Caretaking vs Caregiving

two men hugging
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"When the act of caring becomes more about the caregiver than the person in need of care, something's out of whack."

Cynthia Orange

I awoke the other day with the saying "Love knows no bounds," running through my mind like a jingle you can't get out of your head. Perhaps it's the editor in me, but I wanted to revise the statement because it struck me as incomplete. While on the surface the line sounds like a lovely truism, it hit me as a dangerous enticement for those of us with codependent or caretaking tendencies. Candy to a child and all that. I found myself adding a bold-faced, italics, underscored, all in capitals BUT that screamed a warning.

Then my internal editor changed the "but" to "SO," finally amending the adage to: "Love knows no bounds, SO it needs boundaries."

My monkey mind wasn't content to let it go at that, however, and two other familiar lines from songs about love popped into my head. So now I had actual tunes swimming around. I amended one to, "What the world needs now is love, sweet love, WITH reasonable limits." The other became, "All you need is love AND balance."

Why all this focus on boundaries, limits, and balance when it comes to something as wonderful and necessary as love? Because I've seen the toll providing too much to too many too often can take. And I know from my own life how easy it is to get so consumed with being a caregiver to others that we forget to care for ourselves in the process. Through trial and way too many errors, plus the collective wisdom of caregivers who have "been there and done that," I have learned the difference between caregiving and caretaking. Here's how I describe it in my recent book Take Good Care: Finding Your Joy in Compassionate Caregiving:

"I think of caretaking as codependency's close cousin. However, while there has been a trend to think of codependency as a pathological disease that requires treatment (or a support group), I don't view caretaking through that same lens. While many caretaking behaviors may be similar to codependent behaviors, my aim is to normalize them somewhat because I believe we all have a tendency to caretake from time to time.

I think it helps to think of caretaking as the out-of-balance and ‘self-centered' behaviors that reflect a person's deep need to be in control and accepted. On the other hand, caregiving consists of more balanced behaviors that reflect compassion and concern for others. You might say caretaking is more about getting love, while caregiving is more about giving it."

This chart I came up with shows what I mean.
On which side do you most often reside?

Often need to be needed
Want to be of help
Have a need or desire to fix
Support others in problem solving
Like to be the "special one"
Are usually good team players
Often try to control a person or situation     
Are content to be helpers
Often try to manipulate
Try to cooperate
Often struggle with low self-esteem   
Usually have a healthy sense of self
Often overstep or disregard boundaries   
Respect boundaries (their own and others')
Have difficulty saying "no"   
Can gracefully decline an invitation or request when it is necessary to do so
Tend to put others' needs above their own
Practice good self-care
Are often judgmental and critical   
Are usually accepting and non-judgmental
Often feel responsible for others' needs and feelings   
Understand that they are only responsible for their own actions and feelings
Often "give to get"—i.e., help others out of a need to be thanked, liked, accepted, etc.   
Act out of compassion and concern for others with "no strings attached"
Often have difficulty making decisions   
Are not usually "second guessers"
Frequently have lives out of balance   
Try to live a balanced life
Are often "people pleasers"
Have a healthy respect for self and others
Are often poor listeners
Are usually attentive and "active" listeners
Have trouble setting and honoring priorities   
Try to set and maintain priorities
Are often resentful
Are usually grateful
Often adopt an attitude of "self-sacrifice"
Try to maintain a spirit of generosity
Frequently lavish praise on others
Are genuine in their admiration and praise
Have a tendency to get overly involved in another person's life or problems                    
Maintain appropriate boundaries
Often offer advice or help without being asked   
Maintain appropriate boundaries
Often have "uneven," one-up/one-down relationships    Thrive on healthy relationships that have a good balance of "give and take"
Often assume they know what's best; invested in being right regarding someone's care choices and may argue their point of view (even when they weren't asked for their opinion)    Respect another's opinions and choices and accept that person's decisions about their own care (even though they may disagree with them)

 From Take Good Care by Cynthia Orange

If you're like me, you most likely float from one side of the chart to the other, depending on the circumstances, the person, or the amount of love left in your heart. Sometimes—in an emergency or when a family member or loved one incapacitated because of dementia, for example—it is even necessary to take charge and be more caretaker than caregiver. But even on ordinary days I confess that I can be a confident and compassionate caregiver one moment and an insecure, controlling caretaker at other times. Truth be told, I came up with this list rather quickly when I honestly reflected on my own behaviors on my out-of-balance caretaker days.

