Compulsive Caregiving, Overfunctioning, Codependency & Nice Guy/Good Girl Syndrome

Roots, Common Traits & Healing From Invisible Sources of Chronic Stress

Jan 13, 2024

“Worthy to Receive” - #2 (Cut paper and ink on dining room table)

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-15:12

If you don’t identify with one of the labels in the title, you likely know someone who does. These tendencies are more common in those of us who work in caring professions. As with all labels, however, they don’t completely define us. Those of us who have these patterns are not the same, nor struggle to the same extent. Still, this psychological construct has been repeatedly recognized in the mental health field. Perhaps because it is so common, you won’t find it included as a condition or personality disorder in the DSM (Diagnostic and Statistical Manual of Mental Health Disorders). Nonetheless, this way of being in the world can be painful and stressful. At the very least, these tendencies can keep us from enjoying the full potential of our lives.

Here are 10 thoughts.

1. Definitions

From the attachment theory - Compulsive care-giving is an attachment pattern in which the person emphasizes the importance of giving care in relationships rather than receiving it. The earliest manifestation of this is the parentified child. (From the work of John Bowlby, a psychologist and pioneer in Attachment theory.)
From the world of family therapy - Overfunctioners take on the responsibilities, emotions, wellbeing, and needs of those around them whether welcomed or not, often as a way of managing anxiety or insecurities. They are typically responsible, reliable, competent, and care for those around them. They are usually good leaders, problem-solvers, and high-achievers. ( From My Wellbeing referencing the work of psychiatrist Murray Bowen, MD, a pioneer in family therapy.)
From the 12 step world - Codependency is described differently in different places, but is basically the concept of losing oneself in the name of helping another. “A codependent person is one who has let another person’s behavior affect him or her and who is obsessed with controlling that person’s behavior.” - Melody Beattie (author of Codependent No More)
Related terms include People Pleaser, Nice Guy Syndrome and Good Girl Syndrome

2. Nurture:

Our repeated experiences shape us. They reinforce our neuronal pathways in such a way that they become our default. As adults we can have the repeated experiences of caring for others often at the expense of ourselves. This can be through our work, parenting or caregiving for an aging parent. Even with its rewards, this caregiving identity can lead to our forgetting that we are separate people with our own needs, feelings and wishes.

For many, however, the bigger influence appears to be early life experiences. From our start, we are wired for connection with others. As children we learn how to maintain proximity to our parents (physically and emotionally). A parent may be responsive enough, leaving us confident of that connection, and we are then able to start to move out into the world more independently. Parents, however, may have been emotionally immature, self involved, rejecting, narcissistic or codependent themselves (all from their own experiences combined with their biochemistry). They may have been sick or had other life circumstances that were a higher focus.

While various forms of abuse can be more obvious, emotional neglect can be less so. As children, we can learn that the most effective way to maintain proximity to our caregivers is to be especially tuned into their feelings and needs instead of our own. We may not have learned to recognize and communicate our feelings. We may have become cut off from our true selves or never had the opportunity to grow a true self to begin with. To decrease attachment anxiety, we may focus our attention and energy on tending to the feelings of others. “If they’re okay, we’re okay.”

These experiences and these tendencies exist on a wide spectrum - from very mild to severe.

3. Culture

Repeated cultural messages reinforce ideas of what it means to be lovable. The message for women is to be a comfort to others. A study by Stanford University found that the most desirable adjectives to describe women were compassionate, warm, cheerful, soft-spoken, and loyal. The most desirable adjectives for men were independent, assertive, dominant, and decisive. What would it be like to live in a world that wants us to be whole…that wants us to stand on our own two feet while having loving connections with others….who can stand on their own two feet?

4. Nature

Not all siblings have the same experience. Parents can react to their children differently. There can be varying circumstances going on during each of the children’s early lives. But, there can also be differences in temperament due to biochemical differences. Some of us are undoubtedly more sensitive and/or reactive. I would suspect that slow COMT and/or MAO variants (which are hormonally influenced) may be contributing to a tendency to be highly observant and sensitive to the feelings of others. I also suspect undermethylation may be a factor. Together, these variants might explain the high sensitivity and anxiety, as well as addictive tendencies.

