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The caregiving behavioural system
Attachment theory, an influential theoretical framework for the study of intimate relationships, argues that all humans are born with the capacity and motivation to engage in caregiving behaviours aimed at providing protection and support to close others. These behaviours are organized by an innate behavioural system, called the caregiving system, which is believed to have emerged over the course of primate evolution to ensure the survival of vulnerable offspring. That is, because infants in many primate species, including humans, are highly altricial (i.e., immature and helpless at birth), they cannot survive without caregiver support. Attachment theory proposes that this evolutionary pressure favoured the establishment of the caregiving behavioural system, which activates in response to a close other's distress and motivates the caregiver to provide that close other with protection, comfort, and help during times of threat or need. Caregiving behaviours are aimed at reducing the partner's distress and supporting his or her coping efforts, for example, by communicating interest in the partner's problems, expressing confidence in his or her ability to cope with the stressor, supplying love and affection, and/or providing instrumental help such as advice or tangible resources. Although this system was first conceptualized in child-parent bonds, its operation has since been established in adult intimate relationships, where both partners may occasionally take on the role of caregiver. Attachment theory assumes that the effectiveness of the caregiving behaviour enacted determines the quality of the attachment bond between a caregiver and his or her partner.

Effective caregiving
The central component of effective caregiving is the taking on of what Batson (1991) called an empathic stance toward another person's suffering or needs. This means adopting the perspective, or "putting oneself in the shoes", of the partner in order to help lessen his or her distress in a stressful situation, or to help him or her pursue personal growth and development goals in challenging contexts. The empathic stance is characterized by two key, related components: sensitivity and responsiveness. Sensitivity refers to the ability to effectively detect and interpret the partner's cues of distress, worry, or need, and to provide the type and amount of support that is well matched to the partner's wants and needs. This tailoring of caregiving efforts to the particular characteristics of the specific situation is essential for effective care. Responsiveness is the ability to provide support in a way that makes the partner feel understood (i.e., the caregiver has accurately captured the speaker's problem, needs, and emotions), validated (i.e., the caregiver confirms that the care recipient is a valued individual and that his or her feelings and responses in the situation are reasonable), and cared for (i.e., caregiver should communicate affection and concern). Caregiving that lacks these two components - for example, care that is intrusive or domineering - can lead the care recipient to feel misunderstood, disrespected, and like a burden to their partner, thereby actually impeding coping.

Invisible support
Even well-intentioned support can negatively impact the care recipient's psychological adjustment to stressful events if it is inappropriate or excessive, or inadvertently highlights the fact that the care recipient does not have sufficient skills or resources to handle stressor by him- or herself. Consequently, Niall Bolger and colleagues have put forward the idea that support is most effective when it is invisible, or operates outside of the care-recipient's direct awareness. To investigate this proposition, the researchers recruited couples in which one member was preparing to undergo a highly stressful event, the New York State Bar Examination, and had both members of the couple complete daily diary entries about given and received emotional support. They found that the law students exhibited heightened levels of depression on days they reported receiving support, but lowered levels of depression on the days when their partners reported providing more support than the law students reported receiving. That is, participants in this study gained most psychological benefits from support they were not explicitly aware of having received.

Definition and functions
In addition to giving support and reassurance during distress, another important function of caregiving within intimate relationships is the provision of support for a relationship partner's personal growth, exploration, and goal strivings. In attachment theory, this type of support is termed secure base and is postulated to encourage the relationship partner's confident, autonomous exploration of the environment outside of the attachment relationship. This phenomenon was originally observed in young children; children whose parents showed more intrusiveness were less likely to engage in play and exploration in a novel environment.

Components of the secure base
Feeney and Thrush (2010) have identified three main functional components of secure base caregiving. First, individuals can support their relationship partner's exploratory, autonomous behaviour by being available in case support is needed. This can include actions such as removing obstacles to the partner's goal pursuit (for example, taking over some household chores to free up time for the partner to engage in a new activity), being sensitive and responsive to the partner's communications of distress, and communicating readiness to help in the event that support becomes needed. Second, effective caregiving does not unnecessarily interfere with exploration. That is, effective caregivers do not provide support when it is neither needed nor desired, attempt to take over or control the activity, or disrupt the partner's goal strivings. Third, partners should communicate encouragement and acceptance of exploration (i.e., convey enthusiasm about the pursuit rather than suggest that it is not worthwhile or will somehow detract from the relationship). Individuals who perceive their partners to be available to help are more persistent in the performance of challenging activities, whereas individuals whose partners show more interference during an activity show less persistence at the task, poorer performance, less enthusiasm for the challenge, greater negativity/hostility toward their partner, and decreases in self-esteem. Partners' communications of enthusiasm are related to better performance, heightened enthusiasm, better mood, increases in state self-esteem and enhanced self-perceptions, greater enjoyment, and more positive feelings toward the partner.

