Ask Dr. Giles: I don't know how to balance it all. Any suggestions?

Cindy writes:

I am a mental health counselor in SC. My mother-in-law has cholangiocarcinoma, inoperable. She is 76. My husband is an only child and is trying to balance work and caring for his mother 3 1/2 hours away. His father is partially blind and deaf, diabetic and very difficult as he seems to be getting dementia. I am self-employed and have to keep up my income right now. I am having trouble emotionally supporting my husband and two daughters, being attentive to my in-laws and parents and being an effective therapist to my clients. (My mother cares for my stroke disabled father in their home 4 1/2 hours away). I constantly daydream about finding some other line of work to ease off the stress, but wonder if this would be too impulsive given my state of mind. I have an ethical responsibility to keep it together don’t I ? I don’t know how to balance it all. Any suggestions?

First, Cindy, let me say that I very much respect all that you are trying to do. It’s all very important, right? And you want to do your part, right?

You are approaching your ability to help and support a little like my family approaches my wife’s amazing strawberry jam. When we open a jar, we are very generous with our helpings (it’s delicious on toast and fresh-baked rolls!). All too soon, however, we’re at the bottom of the jar. We reach and scrape with the butterknife to try to get more of that fabulous goodness out of the jar. I feel regret and guilt when I finally put the jar in the sink and fill it up with water to soak: there’s probably still another half-spoonful of jam in there if I would just scrape a little longer! It’s like I’m in denial that there’s a finite amount of jam to go around. I wish there was an unending supply. But there is not. Do you see where I’m going with this?

In a related way, you might be in denial that there’s a finite amount of you to go around. You might wish there was an unending supply. But there is not. Your wistful imagining of another line of work is evidence that you are burning out. We can’t have that. You are too valuable. Without some emergency intervention, you are likely to become less and less effective. Please do the following three things immediately:

Resist the urge to make a major life change right now. Don’t change jobs, relocate, or get a tattoo just yet. Let’s first take stock of your current situation and then decide what must go.

Second, ask yourself this question, “What, on the list of things I do, are the things that only I can do?” Two possible things on that list might be 1) be my husband’s wife, and 2) be my daughters’ mother.

Keep doing the things that only you can do, and divest yourself of all others. Let others do them. There is not enough of your fabulous goodness to go around, Cindy. Imagine you are in a hot air balloon plummeting to the ground. You must jettison everything you can to stop its dangerous descent: fuel tanks, ropes, even pocket change. Everything that can go, must go if you are to avoid disaster. And, Cindy, make no mistake about it, you are heading for disaster. You must carry these three things out immediately so you don’t come crashing to the ground.

In addition to these three things, let me emphasize the importance of rest and fuel. Please take steps to insure that you are getting adequate rest and you are eating right. Rest and fuel are basic building blocks to good mental health. After you have done the three things I have suggested, keep an eye on your emotional descent. If it has slowed or stopped, congratulations! You have successfully made progress in your own self-care. If not, write back and we will talk more.