• Dr. Emi Garzitto

Martyrs Make Terrible Caregivers



There are many ways a child will use a Kleenex inside my counselling space. There is the one-blow-and-trash-it method; the I-will-hold-on-to-this-but-do-nothing-with-it; or, origami-folds, or the I-will-keep-this-on-my-lap-and-not-touch-it-at-all.


What I see with a surprising regularity is the twist-and-knot method. This is where the child will take the Kleenex and roll it and twist it and break it apart into tiny small pieces that fall on the cheap Public School carpet. The pieces seem so fragile and so small but once it is broken into tiny bits, they become almost impossible to clean and remove from my floor. In their bits of cellulose, they have this kind of stubbornness that seems to fuse with the carpet.


There are times I try to pick these pieces up and put them in the recycling bin. It takes a lot of time and the work is meticulous. I wonder why I am using my time to remove the remnants of the small child’s attempt to try to manage the big feelings coming out of a body that is making sense with grief or rage or abandonment or whatever it is that we are working on.


There is a boy in my chair. He is a big boy. 9 years old but tall and large. He has his eyebrows furrowed, meeting in the middle. His hands are clenched. His breathing is shallow but fierce.


I know it won’t take me much. I know that with one or two questions I will have him reaching for the Kleenex box.


Your teacher tells me that you are out of sorts. You are not yourself. It’s not like you to hit another classmate. And he’s your friend, right?


His hand moves towards his heart in a feeble attempt to protect it. His body curls into a fetal position and suddenly he is small. He is 5 years old and he blurts “My father hates me!”


The tears come.


I sit and watch as he grabs a Kleenex and begins the process of twisting and twisting and twisting. He seems unaware that fluid is running from his eyes and his nose. He makes no attempt to use the Kleenex to wipe away the fluid. He twists and twists the Kleenex slowly forming those small little bits and pieces that fall without permission onto the carpet.


My father hates me and I know it because he tells me.


I want him to stop telling me that I’m fat that I’m lazy.


I just want him to come play soccer with me.


I am so sorry. I can see that this must hurt. I can see that you are breathing hard, that your hands are curled into fists. You look like you are feeling hurt. Is that true? Where do you feel this distress in your body?


He pauses for a moment and points to his chest, “It’s like I can’t breathe. I am choking.”


Okay. Keep Breathing I say. You are doing good work, I say. You are going to get through this, I say. You are going to get through this, I say.


I say, I say, I say, and I say.


When I get enough visits in, when I get enough trust, I can help build his skills I can help give him strategies I can push his capacity to take responsibility for his self care but in the meantime I sit and I share in his moment.


I watch the Kleenex disintegrate until suddenly the bits of nothing accumulate so that the weight becomes more than I can bear.


I hate my Kleenex box. I hate how often I have to go downstairs to the office to pick up and replenish my empty box.


Compassion fatigue comes in small little tiny bits of feather light cellulose that gets stuck inside your being. Unnoticeable at first but over time, even if you work hard to pick up the pieces and remove them, even if you try hard to gather the pieces one by one, they lodge there in between your knee joint or in the middle of your leg or in between the joints in your hands that suddenly find it hard to move or in the neck and shoulders that take the weight of the child in the arms of a mother.


This is what compassion fatigue feels like and looks like. It looks and feels weightless at first like I can handle this like it is fine I am fine. I am fine. I am fine. And then suddenly I am NOT fine.


It is the one final empty piece that lands and makes it impossible to be present to the tears to the ache to the suffering of the being that sits in front of you.


And at that point you are no good. At that point you have not done your job because you have failed to take care of the most important body in the room — Your own. Without your ability to manage your body your spirit your mind your soul, you will become twisted knotted and useless to the person who requires care.


You cannot do the work of sitting in the presence of suffering without also doing the tedious work of managing your own suffering.


You cannot do the work of sitting in the presence of suffering without also doing the tedious work of picking out all of the grief stuck in your body. You do this through meditation, prayer, connection, laughter, movement, conversation and stillness, breath and fresh air.


Martyrs make terrible, mothers, fathers and partners. Martyrs make terrible counsellors, and caregivers.

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