Dependency paradox
All humans have a fundamental, evolutionarily-rooted need to feel socially connected to other people (i.e., to achieve "belongingness" or "relatedness"). Simultaneously, people also hold a need for "autonomy", or the desire to maintain a sense of independence and self-sufficiency. While these two psychological needs may initially appear to be contradictory (that is, it is not readily apparent how people may reconcile their need for social connection with their need for independence), psychological research shows that individuals who are more dependent on their intimate partners for support actually experience more autonomy, rather than less (a phenomenon that has been labelled the "dependency paradox"). For example, Feeney (2007) showed that individuals whose romantic partners were more comfortable with having their partner depend on them were more likely to independently pursue and achieve their personal goals over a period of 6 months (without their partner's direct assistance). Such research is consistent with the idea that the most effective type of support for promoting personal growth (e.g., accepting challenges, trying new things, exploring) is support that involves being available and prepared to help, and that individuals who feel confident in the availability of a secure base to fall back on in case their goal pursuits go wrong are less likely to actually cling to their secure base.

Variability in caregiving
Although the tendency to care for intimate others is universal, there is wide variability in the quality and amount of caregiving that individuals enact. This variability is determined by a multitude of factors, including characteristics of the caregiver, the care recipient, and the relationship; some of these factors are more stable (e.g., personality differences), whereas others are more malleable and context-dependent (e.g., motivation).

Motivation
As effective caregiving involves a great amount of responsibility, as well as the expenditure of cognitive, emotional, and/or tangible resources, caregivers must be sufficiently motivated in order to provide responsive support to their relationship partner. That is, people who do not possess enough motivation to help will be less effective at providing care that is appropriate for their partner's needs. Furthermore, individuals may differ in the degree to which they hold altruistic versus egoistic motivations for helping. Altruistic motivations are centred on the desire to advance the significant other's welfare, whereas egoistic motivations are centred on the desire to gain benefits for oneself, or to avoid sanctions for not helping and/or other negative consequences to the self. More altruistic and less egoistic motivations for caregiving are linked to better outcomes for the care recipient and enhanced relationship quality.

Skills, abilities, and resources
Effective caregiving requires the caregiver to possess sufficient cognitive and self-regulatory resources. For example, caregivers must be able to regulate the negative emotions aroused by witnessing another person in distress. Failure of this emotional regulation may lead the caregiver to become overcome by their personal distress, adopt the role of a needy person rather than the caregiver, or to distance oneself from the partner as a way of regulating that distress. Research shows that particularly severe or chronic stressors may overwhelm the caregiver and decrease his/her ability to provide support to the partner. For example, Bolger, Foster, Vinokur, and Ng (1996) found that breast cancer patients who experienced the highest levels of distress in the month immediately following their diagnosis were less likely to receive support from their husbands over the following six months.

Attachment style
Personal attachment style is tightly linked to beliefs about, and strategies in, providing care to dependent others. Attachment avoidance, which is characterized by discomfort with intimacy, is related to less support giving and with keeping distance from a partner in need, particularly when the partner is experiencing higher levels of distress. When avoidant individuals do provide support, they tend to be more controlling. Attachment anxiety is related to controlling, overinvolved, intrusive, and compulsive caregiving (e.g., preoccupation with the fear that the partner will leave them if they do not provide adequate care). For example, anxiously attached individuals provide higher levels of support to partners who are about to engage in a stressful laboratory task, and this support is not matched to the level of need expressed by their partner. Anxiously attached individuals also display more negative support behaviours, such as blaming. Secure attachment is associated with more effective forms of caregiving (i.e., care that is responsive and not overinvolved).

Care recipient characteristics
Because careseeking and caregiving are highly interdependent, complimentary processes, individuals are more likely to receive caregiving efforts from their partner when they experience and express higher levels of distress or need. Individuals high in attachment avoidance, who are uncomfortable with intimacy and relying on others, are less likely to seek support during a stressful situation, and, when they do seek support, are more likely to use indirect strategies (e.g., hinting, sulking).

Benefits of caregiving
Receipt of social support, or the perception that social support will be readily available when needed, is linked to a multitude of benefits, including improvements in mood and self-esteem. Provision of effective care can also benefit the caregiver because it is likely to foster feelings of self-worth and efficacy, build confidence in one's interpersonal skills, promote the self-view that one is a moral person, and increase feelings of love and social connectedness. Research has also linked the provision of social support within intimate relationships to enhanced relationship satisfaction for the care recipient and caregiver. For example, higher levels of support in newlywed couples predicted higher relationship satisfaction two years later. Responsive care is especially important for relationship satisfaction.