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I know I keep doing this thing where I’m like “OH! One more point!” But. I have about three more points.
First:
I would be remiss not to revisit the Filial Piety debate
We touched, just briefly, at the end of episode four on the fact that those with strong filial piety don’t necessarily have differing frequency or severity of depression symptoms during caregiving than those who do not. That is, those who subscribe to the “live life to honor your parents and expect to care for them like they’re children when they age because it’s the correct thing to do,” may not personally have an easier time with fulfilling those expectations.
This was deduced via analyzing caregiving depression reports cross-culturally and finding that Eastern and Western results were not significantly different. So, clearly, belief that you’re becoming a better person by meeting your parents needs doesn’t make much of an improvement for us children, right?
According to some, right.
HOWEVER.
I would be a terrible researcher not to acknowledge… These findings are all over the board. SOME research supports that finding. SOME research contradicts it. And some research somehow does both.
I’ve been doing a ton of additional Filial Obligation research as I’m putting together a very heavily study-based course on the topic (holy shit, the dozens of papers I’ve poured through in the past few weeks) – and one thing that’s for certain is….
No one is certain about the connection between expected parental care and outcomes of giving that care. And that’s directly reported IN the research studies on the topic. It’s studied over and over again – the connection between filial piety and personal outcomes. Authors regularly mention that results between studies are discordant and they can’t seem to come to one solid conclusion…
BECAUSE
It’s such a personal, circumstance-affected, perceptual, discussion.
SO. Some folks are further depressed by their Filial Obligation seemingly BECAUSE the cultural belief in Filial Piety is so strong that it puts enormous pressure on them.
And some folks find this to be a fulfilling and grounding experience that actually builds their resilience OR EVEN keeps them from committing suicide due to the sense of purpose it gives them. (Yeah, there’s a paper on that)
The whole story is… “there’s not one story.”
It depends on how each person is interpreting the modern day events, their general stability in life, the degree of care that’s being demanded of them, and the relationship that they’re contributing energy towards.
And furthermore, realizing that the real debate is all about perception, we can say that…
That defines “burden.”
Filial Piety, Caregiving Appraisal, and Caregiving Burden
Daniel W. L. Lai1
Caregiver burden is defined as the stress, tension, and anxiety that caregivers feel and experience when they are faced with problems and challenges when caring for their care receiver (Chappell and Dujela 2008). Burden is a word used to describe feeling emotionally or physically heavy (Mendez-Luck et al. 2008). Caregiver burden could be both observable and perceived. Observable burden is related to the costs and tasks of providing care to the recipient. Perceived burden is the extent to which the caregiver is troubled or disturbed and the feelings that they experience while providing care (Gupta, Rowe, and Pillai 2009). The perception of burden affects the impact of that burden on the caregiver’s life (Van Den Wijngaart, Vernooij-Dassen, and Felling 2007).
The act of balancing the caregiver role within one’s lifestyle depends on many different factors that can lead to feelings of satisfaction or burden. Stress is often a key factor resulting in caregiving burden. In turn, stress has been associated with role conflict, which is related to caregivers having to simultaneously balance the roles of spouse, parent, breadwinner (i.e., employee or employer), and care provider for elderly relatives (Gupta and Pillai 2002). Role conflict is also seen when caregivers have less time for their children and family, possibly leading to potential psychological stress for the caregiver (Ho et al. 2003). Caring for an elderly family member also decreases the amount of self-care and relaxation time (Ho et al. 2003). These conflicts may have the consequences of decreased marital satisfaction, increased marital stress, physical feelings of exhaustion, and somatic responses such as disrupted sleep patterns (Gupta and Pillai 2002; Health Canada 2002).
Other stressors such as financial stress may occur in addition to role conflicts. Financial stresses may include purchasing equipment to assist with the mobility, medical bills, and home improvements for the health and safety of the elderly (Ho et al. 2003). Stress is increased if the care receivers are unable to care for themselves and have problems with incontinence, dressing, mobility, and especially cognition (Holroyd 2001). The caregiver stress-coping model, adapted from House (1974) and George (1980), actually encompasses much of the relationships between stressors and caregiving burden, as previously discussed. It reflects on conditioning variables in caregiving such as health, income, social support, social relationships, nature of prior familial relationships, personality factors, and coping strategies. The model relates these caregiver factors to conditions that can add stress and burden to the family. These include functional status and affective state of the care receiver, namely, the nature of a dependent’s disability, prognosis, and visibility.
Another thing that MIGHT matter?
Perception of burden is deeply connected to relational feelings – including ambivalence
Lemme throw another paper excerpt at you before we discuss.
