Leilani M Norman

Blog

  • Help for Caregiver Burnout

    Help for Caregiver Burnout

    ACT  for Caregivers

    Caring for someone you love can be meaningful—and also emotionally demanding. Acceptance and Commitment Therapy (ACT) is an evidence-based approach that helps caregivers respond to stress with greater flexibility, compassion, and clarity, while staying connected to what matters most.

    ACT focuses on building psychological flexibility: the ability to stay present, open, and engaged in life—even when things are difficult.

    The Six Core Skills of ACT

    1. Acceptance

    Making room for difficult thoughts and feelings

    Acceptance means allowing uncomfortable emotions (such as guilt, grief, anger, or exhaustion) to be present without fighting or judging them.

    Try this:
    When a difficult feeling shows up, pause and say silently:
    “This is hard—and I can allow it to be here for now.”
    Notice where the feeling shows up in your body and take 3 slow breaths.

    2. Cognitive Defusion

    Creating space from unhelpful thoughts

    Thoughts are not facts. Cognitive defusion helps you step back from distressing thoughts so they don’t run your life.

    Try this:
    When a painful thought appears, add the phrase:
    “I’m noticing my mind is telling me…”
    Repeat it slowly and observe how the thought feels less overwhelming.

    3. Being Present

    Coming back to the moment you’re in

    Being present means gently returning your attention to what’s happening right now, rather than getting pulled into worries or regrets.

    Try this:
    Name 3 things you can see, 2 things you can hear, and 1 thing you can feel in your body.
    No need to change anything—just notice.

    4. Self-as-Context

    You are more than your role or your struggles

    You are not just “the caregiver” or “the overwhelmed one.” You are the observer of your experiences—not defined by them.

    Try this:
    Silently complete this sentence:
    “I notice that I am having the experience of…”
    This reminds you that there is a part of you that can step back and observe.

    5. Values

    Clarifying what truly matters to you

    Values are qualities of living that guide how you want to show up—especially during hard times.

    Examples: compassion, presence, patience, connection, balance.

    Try this:
    Ask yourself:
    “In this situation, what kind of person do I want to be?”
    Write down one value that feels important right now.

    6. Committed Action

    Taking small steps aligned with your values

    Committed action means choosing doable actions that reflect your values—even when energy or motivation is low.

    Try this:
    Choose one small action you can take this week that aligns with a value you named (e.g., a 5-minute walk, asking for help, a moment of rest).

    A Gentle Reminder

    ACT doesn’t aim to remove stress or pain—it helps you change how you relate to them. You don’t need to feel better to live meaningfully. Small, values-based steps matter. You can care deeply—and still care for yourself.

  • Disenfranchised Grief (Part 2) The Loss of Friends 

    Disenfranchised Grief (Part 2) The Loss of Friends 

    Today I am missing my longtime friend who died of ovarian cancer this year. The pain of this loss prompted me to write this post to share some of the information that I have gained. I hope it is helpful for you or someone you know.

    Disenfranchised grief is grief that is not acknowledged, supported, or socially validated. It occurs when a person experiences a significant loss, but others minimize it, judge it, or view it as less legitimate. As a result, the grieving person may feel isolated, misunderstood, or unable to openly mourn. While this type of grief is often discussed in relation to losses such as an elderly parent, an ex-partner, or a miscarriage, it also commonly arises after the death of a close friend.

    Friendships are often chosen family, yet their loss is frequently overlooked. Society tends to reserve public rituals, extended support, and long-term compassion for grief tied to kinship or romantic partnership. When a friend dies, the bereaved may feel pressure to downplay their pain, question the legitimacy of their grief, or mourn privately. This lack of recognition can make the loss feel invisible, compounding the emotional impact.

