Frank is a social worker in a hospital. His job is demanding and involves the daily problems of patients and their needs once they leave the hospital. He is continually interacting with doctors, nurses, family members, and community agencies. Due to budget cuts, Frank and two other social workers carry the workload of five people.

Not only is the workload stressful in itself, but Frank’s temperament makes his job harder. He has difficulty setting limits, takes work home, and is unable to maintain appropriate distance from his patients.

Frank absorbs his patient burdens to such an extent that he becomes drained. He feels personally responsible for their discomfort. If someone were to confide sadness, he becomes sad and takes on the full impact of his or her hurt. Frank’s over-involvement and inability to recognize when he is taking on too much are typical caretaker traits.
Caretaking tendencies also influence Frank’s life away from work. His 23-year-old daughter called him because she was distressed at having been refused health insurance. Frank’s immediate impulse was to make every- thing okay, and ‘fix’ his daughter’s situation by making several phone calls for her. A caring response would involve listening attentively and allowing her to shoulder some of her burden by suggesting that she make the calls.

Caretaking is a common problem in various lines of employment.

Caretaking is a common problem in various lines of employment. For example, Janet’s job as a supervisor for a utility company is to facilitate team -work, manage conflict, and delegate authority. However, Janet has difficulty with conflict and prefers constant harmony. When two employees in her department were not getting along, she attempted to alleviate her anxiety by trying to get the two employees to be close friends. Janet’s emphasis on harmony undermined her ability to be firm yet compassionate.

Like Frank and Janet, many people in helping roles often confuse being a caring person with caretaking. This confusion results in burnout as well as inhibits those who are being helped from taking responsibility for them selves. Caretaking also can interfere with the helper’s ability to recognize their feelings and needs. The extent to which people are influenced by caretaking will determine how much they will in- cure negative consequences.
People in helping roles are concerned with delivering service excellence. Some situations require caretaking such as parenting young children and helping an injured person recuperate.
Caretaking, however, often stems from the helper’s needs rather than the person who is being helped. For example, the helper may need to have others depend on him in order to feel worthwhile.
In an attempt to be helpful, the caretaker may be perpetuating familiar self-destructive habits of relating. Family history often provides clues about the confusion between caring and caretaking. For instance, taking care of others was a familiar role to Frank. He grew up being a confidant to his mother. At a young age, he learned that his mother’s needs and feelings were always more important than his own.
In an attempt to be helpful, the caretaker may be perpetuating familiar self-destructive habits of relating.

By confiding her problems to Frank, his mother crossed over his boundaries. Mother’s over-involvement with Frank led him to assume an adult role, and prevented him from developing a clear and separate identity.
Children are very sensitive to their parents’ emotional state. When a parent (or other family member) is fragile or sad, they absorb the family pain. They also become compliant and over- achieve in order to ease tension when there is a lot of conflict at home. This altruism encourages parental approval and cements the identity of caretaker.
Frank experienced his mother’s problems as if they were his burden, and felt responsible for her emotional well-being. He grew up reproducing his caretaking role in adult relationships. Frank was drawn to people who were needy or in crisis. His career choice was a natural one, given his role in the family. Frank, like many caregivers, had difficulty asking for support, but was comfortable having others rely on him.
Frank became less of a caretaker when he realized how his behavior was influenced by his upbringing. Through counseling, he recognized how his role with his mother led him to give too much, neglect his needs, and experience difficulty knowing his limits.
He began to change as he realized the unfairness of his mother’s reliance on him, as well as her neglect of his needs. His anger enabled him to become less of a people-pleaser. Frank began to take time for himself by paying attention to leisure. He also learned how to be compassionate while keeping others at a healthy distance. In doing this, Frank was taking care of himself while caring for others.
To be able to discern between caring and caretaking, and help modify the caretaking habit, the caretaker should ask himself the following questions:

1. Did you play the role of peacekeeper in your family?

Pleasing others and solving problems are often attempts to get attention and ensure emotional safety. Keeping the peace and ‘being good’ offers a sense of control and order in a family marked by unpredictability, chaos, and tension. You often attempt to ‘make everything “all better” because you feel responsible for the family problems.

Pleasing others and solving problems are often attempts to get attention and ensure emotional safety.

