Conversations about communication, caregiving, and changing the experience of serious illness.
Hosted by physician, educator, and speaker Dr. Delia Chiaramonte, The Integrative Palliative Podcast explores one central question:
How do we improve the experience of serious illness when we cannot change the illness itself?
Through thoughtful conversations, practical tools, and evidence-informed insights, each episode helps listeners navigate the challenges of serious illness with greater clarity, compassion, and confidence. Topics include communication, family caregiving, clinician wellbeing, decision making, whole-person care, and the emotional realities that accompany serious illness.
Whether you're a healthcare professional, a family caregiver, or simply someone walking beside a loved one through illness, you'll discover practical skills that can improve your confidence, reduce your stress, and help you find meaning even if the patient's illness can't be cured.
If you're a caregiver, visit www.DoctorDelia.com for information about programs, resources, and personalized support from Dr. Delia.
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We create much of our own suffering, and I suggest that we all cut that out! Life sends us enough stress and challenge - why would we add to our suffering for now good reason?
Expectations can add to our suffering.
Learning to modulate your expectations allows you to stay in the moment and enjoy your experiences, your people, and your moments.
Holidays are packed with expectations which can turn happy times into frustrating times - but it doesn't have to be that way.
Have a listen and share with a friend.
I appreciate you, Dr. Delia Delia Chiaramonte, MD www.integrativepalliative.com
Coping Courageously: A Heart-Centered Guide for Navigating a Loved One’s Illness Without Losing Yourself is available here: www.copingcourageously.com
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Welcome to the Integrative Palliative Podcast. If you care for the ill or aging, either at work or at home, this podcast is for you. You'll get plenty of tips for how to help care for the ill person and just as many tips on how to care for yourself. I'm glad you're here. Let's get started. Welcome to the Integrative Palliative Podcast. I'm Dr. Delia Caramonte, and it's around holiday season when I'm recording this podcast, 2024, and it got me thinking about one of the topics that I think are really most important for preserving our well-being, and that's the concept of expectations. So I'm calling today's episode the tyranny of expectations. So why are expectations tyrannical? Okay, look at this very silly simple example. Let's just imagine that I've been really frustrated that my house is messy. This is an accurate representation of what's probably going on right now. And I have a whole day off and I think, oh my goodness, thank goodness I have the time. I'm going to clean my whole house, the upstairs and the downstairs in the basement. I have a whole day. There's no reason I shouldn't be able to straighten up this house. And then I sleep a little later than I want to. I take a little longer sitting and having my coffee. I get distracted, going through old mail. I take the dog for a walk. Time passes, and I do get to the cleaning, but gosh, it's nighttime and I'm getting tired before I've done the whole house. I just did the main floor. That's it. So what might I think? I might say things to myself like, oh my gosh, I can't believe you wasted this whole day. You've been waiting so long to have this whole day. You said you promised yourself you were going to clean the whole house and you didn't do it. You failed, basically, right? That's what I'm telling myself. Oh my gosh, you're such a loser, you failed. One simple task and you didn't get it done. So now I feel bad. I did clean the whole main floor, but I feel badly about myself because I didn't do what I told myself I was going to do. Now imagine that I said to myself, okay, yay, you have a whole day off. That's amazing. Why don't you spend some time today cleaning the main floor? That will really feel good. If you clean the main floor, all you got to do is clean the main floor, and you'll feel like you got something done. That would be really great. And so I sleep a little later, I take time with the coffee, I take the dog for a walk, I go through the mail, and I manage to clean the main floor. At the end of that day, I feel like hallelujah, I did it. I had a plan, I implemented the plan, the house is clean on the main floor, and I feel really good about myself. So that story, while silly, is important because think about it, the exact same thing happened. The literal only difference was my expectation. So when I expected to do two or three floors and I did one, I feel like a failure. When I expected to do one and I did one, I feel like a success. So it wasn't about what I did, it was about what I expected. And yes, this is a silly example, but it really replicates itself over and over and over in our lives. And it's a big cause of us creating suffering for ourselves, unnecessary suffering. And the way I see it, life sends us enough real suffering. Let's not add to the suffering by creating it inside our own head. So let's