Family Roles From
Family Systems Therapy -
Coping With Chr
onic Illness

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Family roles are useful in helping to adapt to any dramatic change in our life situation that involves significant change on our part.

Letting go of family systems psychology roles can be an important part of healing the past and creating a new future.

On this page I discuss rigid roles within our family that can be taken on when young and which we may need to challenge when coping with chronic illness.

Working with family roles can help to answer the questions below.

If you are dealing with a change other than illness, please adapt these questions as needed.

  • How do I adapt and find a life within illness?
  • How do I adjust to a different self image now I am unable to perform the family systems role I once did?
  • How can I heal from the compulsion to behave in ways (perform a family role) that are not possible at my current level of health?
  • How can I gain the behavioural flexibility I need to (break out of a role) live and heal?
  • How can I use illness as an opportunity to challenge and change patterns of behaviour?

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For the many years I was living with severe ME/CFS, I explored psychology self help and spiritual practices to help me keep my sanity, survive physically and increase my chances of being healed. Looking at family roles was part of that journey of self growth.

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How can family roles lead to the denial of illness in a family member?

Are you asking:

  • "Why are my family being so unsympathetic when I am ill?"
  • "How do I deal with my family now I am ill?"
  • "Why are they acting as though they don't believe me?"

Reading about family systems roles can help you gain insight into why your family may be in denial about the illness and the help to provide some answers and give you the understanding you need.

When I became ill with ME/CFS, my family were angry rather than sympathetic. I was confused. I was inclined towards denial of the illness.
After all, if I was ill, they would be helpful and sympathetic, wouldn't they?
Learning about family roles made sense of this family behaviour.

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Click through for psychology self help,
the 8 rules of dysfunctional families.

It was as though there was an unwritten rule that I was simply not allowed to be ill.
Reality was being ignored by the family, often including myself.

I came to think of it as the members of the family having an outdated map of the world - one on which the illness was not marked. (When I returned to walking and talking again, and trained in NLP, I discovered that "map of the world" is actually a term used in NLP (NeuroLinguistic Programming).

We all have our own maps of the world. They are all different and our maps may be more accurate in some places than in others.

My living with illness was not written on the map. Instead of updating the map, the family tried to carry on as though I was still well.

As I became more ill and the illness was more visible, this meant they mostly stayed away.

When they did visit, they found it very stressful.

I found it stressful! Their words – and sometimes their expectations – revealed an outdated image of me – an image of me as a well person.

In a Dysfunctional Family, the family roles become rigid

Family roles are taken up in every family and are not unhealthy. The difference is that in a dysfunctional family they become rigid.

In a dysfunctional family, the roles are not chosen by the child, but assigned by the circumstances and tensions within the family.

This idea of family system roles was very helpful to me in pursuing psychology self help.

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Why break out of a family systems role? Can you afford not to?

It is not easy to change yourself. Many of us go through life behaving the same way and saying “This is just the way I am.”

When you are living with ME aka CFS or another chronic illness, you may have a clear idea of why you want to change.

  • You need to change for the sake of your health. You need to learn to rest.
  • You need to learn to put your own needs first at times, both for your sake and for the sake of those who love you and want you as well and happy as you can be.
  • You need to learn to feel OK about yourself even when you are not able to help others.

To be clear, when we are well again, we may once more fill these family roles in our new families or in our community.
The filling of the roles is not a problem.

But it is not healthy when we are defined by these family systems roles to the point where we are not in a place of choice, freedom and flexibility.

How Can Family Systems Roles Help Us Heal The Past And Move Forwards On Our Journey of Self Discovery?

In my journey with psychology self help, family roles helped me to come to terms with the denial and anger of my family in a time of illness.

Recognising that I had played a certain role in the family helped me stop looking to others for permission to take the illness seriously.
My life, the people I attracted in my life, and my expectations were programmed not to allow myself to have problems.

I recognised that I would have to give myself the permission to be ill that I needed.

Living with illness meant giving up the role of caretaker

One of my family systems roles had been the role of Caretaker.
(For the definition of the Caretaker, see below.)

