When Doing for Others Is Really About Doing for Yourself

My patient entered the office and had a serious look on her face.

"It seems there is something on your mind," I said.

"Yes," she said thoughtfully. "Something you said last week really clicked, and I have been thinking about it all week."

I scanned my memory for last week's session. I had an inkling about what she was talking about, but I really was not sure, so I asked simply asked: "And that was?"

"You said: 'Yes, but who is the giving for? Is it possible that you are giving to others because of your own needs for them to need you?'"

I remembered the exchange, but I had not really thought much about the question at the time. Paula was a 55-year-old woman who had what I call an "other-oriented" structure. As described in this blog, an other-oriented person is someone who: (a) focuses on the needs of others; (b) is sensitive to being liked and obtaining approval; (c) often worries about rejection and abandonment, and (d) often tries to be giving both to help others and to achieve social influence and relational value. Such individuals frequently struggle with anger, being assertive, and embracing healthy pride, and often have a strong inner critic.

I have found that many such individuals have complicated feelings and drives when it comes to giving. First, like most humans, they are genuinely prosocial. Indeed, their structure tips toward being empathetic and sympathetic and wanting to help people in need, so maybe they are even more naturally prosocial than most. Although it usually starts here, what develops, especially in adolescence, is that giving becomes a “safe way of being.” That is, it becomes an identity and way of relating that has strong attractors toward not only affiliation, but also dependency and deference, and feelings of guilt and shame.

This style sets the stage for an inner world that (a) narrates that the person should be a good, caring person who (b) is not selfish and (c) looks out for others to meet their needs. Doing so proves to them and the world that they are good people who care and are not selfish.

And yet if we pause and reflect on this way of being, we can see a bit of a paradox. That is, the person is now set up to have a need to be needed. Framed this way, the giving is not so much about the needs of the other, but really is about the needs of the person in the giving role.

“I realized that you were right,” Paula said.

In hearing this, I had a moment that many therapists experience. Patients will often hear things that the therapist was barely conscious of saying and report it had a profound impact. Finding myself in this spot, I did the classic therapist move and said, “Tell me more about that.”

“Well, I just always saw myself as a giving person," she said. "That is… or was… who I was. And, now, this week, I realized I am not so sure. I definitely think about others and am there for others. But now I am wondering: Who really is this for? Why do I do this, really? Am I giving just so I can be giving? That would mean really it is for me. And seeing it that way felt weird and made me question so many things.”

“Wow," I said, taking in a breath and opening my eyes wide. "That is huge.”

“I know. But I don’t know what to do or what it means about who I am.”

“Well, one of the greatest and simultaneously scariest things about therapy is that we start to learn much more about ourselves. We learn about our traumas and how our past shaped us. And we learn to look behind the stories we tell ourselves and ask about our true motives. Really understanding why we do what we do is a big deal.”

“So, do you think that, deep down, I am really selfish?”

“I have thoughts on this. But it is clear to me that you are in the midst of thinking deeply about this, so let’s spend some time exploring what it means to you.”

We proceeded to grapple with some of the most interesting and difficult questions of motives. We considered questions such as: Is there really altruism? Does everyone give just because they really are meeting their own needs? How do we know when we are giving for others versus giving for really doing it for our own needs? As she grappled with these issues, Paula’s self-awareness grew and her philosophy of living and giving also deepened.