Wednesday 28 December 2022

The Three Kinds of Care

By Janet Coburn

December is National Family Caregivers Month, so it seemed like a good time to talk about caregiving. In my view, there are three kinds of caregiving: giving care, receiving care and self-care.


Caregiving is not an easy task, no matter whether you’re a family member or a professional. With an uncommunicative person such as one with depression, it practically takes telepathy. At times it seems impossible to know what kind of care is needed. A hug? Encouragement? Alone time? Help with chores? A listening ear? My husband, who is my principal caregiver, does all those things for me.

One thing about caregiving that I learned from my parents is that caregivers need recognition, too. My mother took care of my father all through the years of the illness that killed him. He wasn’t mentally ill, but his physical needs were many. Once my mother came to me and asked if she was doing a good job of caring for him. Of course, I reassured her. The thing is, objectively she knew that she was meeting his needs well. She just needed to hear it from someone else. You can talk about not looking for external validation, but sometimes it’s the kind you really need.

Receiving Care

All caregivers need recognition, and the best kind comes from the person for whom they care. That’s not always possible. Many therapists find it inappropriate to get gifts from their clients (mine accepted a small plant graciously). But a simple holiday card can be a nice remembrance. Other recipients of care have something to offer their caregivers as well – simple human connection.

Certainly, those of us receiving care can be irritable or even angry about needing care, but some recognition from us can go a long way toward keeping our caregivers, well, caring. Kindness is reciprocal. I know it’s hard to remember that or to act on it.

I owe my husband – my primary caregiver – more than I can say. Without him, I wouldn’t be able to do what I can do – take care of paying the bills and work enough to keep us mostly current, for example. And I thank him, appreciate him, and do what I can for him. I try not to be greedy with his time and efforts – I know he has other things he’d rather be doing or needs to do for his own care. I know I don’t do nearly as much for him as he deserves.

Self Care

For people who have a mental illness, self-care can be difficult. We know what we should be doing, but it’s often difficult. It feels like self-care is just another chore, on top of all the other things we’re not able to do. If I can’t keep on top of laundry and dishes, how am I supposed to keep on top of showering? If I can’t manage to get out of bed for more than a couple of hours a day, how am I supposed to find time and motivation to exercise?

I know that self-care is important, but I have trouble doing it sometimes. I know I’m capable of it. I’m on my own while my husband is at work, and I managed to keep up self-care while he was out of town earlier this year. But somehow, I never seem to get beyond the very basics of self-care – eating and sleeping regularly. Never mind the manicures, shopping sprees, and bubble baths that some recommend. Those might require getting dressed, going out among people, and spending money. (Bubble baths don’t, of course, unless you count going out to get the bubble bath, which I do count. I sure don’t have any on hand.)

If you’re able to make even modest efforts toward self-care, make sure you give yourself a metaphorical pat on the back. Believe me, you’ve earned it.

The bottom line is this: No matter whether you give or receive care or care for yourself, you need and deserve recognition and appreciation.

Originally published in December 2022 at Bipolar Me.


About the Author

Janet Coburn is a freelance writer/editor with bipolar disorder, type 2. She is the author of two books: Bipolar Me and Bipolar Us.

Janet writes about mental health issues including talk therapy, medication, books, bullying, social aspects, and public policy, but mostly her own experiences with bipolar 2. As she says, “I am not an expert and YMMV – Your Mileage May Vary.”


Wednesday 21 December 2022

And Sometimes It Happens: The Gentle Art of Letting Go

And sometimes it happens that you are friends and then
You are not friends,
And friendship has passed.
And whole days are lost and among them
A fountain empties itself.

— Brian Patten, “Sometimes It Happens”

Fran and I talk a lot about friendship. We post about it on social media. We blog about it here. We wrote a book based on our experience as transatlantic best friends. We believe friendships are healthiest and most resilient where there’s a commitment to honest and open communication. That’s not to say, of course, that honesty and openness guarantee a friendship will last forever. Things change, and that’s as true of friendship as anything else. Fran and I have weathered more than a few storms over the years. I’d say we’re stronger for it. But not all change is navigable and not all friendships endure.

That’s something I’ve not written about before, although it’s a topic I’ve wanted to explore for a long time. The starting point for this article was a conversation with Fran in which she shared that a friend had told her she’s “too kind,” and that people take advantage of her as a result. Fran agreed she finds it hard to maintain healthy boundaries, and this has led to problems with some friends in the past. I knew what she meant, but the conversation left me feeing uneasy. I knew why; it was the idea that kindness leads to being used or taken advantage of.