To illustrate, Janet grew up in a family that frequently argued, and she felt threatened by confrontation and disapproval. Janet became hypersensitive to people’s reactions and tried to please and maintain harmony. Long after she left home, Janet continued to mold her responses in a manner that ensured tension would not arise.
Childhood beliefs and fears are enacted in adult relationships. Janet observed the feelings that surfaced when she practiced expressing opposing views. She gradually realized that her fears did not match present-day reality. Janet improved her capacity to tolerate confrontation and tense situations and to say, “No.”
Other situations that foster the peacekeeper role are parents who put their children in the middle of their tension by expecting them to take sides or to be a referee. There are also ‘nice’ families who reward children for being compliant and obedient. These families never get angry and teach that it is unacceptable to make waves.
Peacekeeping and pleasing is often related to getting attention for excelling and living up to others beliefs of how you SHOULD think and act. Parents, teachers, and religious authorities expect you to act in a particular manner. Make a list of other’s expectations of you growing up (include expectations that were unspoken). See if these expectations relate to peacekeeping and ‘feeling responsible.’

Caretaking is often linked to unclear boundaries.

2. Did you assume the role of caretaker in your family?

You may have learned to be an adult and focus on others at an early age. When you are cast in the caretaker role, you are ‘responsible’ for looking after your own needs as well as the needs of family members. You may have had to take care of the well-being of a family member who was unstable or ill. You also are saddled with an excessive amount of chores.
You learn early that everyone else’s needs are more important than your needs. You are drawn to people who are needy or in pain.You become the ‘dutiful’ son or daughter. If you were valued for helping others, your worth is linked to caretaking. When your esteem is at stake, your impulse to help may be based more on your needs than the needs of the person you intend to help.
Look into your past and see what messages you received that caused you to focus primarily on others. For example, the unspoken message Frank’s mother conveyed was that her needs were always more important than his needs. Other messages include being told ‘You are selfish,’ or when your feelings are not taken seriously.
In addition to exploring messages from upbringing, you need to become aware of the guilt and fear associated with not focusing on yourself.
Say “Yes” to your needs. Make a list of things you do to nurture yourself. Now set aside times for yourself and write on your weekly calendar, ‘my leisure time”. Treat these appointments with yourself as the same way you would any valuable appointment.

The caretaker in you can thwart your ability to receive. You are more comfortable giving then asking for and accepting support. Think of someone you have given to a lot in the past or currently. Imagine giving less.
Now imagine that person giving to you equally. Is this difficult?

People in helping roles often have difficulty knowing the difference between caring and caretaking.

3. Do you understand appropriate boundaries?

Caretaking is often linked to unclear boundaries. When you have difficulty defining your boundaries, your clear separate identity becomes hazy at times.
Boundary confusion is directly related to functioning on the same level as a parent, and having to assume an adult role. For example, Frank’s mother was too involved with him and made him into her confidant. He was unable to distance himself. His mother’s involvement also prevented Frank from developing his own separate interests.
Other family dynamics that create boundary confusion include:

Your privacy was not being respected.
An authority figure is over protective, controlling and/or physically verbally abusive.
Your parents were too permissive and did not set enough limits.
Your family did not tolerate having values and opinions that differed from the family.

When your boundaries are unclear, you easily get pulled into people’s pain and problems. You also give too much because you lose sight of your limitations and needs.

4. Do you feel compelled to fix and find solutions when others are uncomfortable?

Fixers have similar histories to peacekeepers. Like Janet, you feel pulled to patch up tension. It is difficult to simply listen with empathy because you need to ‘take away’ their discomfort.
Other people’s discomfort elicits a lack of order and helplessness. If your worth is linked to being a helper, you will feel like a failure if unable to resolve their dilemma.
You tend to believe ‘if you do not do it, it will not get done.’ When you feel ‘responsible for finding solutions, it is not okay to disappoint others. You also feel guilty when setting limits. People in helping roles often have difficulty knowing the difference between caring and caretaking. In the beginning of this article, I suggested that giving and caring can be a reenactment of old familiar roles.

... giving and caring can be a reenactment of old familiar roles.

Knowing the roles you played in your family helps you understand your motivations, being compassionate without becoming over extended frees you to take better care of yourself while caring for others.

Author's Bio: 

Dennis Portnoy is a licensed Marriage and Family counselor in San Francisco. He lectures and conducts trainings on caregiver burnout, compassion fatigue and self-care. More information is available at