Codependence

The term codependence replaced an earlier term, coalcoholism, in the early 1970s and achieved widespread acceptance among the general public during the 1980s. Both terms point to problematic beliefs and behaviors that family members of chemically dependent people tend to have in common, although the term codependence broadens the concept to cover a wider range of family dysfunctions than chemical dependence alone.

A rather large nonscientific literature has developed on the topic of codependence. Much of it is couched in terms of the need to deal with injuries to emotions sustained during childhood—that is, to heal the wounds of the "inner child," a term popularized by John Bradshaw.

Despite the current popularity of codependence, awareness that one person's alcoholism affects everyone in the family is not new. The Big Book of Alcoholics Anonymous (1939; 1976) described the experience of family members of alcoholics in the following manner:

We have had a long rendezvous with hurt pride, frustration, misunderstanding and fear. These are not pleasant companions. We have been driven to maudlin sympathy, to bitter resentment. Some of us veered from extreme to extreme, ever hoping that our loved one would be themselves once more.

We have been unselfish and sacrificing. We have told innumerable lies to protect our pride and our husband's reputations. We have prayed, we have begged, we have been patient. We have struck out viciously. We have run away. We have been hysterical. We have been terror stricken. We have sought sympathy. We have had retaliatory love affairs with other men.

Usually we did not leave. We stayed on and on [pp. 104-106].

In his book I'll Quit Tomorrow (1973), Vernon Johnson described the same experiences when he wrote that the ism of alcoholism is shared by other family members. In his words,

While there may be only one alcoholic in a family, the whole family suffers from the alcoholism. For every harmfully dependent person, most often there are two, three, or even more people immediately around him who are just as surely victims of the disease. They too need real help and should be included in any thoroughgoing model of therapy…. With every drunk there is a sick dry who is almost a mirror image. [italics added]

The people around the alcoholic person have predictable experiences that are psychologically damaging. As they meet failure after failure, their feelings of fear, frustration, shame, inadequacy, guilt, resentment, self-pity, and anger mount, and so do their defenses. They too use rationalization as a defense against these feelings because they are threatened with a growing sense of self-worthlessness. They too begin to project these masses of free-floating negative feelings about themselves upon the children, back on the spouse, on other family members, on employees, and everybody else at hand. Their defenses have begun to operate in the same way as the alcoholic's, although they are unconscious of this, and they are victimized by their own defenses rather than helped. Out of touch with reality, just like the alcoholic, they say, "I don't need help. It's his problem, not mine!" The chemically dependent and those around him all have impaired judgment; they differ only in the degree of impairment [p. 30].

DEFINITION

Although considerable debate still remains among professionals regarding the definition and meaning of codependence, most addiction specialists agree that the concept has successfully ushered huge numbers of people into recovery. Perhaps the best general definition of codependence is called the Scottsdale definition, after the conference location where several lecturers met to achieve consensus:

Co-dependence is a pattern of painful dependence on compulsive behaviors and on approval from others in an attempt to find safety, self-worth and identity.

CHARACTERISTICS

The following five characteristics form the common thread weaving through the lives of many, if not most, family members of alcoholics and other drug addicts:

