Most caregivers do not enter their roles reluctantly. They care deeply. They show up day after day because someone they love needs them. Whether you are caring for a child with special needs, an ill spouse, an aging parent, or another family member, your caregiving likely stems from love, loyalty, and commitment.

Yet even the most devoted caregivers can reach a point where caring begins to feel different.

You may notice that you are more irritable than usual. Small frustrations feel bigger. Your patience is shorter. You find yourself withdrawing from people or feeling emotionally numb. Sometimes caregivers become troubled by a thought they never expected to have:

“I just want a break.”

Or even:

“I don’t know how much more of this I can do.”

When this happens, it does not mean you are a bad caregiver. It may be a sign of compassion fatigue.

More Than Burnout

Compassion fatigue is often confused with burnout, but the two experiences are not quite the same.

Burnout usually develops from chronic stress, excessive demands, lack of resources, or feeling overwhelmed by responsibilities. A burned-out person may feel exhausted, frustrated, or ineffective.

Compassion fatigue is more personal. It develops through prolonged exposure to another person’s suffering. It is rooted in the emotional connection between caregiver and care recipient.

People experiencing burnout often think, “I can’t keep up with all of this.”

People experiencing compassion fatigue often think, “I have nothing left to give.”

The difference matters because compassion fatigue strikes at a person’s sense of empathy and connection. It can leave caregivers feeling guilty, confused, and ashamed precisely because they care so much.

A Common Scenario

A mother has been caring for her adult son with developmental disabilities for years. She has coordinated appointments, managed paperwork, supervised daily activities, and encouraged him to develop independent living skills. She loves him deeply.

Yet lately, she finds herself snapping at him over small things. She feels emotionally drained. She feels guilty whenever she takes time for herself. At night, she lies awake worrying about what will happen when she is no longer able to care for him.

What she is experiencing is not a lack of love.

In many cases, it is the accumulation of years of caring without enough opportunity to rest, grieve, process, or replenish herself.

Signs of Compassion Fatigue

Compassion fatigue can show up as:

• Physical and emotional exhaustion
• Sleep disturbance
• Headaches or digestive problems
• Irritability and impatience
• Numbness or detachment
• Anxiety or sadness
• Intrusive thoughts and excessive worry
• Feeling trapped, hopeless, or resentful
• Withdrawing from friends, family, or enjoyable activities

Many caregivers are surprised by these reactions. They may judge themselves harshly or wonder why they no longer feel like themselves.

Often, the problem is not a lack of commitment. It is a lack of replenishment.

Caring for the Caregiver

One of the greatest challenges for caregivers is recognizing that their own well-being matters.

Many people believe they must put themselves last. Over time, however, chronic self-neglect can undermine the very compassion they are trying to provide.

Protective factors can include:

• Maintaining supportive friendships and social connections
• Establishing realistic boundaries
• Taking regular breaks when possible
• Prioritizing sleep, nutrition, and exercise
• Engaging in spiritual or mindfulness practices
• Participating in caregiver support groups
• Seeking therapy or counseling

Just as importantly, caregivers benefit from having places where they can speak honestly about their frustrations, fears, grief, and exhaustion without being judged.

Extending Compassion to Yourself

Compassion fatigue is not a character flaw. It is a human response to prolonged exposure to another person’s suffering.

If you recognize yourself in these descriptions, consider offering yourself the same understanding you would offer a loved one. Caring for others requires energy, patience, and emotional presence. You need the same.

Seeking support is not a sign of weakness. It is often one of the most caring things you can do—for yourself and for the people who depend on you.

As the physician and author Dr. Naomi Rachel Remen observed:

“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.”

Posted by Heidi Cohen LCSW-C 

Heidi is a therapist at Jonah Green and Associates, LLC, which provides therapy for children, teens, families, and adults in North Bethesda, Maryland, for clients in Chevy Chase, Montgomery County, Washington, DC, and the surrounding areas.

The post Tending to Compassion Fatigue: Caring for the Caregiver appeared first on Jonah Green and Associates.

They were thoughtful, committed, and trying.

