Lisa C. DeLuca's Blog

Posted by Lisa C. DeLuca

Many years ago, I quit my job and went back to school to pursue my lifelong desire to become a family therapist. The reaction people had to me at that time was stunning. When people heard I was pursuing a life-long dream they became wistful, teary eyed, and eminently supportive. Even those who had hoped I would take some other career path - those who would finally have to face the fact that their dreams for me would never come true - even they could not help but be happy for me. Why?

I think that humans are born with an inner knowledge that we are each here for a reason. We seem to have an intuitive understanding that each of us has unique gifts that benefit the world in some way when they are used. And I believe that each person desires nothing more than to express these gifts.

But somewhere along the way we forget this. We lose our faith and we become distracted, despondent, bored, self conscious, self-doubting, caught up, enslaved, addicted, numb, confused, unsure.

I want to say this emphatically : it is never too late to pursue your dreams. I was in my thirties when I finally did, I don't care if you are in your sixties - you could live another 20 or more years! I know people in their eighties who are making a difference finding and pursuing their path.

People ask me how I discovered what I wanted to do. The truth is I didn't discover it, I had always known, I just wasn't listening. Maybe you know too. Maybe it's not 100% clear, but if you are open to following where the currents lead you it should become clearer.

I've written a couple of articles on this. The second one is about spirituality which is the part of human beings where this inner wisdom is stored. Spirituality goes hand in hand with personal development, IMHO. I hope these help motivate you.

How to Achieve Your Personal Best

Spirituality vs. Religion: Don't Let Problems With Religion Hinder Your Spiritual Life and Growth

Maria Shriver's New Book: Just Who Will You Be

Posted by Lisa C. DeLuca

Parenting can have more ups and downs than the biggest roller coaster ride you've ever taken.

One of the reasons parenting can be so challenging is that it sparks so many emotions, many of them completely contradictory, and you feel them all at exactly the same time. It is not easy to love a child so much that you would throw yourself in front of a bus to save her, and to be so annoyed at that child that it's hard to be in the same room with her.

People have difficulty feeling contradictory emotions simultaneously. It is unsettling. They feel like they need to resolve it, one way or the other. Once parents realize that this is the nature of parenting, they can let it go, learn to be ok with it without trying to solve it. In the end, the love is more important.

Another reason parenting is so difficult is that it puts you in the role of teacher. As teacher, you are challenged to grow as a person, to make sure that you are practicing what you preach. For putting parents in this position, children are a precious gift, IMHO. In helping them evolve as people, if we open up enough, they in turn help us evolve at the level of our very souls.

All of this personal evolution can be exhausting. Here are a few resources to help. Hint: if you want your children to be confident, you be confident, if you want your children to be joyful, you be joyful, etc.

The last article listed here is a review of a book written by Janine Caffrey. This book is essential reading for parents of this generation. Happy reading!

Parent Confident Children

Celebrate Spring WIth Your Kids

Parenting Joyful Children

Advice to Parents of Generation Me: How to Motivate Your Children to Achieve

Posted by Lisa C. DeLuca

In addition to treating panic disorder in my psychotherapy practice, and working with families and individuals on their life journeys, I have the privilege of working with family caregivers who are caring for loved ones at the end of life.

Witnessing the end of life process alongside these caregivers has been one of the most rewarding experiences of my life. It astounds me that we are so protected from aging, death and dying in our culture, that most people will never be exposed to the valuable lessons to be learned about life from this perspective. As Dr. Melvin Morse, a near death experience researcher pointed out, we all know how we are born but none of us know how we die.

How have we let this happen? The truth is that we cannot insulate ourselves from death, no matter how much we try to deny its existence. What is most important to people at the end of their lives? Why are we here? What do people regret at the end of life? What happens after death?