  1. Codependents change who they are, and what they are feeling, to please others. Codependents are chameleons who sacrifice their own identity in an effort to get others to love them. They do this for two reasons. First, they fear being abandoned if people know how they really feel or who they really are. Second, they have so little sense of who they are that they need to be in relationships in order to organize their lives and feel complete. Unless they are in a relationship, and can take their cues from another person, they feel desperately lonely and worthless. As a result, codependents are split between two worlds. One world is the facade they show other people—the false version of themselves. The other world is how chaotic, fearful, and empty their life feels underneath.
  2. Codependents feel responsible for meeting other peoples' needs, even at the expense of their own needs. Codependents are so afraid of rejection that they will do anything to keep other people happy, including sacrificing their own needs to keep people from leaving them. They actually get more upset if others are disappointed or hurt than if their own problems go unsolved. This habit of focusing more on others often leads to codependents' enabling a family member's drinking. Enabling means that the codependent protects the chemical dependent from the negative consequences of their drinking and other drug usage to keep the other person from having to feel any pain or embarrassment.
  3. Codependents have low self-esteem. Most people who are chemically dependent feel ashamed of themselves and are inwardly very self-critical. So perhaps it is not strange that other family members also begin to feel bad about themselves. For codependents, low self-esteem comes from two main places:
    • It comes from having very little sense of self to esteem. By always pleasing others and taking their whole identity from others, codependents end up not knowing who they are apart from the relationships they are in. It's hard to respect people who are afraid to be themselves, even when it's you!
    • Low self-esteem also comes from believing that they truly are responsible for someone's alcohol/drug use. Once they believe this, they will always feel inadequate when they fail to control the chemical dependent's behavior. This mistaken sense of what should be under their control is at the very core of both codependence and chemical dependence.
  4. Codependents are driven by compulsions. Codependents feel they do not have any real choices about what is happening to them. They typically feel compelled to keep the family together, to stop the drinking or other drug use, to save the family from shame, to work, to eat or diet, to take physical risks, to spend or gamble, to have affairs, to be religious, to keep the house clean, and on and on. The driven quality of compulsions accomplishes two things:
    • Compulsions create excitement and drama. As people battle their compulsions, the adrenaline begins to flow, and simple decisions, such as what to eat or how much to work, are turned into life and death struggles. This drama temporarily gives a feeling of purpose and vitality.
    • Compulsions also occupy a lot of time and block people from their deeper feelings. Codependents often get locked into compulsive behaviors to avoid more painful feelings of fear, sadness, anger, and abandonment caused by a family member's chemical dependence.
  5. Codependents have the same use of denial and distorted relationship to willpower that is typical of active alcoholics and other drug addicts. Denial and an unwillingness to accept human limitations are the two most destructive parts of the ism of alcoholism described by Vernon Johnson. In their own way, codependent family members fall into the same distorted relationship to reality and willpower as the chemical dependent. Both deny reality and think they can control alcoholism (their own or another's) if they just use enough willpower. For example, if chemical dependents deny that they are abusing alcohol or other drugs and remain unaware of its impact on their lives and their relationships with family members, friends, and coworkers, then codependents show exactly the same denial. They often refuse to see that a family member is chemically dependent, or they refuse to acknowledge that their children are being hurt. Shame and the compulsion to keep things under control cause codependents to deny the problem. Denial is a universal human trait, but it is overused by every member of a chemically dependent family.

Codependents are driven by the firm belief that their coping strategies fail because of personal inadequacy. When they cannot control the drinking or other drug use of someone they love, they blame themselves for not trying hard enough—or for not trying the right way. When codependents take too much responsibility for another person's recovery, it keeps the chemical dependent from seeing that only they can be responsible for their own recovery.

PSYCHIATRIC PERSPECTIVE

In many ways, codependence is the mirror image of a chemical dependent's self-centeredness and grandiosity. Another term for such self-centeredness is narcissism. Codependence is the complement of narcissism, just as a glove complements the hand it is shaped to fit.

In the Greek's myth that gives us the prototype for self-centeredness, Narcissus had relationships only with people who shared his values and interests. He was unable to feel a sense of human connection with people who were separate from him, just as chemical dependents may break off relationships with people who do not support their denial. The myth of Narcissus also gives us the prototype for other-centeredness in Echo—who is the perfect reflection of Narcissus. The two fit together and seemed to complete each other. Their relationship had intense chemistry.

In the eternal struggle within each individual between the need to be nurtured and the need to nurture others, Narcissus and Echo (and chemical dependents and codependents) strike a balance between two extreme positions. Rather than balancing the two needs within each of themselves, they allot the need to be validated and appreciated to Narcissus and the need to nurture and be in a relationship to Echo. Neither is capable of a truly mutual relationship—but, together, they create an intense experience of connectedness.

In healthy families, children remain comfortable with the competing, normal childhood needs to be unconditionally loved and validated as worthwhile (i.e., to be the center) and the opposite need to be completely dependent upon all powerful and good parents (i.e., to have others be the center). When parents are unable to tolerate not being the center of relationships, even with their children (which often happens with a chemically dependent parent), children often renounce their own need to be focused on. They become the opposite of narcissistic; they become codependent.

(SEE ALSO: Adult Children of Alcoholics (ACOA); Al-Anon; Alateen; Families and Drug Use)

BIBLIOGRAPHY

ALCOHOLICS ANONYMOUS WORLD SERVICES. (1939;1976). The Big Book of Alcoholics Anonymous. New York: Author.

BRADSHAW, J. J. (1988). Healing the shame that binds you. Deerfield Beach, Fl: Health Communications.

CERMAK, T. L. (1986). Diagnosing and treating co-dependence. Minnesota: Johnson Institute.

CERMAK, T. L., (1990-1991). Evaluating and treating adult children of alcoholics. Minnesota: Johnson Institute.

JOHNSON, V. (1973). I'll quit tomorrow. New York: Harper & Row.

TIMMEN L. CERMAK