    The death of a close friend can be deeply destabilizing, particularly in adulthood, when friendships often serve as primary sources of emotional intimacy, identity affirmation, and daily support. Friends witness major life transitions, hold shared histories, and often know parts of us that even family members do not. When a friend dies, the loss can disrupt routines, social networks, and one’s sense of continuity. Yet because the relationship is not legally or biologically defined, grief may be dismissed with phrases such as “at least it wasn’t family” or “you’ll always have the memories,” unintentionally minimizing the depth of attachment and loss.

    The loss of friendship can also carry a unique loneliness. Unlike family loss, there may be no formal role for the bereaved friend in funerals, decision-making, or mourning rituals. The griever may feel excluded from services or unsure of where they belong. This is especially true when the deceased friend’s family does not fully recognize the closeness of the relationship, or when the friendship existed outside socially visible norms. The absence of communal acknowledgment can intensify grief and complicate the healing process.

    The loss of a friend may also prompt identity shifts and existential reflection. Friends often anchor us to particular versions of ourselves—who we were at certain stages of life, shared dreams, or mutual understandings of the world. When that person is gone, the bereaved may feel disoriented, questioning who they are without the relationship. This can be especially pronounced when the friend was a primary confidant, a sobriety partner, a co-parenting ally, or a key emotional support.

    Research supports the complexity of grief following the loss of a close friend. In their article, “Losing a Part of Yourself’: How women grieve their close friend’s death,” Sauber and O’Brien (2025) examined how attachment styles influence both prolonged grief and posttraumatic growth. They found that attachment-related anxiety and avoidance shaped how individuals coped with loss through perceived social support and coping strategies. Certain coping styles—particularly avoidant emotional coping and problem-focused coping—played a significant role in shaping grief outcomes. These findings highlight how relational patterns and emotional regulation strategies influence not only the intensity of grief, but also the potential for growth following loss.

    As with other forms of disenfranchised grief, social validation plays a critical role in healing. Without acknowledgment, grief may become internalized, delayed, or complicated. Recognizing the legitimacy of friendship loss challenges the unspoken hierarchy of grief that places family relationships above all others. Acknowledging that love, attachment, and meaning are not limited to blood or legal ties allows grief to be held with compassion rather than comparison.

    Supportive responses to someone grieving a friend mirror those offered for other significant losses. Rather than minimizing the relationship, it is helpful to acknowledge its importance and invite remembrance. Simple statements such as “Your friendship clearly mattered deeply” or “Tell me about your friend” can open space for the bereaved to share their story. Presence, curiosity, and continued support over time communicate that their grief is real and worthy of care.

    Expressive writing can also support healing after the loss of a friend. Writing a letter to a deceased friend may help the bereaved express unfinished conversations, gratitude, anger, or longing. This type of journaling allows emotions to surface without concern for grammar, structure, or judgment. Revisiting meaningful passages later—perhaps in a journal or therapeutic setting—can help integrate the loss into one’s ongoing life narrative.

    In addition to writing letters to a deceased friend, What’s Your Grief offers another meaningful variation: writing a letter from the loved one who has died. This exercise invites the bereaved to imagine what their friend might say to them now, drawing on shared values, remembered wisdom, humor, and relational patterns. It can be especially helpful during moments of longing or uncertainty, such as when facing a life decision and wishing for that person’s guidance. Writing a letter from a friend to oneself can illuminate internalized support, foster self-compassion, and strengthen continuing bonds. Rather than denying the reality of the loss, the exercise honors the ongoing internal relationship while acknowledging the pain of absence.

    When supported by a grief-informed and empathetic professional, expressive writing and letter-based interventions can provide a compassionate container for mourning a relationship that mattered deeply—even if the world did not fully see it.

    References

    Sauber, E. W., & O’Brien, K. M. (2025). “Losing a part of yourself”: How women grieve their close friend’s death. Omega: Journal of Death and Dying.