“We love each other,” one partner said. “But it just feels… tense.”

“I feel like I’m always getting it wrong,” the other partner added. “With the kids, with you—everything.”

These are familiar moments in stepfamily therapy. There is love, effort, and goodwill, mixed with confusion and hurt. Therapy can offer a way forward that can clarify the steps people can take towards creating a family that feels more secure.

A Different Kind of Family

Stepfamilies can bring love, support, and meaning into people’s lives—often after periods of loss or transition.

They also come with built-in complexity.

They are not simply first families with new members added in. There are often strong preexisting bonds, and losses from divorce or bereavement. Children may move between homes. Nearly always, there are questions about roles and belonging.

When tension arises, many families ask, “What are we doing wrong?” or begin to focus on one person as the source of the problem.

More often, people are encountering the natural complexity of stepfamily life.

Widening the Lens

In many stepfamilies, strain shows up in one place at first:

A child may grow distant.
A stepparent might feel shut out or undermined.
A parent feels caught in the middle.
A couple begins arguing about parenting or finances.

People naturally locate the problem in one person or the relationship experiencing trouble.

Stepfamily therapy helps shift that perspective. The therapist helps the family ask:

“What is happening here that is making things hard for everyone?”

This shift creates room for a different kind of understanding.

The child is not simply “difficult.”
The stepparent is not simply “too much.”
The parent is not “failing” at effective discipline.

Rather, each person is responding to the arrival of new relationships and a changing family structure.

How Therapy Can Help

Insider–Outsider Experiences

Stepfamily members often experience the pain of feeling on the “outside.” A parent and child may share years of history, rhythms, and familiarity. As a stepparent enters the family, they may feel peripheral. At other times, a child may feel outside as the couple’s bond strengthens.

Feeling a lack of belonging can show up in small, everyday moments—hesitating before speaking, not knowing where to sit, or being unsure whether it is your place to step in.

Therapy helps name these experiences and understand them as part of the structure rather than a personal failing. That shift often makes it easier for people to be more patient and more understanding with one another.

Clarifying Roles

Questions about roles are common in stepfamilies.

How should a stepparent interact with their stepchildren?
How much should the child be expected to follow the stepparent’s instructions?
How close should stepsiblings be?

When these questions remain unspoken, people tend to fill in the gaps on their own—sometimes stepping back too far, and sometimes stepping in too quickly.

Through conversation and reflection, families begin to define roles in ways that fit their particular situation, helping individuals feel more confident and less uncertain. They can also focus on slowly developing bonds, and as they do so, the possibilities for roles expand.

Loyalty Binds 

Many of the most powerful dynamics in stepfamilies happen under the surface.

Children may feel caught between parents and stepparents.
Parents may feel pulled between their child and their partner.
Other households—ex-partners or extended family—may continue to influence the emotional climate. Therapy helps bring these loyalty triangles into the open, making them easier to work with and reducing hidden tensions.

These dynamics shape what people say, what they avoid, and where tension shows up.

Therapy helps bring these patterns into the open and makes them easier to work with.

How Therapy Proceeds

Effective stepfamily therapy usually moves deliberately. The pacing might include:

• starting with the couple to clarify their understanding and goals
• meeting with a parent and child to better understand their experience
• strengthening key relationships before bringing everyone together

This kind of progression helps create a sense of safety.

From there, families can begin to build a more respectful and workable way of being together. Warmth and closeness often develop gradually, rather than all at once.

At the same time, therapy helps families avoid some common pitfalls, such as:

• expecting immediate bonding
• pushing stepparents into discipline too early
• minimizing children’s mixed feelings
• overcorrecting out of guilt
• losing focus on the couple relationship
• forcing closeness that has not yet developed

Instead, the focus shifts to what fits this particular family.

Building Belonging

Belonging in a stepfamily usually develops over time.

It grows through small, repeated experiences—feeling taken seriously, feeling respected, and sensing that there is room for you in the family, which can inspire hope that belonging is achievable over time.