It was very hard for me when I got ill to no longer be able to take on my role as Caretaker.

I probably only gave up this role because I was forced out of it by physical limitations. In many ways, I continued to play this role even when severely ill. Carers feeding me would take the chance to tell me all their problems, and even ask advice!

I had to accept that my family were not forced to adapt along with me.
Sometimes, as you let go of playing a certain role, some people in your life will choose to move on.

Women who love too much

An excellent psychology self help book on giving up the compulsion to look after other people is Women Who Love Too Much by Robin Norwood.

This role of caretaker applies to men too! It applies to anyone who finds it more comfortable to tend to the needs of another than to their own.

Find the book and others in the...
USA Psychology Self Help Relationships Bookstore.
UK Psychology Self Help Relationships Bookshop.

Family roles help us see that a behaviour has a positive intention. There was a time when it made sense for us or another to take up these roles.

"Every behaviour has a positive intention"

NLP presupposition

Recognising the positive intention behind our decision helps us to have self acceptance and compassion for ourselves for having taken on a certain family role. Change is always easier from a place of self-acceptance.

A List of Family Roles In Family Systems Therapy

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The Caretaker definition – a child who takes on responsibility for the emotional-wellbeing of the family. Sometimes taking a role of parent to other children or to one or both of the parents.

The Problem or Family Scapegoat – the child who takes on the role of rebelling. They thereby often provide a distraction from marital difficulties. Focusing on the problem child leads to an agreement between the couple, thereby helping the couple to stay together.

The Lost Child family systems role– the child who sets aside her needs. Perhaps because they have been ignored. Perhaps in recognition that a parent is not able to meet those needs.

The Mascot or the Clown definition – uses comedy to allow the dysfunctional family system to continue to function. But equally, the comedy may help the family to avoid seeing that there is a problem that needs to be addressed.

The Star Hero definition – Does well at everything. The parent may be living through their child, using the child to fulfil their own dreams. The child may not actually be in touch with what she wants. She may also be working hard in order to feel OK about herself. The family system may have led her to believe she needs to earn her worth.

The Mastermind – This child manipulates the faults of those within the family to get what they want. This results in a feeling of a lack of safety. They have an inappropriate level of power over the authority figures in their life.

The Protected One – Information about dysfunction in the family may be kept from this member of the family. The member can feel excluded as a result and in later life may have a tendency to avoid difficulties rather than face them.

There are many family roles we can take on other than the main ones listed above.

A List of Family Roles We May Have To Give Up In A Time of Illness

Here are some of the family roles you may have to give up in a time of illness. I accompany them with some releases to help free yourself from any compulsion to play these roles.

The Caretaker
If you have been a caretaker, then you are unlikely to be able to continue in this role in a time of illness. This may be painful for you. You need to work on knowing you are of great value even in a time when you are not able to physically help others. It is a great time to be willing to allow God to love you.

It's OK to look after others.
It's OK not to look after others.

It's OK to look after yourself.
It's OK not to look after yourself.

For more about maintaining worth in a time of illness see:
Being blessed and a blessing (in a time of illness)
And also...
Psychology Self Help To Better Live With ME/CFS

The Lost Child
If you learned to hide your needs away, you may find it painful to be suffering from a physical illness where your symptoms are apparent to many. You may feel shame and guilt around being ill.

History may also repeat itself: you may get an illness whose seriousness is not apparent to many. ME/CFS is a great example of an illness likely to be manifested by a Lost Child. You have needs but they are not being recognised.

To move forward you need to allow yourself to have these needs, even in a world that does not seem to give much sympathy or assistance.

Releasing Judgement:

It's OK to have needs.
It's OK to let someone see your needs.
It's OK for someone else to meet your needs.

The Star Hero
In a time of illness you may not be seen to excel at something. In fact, there are probably many things you are doing wonderfully. The fact you are surviving and keeping sane may be a huge achievement in the circumstances in which you are living, but it is unlikely to be one for which you get much recognition.
A time of illness is an opportunity to define yourself by something other than your achievements.

Releasing Judgement:

It's OK to do well at something.
It's OK not to do well at something.