Guilt in Adult Mother–Child Relationships: Connections to Intergenerational Ambivalence and Support
Matthijs Kalmijn, PhD
Almost two decades ago, the flourishing literature on intergenerational solidarity (Silverstein & Bengtson, 1997) was criticized for having an overly positive view of the relationships between older parents and their adult children in western societies (Luescher & Pillemer, 1998). The criticism was not so much that overt conflict between the generations was underestimated, but rather that “positive” parent– child relationships can comprise important negative elements. More specifically, Luescher and colleagues argued that many parents and adult children simultaneously have positive and negative feelings about each other and their relationship, a phenomenon coined intergenerational ambivalence (Luescher, 2002; Luescher & Pillemer, 1998).
Since the criticism appeared, there has been much theoretical development and empirical progress and the concept of ambivalence is now widely accepted (Connidis, 2015; Fingerman, Hay, & Birditt, 2004; Suitor, Gilligan, & Pillemer, 2011; Van Gaalen & Dykstra, 2006). In recent years, authors have proceeded to analyze the consequences of intergenerational ambivalence. One important hypothesis has been that the co-occurrence of positive and negative emotions has negative consequences for a person’s emotional well-being (Fingerman, Pitzer, Lefkowitz,
Birditt, & Mroczek, 2008; Kiecolt, Blieszner, & Savla, 2011; Lee & Szinovacz, 2016; Tighe, Birditt, & Antonucci, 2016). According to Fingerman and colleagues (2008),
“experiencing a mixture of emotions may be more detrimental than experiencing negative emotions alone, because individuals may adjust to a generally negative tone and no longer react strongly or they may avoid negative social partners” (p. 363). Empirically, there is some evidence that ambivalence negatively affects psychological well-being (Fingerman et al., 2008; Kiecolt et al., 2011), but this evidence is not conclusive, in part because of problems in the measurement of ambivalence and in part because of differences in the design of the analysis (Gilligan, Suitor, Feld, & Pillemer, 2015; Suitor et al., 2011). Nevertheless, the notion that ambivalence is not only interesting for its own sake but also relevant for its impact on individuals provides an important avenue for further research.
One other potential negative consequence of ambivalence lies in the concept of guilt. While the literature on intergenerational ambivalence sometimes mentions guilt, it generally sees it as an indicator of ambivalence rather than as a separate construct (Luescher & Pillemer, 1998).
Theoretically, however, the two concepts seem clearly distinct. Guilt can be defined as the negative feelings that arise from having done something that is – or is perceived to be – wrong (Baumeister, Stillwell, & Heatherton, 1994). Guilt is not the same as shame; guilt is the awareness that one has done something wrong, shame is the translation of that
feeling to one’s self-image, that is, the feeling of not being a good person (Tangney, Stuewig, & Mashek, 2007).
Guilt has been considered as one of the primary moral emotions that people have (Tangney et al., 2007) and is seen as an unpleasant feeling that may reduce individual well-being (O’Connor, Berry, & Weiss, 1999; Webb, Heisler, Call, Chickering, & Colburn, 2007). It has also been recognized that guilt is an emotion that often occurs in close relationships; in this context, guilt can be defined as the negative feeling that comes from the real or perceived harm that one has done to another person (Baumeister et al., 1994). Guilt is thus not only a moral but also a relational phenomenon.
A quantitative study of a local random probability sample in Germany (N = 275) examined the determinants of guilt and found that adult children experienced guilt more often if they had little contact with their parents, if they had authoritarian parents, and if their parents had mental health problems (Boll & Filipp, 2002). Finally, a recent analysis of a small and select sample of caregivers of dement family members in Spain (N = 212) found a positive and significant correlation between feelings of guilt toward parents and feelings of ambivalence (Losada et al., 2018).
One hypothesis is that imbalances in intergenerational support exchange lead to guilt. Children who receive more than other children (holding constant what they give), and children who give less than other children (holding constant what they receive), are expected to feel more guilty
(H3). This hypothesis is linked to the finding in previous research that people who receive more support in a personal relationship than they give, experience feelings of inequity
It was found that ambivalence—the co-occurrence of positive and negative emotions—tends to
increase feelings of guilt. Another important finding of this study is that feelings of guilt are linked to intergenerational exchange and to the norms children have about this exchange. The findings show that children who receive more support from their mother and who receive more money from their parents feel more guilty than children who receive less. This effect is adjusted for the amount of support that children give and therefore indirectly measures differences in the degree of balance or reciprocity in the relationship (direct measures of imbalance based on behavioral scales are difficult to construct). This finding is in line with other research showing
that a lack of reciprocity in personal relationships can lower well-being (Liang et al., 2001).
Finally, the norms that children have about support exchange are associated with guilt. Children who have stronger norms—as measured by filial obligations— tend to feel guilty more often and the effect of receiving support on guilt is stronger when children have stronger norms. These findings are in line with the notion that guilt has an important moral dimension (Tangney et al., 2007).