Children often need reassurance of their parents’ continued commitment, along with the freedom to develop a relationship with a stepparent at their own pace.

Stepparents need space to connect without feeling pressure to prove themselves too quickly.

Parents need support in holding both their child and their partner in mind at the same time.

As these pieces begin to fall into place, families often notice subtle shifts. Conversations feel a little easier. Roles feel clearer. People feel less on the outside.

A Different Kind of Hope

Stepfamily therapy is not about making a family look like a first family.

It’s about helping people understand the family they are actually in—and finding a way to live in it together more comfortably.

Over time,  meaningful change can occur: conversations become easier, expectations become clearer, and relationships feel a little steadier. A sense of belonging begins to take hold—not all at once, and not perfectly, but in a way that feels more settled and more real.

-Posted by Jonah Green

Jonah Green, a therapist at Jonah Green and Associates, LLC, offers therapy services for children, teens, families, and adults in North Bethesda, Maryland, serving clients in Montgomery County, DC, and the surrounding areas.

Related posts:

Freely Chosen Love: The Unique Potential of Stepparent–Stepchild Relationships

Step-by-Step for Stepfamily Success

Keys to Stepfamily Success

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Many parents and adult children find that their once-close relationships can become distant or even severed—sometimes gradually, and sometimes after a crisis. As the rock band ABBA poignantly sang, as our children grow, our bonds with them can sometimes feel as if they are “slipping through our fingers.” As a therapist, I’ve witnessed the profound healing that can occur when adult children and their parents come together through family therapy to begin a process of repair and recapture what is slipping away.

Legacy Work: Old Wounds Still Speaking

In a study by Kate Cordukes and colleagues (2024), therapists shared what they’ve learned from years of working with adult families. One phrase came up again and again: legacy work. These are the unacknowledged wounds and unresolved ruptures that continue to shape the relationship.

The road to acknowledging wounds in therapy usually begins with addressing present issues. One therapist in the study described an adult child feeling overwhelmed by getting 30 texts a day from her father, who had a history of chaotic behavior. In therapy, they started with those texts. With support, the daughter discussed openly what felt connected or intrusive. As the intensity of the father’s communication lessened, space opened for the daughter to describe times she had felt overwhelmed as a child.

Legacy work can give voice to grief for what didn’t happen or for what people endured. As one therapist put it:

“Adult children often present with challenges they had to manage as children. When parents see and hear them now, although they may not have then, it can be profoundly healing.”

Redefining Care: Who Takes Care of Whom?

One of the most painful dynamics in many families is parentification, when children assume caregiving before they are ready. Their roles may have helped the family to function, but left the child with unmet needs. Adult children often enter therapy wanting to renegotiate these roles: to stop feeling responsible for managing a parent’s emotions.

At the same time, aging parents face their own losses—of identity, health, or control. They may feel guilt over their past parenting or feel uncertain about how to maintain their connection. Parents may welcome their child’s independence even as they grieve the loss of their former role.

New definitions of care can emerge. Not the hierarchy of parent and child, but a mutual connection—where each person recognizes the other’s needs and limits. Therapists may ask: “If your relationships were repaired, what level of closeness would you want—and what might that look like?”

Space for Exoneration

The therapists in the Cordukes study note that understanding the context of the past can soften judgment and support healing, without excusing harm.

One mother had been violent during her children’s upbringing. In adulthood, one of her daughters refused to see her. In therapy, the children learned about their mother’s history: an authoritarian father, years of solo parenting, and trauma. The mutual understanding fostered in therapy created space for exoneration —a recognition that their mother had been acting out of pain, not malice.

When this kind of understanding emerges, families can begin to level what therapists call the relational ledger: to share responsibility, name harm, and move towards feelings of fairness.

Shifts That Signify Repair

Through therapy, families may be able to laugh again, use softer tones, or simply sit in the same room and feel comfortable. It’s often less about complete reconciliation than “rueful regret“—an ability to say, “I wish things had been different. I understand why they weren’t.”

