
Circumstances: For example, the circumstance might be that your spouse had a stroke. State that as an objective fact, rather than a statement loaded down with negative descriptors. Instead of “My spouse had a devastating stroke. It has decimated our lives,” state, “My husband had a stroke. He is not working.” This brings the situation down to a more neutral place.
Thoughts: The sentences in our heads are the thoughts that we tell ourselves about our circumstances. “What do you make it mean that your spouse had a stroke?” asked Tsgoyna. “What do you make it mean that you are now a caregiver?”
Feelings: Circumstances happen. We have thoughts about those circumstances. These thoughts create feelings.
Actions: The feelings then create your actions. For instance, you may say that you have no one to help you in your caregiving role. That seems true: no one is helping you. That’s the circumstance.
Your thought: “I have no one to help me.” Your feelings, created by that thought, might be anxiety, depression, or even resentment.
Tsgoyna said, “When you believe, ‘I have no help as a caregiver,’ how do you think you show up as a caregiver to your loved one or yourself? When you get no help, you probably give up asking for help. You believe that it’s a foregone conclusion that you won’t be getting any help.”
Your actions of giving up on the possibility of help result from the feelings you have about the thought that you can get no help, which is based on the circumstance that you are currently shouldering the entire caregiving role alone.
What might happen, though, if you changed that initial thought to something like this: ‘Right now, I am doing this alone, but I am open to asking my husband’s sister and best friend to chip in some time once a month.” Would that thought change your feeling? Would it open you up to reaching out and asking for that help?
“The good news about where your power lies is in your ability to look at and challenge your thoughts,” said Tsgoyna. “Be mindful of the actual effect of your thoughts.”
III. CHANGING SHOULD TO COULD
Perhaps you have a thought that you are so overwhelmed with your caregiving role that you have no time or energy to take care of yourself. You think, with a sigh, “I should take care of myself.” What would happen if you changed that thought to “I could take care of myself”?
If you believed that you could, what might be different? How might that thought lead to a more hopeful feeling and perhaps an action of self-care taken, however small, and just for today? Over time, you could–with the proper mindset of “could,” rather than “should,” create a daily, intentional practice of self-care, no matter how overwhelming the caregiver role.
IV. EMOTIONAL FREEDOM TECHNIQUE (EFT), OR “TAPPING”
Tsgoyna next spoke about Emotional Freedom Technique, “…an evidence-based therapeutic tool recognized by the American Psychological Association that helps lessen anxiety and reduce the stress response.” A person begins by rating her emotion or feeling on a scale of zero to 10, with 10 being the strongest. Then using a simple script and tapping on different acupressure points on the head, face, and torso, the strong emotion (anxiety, depression) is diminished and the stored energy is released, such that subsequent rating of the emotion usually goes down on the scale. A person can learn and practice tapping on one’s own. For more information on EFT, Tsgoyna recommends an informational video from “The Tapping Solution.”
V. DAILY JOURNAL
Tsgoyna concluded her presentation by emphasizing the importance of a daily practice of perspective, self-care, gratitude, and acknowledging the “small wins.” She suggested the “Daily Journal” page (see below) from her companion book, The Caregiver’s 12-Week Journal and Workbook.
Many thanks go to Tsgoyna for her wonderful presentation to the caregiver group.
Contributed by Betsy Hardiman