    What’s Your Grief. (n.d.). To me, from you: Writing letters from those we’ve lost. https://whatsyourgrief.com/to-me-from-you-writing-letters-from-those-weve-lost/

  • Disenfranchised Grief

    Disenfranchised Grief

    Disenfranchised grief is not acknowledged, supported, or socially validated. It can occur when a person experiences a significant loss, but others minimize it, judge it, or view it as less legitimate. As a result, the grieving person may feel isolated, misunderstood, or unable to openly mourn. Examples include losses that society considers “less serious” (such as the death of an elderly parent, an ex-partner, a pet, or a miscarriage), or situations where the mourner’s relationship to the deceased is not recognized, as in same-sex relationships.

    The death of an elderly parent often impacts older adult children. Even expected losses can carry significant emotional weight. Society often minimizes this grief, viewing it as a natural event. Adult children may face psychological shifts, confront their own aging, and reassess priorities and relationships. Loss can alter family dynamics, leading to feelings of responsibility for traditions and cohesion. When older adults witness their parents’ gradual decline before death, intense feelings of sadness, loneliness, and disorientation often arise, sometimes mixed with relief from caregiving burdens, leading to guilt. Grief affects identity, as losing a parent can feel like losing a central anchor. Despite these struggles, some individuals find opportunities for personal growth and meaning, though this requires social validation and support, which may be insufficient.

    Bethany Morgan Brett notes that societal attitudes toward grief vary based on the age of the deceased. After the death of an older person, people often use clichés like “they had a long life” to suggest a sense of closure due to the “timeliness” of the death. The death of an older parent is seen as a normative life event, which can lead to the grief experienced being minimized or overlooked. This reflects a hierarchical view of grief, where the loss of a child is generally perceived as more tragic than the loss of an elderly parent. Such views can hinder the acknowledgment and processing of deeper emotions associated with the loss.

    The excellent grief support website, “What’s Your Grief,” suggests that it’s important to recognize that when comforting someone whose parent has died, you can’t “fix” their situation. Instead of trying to console them, focus on acknowledging their pain, being present with them, remembering their loved one, and showing support both in the immediate aftermath and over the long term. One way to talk about a parent’s death is to say, “Please tell me about your parent”, which opens a more personal conversation, allowing the bereaved to share their thoughts and feelings. Check out their article, “What to say to someone whose mother died or father died”, linked below.

    Writing a letter to the departed may help the bereaved express feelings about loss. Expressive writing is an approach to loss that supports healing. Sitting down to write this letter to a loved one begins by letting go of any concerns about spelling or grammar, word choice (curse words are allowed!), or worries about anyone reading or critiquing the document. One can simply start writing and not stop until it feels complete. A second step could be to read the letter and transfer significant passages to another document, such as a journal. This process can be included in psychotherapy when an empathetic and grief-informed professional provides caring treatment for loss.

    References

    What’s Your Grief. (2021, March 26). What to say to someone whose mother died or father died. https://whatsyourgrief.com/what-to-say-to-somone-whose-mother-died-or-father-died/

    Morgan Brett, B. (2023). The loss of parents in later life. In The Child–Parent Caregiving Relationship in Later Life: Psychosocial Experiences (pp. 97–111). Policy Press. https://doi.org/10.46692/9781447319702.007

  • Healing Reads

    Healing Reads

    Books

    Surviving and Thriving in Stepfamily Relationships

    by Patricia L. Papernow
    This book draws on current research, a wide variety of clinical modalities, and thirty years of clinical work with stepfamily members to describe the special challenges stepfamilies face. The book presents the concept of “stepfamily architecture” and the five challenges it creates, and delineates three different levels of strategies―psychoeducation, building interpersonal skills, and intrapsychic work―for meeting those challenges in dozens of different settings.

    Estrogen Matters: Why Taking Hormones in Menopause Can Improve Women’s Well-Being and Lengthen Their Lives — Without Raising the Risk of Breast Cancer

    by Avrum Bluming & Carol Tavist
    A compelling defense of hormone replacement therapy, exposing the faulty science behind its fall from prominence and empowering women to make informed decisions about their health. A sobering and revelatory read, Estrogen Matters sets the record straight on this beneficial treatment and provides an empowering path to wellness for women everywhere.

