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.

MBS For Food Disorders and Other Compusions

MBS Personality Traits
Those who suffer with MBS, says Dr. John Sarno, “tend to be perfectionistic, compulsive, highly conscientious and ambitious; they are driven, self-critical and generally successful.” (The Mindboy Prescription: Healing the Body, Healing the Pain…page 22). Other mindbody experts agree with this as well.

Another dominant trait is the need to be good (coined “Goodism” by Dr. Sarno). We desire to please, to be liked, and to be helpful usually at the expense of self-sacrifice. We develop restrictive personalities, repressing or suppressing emotions such as, rage, anger, aggression and guilt.

We want to be viewed as “nice” people. The problem is, we put far too much pressure on ourselves, trying to live up to high expectations that are difficult or impossible to meet.

Interestingly, none of us ever grows out of the need to be comforted. It is the human condition. If we do not have healthy outlets at the time of our need, we seek solace or pleasure through other gratifications, such as overeating, smoking, sex, drinking, gambling and other forms of entertainment and play.

This is one reason why food disorders are identified with MBS. Knowledge therapy, then, is not only for the reduction or elimination of pain but also helps with food disorders, obsessive-compulsive disorders and other destructive behaviors.

Let me give you an example of how this works. About an hour after I had eaten dinner, I suddenly had the compulsive thought that I wanted to eat something. It came out of the blue, dominating my thoughts. I knew I couldn’t be hungry as I had just eaten dinner not an hour before. Rather than mindlessly wandering to the kitchen as I sometimes do, I stopped myself and asked, “What’s going on here? Think psychologically. What are you thinking?” At first I drew a blank. But then insight started to surface.

I had been reading an excerpt from Byron Katie’s book, Loving What Is. Her work is recommended by Dr. Schubiner and can be found at her website (Click Byron Katie in the blogrolls at the right side of this blog). She had stated that until you can forgive a situation 100%, you are not healed. If you have forgiven 99%, you are not healed. That is when I felt the urge to eat.

I dug deeper into my psyche. What came to light is that I had been thinking of my mother and condemning myself for not being perfect, for not forgiving a certain situation 100%. Furthermore, I held a deep seeded belief that good people don’t have anger toward their mother. My mother grew up believing that. She was sent away from the dinner table by her father the two days before she was to be married because he felt she had said something that did not respect her mother. When I was growing up, I got the message implied and spoken. The famous saying at our house was, “You do not sass your mother.”

The implied belief is that if I said or thought anything negative about my mother, I was a bad person. I was feeling guilty about having a negative thought in regard to anger and unforgiveness. Therefore, I was a bad person. The feeling I wanted to repress and submerge with food a few nights ago was guilt and the idea that I was a bad, bad person for having angry, critical thoughts.

MBS teaches that we all have two voices within us that want to be heard. These two forces are always struggling against each other. They are:

1. The Inner Child who is selfish and dependent and wants what it wants when it wants it.

2. The Inner Parent or Super Ego who is inordinately critical and tells us what we should and should not be doing or thinking. It’s the voice that booms loudly and clearly: You are a bad person because I said so.

I was told in my 20’s by a shrink that I had an overactive Super Ego. I was extremely critical with myself, always telling myself I shouldn’t do this or that, and living more for what someone else wanted or believed than for what I believed and desired. If I was good, very, very good, then people would like me.

There it was again. That super critical inner parent telling me I was a bad person because I dared to hold negative thoughts and was not 100% perfect. Aha. Then the MBS work began.

I engaged in self-talk, telling my brain that thinking I was a bad person and feeling guilty was simply wrong. Byron Katie suggests that we always confront a thought with the question: Is that true?

Believing that a mother is always 100% correct and you never questioned it was my mother’s belief that I integrated fully as a youngster. But I had a right to think differently. I told myself that I belonged to the human race (a very important concept for MBS people to get), and I had a right to feel or think the way I wanted. How could I not have a thought after I had already thought it? How could I not have a feeling after I already felt it? I certainly was not bad for being human. Everyone has those thoughts. And I certainly did not have to feel guilty for having thoughts we all have at one time or another.

The urge to eat completely disappeared. Often we use food, pain or other activities to push down or repress unacceptable emotions and thoughts, when, in fact, we need to look at them, sit with them until we understand them and where they came from, and then decide exactly what belief system, thoughts and emotions we want to adopt for ourselves.

The personality traits of MBS people don’t allow us to be human. We have to be perfect, we have to be good, we can’t have bad thoughts or say angry things.

No, the truth is, we must allow ourselves to have rage, guilt, anger, you name it. We have it anyway. We must tell our inner parent that we will decide what we will believe and that we will no longer blindly serve another person’s beliefs and ideas. It’s not that we want to go around with ugly. negative, thoughts. It’s that we make a conscious decision and a commitment to rejoin the human race and stop holding ourselves hostage to impossible expectations.

I can tell you, this work ended in total freedom. I totally let go of the desire to eat something I did not physically need. It is liberating to be true to your inner self. It allows you to accept yourself which is the end goal for all of us. And especially for those who have MBS.

The next time you want to overeat, drink too much, light up a cigarette that you know is harmful, get hit with pain, ask yourself: What’s going on emotionally in me? What was I doing just before this urge began? What’s going on psychologically right now? The more you stop these thoughts from automatically traveling down a repeated neural pathway in the brain, the easier it will become to stop them the next time and then the next time.