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This article discusses therapists of caregivers who minister to those with neurocognitive disorders. A series of portraits are presented, and patients and therapists come alive in vignettes. Most of the issues discussed in this article are not specific to patients with neurocognitive disorders. The defensive reactions of therapists of caretakers, for example, may be found among those who treat caretakers of patients with other types of illnesses. Dr. Ingram comments “the adversities encountered by the caregiver of the ill spouse may tax the therapist's empathic capacity.” Therapists' empathic capacity toward caretakers of cancer or stroke patients for example, or those with a variety of terminal or chronic debilitating illnesses may be strained in a similar manner.
This lack of specificity indicates that the insights provided here actually have wider relevance than the author suggests. Particularly helpful is the discussion of value conflicts between therapists and caretakers around such issues as truthful communication between those in a committed relationship when one is ill and the complex issues pertaining to sexual fidelity.
The clinical practice of this editor includes a man who cared for his wife through a fatal illness and a man who developed a dementing illness after he had begun intensive psychotherapy and is currently being cared for by a devoted wife. Another man lives at home with his wife who has 24-hour nursing care because of a progressive dementing illness. He cares for her as well and supervises the nurses. Given the prevalence of serious illness in the general population, many clinicians have similar patients in their practices.
Portraits of therapists who treat caretakers of patients like these provide a library of clinical experience sure to be useful to psychotherapists.