It’s certainly true that being unconditionally kind can lead to problems, including co-dependency. My mother was a perfect and tragic example of this, as I’ve shared previously in an open letter to my mother written six months after her death. Toxic, manipulative, and abusive relationships also exist, of course. I’ve no first-hand experience to draw on, but I’ve seen how devastating and long-lasting their effects can be. It seems to me, though, that most friendships struggle for more mundane reasons and with little malign intent on either part. Friendships succeed, I suggest, when we are able to meet each other’s needs. They falter, and sometimes end, when we are no longer able to do so.

No single friendship or relationship can meet all our needs at all times. Temporary imbalances are nothing to be feared, but if they become entrenched, they can lead to dissatisfaction and loneliness. I wrote on the subject of loneliness for Mental Health Awareness Week this year, inspired by an insight by Mark Rowland, CEO of the Mental Health Foundation: “Loneliness is the feeling we experience when there is a mismatch between the social connections we have and those that we need or want.”

But what constitutes a mismatch or imbalance? When does it become an issue? Who gets to decide? It might seem to some people as though I put myself out to meet Fran’s needs, and the needs of my other friends. We touch on this in our book, because it’s a form of stigma that needs to be challenged.

If you devote a lot of time and energy to your friend, others may worry you are being taken advantage of, especially if money is involved. Some may feel displaced in your affections, jealous, or otherwise uncertain as to the nature of your relationship. In our experience, the best response is to be honest and open, although this may not always be appropriate. Most people who learn of my role as Fran’s friend and caregiver are interested and supportive. This is appreciated on a personal level, and helps counter the stigma associated with mental illness. Our friendship has taught me to be more aware of others who may be struggling. That doesn’t mean I try and help everyone, but I offer what I can and neither absent myself nor run away. To do this, I need people prepared to support me in moments of confusion, frustration, and self-doubt — and they do occur — without imposing limits on my capacity to care.

I endeavour to be there for friends if and when they need me. I don’t consider that an unhealthy dynamic if it’s handled responsibly. I’ve explored this previously in such articles as The Constant Gardener: How to Be Someone Your Friends Can Rely On and How to Be There for a Friend When No One Else Is. Do I ever say no? Not often, but yes. Maintaining healthy boundaries will mean different things to different people. For me, it includes protecting my online time with Fran, and my personal “Marty time” when I’m writing or need space for myself.

I describe my friendship with Fran as mutually supportive. We meet many of each other’s needs, but not all. I’m part of Fran’s team, which includes other friends, and her professional support network. Fran is part of Team Marty, but she’s not the only person on the team. She told me once she was glad, because it means there’s less pressure on her. Another friend, Louise, expressed it beautifully. Someone I knew was struggling and I felt utterly unable to offer meaningful support. Louise reminded me that not all the team is on the field at all times. “Keep in mind that your friend is going through her stuff,” she said. “You’re still on her team, just not playing right now.” Her words helped me navigate a difficult and confusing phase in that particular friendship, and informed my concept of supportive disengagement.

What do I mean by [supportive disengagement]? Essentially, it means stepping back from the usual give-and-take dynamic you share with your friend, but being there if and when you’re invited in. It means providing encouragement and support when asked but otherwise getting out of your friend’s way so they can navigate whatever’s happening in their lives the best way they can.

It’s a safe way to manage mismatched needs, without bringing the friendship itself to an end.

Supportive disengagement is for situations when your friendship is taking a break rather than broken, when disengagement is less than total, and — crucially — where the lines of communication remain open.

It’s worth remembering that people’s needs change over time, and our friends may find others better suited or more available than we are to meet those needs. The same can happen in reverse, of course. I recall friendships where there’s been a lessening over time, a diminution, even an ending. Some connections have picked up again after a gap of weeks or months. Other endings have been permanent. Some fractures were intensely painful. Others were less so; a few almost graceful in their passing from engagement to disengagement. My friend Maya expressed this beautifully, looking back on our time as friends.

In recent years there was a sort of tearing that occurred in the fabric of our friendship. I think there have been a few tears, over the years, but most of those have been patched up with some pretty nice fabric and made “roadworthy” for want of a better term. I do believe friendship needs to be mutually strong enough to work through difficulties, differences, obstacles — and some are strong enough, and some aren’t. Although, I think there are times when friendships just dissolve as they come to the end of their meaning or purpose, and perhaps not all friendships are meant to last.

