Individualism
Much of our lives in the United States is spent chasing freedom and independence. That instinct reflects a broader cultural value system we’re steeped in: individualism. Individualism prioritizes personal autonomy, self-reliance, and the individual’s needs over those of the group. The United States has an individualism score of 91 out of 100, making it the most individualistic country in the world according to Gert Hofstede’s model of national culture.
While it’s a successful concept for an annual firework show, the veneration of independence can be disastrous when applied to mental health and caregiving. The more we prioritize the self, the more disconnected and distressed we often become. A study of 1,906 young adults found that increases in individualism are associated with reduced well-being, including anxiety, depression, self-esteem, and interpersonal relationships.
Consequences of Individualism Among Caregivers
The culture of individualism is a problem when healing depends on connection. Eating disorder recovery is one of the most obvious examples. One of the common symptoms of an eating disorder is anosognosia, which means people don’t realize how sick they’ve become. Thus, similar to substance use disorder, it is often friends and family who first recognize the need for treatment. This is when the individualistic ideal of self-reliance is harmful—it takes a village to get through challenging times, and relationships become the key to reaching and maintaining recovery.
It’s no wonder family-based therapy is such an effective treatment for adolescents and even young adults with eating disorders, as parents play a central role in recovery while their child’s brain heals. That’s a hard task for any parent, but it’s made worse by a culture that worships self-reliance.
Parents often tell me they feel ashamed or think they’re the cause of their child’s eating disorder. They’re ashamed that their child is sick, and ashamed that they can’t fix it quietly. Many assume they should shoulder it alone.
But the psychology of caregiving makes isolation dangerous for the caregiver and patient. Studies show that when caregivers experience poor mental health, it impacts their children’s physical and mental health.
What We Can Learn From Familism
We tell caregivers to take care of their mental health and rest, but that advice misses the heart of the problem. Rest requires a community to share the load with, because no one can sustain constant caregiving alone.
The answer to this challenge comes from the adage, “Many hands make light work.” In clinical terms, it’s familism. Familism is a cultural orientation prioritizing family well-being and mutual support. Research shows that cultures that embrace familism have better psychological outcomes for patients and caregivers. In real life, leaning into familism looks like this:
At home, instead of one parent taking on every meal, parents rotate responsibilities. One supervises dinner; another manages medical appointments or insurance calls. Extended relatives are enlisted to bring meals, help with siblings, or spend time with the caregiver.
In treatment settings, clinicians normalize caregiver distress and proactively provide resources. That may look like sharing support groups, acknowledging exhaustion, or screening caregivers for anxiety or depression. Familism here acknowledges that the caregiver’s health is central to the patient’s health.
In friendships, rather than asking, “How’s your child doing?” try, “How are you doing?” Follow it up with a concrete offering, like “Can your kids sleep over, so you can have a night alone this Wednesday?” to create a community of shared care.
Familism won’t eliminate the weight of caregiving, but its redistribution can be lifesaving for struggling families. When we lean into the “we,” the “I” finds room to breathe again. And while shifting away from individualism can feel uncomfortable at first, it opens the door to the support needed all along and the relief that comes with it.