Some psychological syndromes are so familiar that we do not recognize them as a disorder. For instance, in big business, psychopaths might become hot commodities for their cold-blooded focus on the bottom line. In the same way, the psychological problems of self-sacrificers might go undetected because they meet the highest standards for desirable behavior.

Self-sacrificers have huge hearts. They react to the needs of others with an impulsive generosity that can make ordinary people feel stingy and self-centered in comparison. You know you can always turn to them. They seem the perfect model of altruism. But take a closer look and you will see that their behavior sooner or later costs them and certainly costs the people closest to them.

New York psychologist Jeffrey Young has identified the self-sacrificer’s pattern of compulsive overdoing, excessive empathy, and hidden issues with anger. Theirs is not ordinary generosity and empathy, and their anger is not just a healthy reaction to someone doing them wrong.

Self-sacrifice looks like a kind of altruism, but it is only a second cousin to that genuine helping instinct. Altruism is spurred when a person is moved to help in a situation that is clearly dire. Altruism does not seek to establish a grateful or over-involved relationship with the other person. Nor does it go around with radar for needy people. Altruism is not a compulsive life pattern; it is a response to a situation.

The compulsive overdoing of self-sacrificers is seen in the involuntary nature of their urge to help. They focus so intently on other people’s predicaments that their own needs are often eclipsed—and sometimes the needs of their immediate family members. Often there is a dysfunctional person or two in their family that get the lion’s share of their attention, in spite of repeated evidence that their efforts are not helping. The self-sacrificer focuses on the one with the most apparent need, whether that is good for that person or not. It is nearly impossible for them to step back and evaluate their own behavior because they have already decided up front that their generosity and empathy are good things. Other people reinforce this view, giving them lots of sympathy, because self-sacrificing behavior is so culturally admired.

So if dysfunctional people need help and these people are willing to give it, what is the problem? The problem is that self-sacrificers trap themselves in a self-denying way of life that can result in outbursts of anger or secret self-gratifying behavior that would surprise anyone convinced of their selflessness. Affairs are a classic way that people exhausted from self-sacrifice find room for their own emotional needs, but affairs do not solve the problem of not taking care of oneself in one’s primary relationships.

The anger felt by self-sacrificers can be expressed in several ways. They can have blow-ups, complete with screaming tirades, which are always caused by giving too much and neglecting their own needs. These tend to be infrequent, and it is easy for the self-sacrificer to dismiss them as simple stress reactions or not feeling well. But it is plenty shocking to the people who live with them. Or they can indulge in bitter, silent moods that make it clear how furious they are. Finally, they can defeat others with passive-aggressive behavior that withholds what others want from them.

Why are self-sacrificers so angry? Because they are trying to solve their own childhood emotional deprivation by taking care of others. Unfortunately, you cannot satisfy an emotional need of your own by doing for others. Sooner or later, the self-sacrificer feels the anger of being used and disregarded by the very people they are pouring their energies into. Self-sacrificers are frustrated because the more they do, the less they get. Their efforts, Herculean though they are, are never adequately appreciated, and the person they are helping usually does not improve much. The anger and frustration of self-sacrifice can lead to both emotional and physical problems.

Healthy self-interest is as necessary as good blood sugar or low cholesterol. People who are not self-sacrificing do not feel resentful or used. Instead, they expect fair trade and reciprocity in their relationships. The non-sacrificing person chooses relationships with people who can give back.

There is usually great childhood sadness in self-sacrificers, a result of emotional neglect in their early relationships. They were often the parentified child in their family, the little adult that parents counted on not to give anyone any trouble. They learned that the way to be noticed was to be extra good and always be there for other people. Unfortunately, since much of their empathy is based on the projection of their own emotional deprivation, they exaggerate the helplessness and neediness of others. And because emotional deprivation is rarely labeled as such, these people have no idea why they feel a chronic sense of being overlooked.

The way out of self-sacrificing is to finally have empathy for one’s own emotional deprivation, both now and in childhood. Once we start feeling for ourselves, we can start taking care of ourselves. Our inner child-self needs to be protected from over-doing and feeling for others so excessively. The cure for self-sacrifice is self-care.

When self-sacrificers recover, they realize that they were projecting their lonely, deprived child-self onto others, imagining a neediness that may be only partly true. Instead of exaggerating the recipient’s problems and ignoring their own needs, former self-sacrificers can hold back and evaluate if their help is really needed. They can give without depleting themselves and let others solve their own problems as much as possible. They may act quickly to help in a real emergency, but they have sensible standards for what really requires their sacrifice. They do not give until it hurts; they give as much as they realistically can, then they seek outside help. Best of all, they do not harbor resentments concerning those who did not appreciate them enough. They stop trying to save everybody else and finally reach out to that tired child within who needs some caretaking of its own.  

Lindsay Gibson, Psy.D., is a clinical psychologist in practice in Va. Beach. For information, call 757-490-7811.