• La Shawn L. Splane-Wilburn, Founder of Homagi

HOMAGI ManDateMonday Series: Caregiver Abuse

"A healthy relationship will never force you to sacrifice your friends, your dreams, or your dignity." - Mandy Hale

Not every caregiver role comes with conflict and violence and not every caregiver role is carefree and positive. Respecting that each caregivers experience is as unique as the illness, the caregiver, their loved one, and their cultural, environmental, and socio-economic factors are. Sometimes caregivers don't realize they are in volatile situations because they have been functioning in the role with negative behaviors for so long, it's "commonplace". Something to them as "simple" as having a cell phone thrown and hit you in the face causing a knot to swell there may not seem serious. Having dishes, furniture or other objects thrown at you in a fit of rage or anger is very upsetting, add to that the emotions that come with knowing your loved one assaulting you isn't in their right mind at the time, and you have a recipe for very conflicting emotions. To an outsider these behaviors may be alarming but to a caregiver who now sees this as part of the role in their caregiving, it's just a temporary "hiccup" things will be "normal" again soon enough. Abuse is real and what the caregiver is experiencing may be abuse but they just don't call it that. A study conducted by, Juliana Onwumere, PhD, Sarah Grice, PhD, [...], and Elizabeth Kuipers, PhD called, " Caregiver Reports of Patient-Initiated Violence in Psychosis"  says: "One-half of the caregiver sample (52.9%) reported an incident of patient-initiated violence during their interview; 62.2% of these involved violence toward themselves, and 24.3% toward property." The study wasn't broken down into male or female categories so getting an accurate number of the men who fall into this category wasn't possible, in fact the study noted, " Caregiver participants were mainly female, aged in their early 50s, and at least one-third were unemployed. Almost two-thirds were in partnerships. Just under 70% were co-resident with the patient and were related through being their parent or partner. Patients were mainly inpatients. They were also male, single, and at 80%, most were unemployed. Patients had an average 11.5 year illness history." I didn't find a study that held a higher number or specifically for men, however there are men who are being abused by those they care for. Abuse for male caregivers isn't something easily discussed openly, because of the Stigmas that come with men and abuse, and it's evident that even "case studies" are neglecting to address the lack of research on men and abuse. Many men choose not to talk about the struggle with abuse by those they care for out of fear of being viewed at weak. Some excuse the abuse away stating that a mate is just "hot tempered". 

Abuse of any sort to anyone is wrong and those experiencing the abuse should not be made to feel as if they are being "weak" or a "pushover" because it's happening to them. "Wait...you mean to tell me you let her..." should not be part of the response a man hears when discussing concerns about being abused by a loved one. Caregivers regardless of sexual orientation are reluctant to discuss the abuse they may be experiencing for many reasons like: 

Fear of loved one

Fear of judgement

Fear of getting a loved one into trouble

Fear of social workers getting involved and losing their children

Guilt for the loved one suffering with a mental illness

They don't realize it's abuse because it's been going on so long it's normal.

Excusing the behavior away, "It's just a temper tantrum...they just throw things when they get upset"

Justifying poor behavior whether a loved one is experiencing negative symptoms of their illness doesn't help them or you. There is accountability for poor behavior and you must set boundaries to ensure you are not endangering yourself or your family. What Should A Caregiver Do If They Find Themselves In An Abusive Relationship? Seek help. One of the dangers of caregiving is Isolation. Caregivers can find themselves "hiding" to insulate themselves and their loved ones from judgment and criticism, this very act puts the caregiver at risk for being abused even more so. The study noted the following: "Our results indicated that some carergivers may be at greater risk of patient-initiated violence than others. For example, carergivers defined as being on their own, being single (used here as a measure of isolation), reported more patient violence. It could be argued that carergivers on their own have fewer opportunities to access immediate support in their day-to-day caregiving role, and the presence of another adult may discourage violent incidents from occurring or escalating. Caregiving relationships have the propensity to be more intense when the caregiver is on their own, and it may be easier for carergivers to become the targets of patient’s distress or unusual beliefs when they are on their own, or in more contact with the patient.40" Speaking with friends, mental health professionals, or doctors about concerns with your loved ones behavior or acts of violence is an investment in the health and safety of you, your loved one and family. Therapies like Cognitive Behavioral therapy(CBT) can teach you how to cope with emotions and behaviors, other tools like mental health first side, conflict resolution, violence resolutions, and recognizing signs as well as triggers are other ways to protect you and your family. The study also noted: "Carergivers are likely to benefit from interventions that promote their safety, by developing skills in violence resolution and problem-solving, and in identifying and managing warning signs, such as acute affective or psychotic symptoms, and promoting adaptive coping strategies that explicitly include pathways of how and where to access support and reduce or prevent risk.61 Equally, patients may benefit from CBT interventions to address anger management issues, early warning signs, and (or) the negative emotional sequelae that may follow their behaviour, such as regret, shame, guilt, and stigma.62". Each caregiver experience is unique and you must invest the time and patience into managing your role as the caregiver and supporter, always keeping in mind your health and well being as a priority. No one deserves to be abused. If you are afraid for your safety call: Dialing 1-800-799-SAFE (7233) will connect you with an advocate to speak with confidentially at any time, 24/7, 365 days a year. That hotline can also be used by family, neighbors, coworkers, or church family who may think someone is being abuse or has witnessed them being abused. 

Here is a link to the hotline: http://www.thehotline.org/2013/03/what-can-the-hotline-help-you-with/

Are you a caregiver looking for a caregiver support group or community of other mental health caregivers? Stop by " Care-FULLY " an online caregiver support group and community. 

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