“I live with a huge feeling of responsibility in my heart,” she told me. “I was called ‘the lucky one.’ I didn’t experience abuse. My father was away in the mental hospital when I was very little and he was at his most crazy. I’ve never wanted to take my own life. I’m happily married to a kind man and have three wonderful children, now adults. I feel guilty at times about the good things that have come my way. I feel heartbreak for my sisters. I feel selfish for not doing more for them. And I’m exhausted at times—maybe from trying to maintain security, or live life as the girl who didn’t cause any trouble because everyone else’s problems were so much bigger. I daydream about winning the lotto and buying them each a house, setting them up financially for the rest of their lives. Then I might feel freer of this guilt I carry.”
Iris is a beautiful woman, with blond curly hair and full lips. She seemed preoccupied, her blue eyes darting as she spoke—the agitation that comes from a life of trying to earn the A’s. Iris had imprisoned herself in her perception of her role and identity: to make things better for others, to lighten the load, to not cause a fuss or have big problems, to be the capable, dependable, responsible one. She had also become a prisoner of guilt—survivor’s guilt for her journey being easier than her mother’s and sisters’. How could I guide Iris out of a life of patterning herself as the responsible “good girl” and wishing she could fix others?
“You can’t do anything for your sisters,” I told her, “until you start loving yourself.”
“I don’t know how,” she said. “This year I’ve had hardly any contact with them. And I’m relieved, which feels terrible. I worry about them. Are they okay? Could I do more? And I could do more. That’s the truth. And yet, when I do more, it becomes toxic and all-consuming. So I’m in a mess. I don’t know how to move on.
“I’m lost about how to re-form any connection,” she said. “And I’m torn, because while I do want to reconnect with them, when I’m really honest with myself, it’s so much easier when we’re not in touch. And that feels awful.”
There were two things I hoped she could let go of: guilt and worry. “Guilt is in the past,” I told her. “Worry is in the future. The only thing you can change is right here in the present. And it’s not up to you to decide what to do for your sisters. The only one you can love and accept is you. The question isn’t how can you love your sisters enough. It’s how you can love yourself enough.”
She nodded, but I saw hesitation in her eyes, something held back in her smile, as though the very thought of loving herself was uncomfortable—or at least unfamiliar.
“Honey, when you concentrate on what more you can do for your sisters, it isn’t healthy. It’s not healthy for you. And it’s not healthy for them. You cripple them. You make them depend on you. You deprive them of being responsible grown-ups.”
I suggested that maybe they weren’t the ones with the need. Maybe she was. Sometimes we have the need to be needed. We don’t feel we’re functioning well if we’re not rescuing people. But when you depend on being needed, you’re likely to marry an alcoholic. They’re irresponsible, you’re responsible. You re-create that pattern.
I told Iris, “This is a good time for you to marry you. Otherwise, you’re going to make a bad situation worse, not better.”
She was quiet, her expression disoriented. “That’s so hard,” she said. “I still feel guilty.”
When they were children, her eldest sister was very angry and frightening. At the time, no one knew she had experienced sexual abuse. Iris would come home from school and lock herself in her bedroom to avoid her sister’s volatility. She and the other sisters would beg their parents, “Can’t you get rid of her? Can’t you control her?” One day the eldest sister had an enormous fight with their father and pushed him through a screen door. That was when their parents sent her to a girls’ home—and from there, her life became ever rockier.
“I might have been the reason my parents chose to send her away,” Iris said.
“If you want to have a loving relationship with your sisters,” I said, “it can’t be based on needing each other. It’s because you want each other. So, you can choose. Do you want to have guilt, or do you want to have love?”
To choose love is to become kind and good and loving for you. To stop rehashing the past. To stop apologizing for not being there to save everyone. It means saying, “I did the best I could.”
“But it feels like part of my whole life journey is to somehow find a solution to what happened to the three of us,” Iris said. “As the only person in my family who didn’t have a major struggle, I was the only one who could keep it together back then. And now I feel disloyal when I’m not helping them.”
One of the first questions I ask patients is, “When did your childhood end?” When did you start protecting or taking care of someone else? When did you stop being yourself, and start filling a role?
I told Iris, “You may have grown up very fast. You became a little adult, taking care of other people, being the responsible one. And feeling guilty that no matter what you did, nothing was enough.”
She nodded, tears filling her eyes.
“So now you decide: when is enough enough?”
It’s difficult to relinquish our old ways of earning the A’s and discover a new way to build love and connection, one that hinges on interdependence, not dependence; on love, not need.
When I’m trying to help a patient get at his or
