Broadly defined, nearly every adult in this country is now, has been or will be a caregiver of some sort during their lifetime. As adults, we care for children, aging parents, sick neighbors, disabled siblings, and, perhaps most tragically, ill or disabled spouses or domestic partners. If it is a temporary situation, it is easier to be a caregiver. After all, most of us will take care of someone with a broken leg, someone who needs surgery, someone who has a temporary disease, and so forth. It would be foolish indeed to single-handedly take on the responsibilities of caregiving assuming that this was going to be a permanent arrangement.

However, once an acute illness for a spouse begins to look like a chronic condition, all standing agreements and previous expectations need to be evaluated. The caregiver must ensure their own needs, as well as those of their partner, are going to be met before volatile emotions intrude. Failing to make this evaluation is the origin of burnout, anger, depression, and longing for a different way of life--even hating the person we once loved.

Caregivers must care for themselves first, a piece of advice heard all the time. The problem is that nobody offers advice on how to do it. As with so many of life's dilemmas, we turn to society's adages, clichés, maxims, and religious teachings to provide us with guidance. The famous Latin phrase, "caveat emptor" (let the buyer beware), is important as we evaluate the implications of these so-called gems of wisdom.

Here are the top caregiving myths to dispel:

1. There is something noble about sacrificing your life for a loved one.

The idea is that self-sacrifice is ennobling, that giving up your own pleasures in the service of others is something positive. A companion message is "It is selfish to think of our own needs as a caregiver." While these are inspirational ideals, the reality is not as pretty. When caregivers are on call, waiting for a bell or a yell from the person they are caring for, their own needs are frequently put on hold. As we make these sacrifices, we tell ourselves we do it out of love, and that is certainly the truth.

However, giving another person what they want at our own expense is almost never a good idea. As caregivers, we are tempted to give, give, give and ignore the fact that we get little back from the other person. We are always putting forth more to serve the needs of the care recipient than we can ever get back.

Of course, we are not supposed to keep track of this exchange process, based on another message we get: "It is more blessed to give than receive." The fly in the ointment is that the brain has a mind of its own. We keep track of this unbalanced exchange process with our own "internal ledger." The more unbalanced the ledger becomes, the more stress is created for the caregiver, which manifests as resentment, depression, anxiety, verbal abuse, and even physical abuse. When self-sacrifice reaches a certain level, it always backfires.

2. Love is forever.

Another misconception is the idea that once we declare our love for another person, as with a life partner, it is a permanent commitment. This suggests that love is unconditional, that no matter what the other person does, the love will never go away. This belief ensnares us into making unrealistic commitments that could easily go awry.

A more realistic approach is to understand that almost all forms of love--the exception being the love of a parent for an infant--are conditional. Marital love is dependent on certain conditions being met. To be more accurate, the vows should have been worded as follows: "I will love you provided you are sexually faithful to the marriage;" "I will love you provided you do not squander martial resources;" "I will love you provided you are not physically abusive of me or any children we may have together."

3. God never gives you more than you can handle.

For some caregivers, this is the only strength they can hold onto. Regardless of what our beliefs are, there is a deeper issue embedded in this kind of statement. It amounts to a commentary on human resilience. It provides reassurance to caregivers that they will "make out just fine." Or, "I know you will bounce back," or "We all have these crosses to bear in life."

The truth for caregivers of chronically ill or disabled relatives or spouses is that things are not going to be just fine. It does feel like life is too strenuous. There are financial hardships, intimacy problems, unmet needs, and a rising level of exasperation and anger that is real and potentially deadly. There is a whole list of psychological needs that go unmet. To make matters even worse, caregivers in this situation are often so tired of medical waiting rooms they will not see their own doctor when they should. It is not uncommon for the caregiver's physical health to deteriorate for this reason alone. There is no cure, and the exhausted caregiver is waiting for one of them to die for pain relief.

So, what can caregivers do to keep from being victimized by these myths?

There is an important theme running through each of these clichés, social rules, myths, and proverbs. They represent a kind of propaganda initiated by people who want ironclad guarantees, that if they become sick or disabled, their caregiver will be required by these social rules to stick around. The primary club they wield through these rules is guilt, the tool used to bind them to their caregiver. If their caregivers so much as fantasize about walking away from their caregiving responsibilities, guilt will keep them there. To head off feeling guilty for thinking of themselves, caregivers should:

• Remember that taking care of themselves first is the only way they can stay healthy enough to continue to provide care to the patient. Caregivers who sacrifice too much become indifferent to the needs of the care recipient.
• The key is balance. The needs of the patient must be balanced against the needs of the caregiver so everyone wins.
• Caregivers should be skeptical of other peoples' expectations. Unless they are caregivers themselves, they will probably give bad advice.
• Whenever they find themselves angry or uptight, caregivers should ask themselves what they need that they have denied themselves and then find a way to get those needs met.
• Get more sleep.

The available research on caregiver burnout suggests that those who take even minimal steps toward caring for themselves are likely to last years longer as effective caregivers. This means finding a good support group, linking up with another caregiver for mutual support, arranging for substitute care on a regular basis, or reading a "how to" book on finding life balance as a caregiver. Try to avoid support groups that focus on helping you be a better caregiver; something you can find out by interviewing the leader.

Caregivers who put the needs of the care recipient first are neglecting themselves. And caregivers who neglect their own physical and psychological health gradually become poor caregivers. Another way of putting this is, if you don't take care of yourself, your sick relative or spouse will suffer. Since caregiving is a one-sided affair, we will eventually become resentful and indifferent to the needs of the care recipient. The cure is caregivers must take care of themselves first. There will be plenty left over for the person who is sick or disabled, and everyone wins.

David A. Travland, PhD, is a clinical psychologist and a former caregiver. He and co-author Rhonda Travland wrote "The Tough & Tender Caregiver, a Manual for the Well Spouse." He is a nationally recognized organizational development consultant to small, medium-sized and Fortune 500 organizations. Rhonda is a gerontologist, a former nursing home administrator and was a caregiver for over ten years. Together, they are co-founders of The Caregiver Survival Institute, offering services to caregivers and their families. For more information: www.caregiversurvival.org.