These topics fascinate me because they inform us how to live. I've shared some of what I've learned in a couple of articles. You will find them in the "Hospices" category of the "Caregiver Support" topic which is found under the "Partners and Parents" section of Suite101. All of the rest of my caregiver support articles can be found in the "Caregiver Support" topic and its categories. This entire section is dedicated to all of the brave caregivers who have given me the privilege of walking alongside them and witnessing their late life journeys.

Please contact me or add a comment to the articles if you have questions.

Posted by Lisa C. DeLuca

When I was in graduate school I was shocked and appalled at how misunderstood panic attacks were by the people who were being trained to treat them. Since graduate school doesn't provide the training needed to treat panic disorder (at least mine didn't) I realized that people would have a difficult time finding someone to treat their panic attacks.

Since I was lucky enough to already have had some training in cognitive behavioral treatment of panic disorder, I decided to specialize in it. Recent studies are showing that cognitive-behavioral therapy alone is preferable to combining the therapy with medication. Medication alone is the least effective option long-term. Panic disorder is one of the easiest disorders to treat, though finding a specialist to treat you may be difficult.

Self-help is useful but it is not a substitute for treatment. I have written several articles about panic disorder on this site to help inform people who are having panic attacks, and motivate them to seek treatment. There is hope, even though it might feel hopeless. Even if panic attacks are due to something other than panic disorder, it is possible to find ways to cope better.

I hope you find these articles useful.

What is Panic Disorder?

Going Crazy or Dying of Panic?

Symptoms of Fight or Flight

The Many Causes of Panic Disorder

Some Chronic Symptoms of Anxiety

A Panic Sufferer's Plea

How Chronic Anxiety Triggers Panic

Panic Attack Triggers

What is Shallow Breathing?

Posted by Lisa C. DeLuca

According to the formula for determining stressful jobs in the workplace, people who are independent appliance repair men have one of the most stress-free jobs around. They have high control (i.e. control over their own schedule, whether or not they accept you as a customer, etc.) and they have low demand (they fix it when they fix it.) Jobs with low control and high demand, on the other hand, cause the most stress. Think of family caregivers.

Studies have shown that the mere perception of having control reduces stress, even if the perception is false. Making a list of everything that feels so out of control can be helpful. When looking at the list, you may find that you can gain control of some of these things by using some creativity. Do the same with the demands. If at the end of the day the demands are more than what is humanly possible to meet, this may motivate you to enlist help.

If a loved one needs surgery, the caregiver doesn't perform it, a surgeon is hired. The same principle can be applied to other types of care, whether it is bathing, monitoring, or cooking/feeding. Spouses, when they are well, take care of each other. When one becomes ill, the well spouse not only has to take care of him, she also loses the support for herself she once had. This is an enormous shift.

There is no rule that requires the spouse to do it all alone. Feeling the stress of it is a normal part of being human, not a sign of failure. Enlisting help is an act of problem solving that can benefit both parties ,and create a more peaceful atmosphere that is conducive to mutual healing.

Posted by Lisa C. DeLuca

When elderly parents have a crisis, adult children are the ones they turn to. Yet when adult children have perfectly legitimate ideas that will help parents or avert crisis, the parents often won't let them implement these plans. The adult children, rightfully, grow frustrated.

On the other hand, parents naturally expect to be in charge of their own lives and don't want their children taking over and discounting their parents' abilities to know what is best for themselves. Parents often resent it when their adult children criticize how they are managing, and presume to know what's best from a distance.

What is needed is a new, respectful collaboration.The late Murray Bowen was a genious when it came to helping people break out of old, futile, family patterns of relating. Bowen helped people "differentiate" from family members. This means to take a position of difference while still remaining emotionally close. This is a lifelong task for all adult children to master, whether their parents are sick or well.

It involves listening as well as talking. It involves acknowledging the other's position as well as honestly stating your own - not by criticizing the other person, but by revealing something about yourself. For example, "It makes me so sad and worried to see you working so hard and never getting time to yourself. I would be so sad if you became ill too," instead of, "You aren't taking care of yourself and it's silly to think that you have to do everything, you should just get some help."

