Walking Beside the Carer: How Therapists Can Alleviate the Hidden Grief
With thanks to our member, Jurgen Schwarz, for this article.
Family carers often do some of the most meaningful yet demanding work anyone can face. They look after partners, parents, or other relatives who live with dementia, chronic illness or disability. On the surface, their role may appear practical: cooking meals, organising medication, arranging appointments and keeping the household running. But underneath these daily tasks lies something much deeper and harder to describe. It is the emotional labour that forms the true weight of caring, and it is this hidden burden that therapists can help to carry.
Caring does not simply mean “helping someone”. It often means watching the person you love slowly change. This is particularly true when looking after people with dementia but also applies to people living with other illnesses. For many carers, this brings a quiet, persistent grief. They grieve the loss of the relationship as it once was, even while the person is still alive. This form of grief has no clear ending and no socially recognised rituals. There is no funeral gathering, no moment when people say “I’m sorry for your loss”. Instead, carers often feel that they must carry on, coping as best they can, while holding inside a mix of sadness, exhaustion, worry and sometimes guilt.
The emotional labour of caring is constant. Carers must remain patient, even when they feel frustrated. They must remain strong, even when they feel like breaking down. They often put their own needs aside because there is simply no time or energy left. They may feel responsible for maintaining stability in the entire family, smoothing conflicts or explaining the illness to others. The carer becomes not only a helper but also a protector, mediator, organiser and sometimes even a shield from painful truths. This emotional juggling act drains their inner resources far more than most people realise.
The challenge is that this labour happens quietly and often invisibly. Many carers say, “I knew it would be hard, but I didn’t expect the loneliness”. They miss the person they once knew: the partner who used to share decisions, the parent who once offered guidance, the sibling who once laughed with them. When personality changes, memory loss, or confusion appear, carers find themselves living with a version of their loved one that feels both familiar and unfamiliar. They may feel guilty for grieving this difference, or for feeling angry or resentful at times. Therapy can offer a safe place to explore these feelings honestly.
In many families and cultures, women are often expected to be the ones who care for others. From a young age, girls are taught to be kind, helpful, and responsible, while boys are given more freedom. Films, books, religion, and family traditions often show women as the natural carers. When parents grow old, a partner becomes ill or children need extra support, it is usually the woman who steps in. This is particularly reflected in the number of carers who look after people with dementia. Over time, this can feel less like a choice and more like a duty. Giving so much without rest, thanks or support can leave women feeling tired, unseen and even resentful, even when they still love the people they care for.
A therapist’s role is not to fix the situation or provide medical answers. Instead, the therapist walks beside the carer, offering presence, clarity and understanding. This companionship can be a lifeline. In therapy, carers have permission to speak the truth about their experience, something many feel they cannot do with family or friends. They can express fear, sadness, anger or hopelessness without being judged. This emotional honesty helps prevent the heavy internal pressure that builds when feelings are pushed aside.
Therapists can also help carers recognise that the emotions they feel are not signs of failure. Many carers believe they must “cope better” or “be strong all the time”. Over time, this belief becomes a source of shame when they inevitably feel overwhelmed. Therapy helps them understand that exhaustion, frustration and grief are natural responses to an impossible situation. Naming these feelings brings relief. Instead of believing they are “not good enough,” carers begin to see that they are simply human.
Another important part of therapy is helping carers balance their role with their own identity. Many become so absorbed in caring that they lose sight of their own needs, goals, friendships or health. A therapist can help the carer re-discover small pockets of time and space that belong only to them. This might be as simple as encouraging a brief daily walk, reconnecting with a hobby, or finding support groups that share similar experiences. These moments of self-care do not reduce their commitment. Instead, they strengthen their ability to continue.
Relationships also change under the strain of caring. Partners may feel more like nurse and patient than a couple. Children may feel ignored or confused. Siblings can disagree about responsibilities or decisions. Therapy can offer a space to explore these relationship pressures. When carers understand their emotional reactions better, they can communicate more calmly with others and set boundaries without guilt. Even small improvements in communication can ease tension within the family.
Therapists can also help carers prepare for the future. This does not mean predicting what will happen but supporting them emotionally as they face difficult decisions. Whether it concerns residential care, medical interventions or changes at home, these decisions often bring guilt, doubt and fear. A therapist can help the carer explore their values, reflect on the realistic limits of human endurance, and find clarity in complex situations. Feeling supported in these moments reduces emotional strain and helps prevent long-term regret.
Importantly, therapy validates the carer’s grief. This is grief that renews itself in waves: the grief of watching abilities fade, of losing shared conversations, of watching a partner forget names or get confused. Therapists can help the carer understand that this grief is real and justified. When grief is acknowledged rather than hidden, it becomes easier to bear. Carers can also learn ways to hold onto meaningful moments and preserve their connection with the person they care for, even as the relationship changes.
At its heart, therapy offers companionship on a difficult path. Carers do not need someone to “take over” their duties or offer unrealistic positivity. They need someone who listens, who holds their story without judgement, and who helps them stay emotionally grounded. When a therapist walks beside the carer, the burden feels lighter, not because the tasks disappear but because the carer no longer feels alone.
Family caring is an act of deep love, but it is also an emotional marathon. Therapists can provide the support, understanding and emotional tools that help carers survive, and even grow through this journey. By recognising the hidden grief and emotional labour involved, therapy becomes not a luxury but a crucial source of relief and resilience for those who give so much of themselves every day.
