CARING FOR THE CAREGIVER: THE YOGIC PERSPECTIVE
Introduction:
Very often we have patients come to us who are in the end stages of terminal illnesses, people who need constant care, day in and day out, people who need care every moment for the rest of their lives. Or we come across the parents who are taking care of children with special needs and have made physical and mental impairments. When dealing with such patients, when trying to evolve the Yoga therapy protocol for them, I am often made to think: what about those who are caring for these people? And that is where we realize: who is going to care for the caregiver? And this is a very vital region where Yoga can contribute a lot, because Yoga can enhance the feeling of helping, the feeling of caring, and it can give a new purpose for the entire life of the care-giver.
Why is “care” being given?
The first question we need to address is: is the person giving the care out of choice or out of compulsion? Very often the care is given because there is nobody else. In the moment of crisis, everybody runs away. “It’s not my job” — passing the hot potato sort of! So is it out of compulsion? Or have they made a conscious choice to be a care-giver for the person they are caring for? This is a vital question because it will determine already the attitude with which they are doing what they are doing. Are they paid or is it voluntary? Are they doing it out of love, out of care or because it is another job? Often we find that people are employed to give the care — how much of care can they give when they are being paid? Again, it is a personal response, it is a personal decision and that is where whether you are going to make a job out of it or make it an opportunity to serve and also be served.
Dealing with the social and family dynamics:
The family dynamics are a real quagmire and one hesitates to even go into that! Each family has such amazing dynamics — the politics within a family can be quite amazing I have often seen people who go to the trouble of caring for someone because others are not willing or cannot, but then the others keep on giving all this unnecessary advice. “Did you do that? Did you do this?” on the phone. Already the person is struggling to take care of the person in need of the care and also take care of themselves, and on top of that, people, instead of caring will start giving all this advice and then feel they have done their duty by telling you that you should make a special wheatgrass juice after keeping the wheat for three days and then growing it and in this situation you grind it for two hours and then give it to the patient, and then they just phone to ask you “did you do it?” It’s very difficult — the family dynamics are something very difficult and one needs to have a lot of strength before even going into it!
Dealing with caregiver stress:
The stress that is put on the caregiver, the physical stress of taking care of someone 24 hours a day — the mental stress, the emotional stress — dealing with the emotions because it is not just your emotions but the emotions of the person you are taking care of.
And often the person being taken care of starts to treat you in such a bad way, like dirt, and someone who comes in once a month and just holds their hand becomes a saviour while you, who spend 24 hours with them, are treated like “what do you know, look at that person, how much care they give me, look at that love and look at you!” forgetting the person who is really doing the hard work, the dirty job. So you have the emotional stress, the metal stress, the physical stress, the social stress.
The social stress also — you give up your social life to take care of someone; and on top of that the financial stress, because if you are getting paid for it at least you are getting paid, but if not, you are using your financial resources. And if you are spending 24 hours a day caring for someone, where do you take care of your financial needs?
The spiritual angle:
Spiritual health is vital for wellness to manifest in a wholesome manner and so we need to help them deal with self facing questions like “Why am I doing it?” You know, it’s a big question “why me,” that is often asked by people. “I’m trying to be a good person; why does God put all these challenges on me?” These are questions that come. And this is where the spiritual stress, or the stress because one is not connecting to one’s spirit — because if we are spiritually healthy, if we can connect to our own Self we will start to understand others as our self, and then that stress won’t be there. It is only when we are at ease with ourselves that mental peace and equanimity can manifest in our lives. When we connect to the “Self” we strengthen ourselves immensely and this enables the impossible to become possible in many a case.
Developing Yogic attitudes in caregivers:
The yogic attitudes help a lot; the chatur bhâvana, adopting the four-fold attitude suggested by Patanjali towards those who are at ease with themselves, those who are suffering, give them compassion, karuna, and telling the patient to adopt an attitude of cheerfulness, muditâ, towards the person trying to help them, punya. And this is where one needs to work with both the caregiver and the patient, the person being cared for, if one is to develop this.
Pratipaksha bhâvana, the Yogic attitude replacement therapy — the replacing of negative self-depreciating attitudes of “why me? why me?” with positive affirmative “try me” attitudes. Instead of saying “look at my life, it is always taking care of so-and-so” to “take it as an opportunity for self-growth” — an opportunity to burn up ones karma — positive attitudes towards negative situations.