    I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression

    by Terrence Real
    The author writes that “depression is a silent epidemic in men; that men hide their condition from family, friends, and themselves to avoid the stigma of depression’s ‘un-manliness.’” Problems that we think of as typically male; difficulty with intimacy, workaholism, alcoholism, abusive behavior, and rage-are really attempts to escape depression. And these escape attempts only hurt the people men love and pass their condition on to their children.This ground breaking book is the “pathway out of darkness” that these men and their families seek. Real reveals how men can unearth their pain, heal themselves, restore relationships, and break the legacy of abuse. 

    Scream Free Parenting: 10th Anniversary Revised Edition: How to Raise Amazing Adults by Learning to Pause More and React Less

    by Hal Edward Runkel
    “You can have the structured, rewarding home life you’ve always craved, with respectful kids who are responsible for their own actions. All you have to do is learn to pause, so you can respond more and react less. It really is that simple. Once you learn to control your own emotions and behavior, your children will soon learn how to control theirs.”

    Fuel Your Brain, Not Your Anxiety: Stop the Cycle of Worry, Fatigue, and Sugar Cravings with Simple Protein-Rich Foods
    by Kristen Allott & Natasha Duarte
    Discover how high-protein, brain-fueling foods can help overcome anxiety, worry, and fatigue. It is common to struggle with anxiety, sugar cravings, weight gain, and fatigue. This practical, feel-better-now workbook offers ways to make healthier food choices and discover how protein and sugar affect emotions and energy.
    Convenient meal planning and tracking tools help monitor progress, and a wealth of easy tips and doable ways to improve diet, overcome fatigue, and restore vitality and mental clarity.


    No Time Like the Present: Finding Freedom, Love, and Joy Right Where You Are
    by Jack Kornfield
    The author offers wisdom through warmhearted, poignant, and
    often funny stories that provide keys for opening gateways to immediate shifts in perspective and clarity of vision, allowing us to grapple with difficult emotions and learn how to change course, take action, or—when we shouldn’t act—relax and trust. Each chapter presents a path to a different kind of freedom—freedom from fear, freedom to start over, to love, to be yourself, and to be happy—and guides you into an active process that engages your mind and heart, awakens your spirit, and brings real joy, over and over again.


    When Things Fall Apart: Heart Advice for Difficult Times
    by Pema Chödrön
    Drawn from traditional Buddhist wisdom, this book offers radical and compassionate advice for what to do when things fall apart
    by going against the grain of our usual habits and expectations.
    The self-described “example of ordinary neurosis,” the beloved American Buddhist nun offers practical and achievable practices.


    Self Help: This Is Your Chance to Change Your Life
    by Gabrielle Bernstein,Foreword byRichard C. Schwartz
    Bernstein demystifies the power of Internal Family Systems (IFS) Therapy, bringing its life-changing teachings into everyday life.
    Discover how extreme patterns like addiction, rage, pleasing, or constant self-judgment often develop as ways to suppress old feelings of inadequacy, shame, or fear. Once these patterns
    are brought into the light and cared for, healing happens swiftly.
    An enjoyable read and excellent companion book for those in IFS therapy.

    Podcasts

    Tara Brach
    Tara Brach, Ph.D is an internationally known meditation teacher and author of bestselling books Radical Acceptance, True Refuge
    and Radical Compassion. Tara shares a weekly guided meditation and talk that address the value of mindfulness meditation and self-compassion in relieving emotional suffering, serving spiritual awakening and bringing healing to our world.


    Being Well
    Conversations focus on the key insights from psychology, science, and contemplative practice that you need to build reliable inner strengths, overcome your challenges, and get the most out of life. A world-class group of experts explore the practical science of lasting well-being.