think about other examples where this tyranny of expectations might show up. Let's say your young adult children come home for the holidays and you have in your head this expectation of, oh, it's going to be so great, and they're going to get along, and we're going to sing songs and we're going to have family dinners and it's going to be so great. I've missed having family here, and everybody's going to get along and everybody's going to be happy. Well, if you have children and you've had them come home, you know that sure there will be times like that, but they may also have times where they're cranky, where they maybe feel entitled, where they fight with each other, where they're not kind, where they don't clean up after themselves. Like there's lots of times like that too. So if your expectation is, oh, we're going to have all of these glorious family moments, and then there's a moment where they're bickering. You can create suffering in your own mind because this was not how you expected it to be. And you may overblow your reaction to like, why can't you guys just get along? Why do you have to ruin family time? None of that's helpful, right? None of that makes anybody happier, certainly not you. You may have an expectation if you celebrate Christmas about what Christmas Day is going to look like, or what your Hanukkah celebration is going to look like. You may have a fantasy of everybody's going to be so grateful and happy and get along, and maybe somebody's crabby that day. Maybe somebody's snarky, and maybe it somebody storms off and the perfect vision in your head of how it was going to be is cracked. Well, you can generate a whole lot of suffering for yourself around that because you're you had this expectation of what it was going to be like, and then it isn't that. And so you can feel like, oh my gosh, people in this family are so ungrateful, or my people are unkind, or you know, why do you have to ruin everything, right? You can create all kinds of suffering when maybe 80% of the day was terrific. But if you're expecting 100% of the day to be terrific, then 80% feels like a failure. Whereas if you're shooting for 75%, 80% is a win. And all that's different is what's inside your head. There are plenty of other places that our expectations show up. So let's say you have an aging mom or an aging dad, and you're bringing them over for a family event around the holidays, and your expectation is that they will recognize the grandchildren because they used to, and they used to have this special greeting that they did with the grandchildren. And then your aging parent who has some dementia comes over, the grandchildren show up, and your parent doesn't recognize them. Now, no matter what, that's heartbreaking. I get that. I'm not saying it's not heartbreaking. It is, it's heartbreaking, but it's even worse when you have this expectation of what this moment is going to be like, and then it isn't that. It can make it feel even more crushing because your expectations were cracked. You didn't get what you expected. And it can escalate into, oh my gosh, mom or dad is so much worse. How can this be? What's going on? We better go to the doctor, we have to change the medicines, right? It can escalate into this something is terrible and I have to fix it place, when maybe this is just the reality right now. And it is certainly possible that there are plenty of sweet moments between your aging parent and the grandkids during the day. But if you're focused on how your expectation wasn't met, you can miss those really sweet moments. Let's say you have a sister or a brother who has an advanced cancer, and they come over and you have this expectation that the whole family is going to sit at the table for our holiday meal. And maybe your sibling doesn't want to, doesn't feel well, can't do it, wants to be alone, wants to sit in the back room on the couch by themselves. But this was not your expectation. Your expectation was we are all sitting at the table for family dinner. This could reactivate all kinds of childhood conflict that you may have had with your sibling. Why do you always have to ruin everything? Why are you being so selfish? Can't you just sit at the table with us? Don't you care about us? It's always about you. All kinds of stuff could come up that really have nothing to do with what's happening in that moment. In that moment, your sibling maybe doesn't feel well, doesn't feel up to socializing, just wants some alone time. But the fact that it doesn't match your expectations can make it feel even worse than it might otherwise feel. Once you start to notice this in yourself, these expectations that you bring to situations, you'll be blown away at how often you have an expectation of how things should go, and then how much suffering you create for yourself when the thing happens, not necessarily a bad thing, but a thing that doesn't match your expectations and therefore it feels bad. It can generate all kinds of angst and negativity and fear and anger and even reactivate some childhood traumatic experiences. So expectations can generate so much suffering in us, literally for no reason, right? We can always modify our expectations. So it might sound like I'm saying, oh, well, just expect