The Price of Being Nice: Do You Suffer From Caretaker Personality Disorder

One of the personality traits of those who suffer from tension myoneural syndrome (TMS/MBS) is to be good. Sarno labels us “goodists.” Others in the field might call us people-pleasers.

TMS’ers are ‘nice’ people who put others first at the expense of their own physical and emotional health and happiness. We are nice people, but at what price?

According to psychologist Les Barbanell, author of the book, Removing the Mask of Kindness, (Jason Aronson, Inc.; 2006, ISBN-13: 9780765704108) many people-pleasers are suffering from a pathological condition known as ‘caretaker personality disorder’.

According to Barbanell, these ‘nice’ people feel unhappy, empty, guilt-ridden, shameful, angry, anxious, afraid of rejection and abandonment and are emotionally and physically exhausted because they are brought up to put the needs of other people ahead of their own.

As Dr. Sarno writes in his book, The Divided Mind,( Regan Books, 2006; ISBN: 0-06-085178-3) “…certain personality traits of those with TMS/MBS make the greatest contribution to the internal emotional pain and anger.”

However, it must be remembered that these feelings are repressed in those with TMS/MBS. We are not conscious of them. But we can bring them into the open by using the TMS/MBS techniques.

In one of his columns Dr. Hap LeCrone, (, clinical psychologist in Waco, TX. says the problem with people-pleasers usually comes from “long-held feelings and beliefs of inadequacy going back to childhood and adolescence, when the people-pleaser’s attempts to please parents or caregivers were rejected, made conditional or otherwise unobtainable.”

“Anger, hurt, emotional pain and sadness generated in childhood will stay with you all your life,” explains Dr. Sarno. “Feelings experienced in the unconscious at any time in a person’s life, including childhood, are permanent.”

That is why self-talk becomes such an integral part of recovery from TMS/MBS. We can re-train our brain to think and believe differently, thereby, creating new, healthier neural pathways in the brain.

Repeatedly, I was told I was selfish when I was growing up. My present-day dysfunctional people-pleasing behavior is a continual attempt to avoid being labeled or judged as selfish. It’s comical really. The people telling me I was selfish were people who wanted their agendas met, so who was selfish?

People pleasing includes everything from buckling under to impossible demands to agreeing with a suggestion when we would rather say “no.”

Moreover, people-pleasers often become caregivers to everyone from children to elderly parents to hosting family dinners and functions, all the while, pasting on a happy face while wearing ourselves out.

We’ll loan our favorite, most expensive dress to a friend when we don’t want to and miss our favorite TV program time and again because our mate or significant other wants to watch a different show.

At work we over-commit and try to meet impossible demands and expectations made by our colleagues and superiors.

“They feel the uncontrollable need for the elusive approval of others like an addictive pull,” explained the late Harriet B. Braiker author of The Disease To Please (McGraw-Hill, 2002; ISBN: 0-07-136410-2).

She continues, “Their debilitating fears of anger and confrontation force them to use ‘niceness’ and ‘people-pleasing’ as self-defense camouflage.” We are really hiding our “anger and resentment behind public happy faces,” says the author.

We know repressing our negative feelings can have far-reaching physical and emotional consequences for those who battle TMS/MBS.

Pain, out-of-control eating disorders and the myriad other TMS/MBS symptoms can erupt when we least expect them. ‘Nice’ people get sick when we feel responsible–no obligated– to make everyone else happy

I’ve become aware that either I don’t want to hurt someone’s feelings so I give in to requests, suggestions and demands. Or I don’t want to deal with anger or confrontation if the other party is displeased with me and doesn’t want to meet my needs.

It’s painful to realize that someone doesn’t really care if your needs go unmet. One way to avoid that pain is not to ask for anything or just “go along” with what others want. That’s what I did most of my life.

This is definitely one of those Catch-22 dilemmas. Not wanting to hurt someone’s feelings or sweeping our needs under the rug can trigger repressed rage within ourselves.

But standing up for our wants and needs can trigger another’s rage toward us. We must, then, be willing to assert ourselves if we are to overcome people-pleasing behaviors and the physical or emotional pain of TMS/MBS. This requires work and courage.

Writes Barbanell, “The problem is that being saintly can be deadly. When giving is the reason for living, the person is transformed into a non-person.”

People with TMS/MBS must learn that standing up for ourselves is not selfish but more a matter of balancing the needs of others with our own needs in a mature interaction. We must bring our actions into balance.

I can hear some people now denying that they are enraged about pleasing others but “consciously, we rationalize, unconsciously, we are enraged,” says Dr. Sarno.

“If you are the caretaker type and always worrying about your family, friends and relatives, these drives will also make you furious inside because that’s the way the mind works,” explains Sarno. “The suppressed anger is internalized and becomes part of the reservoir of rage that brings on TMS.”

To stop being a people-pleaser we must find the courage to deal with the possibility of confrontation and anger directed at us. And we must be convinced that we deserve to have our needs and desires met in balance with others. Otherwise, we’ll fall by the wayside every time.

Our old standby is self-talk. We need to tell our brains that we deserve to have our needs and desires met and believe it. Again, it’s a matter of finding a way to be responsive to the needs of others without abandoning our own needs.

The next time we think we “should” do something, transform the words into “I think” or “I want.” We must dare to join the human race and stand up for ourselves if we are ever going to kick the habit of people-pleasing and TMS.

Once we give up our addictive people-pleasing behavior, we will no longer carry the suppressed rage about having to please others. And without the internal, repressed rage, TMS/MBS symptoms will subside and dissipate.