Repair means embracing small shifts:

• Less walking on eggshells.
• More eye contact.
• A shared joke where silence once was.                                                                                                                                         

As the researchers in the study described:

“The repairs work in the service of preventing further damage, or even a fatal blow to family connection. They redefine the purpose of being a family.”

Holding On and Letting Go

That ABBA song echoes in so many parents’ hearts:

What happened to the extraordinary adventures
The places I had planned for us to go?
Slipping through my fingers all the time…

For adult children, the lyrics may cut differently:
“Do they see me? Have they ever really known me?”

In that moment of seeing and being seen, the love that once felt as though it was slipping through their fingers becomes something they can finally hold onto.

-Posted by Jonah Green

Jonah Green, a therapist at Jonah Green and Associates, LLC, offers individual and family therapy, including parent-adult child counseling, in North Bethesda, Maryland, serving clients in Montgomery County, DC, and surrounding areas.

The post From Slipping Through to Holding On: Healing Through Therapy for Parents and Adult Children appeared first on Jonah Green and Associates.

The road is long / / But I’m strong / Strong enough to carry him/ He ain’t heavy, he’s my brother.
—The Hollies, 1969

When adult siblings enter therapy together, they carry not only active concerns, but also a shared past. Sometimes the past includes fierce competition, arguments, and traumas such as violence, illness, abuse, neglect, addiction, or divorce. Many also carry memories of playing together or supporting one another. 

In a world that emphasizes romantic partnerships and parent-child bonds, many of us overlook the potential for healing sibling relationships. Yet, these enduring relationships hold the potential for profound healing. 

Why Sibling Bonds Matter—Even in Adulthood

Psychologist Avidan Milevsky describes the unique protective nature of adult sibling relationships. These bonds can be a source of support during challenging moments, such as relationship problems, difficulties with children, illness, or job loss. This potential for supportive love can remain untapped, however, sometimes due to years of tension or emotional distance.

What Brings Siblings to Therapy

Siblings rarely come to therapy when things are going well. More often, something has cracked open—an illness, an estate dispute, a caregiving imbalance, or the death of a parent—and underneath it lies a tangle of old roles, unmet needs, and untold stories.

Karen Gail Lewis, in her book Sibling Therapy, writes: “Adult siblings enter therapy with childhood voices still echoing in their ears—voices that shaped how they see themselves and each other, often without realizing it.” She describes these memories as “ghosts”—frozen images, unspoken loyalties, old injustices—that quietly haunt them. 

Therapy offers a chance to name these ghosts and loosen their grip, both to heal each other and other relationships.

What Happens in Sibling Therapy

Therapy can help siblings navigate practical matters—such as caregiving or dividing assets—while also revisiting how each sibling experienced the family and identifying emotional patterns that have lingered. In the process, therapists may help siblings practice transparent and intentional communication. They may also explore how each sibling experienced the emotional impact of experiences such as traumatic events, friction between parents, illness, parental favoritism, or the unequal distribution of family responsibilities.

Therapy can help uncover unspoken rules governing sibling relationships, such as who leads, who displays competence, who apologizes, or who expresses vulnerability. As roles loosen, opportunities open for forgiveness and stronger bonds. The insight gained can also have a positive impact on other relationships.

Increased Connection and Empathy

Not every sibling relationship becomes closer through therapy. Sometimes, the goals may be limited to fostering respect and boundaries. However, in many cases, siblings start to look at each other with curiosity rather than old assumptions, and their relationships begin to transform. The moment one says, “I didn’t know you felt that way,” or “I see now what you were carrying,” increased connection and empathy ensue. 

“He ain’t heavy,” the song reminds us. “He’s my brother.” This verse captures the essence of sibling therapy, as loads lighten and opportunities open up to “carry” one another.

A Gentle Invitation

Sibling therapy is not about forcing closeness. It’s about offering space—where people linked by childhood and shaped by the adult world can reflect, speak, and perhaps remember each other with more tenderness.

Sometimes the most potent therapy doesn’t add something new. Sibling therapy can foster a long-term relationship, building understanding and connection, so that each individual can carry the other, with less heaviness and more care.