crap, expect bad things, and then you'll never be disappointed. That's not actually what I'm saying. I'm not saying that. I'm not saying you should never have expectations of happiness or good times. I'm not at all saying that. But I'm just saying maybe turn down the volume a little bit. If your aging parents were able to come, that's amazing. So maybe your expectation would be, I'm hoping that they can come. Your sibling who's ill, if they could just come and spend some time, even if it's a little bit of time with the family, even if they need to take some alone time, but if they could just come to the event. So just turn the expectation volume down a little bit so that you're pretty likely to have it met. You're just trying to turn the expectation down on the unicorn and sparkles. You know, it's all going to be perfect and there'll be music in the back and everyone will be smiling and the champagne will be perfect. Like just turn down the sparkly expectations a little bit. If those things happen, hallelujah. You know, that's a wonderful blessing if you get more than you expect. How amazing. But if you can keep your expectations reasonable to where you're likely to get them met, you reduce the chance that you're going to generate suffering for yourself that is completely unnecessary. So there's two concepts in here of things that I say all the time that I think are really important. And the first one is good enough is good enough, right? If your family shows up and spends a little bit of time together, great, that's good enough. Do they have to be gloriously happy and singing songs together? No, they don't have to do that. But good enough is good enough. Everybody showed up, we tried to do our best, we spent some time together, that's good enough. Your parent with dementia plays a little silly game with the grandkids, and the grandkids are laughing and they have a moment where it's fun and connected, that's good enough. Even if your parent doesn't know the names of the grandkids. If they had a moment and it was precious, that's enough. Good enough is good enough. And then the other concept that's really within this idea is my favorite thing to talk about, which is looking for flowers in the poop, right? So you'd love for the day to turn out a certain way, it doesn't turn out that way. Maybe people are fighting or someone can't come or the food gets burned. So sometimes there really are things that are a bummer. No question, there's things that are a bummer. But in that experience, can you look for the little bits of flowers in the poop? Little bits of something positive that you can see even though you're dealing with the things that are a bummer. So your mom with dementia brightened up when a certain song played that she remembered from her youth. That's a little flower. Your sibling who's ill had a little bit of your pie and said, Oh my gosh, it was delicious. That's a flower. You got a picture of everybody together, and that's important to you. That's a flower. So even in the midst of dealing with things that are a bummer, can you practice looking around for the flowers in the poop? Looking around for the tiny things that are joyful or positive or healing or meaningful or growth experiences, even when you're dealing with something tough. Okay, so your homework this week and through the holiday week that's coming up in 2024 is to look for where you have expectations that maybe you could turn down just a little bit to avoid this idea of causing suffering for yourself that you completely don't need to cause. So if you have events coming up, are there any expectations you're holding around those events? Do you have expectations about how people are going to feel about a gift that you give them? Do you have expectations about how you will look or about how people will respond to the way you look? Do you have expectations about the food that you'll provide and how everybody will feel about the food that you provide and what they might say? So just take a look at where this tyranny of expectations shows up in your own life. Where are you creating suffering for yourself that you don't need to create just because your expectations are filled with unicorns and glitter and perfection? Can you turn that down to reasonable expectations that are likely to be met? And when things are difficult, practice this idea of, you know, good enough is good enough. And can I find some flowers in the poop? If you celebrate holidays at this time of the year, I wish you happy holidays. I am so glad that you're here. I would be grateful if you would spread the word about this podcast. Is there one person that you think might be interested that you could tell about this podcast and maybe send them a link? That would help me. It would be a gift to me. I would so appreciate it. I want to grow my listenership, and I'm so, so grateful that you're here. Happy holidays. Take care, and I'll see you next week. Bye. This podcast is brought to you by the Integrative Palliative Institute. Visit our website, integrativepalliative.com. There you can access physician and clinician training, well being coaching, free downloads, and other cool stuff. And feel free to connect with me on LinkedIn and share your favorite episode with a friend.