Tuesday, July 6, 2010

Codependency... what the heck is it?

As I begin writing on this topic, I think it’s only fair to warn you that like many other conditions that are the focus of treatment by therapists, I’m rather ambivalent about what is often described as “codependency”. It would seem that like many other conditions (anger management problems come to mind), codependency seems to have jumped into popular psychology (and the culture in general) some time during the mid 1970s. The term seems to have been coined by therapists treating alcoholism; then it was more commonly described as co-alcoholism. The concept then (and still today) suggests that one who is in close relationship with an alcoholic, will begin to express many of the same symptoms/syndrome of alcoholism.

In alcoholism, the typical characteristics were well-known and predictable. Some of the more common were:

  • Obsession with the substance. (When can I drink? Does anyone else know I’m drinking? Dealing with consequences of drinking. Thinking of ways to drink without being discovered.)
  • Isolation. While it may seem that drinkers are social, thy actually become emotionally quite isolated after several ounces of alcohol. When under the influence, drinkers do not have meaningful communication with others. When inebriated the drinker is alienated from their own deeper thoughts; they are incapable of fruitful introspection.
  • Social problems develop for alcoholics. They offend people by their drunken comments. They develop occupational problems and sometimes legal problems. Often when inebriated, individuals do things they would never do when sober – and these acts can have disastrous consequences.
  • Distorted thinking is common among alcoholics. Denial, minimization or rationalization of one’s drinking is common.
  • Psychological problems accompanying alcoholism is the rule. Alcoholism can and does mimic nearly any mental disorder and causes many physical disorders.

Co-alcoholics manifested nearly an identical syndrome (a collection of symptom-behaviors). As substance abuse became more diversified (other drugs rather than only alcohol) the term morphed into codependency.

Many of us often do favors for friends and family; is this an example of codependency?

I am often asked what differentiates codependency from normal caring behaviors. It’s a good question which really gets to the core of the more exact concept. Just as one cannot make an assumption of alcoholism with one incident of behavior, one should not presume codependent behavior without knowing the context of the behavior. Whether or not there is a pattern of behavior is important. Often, I ask patients if their behavior is resulting in a problem in their own or someone else’s life. If it does, I begin to wonder about whether the “caring” behavior has crossed the line to damaging codependent behavior.

Some of the more common symptoms which are often red-flags suggesting codependency are:

  • An intense need to be “needed” by others to prolong the relationship.
  • Feeling that your self-worth depends on your connection to another.
  • Becoming resentful when your repeated acts of kindness and self-sacrifice are not reciprocated.
  • Feeling that you know what is best for others more than they themselves do.
  • A lack of awareness about your own needs.
  • Too much self-sacrifice. (When you stop doing what is pleasurable or important to YOU.
  • Excessive gift-giving as a way of insuring a relationship.
  • Limiting your social interactions with others.
  • Being embarrassed to tell others of your behavior in service of another.
  • Making excuses for another’s behavior.
  • Reactive depression and/or stress that is caused by another’s behavior.

Just as substance-abusers can develop physical problems due to their use of substances, codependents can develop many of the same physical-medical problems – among them: headaches, gastrointestinal problems, sleep problems, fatigue, diminished concentration. Codependents are often perfectionists, workaholics and hypochondriacs.

If the above is sounding uncomfortably like you, you may be wondering what the answer or solution is. You may even think that if the other person would change THEIR behavior, you wouldn’t have these problems. (I’m sorry to say if you believe this, you’ve got a SERIOUS case of codependency.)

Again, think of the treatment/recovery process of an alcoholic. They may begin abstinence with a formal treatment program. Hopefully, the treatment program will lead to long and active involvement in a 12-Step program. For alcoholics it would be Alcoholics Anonymous – for codependents, it would be Al-Anon (Both can be found on the internet – the meetings are everywhere and in every country I can think of – maybe not North Korea.)

When I was clinical director of an intensive out-patient program for the largest medical clinic in the area, I REQUIRED active involvement with 12-Step programs. Now as a therapist in private practice, I’ll admit there is more than one way to skin a cat. (PETA, forgive me.) But really, why reinvent the wheel. Here, I’ll paraphrase a small portion of Appendix II of The Big Book of Alcoholics Anonymous.

Most emphatically we wish to say that any alcoholic [or codependent] capable of honestly facing his/her problems in the light of our experience can recover, provided he/she does not close their mind to all spiritual concepts. They can only be defeated by an attitude of intolerance or belligerent denial.

We find that no one need have difficulty with the spirituality of the program. Willingness, honesty and open mindedness are the essentials of recovery. But these are indispensable.

“There is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep one in everlasting ignorance—that principle is contempt prior to investigation.”

—Herbert Spencer

Many frequently go to a gym to maintain their fitness or they do other regular physical activity. Probably, they would say this is a life-long practice. If one owns a home or has a relationship, they will tell you that it takes constant maintenance.

Recovery from codependency is a continuing effort – it’s an ongoing discipline. Some would say it’s a spiritual practice.

I recommend it.

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