Exploring Shame in Caregiving: A Reflection from a Therapist and Parent

As a psychotherapist working with families impacted by special needs, I often encounter a recurring and deeply complex theme: shame. Time and time again, caregivers share feelings of inadequacy—struggling with thoughts of not being “good enough,” grappling with impatience, wrestling with resentment, and longing for time to focus on themselves.

As a caregiver to a special needs child myself, I understand these emotions intimately. Yet, they continue to surprise me. Not because I don’t empathize—believe me, I do—but because I know just how monumental the caregiving role is. Being a lifelong caregiver requires an extraordinary level of perseverance, patience, and selflessness. It demands that you put another’s needs first, often at the expense of your own. Knowing the depth of this responsibility, it’s heart-wrenching to see so many caregivers burdened by shame.

This led me to reflect deeply on the word shame. Brené Brown, a leading voice on the subject, defines shame as “an intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.” While I haven’t always been a devoted reader of Brown’s work, I recently revisited her research, and it gave me new insight into the emotions so many caregivers experience.

Brown’s distinction between shame and guilt is particularly important here. Guilt, she explains, is feeling bad about something we’ve done, while shame is feeling bad about who we are. For caregivers of children with special needs, this combination of guilt and shame becomes an incredibly heavy burden. Guilt arises from what they feel they didn’t do, while shame stems from feeling unworthy for not doing more. Together, these emotions create a dangerous path that can lead to depression and burnout. The constant weight of these feelings is overwhelming and unsustainable, making it crucial for caregivers to find ways to acknowledge and address them before they take an even greater toll.

For caregivers, the emotional landscape is extraordinarily complicated. On the one hand, we’re parents—expected to love our children unconditionally, care for them, and meet their needs. On the other hand, caregiving for a child with special needs often involves sacrifices that others may never fully understand. There are moments of joy and connection, of course, but also moments of exhaustion, frustration, and grief.

I had a client recently who embodied this so clearly. She came into our session tearful and distraught, telling me how she felt like she had no patience left for her child. She described how drained and exhausted she was and how this led her to be short and harsh with her children, which only compounded her guilt and shame.

But as we talked, she opened up about all the things she was doing to support her child. She described the plan she and her child’s behaviorist created—a detailed chart that outlined each day to help her child manage transitions. She explained how she stayed up late every night to prepare the next day’s plan and how she made social stories to guide her child through new situations.

Hearing this, I couldn’t help but reflect it all back to her. “Do you see how much you’re doing? How much patience, energy, and love it takes to do all this? Of course, you’re exhausted. Of course, you’re overwhelmed.”

She paused and nodded, almost as if hearing it said aloud allowed her to really see it for the first time. And this is the thing—so many caregivers lose sight of how much they’re truly doing. These tasks, which are nothing short of extraordinary, have become part of their routine. They stop noticing how draining and consuming it all is because they’ve been doing it for so long.

If you are a caregiver to a child with special needs, try speaking to yourself with kindness, compassion, and empathy. Remember, it takes an extraordinary amount of love, dedication, and strength to show up every single day, to keep trying, and to advocate tirelessly for your child. Instead of focusing on what you feel you didn’t do well or could have done better, shift your attention to your grit, determination, and resilience.

If there’s one thing I hope you take away from reading this, it’s this: every single day, you do more than enough. And on the days it doesn’t feel like that, know that tomorrow is another chance to show up, try again, and do things just a little differently.