It involves validating the other's position without agreeing with it. It involves a loving intent and generosity of spirit, and getting past old wounds. It's another opportunity for healing that caregiving provides.

Posted by Lisa C. DeLuca

To this day, many people struggle with the stigma associated with depression, whether the stigma is imposed by society or by themselves.

Psychological, social and spiritual stress (think of family caregiving) can bring out symptoms of biological illnesses, whether its shingles, migraine headaches, frequent colds, diarrhea, acne, ulcers, high blood pressure, heart disease, anxiety or depression. Many psychotherapists encourage people to solve their problems on all levels: biological (if necessary), psychological, social, and spiritual (when the patient is spiritually inclined.)

Most people wouldn't dream of treating a skin condition or heart disease with psychological, social or spiritual treatment alone. More importantly, people usually don't blame themselves for those problems the way they blame themselves for depression. Yet it is scientifically proven beyond doubt that depression is, among other things, a biological illness. Self-blame, feelings of failure and inappropriate guilt are symptoms of depression. Could a depressed person's self-blame be their depression talking? A contributing factor to depression is a tendency for self-blame. Self-blame could certainly be fueling further depression, even as the person is trying to heal.

As a human race we have not yet learned exactly how to heal our bodies with our minds, though advances are being made. Until then, medicine is often helpful and sometimes necessary to treat bio-psycho-social illness like depression.

Still, all the logic in the world doesn't matter when it comes to core beliefs. Caring for self or others who are depressed is a complicated matter. Listening to people's beliefs about their depression may be as important as, or even more important than, expressing one's concern and offering "the facts."

Posted by Lisa C. DeLuca

It's so easy to say "have your elderly loved one see a doctor at the earliest sign of memory loss." But how do you convince another family member to face the fact that she might have Alzheimer's?

It is too scary to contemplate being mentally compromised. Denial kicks in. People in denial over their memory loss will often make up reasons why they didn't know things, why they forgot. They may blame you, say that you never told them. Underneath the defensiveness is probably deep fear, conscious or not.

In general, it can help to suggest to the family member that "Many people ask their doctors for routine memory testing as they age and that they are smart to do this so that they can learn ways to slow inevitable memory loss." This can "normalize" getting tested so they feel comfortable doing so without having to admit that there may be something wrong with their memory.

Still, family members in denial will probably not be motivated to follow through on their own. Offering to accompany them can help. If it is your spouse who is having problems, make an appointment for both of you.

The way your family always copes with stress and communication is the way it will cope when someone starts losing their memory. This may or may not work well. But the courageous can always keep lovingly trying new ways and hoping for some small progress.

Posted by Lisa C. DeLuca

One of the family issues most fought over is money.

One of the most avoided topics of conversation in families is death.

One factor in most family struggles is power.

One of the most contentious issues in sibling rivalry is equity.

Health care planning is nothing if it is not about these four horsemen: money, death, power and equity.

Health care planning is critical if families are to retain power over their finances and the medical care received by their loved one if he or she becomes incapacitated. However, sometimes trying to do the right thing can cause conflict, avoidance, fear, suspicion and arguments among family members.

This is why it is so important to consult a good elder law attorney. Spouses should do this together. However, if it is left to the adult children, there may be differences of opinion so the attorney becomes even more critical. This neutral party will be able to supply the family with objective facts, as well as logical, well-reasoned, advice.

It can be important to include everyone around the table with the attorney because when people get left out they often feel suspicious. Family members need to feel that they have access to the same information as everyone else, as well as to the person giving it.

Although this process can cause upset or discomfort, it can be done with patience in a loving way. Keep revisiting the issue. Keep trying. Agreements may not be reached over night but persistence pays off.

Considering the emotionality around these issues, family caregivers should remember to pat themselves on the back if and when they get these legal matters in place, It's just one more courageous thing family caregivers do.

Posted by Lisa C. DeLuca

Aside from the concrete demands of caregiving, caregivers must navigate an emotional minefield.