    You Are Not Broken
    Empowering women (and the partners who love them) to live their best lives. Combining the power of mind-work, body science, and relationships, Kelly Casperson, MD, “joyously breaks down the societal barriers that are keeping us from living our best intimate lives. Whether you are young or past menopause, single or in a long-term relationship, it is never too late or too early to realize YOU ARE NOT BROKEN.”

  • Put it down and go outside

    Put it down and go outside

    If you are like me and many other people and have a neurodivergent person in your life, you know the joys and challenges in this relationship. My personal and professional curiosity recently led me to a webinar on non-medication interventions for ADHD. 

    The webinar was aimed at neurodivergent folks, people who love them, and clinicians working with them. The presenter was David Nowell, PhD, who provided loads of helpful information.

    In the process, I became more aware of the disruptive influence of always having our phones nearby. I turned off notifications for many apps on my phone. I can always check, but I don’t have to be continually interrupted throughout the day. I feel a sense of peace that I didn’t realize I was missing. I hope this is helpful to you, too.

    Check out these tips for improving self-regulation by reducing screen time that can be useful for neurotypical and neurodivergent folks alike:

    1. Limit the amount of screen time and schedule social media use.
    2. Seek out “Green Time” by being outside. This is not the same as exercise.
    3. Notice when you reach for your device.
    4. Remove apps from your device that you don’t need. Go to the website instead.
    5. Move icons off your home page. One extra swipe can offer the opportunity to refrain.
    6. Turn off notifications on all but critical apps
    7. Consider a technology fast, which can change habitual use. 

    Thanks for reading,

    Leilani

  • The End of Caregiving

    The End of Caregiving

    A study of dementia caregivers revealed that those who were prepared for the death of their person with dementia (PWD) had better bereavement outcomes than those who were not. The study identified several themes that contributed to poor grief outcomes, such as the perception of the dying process as traumatic or unexpected; traumatic loss of the caregiver role and accompanying loneliness; and perceived unavailability of support, either pre- or post-loss (Supiano et al., 2022).

    While the majority of bereaved dementia family caregivers emerge after loss through largely positive and adaptive grief processes and resume previous levels of function after the death of their PWD, an estimated 9-25% experience complicated grief (CG), which increases with age and is associated with worse biopsychosocial outcomes for the griever (Supiano et al., 2022). CG is “characterized by yearning for the deceased, intrusive thoughts of the person who died, unrelenting sorrow, withdrawal from previous social relationships, difficulty accepting the death, and a sense that life is without purpose” (Supiano et al., 2022, p. 369). 

    Caregivers of PWD face increased poor outcomes because their care recipients are more likely to experience distressing events that may lead to poorer quality of life, earlier institutionalization, more hospitalizations, and risk of elder abuse (Young et al., 2023).

    Non-White caregivers tend to provide care for a longer duration, requiring more time-intensive care, engaging fewer formal support services than their White contemporaries. Non-White caregivers are more likely to face negatively biased interactions with health care services on behalf of their care recipients (Young et al., 2023)

    What can caregivers do to prepare?

    A combination of family and community support can ease caregivers’ transition to life after the passing of their loved one. Spiritual and religious communities offer fellowship and understanding from those who have walked this path before.

    Hospice care provides support for caregivers and family/friends of the terminally ill. Many people wait longer than they have to before requesting these wonderful services. According to Barbara Karnes, RN and end-of-life educator, “Hospice helps these patients live as comfortably as possible with the understanding that they won’t be cured. Hospice also provides reassurance and practical assistance to families of the patients.” Karnes’ blog offers practical and warm end-of-life education.

    Thanks for reading,
    Leilani

    References:

    Supiano, K. P., Luptak, M., Andersen, T., Beynon, C., Iacob, E., & Wong, B. (2022). If we knew then what we know now: The preparedness experience of pre-loss and post-loss dementia caregivers. Death Studies, 46(2), 369–380. https://doi-org.library.capella.edu/10.1080/07481187.2020.1731014

    Young, K. M., Young, T. D., & Young, K. (2023). Caring for the caregiver in dementia. The Journal of Family Practice, 72(5), 215–219. https://doi.org/10.12788/jfp.0606

  • Mother’s Day Thoughts

    Mother’s Day Thoughts

    To all mothers and mothers in spirit, thank you for the love you’ve given and the efforts you’ve made for those you love.