Maya’s words echo a quotation many will recognise: “People come into your life for a reason, a season or a lifetime. When you figure out which one it is, you will know what to do for each person.” Those are the opening lines of a poem frequently attributed to Brian A. Chalker, although authorship is uncertain. The full poem can be found in this blog post on the subject of friendship by Selina Man Karlsson.

When Maya and I were first friends, I remember telling her about someone who was very important to me at that time. Maya asked what purpose the friendship fulfilled in my life. The question caught me off guard. I’d never thought about my friendships in that way before. I probably answered by saying this person didn’t serve any purpose, she was simply my friend, someone I cared about. I understand rather more about needs and their fulfilment — and nonfulfilment — these days, through the work Fran and I have done with Non-violent Communication (NVC). The twin concepts of NVC and supportive disengagement have helped me navigate changes in the dynamics of friendships which previously would have been very hard for me to accept and process.

No matter the emotional tools at our disposal, there’s no escaping the fact that breakups are hard, especially if they come out of the blue. Even if the disengagement is gentle and mutually orchestrated, most closures involve loss, tears, and bereavement. That’s natural and nothing to be feared. Rationally, we might accept what’s happened, but our emotions are not rational and need to find their own equilibrium. They, and we, deserve time, care, and respect while we work things through.

Breakups can leave us feeling we’ve done something wrong — or worse, that there’s something wrong with us such that people always leave. (So why bother trying?) Self-pity may be part of how we process endings, but it’s unlikely we’re totally at fault. It’s easy to look back at previous friendships that have ended, seeing patterns where there are none, and ignoring or forgetting the reality that not all friendships are destined to last. Endings do not represent failure, on either part.

That said, sometimes the other person has chosen to end the friendship because of something we’ve said or done. To put it bluntly, sometimes we are the toxic one. If there’s something in how we behave towards others that tends to hurt or drive them away, we have a responsibility to acknowledge the fact and change our behaviour. That’s been the case with me at different times. There are people I will never meet or hear from again because of how poorly or clumsily I treated them. I hope I’ve learned at least some of the lessons.

Most times, though, neither of you is to blame. It’s simply that the imbalance of priorities and needs between you has become unsustainable. What happens then is up to you (both). Perhaps there’s enough of your friendship left to talk it out and find a way forward. Maybe things fractured harshly with no opportunity for discussion or repair, or faded so gradually it was hard to say where friendship ended and absence began. You might hold space for a while to see if things will realign, but there may come a time when you’re ready to let go. Not because you stopped caring about your friend. But because you started caring about you.

Allow the hurt and tears their place and time. Don’t push the feelings away. Acknowledge them. Invite them in. But don’t allow them to overstay their welcome. They have other places to be, and you have other guests to offer a place at your table. The warmth of friends you have not lost. The joy of those you’ve yet to meet. It’s not easy, but there is a way through. As one unattributed quotation I encountered whilst researching this post puts it, “Your peace will come when you learn to let go of whatever has let go of you.”


Over to You

The poem I quoted at the start of this piece has helped me a lot over the years. You can read Brian Patten’s “Sometimes It Happens” in full at Poetry Hoard.

I’ve shared how I approach the ending of friendships, but everyone’s experience is different. How do you feel and respond if a friendship fades or closes? How do you handle breakups? I’d love to hear from you, either in the comments below or via our contact page.


Photo by Peter Herrmann at Unsplash.


Wednesday 14 December 2022

I Am Known, Inside and Out


I am known, inside and out.

I do not feel the need to hide parts of myself away for fear of scaring you.

I listen, unafraid of the places you take me.

We express love, wonder, anger, jealousy, envy, frustration, freely.

We laugh and cry.

Real laughter. Real tears.

I tell you my how-it-is even when I know it is different from yours.

I listen to your how-it-is, holding it gently in the space between us.

We dance in the differences, the gaps where the magic happens.




This post was originally shared on social media, November 25, 2011.
Photo by Leslie Jones on Unsplash.


Wednesday 7 December 2022

Ready When You Are: Four Little Words That Mean So Much

I’m just waiting on a friend.
— Mick Jagger / Keith Richards. “Waiting on a Friend.”

Pretty much every voice or video call that Fran and I share begins with me messaging her “rwya” — our shorthand for “ready when you are.” It’s become so much a part of our friendship that I rarely stop to think about it. Except today I did as I was waiting for Fran to call. I thought it might be interesting to explore what that little acronym means for us, in the hope others might find it useful.

I can’t remember exactly when we came up with “rwya” but it was early in our friendship when transatlantic calls were still a novelty for us. In those days, Fran was going through a protracted episode of mania. She wanted and needed frequent and often immediate contact. I loved spending time with my new friend and was happy to accommodate her need for connection, but we needed to figure out how best to do that.