-Posted by Jonah Green

Jonah Green, a therapist at Jonah Green and Associates, LLC, offers therapy services for children, teens, families, and adults in North Bethesda, Maryland, serving clients in Montgomery County, DC, and the surrounding areas.

The post He Ain’t Heavy: How Therapy Helps Heal Adult Sibling Relationships appeared first on Jonah Green and Associates.

Sibling relationships are often our longest. While they can offer immeasurable support, they can be among the most hurtful when bonds rupture. In Brothers, Sisters, Strangers: Sibling Estrangement and the Road to Reconciliation, Chapman combines personal experience with interviews to guide those inhabiting this confusing and painful terrain.

Understanding the Roots of Estrangement

Estrangement often has roots in early events or old patterns—childhood trauma, parental favoritism, or long-term differences or misunderstandings. Differing expectations about contact or support, friction with siblings’ partners, triangulation with other family members, and battles over parental care or asset distribution can all precipitate ruptures during adulthood. Chapman’s insights invite people to look beneath conflicts and explore the emotional forces underlying divisions. Understanding these roots facilitates healing, with or without reconciliation.

Here are some helpful ideas from Chapman:

1. Self-Inquiry

Before reaching out, take time to reflect. What are you hoping for? What still hurts? Are you seeking reconciliation or closure? Chapman’s companion workbook, The Sibling Estrangement Journal, can clarify these questions. I sometimes encourage clients to write letters they won’t send to illuminate thoughts and feelings. 

2. Reconnection Isn’t Always the Goal

One of the most valuable messages in Brothers, Sisters, Strangers is that healing from estrangement does not always require reconnection. Sometimes, finding ways to manage the feelings that come with accepting estrangement offers the most realistic path. Chapman’s perspective encourages readers to explore the question: Can I live with the relationship as it is? This approach liberates you from the pressure of always aiming for reconnection. 

I would add that reconnection can sometimes happen at later stages, after conflict has simmered down, and acknowledging the sibling through nonintrusive communications like birthday cards can keep the possibility of reconciliation open.

3. If You Reach Out, Proceed with Gentleness

If you attempt reconnection, Chapman recommends avoiding past grievances in initial contacts. Expressions of care or curiosity are usually the best route. I sometimes encourage clients to share personal feelings without blame: “I’ve been thinking about you. I wonder if you’re open to talking.” This approach allows you to express feelings and desires without stimulating defensiveness. I may also strategize with clients on managing if siblings raise grievances and practice “acknowledging and redirecting.”

4. Maintain Dignity and Boundaries

Chapman advocates a “dignity model” for re-engagement: listening to understand, not to correct, and practicing active listening–reflecting and validating. She also emphasizes healthy boundaries that help you feel respected and safe. It’s okay to say, “I want connection but also respect.” This approach can help you feel respected and secure, and set clear boundaries and expectations for re-engagement.

I would add that demanding apologies is particularly treacherous. While a sibling’s acknowledgment of past misdeeds can feel liberating, it is best to allow for softening by acknowledging your role in the estrangement, making requests, providing validation, and actively listening. 

5. Build Connection—Even Without Your Sibling

If reconciliation is not possible, that doesn’t mean you have to live without close bonds. Chapman reminds us of the power of “chosen family”—friends, mentors, committed partners, and communities who help us feel valued. When clients mourn the loss of sibling relationships, I invite them to name other sources of support and explore what connections they wish to create.

Moving Forward with Compassion

Estrangement represents “ambiguous loss.” There is no funeral, but grief is real. Whether you seek reconciliation or peace of mind, Brothers, Sisters, Strangers offers thoughtful guidance. The book reminds us that whatever path we choose—reaching out, letting go, or holding both—we can maintain self-respect and compassion, and offer ourselves the care and acknowledgment we may never have received from our siblings.

-Posted by Jonah Green, the owner and director of Jonah Green and Associates, LLC, which provides therapy for children, teens, families, and adults in North Bethesda, Maryland, as well as for clients in Chevy Chase, Montgomery County, Washington, DC, and the surrounding areas.

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