I am of inherent value.
Whatever I can do and can't do right now, I am as God created me. There is a Beauty and Love in me that I can never lose.

Psychology self help books such as John Bradshaw books reviewed here can help us to identify these family roles and learn to free ourselves from these behaviour patterns.

See or buy John Bradshaw books:
For the USA, click on the icon below or on USA Psychology Self Help Books
Click here to see or buy the books from the UK Psychology Self Help Books

...Continued. List of family roles that can be difficult to maintain in a time of illness.

The Listener
Living with ME/CFS or many other chronic illnesses, your ability to tolerate noise and to listen may be much reduced. If you played the family role of Listener, it may be uncomfortable for you not to be able to listen.

You may also need to talk to someone about how you feel about having an illness and its impact on your life.
It may feel uncomfortable for you to be the one talking about your problem, because you feel you should be listening.

On the other hand, you may find that if your speech is reduced, you end up listening quite a lot.
Well done for the value you provide by listening.
Well done for saying when you are too tired to listen.


It's OK to listen.
It's OK not to listen.

When I am unable to listen, I am still of value.

The Busy One
Our society often views being busy as being of value.
Being busy can distract us from feelings of not being of value. These feelings may come to the surface when we are forced through illness to sit still or lie still. For ourselves and for others, we can do the important work of allowing God to love us as we are. (You may not use the word God by the way. But research shows that making a spiritual connection is one of the 6 key factors in spontaneous recovery from cancer)

To recover from ME/CFS it is important to learn to rest, and this becomes easier as we let go of the need to be the busy one.

It's OK to be busy.
It's OK not to be busy.
Whatever I can do and can't do, I am of value.
I am as God created me.

Mummy’s Helper
If you were designated the family role of Mummy’s helper (or Daddy's helper), and this role was inappropriately rigid, then even if you get ill as an adult, your family system may be annoyed that you cannot fulfil that role.
When I speak of the family system, this may be your mother, but also your siblings, your father and yourself.

In a flexible system, someone will step in to take on the role of helping your parent. Perhaps your parent doesn't actually even need help and would be better off looking after themselves!

In a dysfunctional family system, there is huge pressure to continue taking on the family role of helper even when it is not healthy for you to do so.

It's OK to look after your parent.
It's OK not to look after your parent.

It's OK to be looked after by your parent.
It's OK not to be looked after by your parent.

The last release is as important as the rest. Sometimes if we take on role of helper to our parents it can be to avoid the existential pain of finding that our parents do not know how to look after us in some way. We can define ourselves by our parents’ abilities:

False Belief:
“If my parents don't look after me then clearly I am not worth looking after.”

To solve the existential pain of knowing that our parents don't know how to look after us well, we can take on the family role of looking after them instead.

It's OK not to be looked after by your parent.
This release invites us to know that "it is ok not to be looked after". It is nothing to be ashamed of.
It is the way our world was at a particular time.
It may be the way the world is now.
But it is not the way the world has to be.

We are calling in a new world – one in which we can be looked after.

Statement to open to a new world:
I allow myself to be looked after by myself and others.

Other pages related to Family Roles and How To Learn To Live With Illness:

Book Reviews For John Bradshaw Books on Family Systems Roles

Other Psychological Approaches To Better Live With CFS

Being Blessed and A Blessing (in a time of illness)

7 Stages Of Mourning The Loss Of Health

Poems About Learning, Changing, Growth And Success

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Be Loved

15 Spiritual Love Poems
God Love Self Love

(by the author of

For 14 years, Katherine was severely disabled with CFS/ME, unable to walk, with little speech, and with inadequate care.

Katherine's small beautiful collection of poems take the reader with her as she journeys to know both self love and
God's love.

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Support independent publishing: Buy the paperback on Lulu.

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"One thing that struck me was the stripping of ego in the work. Most of us have a comfy ego façade, but weakness and disease tore Katherine’s away. The poems in Be Loved Beloved come from the heart."

Dana Taylor, Author of Ever-Flowing Streams: Tapping into Healing Energy