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The Missing Piece of Managing Caregiver Stress

Nervous System Regulation (NSR) through practices such as breathing exercises and gentle yoga can have an impact on the caregiver as well as on the one they care for

By Staci Backauskas

I spent many years wondering why self-care wasn't enough to manage the stress of being a caregiver. It was only when I discovered Nervous System Regulation (NSR) that I began to understand that no matter how delightful self-care might feel at the time, no matter how much relief I experienced in the moment from talking to a friend or therapist, it wasn't enough for the relief to last.

A person working on nervous system regulation with breathing exercises. Next Avenue
Nervous System Regulation involves stimulating the vagus nerve, which lets the body and limbic brain know that you are, in fact, safe.   |  Credit: Getty

Part of the reason is because the stress from being a caregiver is constant. Rarely do two days look the same. It can require enormous emotional labor, include frequent feelings of guilt and present an ever-moving tightrope that spans supporting agency and trying to control everything. The list of stressors is endless.

"The nervous system is telling us all the time to pay attention."

This can make your nervous system feel unsafe, and self-care alone isn't enough to change it.

What Does It Mean to Feel Safe?

When most people think of not feeling safe, they envision a scary dog chasing them or a suspicious person standing near the ATM, but our bodies communicate about so many other situations that don't feel safe. This communication comes from the limbic brain, the part responsible for autonomic functions like breathing and heartbeat. Often referred to as the lizard brain, it also processes our emotions and determines whether or not we are safe.

The issue is that the frontal lobe, or the thinking part of our brain, often overrides the communication from the limbic side, which doesn't use language, but rather creates sensations in the body to send its messages.

If we look around and see things that are familiar, like relatives or situations we've been in multiple times, the rational side of us asserts that we must be safe even when the limbic brain says we're not.

"The nervous system is telling us all the time to pay attention," says Deb Dana, LCSW . "We have to have spaces that make us feel safe."

Stress can make us feel unsafe and there are signs that we have slipped into one of the four aspects of survival mode — fight, flight, freeze and fawn. Where we can get tripped up is believing that fight needs to include boxing gloves or that flight requires sneakers. The reality is there are so many subtle signs that we feel unsafe.

According to Dr. Stephen Porges, who created Polyvagal Theory, which lays the foundation for NSR and somatic healing practices, "The need to connect and feel safe with others is the core of what it means to be human." It can be challenging to feel connected to someone we take care of because the stress of the responsibility overshadows the connection. And that lack of connection can make us feel unsafe.

"We're an amazing species because we literally have self-healing capacities within us."

"We're an amazing species because we literally have self-healing capacities within us," Porges says. "And those self-healing capacities are neurally mediated through our sociality."

While developing connections through relationships and community are vital aspects of feeling safe, sometimes the caregiving role reduces our ability to participate in activities that provide that connection.

If Self-Care Alone Isn't Enough, What Do We Do?

First, we can recognize signs that we've slipped into survival mode – shutting down when we're home alone or with loved ones, scrolling mindlessly on social media/binge-watching Netflix, or not taking care of our own needs – and not judge it as a flaw. Second, we can establish an NSR practice.


Nervous System Regulation involves stimulating the vagus nerve, which lets the body and limbic brain know that you are, in fact, safe. The longest of the cranial nerves, it extends from the bottom of the skull to the base of the spine and is responsible for bodily functions like digestion, breathing and heartbeat. When it begins to shut down, which can happen from prolonged stress and being in survival mode, it not only impacts your ability to function, but the body's as well.

While there has been some pushback from the traditional scientific community, relegating NSR to the heap of social media trends, it has had a tremendous positive impact in my life, and the life of my 83-year-old mother, who has her own NSR practice. I credit it with strengthening our relationship and reducing the tension that arises in a caregiving dynamic.

"Any type of vagus nerve breath practice will drop you into your body."

How to Explore NSR

Dr. Cathleen King, who has worked with thousands of clients to mitigate chronic pain and stress, asserts that raising awareness of how you feel at any given moment is a great way to begin exploring NSR.

"Any type of vagus nerve breath practice will drop you into your body," she says. "It will help you realize that you're saying yes when you want to say no. Or that you're clenching inside."

She also encourages people to explore Porges' Polyvagal Theory. She admits the science can feel complicated and encourages people to use resources like Porges' new book "Our Polyvagal World: How Safety and Trauma Change Us" or her e-book, "How Healing Happens," a free guide that breaks the technical aspects into easier to understand language.

Because it's become such a popular topic, there are many on social media proclaiming to be NSR or somatic practitioners. To stay safe, King recommends digging into the backgrounds of people whose work piques your interest to make sure they have professional education and clinical experience.

"It's a journey you need to build upon and expand."

It's also important to understand that NSR is a journey, she advises. "Using the tools as a solution rather than as a means to reconnect with yourself is the equivalent of a holistic Xanax pill," she says. "It's a journey you need to build upon and expand."

I have found this to be true. In the beginning, I did neuro-drills like these when I was upset, resentful or angry. While this was helpful, within a year I realized a regular practice would offer me much more than a Band-Aid on an unstable feeling. I leveled up to a daily NSR practice, ten to fifteen minutes in the morning, and it's had an enormous positive impact.

Other methods of NSR include gentle yoga, Havening — soft self-touch, EFT Tapping — gently tapping on acupressure points accompanied by a script affirming your intentions, and many others. There are NSR techniques to fit everyone.

I know science requires double blind, peer reviewed studies to prove efficacy, and that hasn't happened with NSR. All I know is that when my mother and I both had a bad day recently, instead of taking it out on each other (which likely would have happened before we began our NSR practices), we became co-conspirators in creating joy.

We shared a delicious meal at our favorite restaurant, engaged in delightful conversation with those around us and enjoyed a malt to end our day. And that's enough proof for me.

Staci Backauskas
Staci Backauskas Staci Backauskas is a writer, and trauma-informed systems advocate who collaborates with like-minded people to facilitate healing and wellness. She is the author of seven books, including The 10-Minute Self-Care Journal: How To Level Up Your Self-Care Game In 10 Minutes A Day  and the novel Where Fat Girls Haven’t Gone. Staci has written articles, essays, and blogs for the Tampa Tribune, The City Paper, Medicinal Media, and many other print and online publications. Read More
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