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Episode 3: Compulsive Caregiving — The Child Who Learns to Look After Everyone Else · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  Hello and welcome back.
• 0:02
  This is Kim Lee, child and adolescent psychotherapist.
• 0:06
  And this is the third episode in the second series on the circuit the psychology of attachment.
• 0:14
  And in this episode, I want to look at compulsive caregiving.
• 0:18
  This is about the child who learns to look after everyone else.
• 0:24
  And some of you listening may recognize that there are certain traits in this particular style that you're familiar with.
• 0:34
  Now, sometimes there are children that many people admire because they're thoughtful, they're kind, they're responsible, and they're helpful.
• 0:45
  They notice when others are upset, and then they try to make things better.
• 0:52
  They comfort others, they try and avoid conflict, and they rarely complain.
• 0:58
  And teachers love them, parents praise them, and professionals often describe them as mature beyond their years.
• 1:08
  But sometimes beneath this apparent maturity lies a hidden burden.
• 1:14
  Because some children learn very early on that relationships feel safest when they are looking after everybody else.
• 1:24
  And so they become the caretaker, the peacemaker, the emotional manager, and the child who quietly carries responsibilities for things they were never supposed to carry.
• 1:38
  Welcome back to the psychology of attachment.
• 1:42
  Last time we explored compulsive self-reliance, the child who stops needing anybody.
• 1:49
  But now we turn to a very different attachment adaptation, and that's called compulsive caregiving.
• 1:57
  Now this isn't ordinary kindness, it's not healthy empathy or generosity.
• 2:04
  It's an attachment strategy, and it's a way of preserving emotional safety through looking after other people.
• 2:12
  And it's the central belief, it sounds something like if I take care of everyone else, everything will be okay.
• 2:23
  Quite often, in situations when a sibling is behaving in ways that take up lots of parenting time because the sibling is troubled or in some way demanding or difficult, the other child will take on a counterbalancing position.
• 2:45
  But to understand compulsive caregiving, we need to imagine a child growing up really in an emotionally unstable environment.
• 2:55
  Perhaps a parent is depressed, anxious, overwhelmed, emotionally fragile or chaotic.
• 3:04
  Perhaps there's a conflict within the family, arguments, tension, unpredictability, and perhaps the adults themselves appear to be unable to manage their own emotional lives.
• 3:18
  And the child notices.
• 3:20
  Children always notice.
• 3:22
  Long before they understand what is happening intellectually, they feel it and experience it emotionally, and gradually they begin adapting.
• 3:34
  The child discovers something important.
• 3:38
  When I help, people seem calmer.
• 3:41
  When I comfort, relationships feel safer.
• 3:46
  When I manage the atmosphere, things become more stable.
• 3:52
  And so the attachment system begins reorganizing itself, and they become a caretaker.
• 4:01
  Because something subtle but profound begins to happen.
• 4:05
  The child starts monitoring everybody else, who's upset, who's angry, who's anxious, who needs help.
• 4:13
  So the attention moves outward.
• 4:16
  So instead of asking, How do I feel?
• 4:26
  And over time, this becomes automatic.
• 4:30
  The child becomes emotionally responsible, but the responsibility and burden are really not the same thing.
• 4:40
  And such children are, as I said, counterbalancing.
• 4:45
  They need the grown-ups to be okay because their survival emotionally depends on it.
• 4:53
  And one of the tragedies of compulsive caregiving is that it often looks like exceptional maturity.
• 5:02
  And these children are frequently described as thoughtful, dependable, nurturing, considerable, and selfless.
• 5:09
  And whilst some or all of these qualities may genuinely exist, they come at a considerable developmental cost.
• 5:17
  Because children are not supposed to become the emotional caretakers of adults.
• 5:23
  Children are supposed to be cared for.
• 5:26
  This is what we call parentification.
• 5:30
  So instead, the direction of care becomes reversed.
• 5:34
  The child begins carrying emotional responsibilities that actually belong somewhere else.
• 5:42
  Now, what happens during adolescence as the young person grows older is that the strategy becomes increasingly sophisticated.
• 5:52
  The adolescent becomes highly empathetic, highly observant, emotionally perceptive, exceptionally aware of other people's needs.
• 6:02
  But what comes with that is an unrealistic and profound sense of responsibility.
• 6:10
  So they may become the person everyone talks to, the friend who solves the problems, the one who always listens, the one who never says no.
• 6:20
  And because everybody values them, the strategy becomes reinforced.
• 6:25
  So the young person learns.
• 6:28
  My value comes from being needed.
• 6:33
  In adult relationships, we really begin to see the cost.
• 6:38
  In adult compulsive caregivers, we see an extraordinary selection in terms of partners, parents, colleagues, and professionals.
• 6:48
  They anticipate need, they notice distress, they support others, and they carry burdens.
• 6:59
  But underneath there's an uncomfortable reality.
• 7:03
  Many compulsive caregivers just don't know how to receive care themselves because it was never available.
• 7:11
  They know how to give, they just don't know how to receive.
• 7:16
  And this is where attachment becomes visible again, because beneath the caregiving often lies an anxiety about dependency, because the person may unconsciously believe if I become the one who needs support and help, I may be disappointed.
• 7:38
  If I stop looking after everybody, people may stop needing me.
• 7:43
  And if people stop needing me, then they will stop loving me, and I won't exist.
• 7:52
  Many compulsive caregivers become rescuers.
• 7:56
  They're often drawn towards people who are struggling, damaged, chaotic, emotionally unavailable, and difficult to help.
• 8:05
  Not consciously, but because parenting others is so to speak, and caring has become part of how attachment works.
• 8:14
  And so they often find themselves in relationships where they are constantly giving, constantly helping, constantly trying to save somebody whilst their own needs quietly disappear from view.
• 8:28
  What we see clinically is important because in clinical practice, compulsive caregivers often arrive exhausted, burnt out, anxious, depressed, resentful, stunk.
• 8:42
  And yet, when asked about themselves, they often begin talking about everybody else, their partners, their children, their parents, their friends.
• 8:53
  And this is because they've spent so long attending to other people that they've lost touch with themselves.
• 9:02
  And one of the most common statements sounds like this I know exactly how everybody else feels.
• 9:10
  But when asked, they don't know how they feel.
• 9:14
  Now, here's something important.
• 9:16
  Compulsive caregivers often carry anger.
• 9:20
  Not because they're unkind, but because giving without receiving eventually creates imbalance.
• 9:27
  And when somebody spends years prioritizing everybody else's needs, they often start to feel unseen, unappreciated, and invisible.
• 9:40
  Yet expressing those feelings may itself feel frightening because caregiving has become part of the identity.
• 9:50
  What's important here is that the person is caught in a trap.
• 9:53
  In order to be valid and validated, I have to give.
• 10:27
  Helping the individual recognize that they are allowed to exist as a person rather than a function.
• 10:36
  Allowed to have needs, allowed to receive support, allowed to disappoint people, allowed to stop rescuing everybody, but also allowed to be cared for.
• 12:10
  Not because they're useful, not because they're needed, not because they're carrying everybody else's burden, but simply because they exist.
• 12:21
  Because secure attachment isn't built upon rescuing, it's built upon reciprocity, the freedom to give care and the freedom to receive it.
• 12:34
  And perhaps that is where true emotional security begins.
• 12:41
  As a therapist, I see these patterns frequently.
• 12:46
  And I also see how people who give in this way are frequently used and they get stuck in a paradox.
• 12:55
  I have to give.
• 13:24
  Thank you for listening.