Caring for and loving friends and family with an open heart and helping hand are good things to work on to bring out the best in us, and I don't want to discourage you from performing acts of generosity and kindness when the opportunity arises. But when the act of caring becomes more about the caregiver than the person in need of care, something's out of whack. This cautionary tale is about the importance of becoming more self-aware so a caring interaction can be a rich and heart-felt one for both the caregiver and care receiver. It is about loving with your eyes and your heart wide open.  

When we love "without bounds," we risk opening ourselves and our hearts to unrealistic expectations. We may subconsciously believe that if we do something nice for someone, they will return the favor by doing something nice for us. I've been guilty of this more often than I like to admit. In my effort to be loved and accepted for being the perfect partner, mother, friend, relative, coworker, caregiver, and all-around good person, I used to set the relationship bar so high that no one could achieve the level of devotion I yearned for in return. Thanks to a wonderful therapist and a lot of honest self-reflection, I realized I was looking outside myself to fill a void within myself. I hoped others would provide the esteem I was so lacking in myself. Without knowing it at the time, I had become a "strings-attached" caretaker.

As I discovered, unmet expectations can lead to disappointment and even depression. In addition, as is often heard in recovery group meetings, "expectations are resentments waiting to happen."

These complex emotions can leave us especially vulnerable to problems with alcohol and other drugs. It can be tempting to try to numb feelings of being unappreciated, unloved, disappointed, or resentful, by having a drink or smoking a joint. And those in recovery know all too well how such emotions can create triggers that can lead to relapse.

As I stress in my book, healthy caregiving isn't about giving up all expectations in life; it's about sorting out the unreasonable expectations from the reasonable ones. For example, while it is unreasonable to expect someone to give us their total and constant attention and devotion, it is reasonable to expect to be treated with a certain degree of kindness and consideration. I also find that when words like alwaysneverif onlyshouldmust, or supposed to creep into my mind or vocabulary, it's a clue I'm headed to resentment city. "I always remember her birthday, but she never remembers mine," is an example of a resentment-laden message.

One way to lessen our expectations is to practice random acts of kindness. Try doing or giving something anonymously. Mow a neighbor's lawn when they're out of town without being asked or needing to be thanked. Can you show such acts of kindness without telling anyone you've done them? These are just a couple of ways to exercise our compassionate caregiving muscles and to love with an open heart.

As I mentioned early on, loving within bounds is also about living with healthy boundaries, balance, and limits. I write this knowing full well we all have different balance points, just as we have different tipping points. Here's another passage from my book that says more about this:

"Setting boundaries is about acknowledging limits, not building walls. The goal is to gain enough sense of self and of others that we can get comfortably close to other people without disappearing into their shadows or taking over their lives. When our boundaries are unclear, it is often too easy to get pulled into someone's pain and problems or give too much because we've lost sight of our own needs or limitations."

When we maintain healthy boundaries and balance and lessen our fierce hold on expectations, we are practicing better self-care, which, in turn allows us to be more compassionate caregivers and love with a whole heart. Although practice doesn't make perfect, putting in the extra work will make a difference in personal growth and improvement. We are, after all, imperfect beings just trying to do the best we can.

There is another saying that I believe requires no edits: "We love with great difficulty." But the important thing is we do it—we love. And, yes, despite all the challenges, "What the world needs now is love, true love"—especially in these days of derision and despair. I hope you'll open your hearts and your voices to sing it with me as we try our best to fill the universe with compassionate care for others and for ourselves.


Cynthia Orange is the author of Take Good Care: Finding Your Joy in Compassionate Caregiving and the Nautilus Award winning book Shock Waves: A Practical Guide to Living with a Loved One’s PTSD. She co-facilitates a caregivers’ support group and has written hundreds of articles about addiction, recovery, parenting, post-traumatic stress, and caregiving.

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