The guilt that arises from intergenerational ambivalence may be problematic for the parent–child relationship. In theories about guilt in interpersonal relationships, guilt is often seen as a factor that motivates positive behavioral change. For example, guilt that arises from not doing one’s fair share in household tasks may motivate spouses to contribute more (Baumeister et al., 1994; Felmlee & Sprecher, 2000). When guilt arises from negative emotions such as anger and irritation, both of which are measured in this study, it is less clear which behavioral changes a person could make. Guilt that stems from ambivalence may therefore be perceived as more awkward.
For example, adult children may visit their parents more often or offer more support when they feel guilty, but changing the way they feel about their parents is a different matter.
Children may begin to feel more positive or less ambivalent if they do change their behavior—for example, by visiting their parents more or helping more—but to the extent that these feelings do not result from the amount and type of support that is given to
the parents, it will be a more difficult problem to solve.
Feelings of guilt are clearly unpleasant and several studies found that guilt is positively related to depressive feelings and other measures of emotional well-being (O’Connor et al., 1999; Webb et al., 2007). Later studies argued that not guilt but only shame predicts depression
(Orth, Berking, & Burkhardt, 2006), but this does not rule out that guilt has indirect negative consequences on wellbeing via its effect on shame (Tangney et al., 2007). In so far as guilt reduces well-being, it may also be relevant in understanding the presumed effect of intergenerational ambivalence on well-being. People who have conflicting emotions about their parents or children may have lower emotional well-being in part because they feel guilty about
having these feelings (Losada et al., 2018).
So, we can say…
Caregiving burden is all about tension and anxiety.
It’s far less about definite measures. Caregiver Burden isn’t a definable load of tasks or concerns. THat’s why these papers are all based on self-reports.
Because caregiving burden – the strongest indicator of our personal outcomes in filial obligation – It’s all about feelings and perception. Those who don’t perceive their duties as being difficult or draining – practically or mentally – don’t suffer from the same ill effects.
And therefore, some people find protection in Filial Piety. Because what they’re doing is expected to have great payoff – for them, for their parents, and for their (sorry) souls. It gives them clear direction in life while increasing their sense of purpose. Therefore their perception isn’t about “the weight.” It’s about “the benefit.” They can center AROUND the filial care, as a directive of their existence, and garnish both resilience and self-esteem from engaging with it.
OTHERS don’t find the experience to be a self-esteem building experience because – well… differing cultures and expectations, sure.
But here’s where I toss my theory hat in the ring – we don’t gain a greater respect for self, for other, and for life from it because… well, it isn’t a life-integrating process. Generally, it requires us to assume new roles that contradict other roles. And, going deeper into the psyche, it’s even more significant that FIlial Caregiving (for most of us) isn’t a self-integrating process. ]
In fact, it turns our brains against themselves. Especially when we’re discussing the administration of guilt.
And from those two sentiments, I have to ask…
Do you think a lot of that ambivalence and internal strain we were just discussing is due to parts?
The mixed feelings towards our parents… that dangerous ambivalence… don’t you think there’s a good chance that’s related to segmented portions of our memories?
If our parts are fighting each other because we’re not sure how to navigate this situation based on our diverse recollections of this being, our prior instructional systems around dealing with them, and our predictions for the future… yeah, that’s going to create a ton of internal tension.
Some parts say “get closer” some say “stay away.” And we’re caught in the middle.
If we DON”T participate, we chide ourselves with guilt while making no behavioral changes, which is a self-destructive experience.
If we DO participate, it’s often DRIVEN by that ambivalence guilt… and we often end up chiding ourselves for the wasted effort and received pain.
Because we have to go against parts of our minds, we have parts that are keeping track of our efforts versus the outcomes, as they wrestle with the contradicting parts that overrode their better judgment. And therefore… with every effortful obstacle or perceived failure, we’re going to be far more aware of the BURDEN that’s on us and far more likely to harass ourselves for it.
Because our brain was never wholly stoked on the idea or certain that we could do it, now we’re paying great attention to the results of our work, and when positive outcomes are few and far between it becomes heavier and heavier on the psyche, which was always on the fence about it in the first place.
We’re disintegrated by the idea of the filial obligation experience, and even more internally at war as the work proceeds and our initial instincts are mayyyybe proven to be more correct than not over time, with repeat disappointment, frustration, and re-wounding.
Which makes us an enemy of us. WE did this to ourselves. WE knew better (in some parts) and WE forced this on ourselves, anyways. And now… we are stuck. Cue the defeat, entrapment, hopelessness spiral that can lead to suicidality.
Especially, if we’re lacking resilience factors like self-esteem to keep us afloat. And we WILL be if we’re in a disintegrated state.
PLUS.
The mention of ambivalent awkwardness earlier really got me thinking… how uncomfortable it truly IS when you try to sort out your ambivalence with another person. When we make an attempt to push the dynamic in a positive direction? It’s like a middle school moment, as two socialization programs simply don’t align and everyone walks away questioning their self. Kicking themself for how that interaction just panned out.