• They must deal with grief, loss and disappointment – their own and that of the patient.
• They can feel total love and complete negativity toward their loved one all at the same time.
• They can become caught up in guilt about being the healthy one, guilt over their negative feelings, guilt if they have any joy while their loved one is suffering, guilt about taking care of themselves when their loved one is worse off.

Members of the mental health profession have been saying for decades that mental and physical health are all tied up and shouldn’t be treated as unrelated entities. Anyone who wasn’t convinced of this before will be, once they see the health statistics on family caregivers.

Those caring for loved ones are roughly twice as likely to experience depression, colds, flu, back injury, cancer and other illnesses. Those caring for someone with dementia are twice again as likely to develop depression. This cannot all be accounted for by physical demand alone.

When a loved one falls ill it is truly a crisis. But if the illness is chronic, caregiving will be a way of life and balance must be achieved, physically and mentally, if the caregiver is to stay well too.

Marathon runners wouldn’t think of running the race without water stops. Caregivers need water. They need things that will rejuvenate, revitalize, replenish some of what is depleted. If health and quality of life are the goals, the caregiver’s water, like the patient’s medicine, is not a luxury, it is a necessity. What kind of water do you need?

Posted by Lisa C. DeLuca

As illness progresses, the patient’s world gets smaller. Real moments of connection between people are sometimes all that matters of what is left. For a caregiver, these moments can be healing too, especially if the relationship has been rocky. Moments of connection can be defined simply as when an inner truth is revealed by one person's words or actions, that is heard, received and genuinely accepted by the other.

Anyone contemplating the questions of death and connection, should read Mitch Albom’s Tuesday’s With Morrie (NY: Doubleday, 1997). Morrie lived a purposeful life right up until he died. His life and death were meaningful - for himself and for others – because he expressed his love for and interest in others who came into contact with him, all his life and during his illness. He sought to bring and keep them in his world during the process of his dying.

It’s a risk, reaching out to others like he did. People risk rejection when they do this. They make themselves vulnerable. The risk runs both ways. Morrie took this risk, but so did his former student, Mitch, who reconnected with Morrie knowing he was dying. Mitch could have closed himself off to prevent feeling the sadness of the loss he knew was coming. But instead he opened up and moved toward Morrie, strengthening their connection. This enriched both their lives, and it made the loss of Morrie more difficult for Mitch to bear.

Connection can even be possible in the case of dementia or Alzheimer’s, where the person the caregiver knew is slowly lost over time. This was beautifully expressed by Jack, a caregiver, in the Caregiver.com article, ‘Alzheimer's: She Wanted Two Kisses’ by Gwendolyn de Geest.

Caregivers keep hope for meaningful connection alive.

Posted by Lisa C. DeLuca

A long time ago I read somewhere that fear of dying was not fear of death, it was fear of a life not well lived. Those facing old age or end of life illness are facing more than just physical symptoms; they are coming to grips with life and how they lived it. Whether they acknowledge it aloud or not, there it is.

A family caregiver has to deal with her own feelings about what is happening to the patient and what is happening to herself as a result of the patient's illness. The feelings can be complicated for both parties. There can and will be conflict and difficult moments.

Caregivers themselves may be at the age when they are doing their own life reviews too. Caregivers of any age may feel that caregiving responsibilities are pulling them off of the track they wanted their lives to take, and that they are missing opportunities for a meaningful life. Others may feel trapped in a role that they would never have chosen but yet, ironically, it expresses who they are and what they value. Others may feel that they are making an important difference in someone’s life, maybe for the first time.

Through my psychotherapeutic work with people I have come to believe that many people judge whether or not their lives are well-lived by how connected they have felt - to others, to the world, to their Creator, to their true inner selves, and to their purpose.

Caregiving is about connection with others. Whether they are providing care themselves, arranging for the care, or just visiting, caregivers are keeping the chance for meaningful connection between two people alive, even when it can be difficult to do so. This may be their most important role.