5. Boundaries

Without having developed a true self, a separate self can be hard to recognize in others. We can pick up and run with other people’s emotions and problems. For those of us who fall on this spectrum, it can be difficult to recognize where we end and where someone else begins. We can feel responsible (and anxious) about other people’s feelings, thoughts, actions, choices, needs, well-being, lack of well-being…

6. Communication

Instead of communicating directly (one true self to another true self), we may be indirect, say what we think others want to hear and be unable to say no. We may be overly or unnecessarily apologetic. For some of us, this may harken back to an early feeling of being sorry for our existence, depending on our parent’s reaction or lack of reaction to them. We may even manipulate or coerce.

7. Behaviors

Dependency, compulsive caregiving, and controlling behaviors are each fitting, given the roots of the attachment style that I’m describing.

Dependency can look like trying to prove we are enough, looking for happiness outside ourselves, not taking time to see if people are good for us, centering our lives around other people, losing interest in our own lives, letting people hurt us and then hurt us some more, and staying in relationships that don’t work, essentially settling in an attempt to feel loved.

Compulsive caregiving can look like doing things we don’t want to do, being unable to say no, overcommitting, and doing more than our fair share of the work. We essentially neglect ourselves to take care of others. Again, this learned dynamic is what we know.

And, though the people-pleasers among us don't want to think of ourselves as controlling, that is a less obvious but clear trait. We can think we know what is best for others. If we’ve not met or tended to our inner wisdom, we can’t imagine it in others. Add to this our excellent problem-solving abilities and addictive tendencies. Before you know it, we will be helping, fixing, giving advice, setting straight, and rescuing those who welcome it or not.

8. Emotions

Anxiety can also relate to a sense of low self-worth. We can worry that others don’t like or love us and fear rejection. This can contribute to perfectionism. Anxiety is often due to our being hyper-attuned to the feelings of those around us - whose feelings we desperately want to fix. We can’t feel okay if they don’t feel okay. We can feel shame and discomfort with compliments, praise, or the generosity of others. We don’t trust intimacy.

Sadness, arguably the most uncomfortable feeling for anyone, is often repressed. Another protective defense mechanism is denial. This is where we can ignore problems and pretend they don’t exist, or we can believe the lies of others. We can also believe the lies we tell ourselves. Remember, we are wired for connection - for proximity, in some cases, at all costs. Unexpressed feelings easily lead to illness and other addictive tendencies, including overeating, which is fairly common. Codependency is considered an addiction for which there are 12-step programs.

Even though we may fear anger (others or our own), we can become angry that others aren’t doing what we think they should or they're not following our advice. We are quick to blame others or ourselves. We live in a world of shoulds and judgments (perceived by others and ourselves). We can have increasing resentment that others aren’t doing for us what we do for them.

We understandably and unconsciously keep finding ourselves in our earliest attachment dynamic, hoping to finally master it, get what we needed, and have a better outcome. The turning point in our story comes when we realize there is another way.

9. Education

Because we can be so put together and so gosh darn nice and helpful, our struggle goes largely unnoticed. We may see doctors and even therapists and still not have a name or construct for this part of us that wants and needs to be healed. But, we can start to recognize the patterns and become educated. There are informed therapists, support groups, 12-step groups, and healthy others. There are endless books. A few that I’ve liked - The Drama of the Gifted Child, The Narcissistic Family, Adult Children of Emotionally Immature Parents, Codependent No More.

“You know you’re codependent when as you read Codependent No More, all you can think about is who you want to have read it.” [ My realization while growing some insight into my own issues.]

10. Parenting Our Inner Child

Because many of us have learned our lessons well, it takes time, patience, and self-compassion to unlearn some lessons and learn some new ones. We each carry within us that child that we were. But, we also carry an unconditionally loving and compassionate parent (even if we never had that) - the one we inherently wanted to seek proximity to. Even if that external presence wasn’t there on the outside to help us grow our inner parent on the inside, we can access that part of us.

With help, our inner parent, inner wisdom, or soul can teach us how to listen to it - to hear our inner voice, messages from our body, and our feelings. It can teach our inner child how to be independent while staying connected, how to say no, and how to set boundaries with those who haven’t done their own emotional work. Our inner parent can help us say what we feel and need. It can teach us how to care for ourselves, which isn’t just about providing comfort but is also about tending to our responsibilities (and not having them second to everyone else’s).

"If your compassion does not include yourself, it is incomplete."
– Jack Kornfield

I say, go for complete….If you have other resources or strategies you’ve found helpful, and it doesn’t feel like over-functioning ;) please consider commenting.

Holistic Psychiatry

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