I consider it a kindness and mark of respect if someone messages me before calling to check if I’m available. Fran almost always did so, but the request might come at any moment, day or night. It’s fundamental to our friendship that I never ignore her messages but she recognised it wasn’t always possible for me to chat or speak immediately. She’d wait for my “rwya” before calling. For some technical reason that eludes me, our calls always worked better when Fran called me rather than the other way round, and we’ve stuck to that way of doing things. It also reduces the chance of us trying to call each other at the same time!

First and foremost, then, “rwya” lets Fran know I’m ready. I have time and space to connect, and any technology I need is at hand. That might be my PC, tablet, or mobile phone, my folding stand, and my Bluetooth headset. (I can’t understand anyone not having a phone stand and headset. They make life so much easier!) We mostly use Skype for our voice and video calls, and that works much better on my phone if I have the app open in advance. “Missed call from Fran” notifications are annoying for us both!

Our acronym carries another important message, though, represented by the “when you are” bit. Fran and I soon settled on times of day which were as mutually convenient as we could manage given the five hour time difference between us. If we were both free at those times, then we had our call. Mostly, that meant if we were each at home, but sometimes we’d call if we were out and about. Sharing aspects of our lives in this way is a great way to deepen a connection between friends. It’s also fundamental to our supportive friendship, as we describe in our book.

It might seem as though a five hour time difference would make it difficult for us to connect, but our lives mesh well. On a typical day we talk briefly in the morning and meet twice later for video calls, usually at two o’clock in the afternoon and six o’clock in the evening for Fran (seven and eleven o’clock in the evening for me). This regular scheduling provides stability and structure, which are otherwise lacking in a life governed by illness.

We’ve always let each other know if we’re likely to be to unavailable, but inevitably there are occasions when I’m set to take a call at our usual time but Fran isn’t quite ready, or can’t make it but hasn’t had chance to let me know her plans have changed. This is when the “wya” bit of “rwya” comes into its own. It means precisely what it says: I’m here and ready when (and if) you are. Most importantly, it means “it’s okay if you’re not ready, or if something’s come up.”

This might sound obvious, but I haven’t always been as patient and understanding as that description suggests. On more than one occasion I became frustrated and cross if Fran didn’t show up for a call and hadn’t let me know in advance. It came to a head one evening. I was pretty sure Fran was at home, and couldn’t understand why she hadn’t called yet or let me know what was happening. When we did eventually connect, I wasn’t shy in voicing my frustration. Fran calmly explained that she hadn’t been able to call me or let me know because she’d been helping support a friend who was in acute distress.

I don’t use our little acronym with anyone else, but its wisdom applies equally to my other friends. No matter who it is or what we’re arranging — a chat online, a call, or a get together in person — I approach it with the understanding that we both want it to happen but that other things might get in the way. It’s an approach that’s served me well on a number of occasions, saving me a good deal of frustration, anxiety, and hurt.

I appreciate friends who let me know when they’re on their way to meet me, or if they are delayed or need to reschedule. There’s an example of this in a short piece I wrote in November 2019 titled A Few Thoughts on Friendship Whilst Waiting for a Friend.

I’m sitting at a table in Newcastle’s City Library. At my side is the library copy of High Tide, Low Tide, the book I wrote with my best friend Fran. I never tire of seeing it on the shelf. It’s a proud moment for any author; second only to not seeing it because someone has taken it out on loan. I’m waiting for a friend. We’ll meet for coffee and then go for a drink or two; maybe something to eat. We’ll catch up with what’s going on for us. We’ll laugh, share old memories and make new ones. It is at moments like this that I feel most blessed.

The piece ends: “My friend has just messaged to say she’s on her way. Time to return the book to its place on the shelf and head out to meet her.” As far as I recall, she was on time, but I remember waiting for a different friend on a different occasion. She was more than an hour late in the end, but she’d let me know the reason for the delay and offered to reschedule. I was happy to wait. I was “ready” but she wasn’t, and it wasn’t a problem at all.

Whatever the situation, ready when you are is about maintaining a healthy balance between honouring the commitments we make to each other, and respecting our boundaries and needs as individuals.

Over to You

How do you handle making arrangements with friends and loved ones? Do you get frustrated if they’re unavailable or delayed? Do you find it easy to let other people know you can’t connect when they want to? How do you navigate these moments in your relationships? We’d love to hear your thoughts and ideas, either in the comments below or via our contact page.


Photo by William Krause at Unsplash.