Sign up for the Slatest to get the most insightful analysis, criticism, and advice out there, delivered to your inbox daily.
Jane shifted nervously on the hard examination room table at her regular semiannual visit. In some ways, she was happy to be there. She loved her doctor. A few years before, after years of misdiagnoses by other doctors, this one had discovered her brain tumor and successfully removed it.
That day, Jane expected to once again express her gratitude to the woman who had saved her life. Instead, a stranger walked through the door.
“I’ll be replacing your doctor,” said the new man while abruptly applying a cold stethoscope. Jane felt like crying.
Following the surgery, Jane had announced that as a gesture of gratitude, her family would be endowing a chair for the doctor who’d performed her surgery at the university hospital where she worked. The position had helped the doctor, then relatively fresh in her career, rise several levels at the hospital in record time. Jane had figured the doctor would be pleased by the gift.
But ever since, Jane had sensed a certain chilliness creep into their relationship. She felt snubbed that day in the exam room—hurt, but also baffled. Despite Jane’s repeated attempts to reach her, she never heard from the doctor again.
As a psychologist fascinated by the paradoxes of the human psyche, I have for years struggled to understand why extreme or continual acts of generosity not only may fail to inspire lasting appreciation in the receiver but can lead to outright hostility. Jane (whose name I’ve changed) is a patient of mine, and her story is one example of many. I’ve seen it over and over in my practice: A gesture that is initially received with intense gratitude curdles into hurt or anger. “You gave too much—it made them hate you,” I’ve said to my patients so often that the line has become jarringly familiar.
I’ve been through this kind of thing myself. Decades ago, one of my closest high school friends overdosed at a party after her boyfriend dumped her. After finding her body slumped on the floor, an empty pill container beside her, I raced her to the emergency room. Her stomach was pumped, and she survived. For weeks after, she showered me with thanks. But before long, the communication tapered off, then stopped altogether. It was my first experience with the tyranny of the gift.
Imbalanced relationships are often thought of in terms of one person’s resentment at feeling that they’ve given too much to the other. A family member or friend may lend money without a clear expectation of when it will be returned. A girlfriend will encourage her partner to spend time with his friends, then stew when she is left behind. But what about the resentment of the person to whom the largesse is given, particularly when there is no quid pro quo? In these cases, the ill will might feel perplexing.
The very notion that generosity can boomerang may at first seem counterintuitive. After all, this is a value we have been taught to strive for, for good reason: It is an important ingredient in successful relationships. A couple who stays married for decades shows appreciation for each other. Even office mates might all chip in for a wedding or retirement gift for a colleague. Yet examples abound in my psychology practice of relationships that have toppled under the burden of generosity.
Once, a patient of mine who covered for a colleague repeatedly at work received from him a poor evaluation that cost him his job. Another patient housed a family whose home had burned down, only to have that family ghost her. Then there was the woman who lent her close friend a sum of money to stave off bankruptcy, telling her not to worry about repayment. Little did she know that what she really had to worry about was that her friend would renege not only on the loan but on their friendship.
So why does altruism backfire?
Shabnam Smith, a psychiatrist and assistant clinical professor at Columbia University Medical Center, warns against “any relationship where there is an imbalance in power.” She describes that imbalance as problematic because “there is a loss of agency. It makes any relationship feel fragile.” She told me she “is concerned about relationships where too much is given because there can be a sense of infantilization, a sense of being beholden.”
As crucial as generosity is to the health of any relationship, so is equilibrium, which is characterized not by dependency but by interdependency. A relationship in which one feels that they owe something to the other makes the dynamic seem imbalanced. Smith says: “When it is not clear how they can make something up to the other person, the person being given to invariably feels a lack of control. It can feel daunting.” When gratitude is too big, it spills over into shame, which inevitably, even understandably, leads to discomfort and anger. In fact, emotional reciprocity—each individual feeling both given to and received from—is not just a benefit to a relationship (romantic or otherwise). It is an essential component.