    This day can be difficult for those of us who have lost mothers and children. Loss comes in many forms, including death, at different times in our lives.

    I recently started writing letters to some people who have passed, or are no longer in touch. It is a way to address any ambivalence or regrets and eventually release those feelings and thoughts. It can be an opportunity to seek a new inner relationship with a loved one, which helps us find renewal in our relationships with others and the outer world.

    My favorite grief site, What’s Your Grief, offers support and reflection for those who are feeling loss today.

    Thanks for reading,
    Leilani

  • Positive self-talk

    Positive self-talk

    Our ability to survive and thrive while providing care is largely dependent upon self-care. Diet, exercise, and sleep all contribute to wellness. However, including this in our caregiving lives is often tricky.

    A critical component of self-care is more easily attained: positive self-talk. Self-criticism can lead to feelings of inadequacy and demotivation. Learn more about the impact of self-talk and ways to use its power for greater wellbeing and caregiving efficacy: https://familycaregiversonline.net/the-power-of-positive-self-talk-a-guide-for-family-caregivers/

    Thanks for reading,
    Leilani

     

  • The Invisible Contributions of Informal Caregivers

    The Invisible Contributions of Informal Caregivers

    Informal caregivers are family members and friends who give their time, money, and love to someone with a chronic health condition. They often sacrifice their health, financial stability, and quality of life. The majority are working full-time. Despite these challenges, informal caregivers are crucial in our healthcare system. As of 2021, 38 million Americans are informal caregivers, providing over $600 billion in estimated economic value. Unpaid carers in England and Wales contribute a staggering £445 million to the economy every day – that’s £162 billion annually.

    Women contribute to 71% of the global hours of informal care.

    In addition to their economic contributions, informal caregivers provide essential emotional and social support to their loved ones. They help to alleviate feelings of isolation and loneliness and give a sense of companionship and connection.

    State and Federal initiatives to support unpaid caregivers are growing. The RAISE Family Caregivers Act, signed into law in 2018, requires developing a national strategy to support unpaid caregivers. The plan will include recommendations for improving caregiver training and support, promoting caregiver health and well-being, and increasing access to respite care.
    Reference: National Alliance for Caregiving. (2018). RAISE Family Caregivers Act signed into law. https://www.caregiving.org/raise-family-caregivers-act-signed-law/

    Several state initiatives to support unpaid caregivers in the US address diversity and inclusion, recognizing that caregiving can impact people from diverse backgrounds differently. New York State’s Caregiver Support Initiative focuses explicitly on supporting caregivers from diverse communities, including LGBTQIA+ caregivers and caregivers from racial and ethnic minority groups. The program provides support services and resources that are culturally and linguistically appropriate and are designed to meet the unique needs of diverse caregivers. California’s Caregiver Resource Centers provide services and resources to a diverse population of caregivers, including those from underserved communities, such as low-income families, immigrants, and rural communities. The program focuses on providing culturally and linguistically appropriate services and resources. Minnesota’s Live Well at Home grant program focuses on supporting caregivers from diverse communities. The program provides funding for community-based organizations to develop and implement caregiver support services that are culturally and linguistically appropriate.

    Thanks for reading,
    Leilani

  • Great Care Begins with Self Care

    Great Care Begins with Self Care

    Caring for family members presents many opportunities to serve, to love, and to grow from the difficulties inherent in the process. Dealing with difficult family members, especially when a legacy of trauma is present, can be one of the greatest challenges of our lives. Learning to give ourselves the love and kindness we don’t hesitate to give others is critical. This is a helpful article on the subject of difficult parent care from WebMd.