With new behaviors being so far out of the known repertoire, it creates a dissonate mismatch that truly is… awkward.
And I have to say, the very idea of Filial Obligation can be a bit uncomfortable.
Not everyone is used to accepting care or consciously accepting it from their children. They may have their own hard feelings about the idea. AND the changes that it signifies – being their own aging and mortality. So how stoked will they be to accept these new, caregiving behaviors, as we children try to work through our spotted memories of the parent? “Not very.”
Take a strained or distant relationship, suddenly make it vulnerably close out of physical necessity which is creating its own mental hangups, and see how weird that feels for everyone.
And then, when we override our own parts instincts, and try to take care of our parents / change our behaviors towards them… and their behavior doesn’t change? In fact, they might root down into their most oppositional parts, pushing AWAY the care that they desperately need out of self-protective and ego-supportive drives?
That IS ALSO awkward.
“Try to be nice,” we say. “And now, everyone is confused about what’s happening and somehow it’s more tense than before,” we find out.
So, the whole situation is highly uncomfortable and socially tenuous.
THEN we’re being told this continued ambivalence is possibly connected with increased feelings of guilt, on top of everything else?
I’m glad that the author mentioned how we can TRY to improve our relationships with better behavior on OUR part (or parts), BUT…. All the care in the world might not matter. The other party might not change things on THEIR part.
SO even if we attempt to change ourselves to settle these emotional mismatches within ourselves… sometimes nothing can change. Our guilt can’t be relieved, our parts are probably more pissed off than ever, and that sense of ambivalence might turn more negative than before.
This enhanced negativity towards the people we set out to help due to our guilt about what we owe them or the very existence of those ambivalent feelings themselves, in turn, might make us feel more guilty than before.
Like a vicious cycle that only increases how distant and down we feel. The harder we attempt to fix it, the worse it gets inter and intrapersonally, because the other party isn’t able to make alterations that positively reinforce the difficult changes we’re enacting. And meanwhile, our oppositional parts of our brains are beating US up for making the effort.
MEANING. Questioning what we know to be correct for ourselves based on our life circumstances and our relationship with this individual – confronting those mixed feelings of ambivalence that we feel guilty for holding, which might make us feel even worse for our attitudes towards Filial Obligation – and trying to “do what’s right” by “fixing our relationship as we deliver care”…
Might all backfire in the end for us in highly significant and regression-promoting manners, anyways.
We enter into a situation that we don’t wholly agree with, and in doing so dis-integrate our own internal system. Set our parts at war with each other. Create brutal note-keeping overseers from some of those naysaying parts, who carefully monitor our perceived “stupid” efforts versus “disappointing” results. Which is pretty much guaranteed to remind us of the non-reciprocity at work in our relationship – the imbalances that have always existed in the dynamic – which either make us feel more guilty or more resentful.
At the same time, we can see that often our present day efforts also don’t make a difference to the receiver of our care. In fact, THEIR feelings of ambivalence continue towards us, in part, BECAUSE of the care that we’re trying to deliver to them. It’s not the right type at the right time. Or they outright don’t know how to accept it positively.
As a result, we feel like fools, as we put in more than we ever get back. We realize we’re unable to change the relationship for the better or settle the mixed regard that exists between both parties. All our work isn’t going to produce the healing results we hoped for. Which, also, is straight up “awkward.” A problem our already shaken self-esteem doesn’t need to deal with.
Overall, the caregiving task is highlighted in our minds. We’re paying attention to it, because it feels so grinding in one way or another. Which increases the burden we feel. Which feeds back into increasing our depression, anxiety, and hopelessness. Which (of course) will start a new round of guilt, ambivalent feeling, and guilt about that ambivalent feeling (which might actually be starting to take a turn towards straight-negativity).
Cumulatively, this is the opposite of what some of our parts tried to convince us would happen, and EXACTLY what other parts of us KNEW would take place. Which sets those “wiser” parts on fire, and gives our brains MORE material for beating ourselves up and reducing our self-esteem. Which increases our perception of caregiving burden once again.
SO, I think the takeaway is..
Filial Obligation stress and resulting mental disruptions are all about perception.
Part of that perception that really matters? Yeah, our feelings towards the other party.
Those feelings of ambivalence MEAN SOMETHING. And, while we can improve our overall mental state by settling on either a completely positive assessment of the other party through relational reparations… uh… we can’t MAKE that happen. We can then find ourselves trapped in an uncontrollable situation in which we’re lacking internal resilience, at great risk while we battle with our own feelings of ambivalence, reciprocity outrage, and abandonment… towards ourselves.
And, uh, I don’t know… seemed worth mentioning. Let me know if this meant anything to you or got you thinking about ambivalent feelings. And I’ll see you in a few days.