Anthropologists have long demonstrated that gifts, particularly extravagant gifts, are never free. As Marcel Mauss’ classic book The Gift demonstrates, every personal gift, even an altruistic one, incurs debt. Personal relationships need mutuality. In its most stripped-down definition, mutuality is about knowing that in a relationship both people have needs and that each person’s needs matter. In their 1992 book Spare Parts, Renée Fox and Judith Swazey write about kidney donation, the extraordinary act of selflessness that gave rise to the term tyranny of the gift:
What recipients believe they owe to donors and the sense of obligation they feel about repaying “their” donor … weigh[s] heavily on them. This psychological and moral burden is especially onerous because the gift the recipient has received from the donor is so extraordinary that it is inherently unreciprocal. … As a consequence, the giver, the receiver, and their families may find themselves locked in a creditor-debtor vise that binds them one to another in a mutually fettering way.
So what can you do to counteract this process? Is there any way to avoid it? In my practice, I have found that there are strategies both before and after that can mitigate or even sidestep the ruptures that relational inequality can cause.
You can avoid falling into the tyranny of the gift by communicating boundaries and worries ahead of time. My patient who helped bail her friend out of bankruptcy told her: “Don’t worry about the money.” That isn’t realistic, nor ultimately is it caring. I wish she had been direct ahead of time about her worry that the money might come between them and set a clear deadline for repayment. What she might have sacrificed in terms of her own feelings of selflessness she would have more than recouped in relational reciprocity. Relationships don’t falter because of hard things; they falter when the hard things are ignored and/or hushed up.
Related From Slate
[
Kathleen Smith
I’m a Therapist. Trump and Musk Are Prompting People to Act in a Very Specific Way Right Now.
Read More](https://slate.com/life/2025/02/trump-musk-bossy-anxiety-therapy-tips.html)
Before giving, the giver should also thoroughly examine themselves and their motives. Are they taking care of things they don’t need to? Are they operating from the belief that someone else’s needs matter more than their own? If so, why? Where did this self-abnegation begin, and why does it persist? Is this person truly caring for a loved one or indulging in a kind of martyrdom that could easily backfire? Delving into these questions honestly can help anyone avoid a whole raft of unforeseen consequences.
But what if, having ignored the warnings, a person finds themself in a nonreciprocal dynamic? The answer: They must name the situation for what it is. It may be uncomfortable to observe and describe disparities, particularly financial ones. But it is important to overcome these anxieties. In the general treatment of anxiety, people are advised to “name it to tame it.” In the context of giving, closely observing the disparities between the giver and the receiver can begin the process of recalibration.
When my friend overdosed, I thought I was being kind to keep silent about what had happened; after all, I didn’t want her to feel bad about the lengths I’d gone to to save her. Judging by her behavior, that was the wrong strategy. If I had to do it over, I would approach the issue with care but also directness. How was she feeling about the fact that I saw her in such a vulnerable state, and did she now think she owed me something? Love and respect can be demonstrated in many ways; one of them is by paying attention to difference and inequality.
Another reason to name disparities is to open the channels of communication. My patient Jane never got to tell her doctor how much the connection meant to her or that her doctor’s care had not only saved her life but enriched it. The truth was, there was no real disparity between them: Jane’s doctor and Jane had both given to each other, just in different ways. If only they had communicated openly, then they might have seen that. “Sometimes what we see at first glance—what is obvious—is not what is going on relationally,” Smith remarked when I told her about my patient’s dilemma. “There’s always a deeper story.”
In any relationship, flexibility is a sign of strength. Adapting and growing with shifting needs is a measure of a connection’s sturdiness. Our stories are not fixed. Neither are our definitions. It’s time to redefine what we have traditionally thought about giving in relationships. The tyranny of the gift can be avoided, but only when we begin to value reciprocity as a gift as well.