And of course the concept of Karma Yoga as so beautifully brought out in the Bhagavad Gîtâ: doing the best we can despite all the obstacles and in spite of us not getting even a good word back for it, just doing the right thing because it is the right thing to do, fulfilling our responsibility because that is what we are born for — to be a responsible human being.
Enhancing health through the limbs of Yoga (yoganga):
The âsanas and prânâyâmas help a lot in relieving the stresses, in strengthening the resolve, in enhancing the stress–tolerance for such people. This type of externalized effort done with mindfulness also keeps them physically, mentally and emotionally more fit and gives them that connection to their own Self.
As Ammaji, Yogacharini Meenakshi Devi Bhavanani, Director ICYER at Ananda Ashram in Pondicherry say, “Yoga has a step-by-step method for producing and maintaining perfect health at all levels of existence. She explains that social behaviour is first optimized through an understanding and control of the lower animal nature (pancha yama) and development and enhancement of the higher humane nature (pancha niyama). The body is then strengthened, disciplined, purified, sensitized, lightened, energized and made obedient to the higher will through asana. Universal pranic energy that flows through body-mind-emotions-spirit continuum is intensified and controlled through pranayama using breath control as a method to attain controlled expansion of the vital cosmic energy”.
We need to understand that caregivers need to be mentally and emotionally as strong as they can be and hence the inner (antaranga) aspects of Yoga are very important. As Ammajis continues, “The externally oriented senses are explored, refined, sharpened and made acute, until finally the individual can detach themselves from sensory impressions at will through pratyahara. The restless mind is then purified, cleansed, focused and strengthened through concentration (dharana). If these six steps are thoroughly understood and practiced then the seventh, dhyana or meditation (a state of union of the mind with the object of contemplation) is possible. Intense meditation produces samadhi, or the enstatic feeling of Union, Oneness with the Universe. This is the perfect state of integration or harmonious health”.
“Letting go” empowers the individual more:
And finally the relaxation and the meditation, the contemplative practices to go deep within, to understand one’s own strengths — the strength, weakness, opportunity, threat –the SWOT analysis that you can start to understand how this situation that you find yourself in, having to take care of someone 24 hours a day can be your strength also and in doing so, what are the weaknesses you need to overcome. What re the opportunities you have for growth, and what are the threats? Usually the threats are from inside, the shat ripus, the six enemies of a spirit that pull you down, that keep on saying “why do you do this? No-one is appreciating you; are you going to get a gold medal for this, a gallantry award for this?” You know all those negative tendencies that keep on coming up inside us; to be able to look at them, face them, and then let go of them, enhancing our ability to be just be our self, do the right thing in helping the people around us and by helping them we start to help our own self. This is the message Yoga gives us when dealing with caring for caregivers, moving from “why me?” to “try me”.
In conclusion:
When we realize that we have in our life an opportunity to serve another human being, we start to truly count our blessings. To go beyond one’s own self and serve others is a true service or rather seva to the Divine. We need to remind ourselves of spiritual messages such as “To serve humanity is to serve the Divinity itself” and “Service to others before self, enables us to grow”, as these bring out the importance of such selfless service. It is only when we express our love for others through care, that we truly love ourselves! When we do so with mindfulness, we give ourselves a deeper purpose and meaning (Dharma in Sanskrit and Ikigai in Japanese) that enables us to have a sense of salutogenic, wholesome wellbeing. This nearly always leads to a greater sense of fulfilment and happiness.
Even scientifically speaking, when we help others with love and compassion, oxytocin, the maternal hormone from the posterior pituitary gets realised. This enables bonding at a deeper level that in turn helps buffer stress and maintains social trust and tranquillity. As is said by the wise Dravidian Saint Tiruvalluvar, “The humane one capable of true love will give away even their very bones; while the loveless can but only think of themselves.” May we all strive to become the ideal of such words by serving those in need with love, compassion and empathy. Then alone will be become true, care givers; the givers of care.
A talk by Dr Ananda based on this concept can also be viewed by those interested at https://www.youtube.com/watch?v=tEX8hAn3Y-A
