Codependence

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Codependence is a term which has been defined variously. In general, the codependent is understood to be a person who perpetuates the alcohol or drug dependence of someone close to them in a way that hampers recovery.[1] This can be done through direct control over the dependent, by making excuses for their dysfunctional behavior or relieving them of the consequences of the dependence. In an act called enabling, this can have negative social and health consequences for both parties.[2]

Contents

[edit] History

Although popularized by 12-step movements such as Adult Children of Alcoholics, codependence first emerged as a simplified form of the "dysfunctional communications patterns" identified by family systems theorists beginning in the 1960s.[3]

[edit] Symptoms

Symptoms of codependence may include controlling behavior, distrust, perfectionism, avoidance of feelings, problems with intimacy, excessive caretaking, hypervigilance, or physical illness related to stress.[3] Codependence is often accompanied by clinical depression, as the codependent person succumbs to feelings of frustration or sadness over his or her inability to improve the situation.[4] Codependency advocates claim that a codependent may feel shame about, or try to change, his or her most private thoughts and feelings if they conflict with those of another person. An example would be a wife making excuses for her husband's excessive drinking and perhaps defending him by calling in sick for him when he is hung over. Such behaviors, which may well lessen conflict and ease tension within the family in the short term, are counterproductive in the long term, since, in this case, the wife is actually supporting ("enabling") the husband's drinking behavior. So, sometimes, the codependent is referred to as an "enabler." It is also worth noting that since the wife in this case is dependent on the husband's alcoholic behavior, she may actually feel disturbed, disoriented or threatened if she sees clearly that he is emerging from his dependence; the threat to her position as a confidante and needed loved one might lead her unconsciously to resist the husband's steps towards recovery.

[edit] Treatment

Individuals who are suffering from codependence may seek assistance through various therapies, sometimes accompanied by chemical therapy for accompanying depression.

In addition, there exist support groups for codependency; some of these are Co-Dependents Anonymous (CoDA) and Al-Anon/Alateen, Celebrate Recovery[1], and Adult Children of Alcoholics (ACoA), which are based on the 12-Step model of Alcoholics Anonymous.

Many books have been written on the subject of codependence. Melody Beattie was one of the first to describe such behaviors. She is the author of Codependent No More among many other volumes.

[edit] Controversies

  • The view that it is just a popular popular psychology concept,[who?] codependency is also a concept in for ex Medical Subject Heading.[5]
  • Caring for an individual with a physical addiction is not synonymous with pathology. To name the caregiver as a co- alcoholic responsible for the endurance of their partner's alcoholism for example, pathologises caring behaviour. The caregiver may only require assertiveness training skills and the addict accountability in taking responsibility for managing their addiction, or not[6] [7].
  • Not all mental health professionals agree about codependence or its standard methods of treatment [8]. It is not listed in the DSM-IV-TR diagnostic manual. Stan Katz & Liu, in "The Codependency Conspiracy: How to Break the Recovery Habit and Take Charge of Your Life," feel that codependence is over-diagnosed, and that many people who could be helped with shorter-term treatments instead become dependent on long-term self-help programs.
  • Some believe that codependency is not a negative trait, and does not need to be treated, as it is more likely a healthy personality trait taken to excess. Codependency in nonclinical populations has some links with favorable characteristics of family functioning [9].
  • The language of symptoms of and treatment for codependence derive from the medical model suggesting a disease process underlies the behaviour. There is no evidence that codependence is caused by a disease process, communicable or otherwise.
  • Not everything promoted by recovery agencies is a demonstrable scientific fact, some of it is based on fashion and faith alone [10] [11].
  • People who have experienced natural disasters, life threatening illness or accident, and personal and community tragedy have been found to perceive a benefit from the ordeal such as positive personality changes, changes in priorities and enhanced family relationships [12]. Caring for survivors serves a worthwhile ethic of empowerment - both for the caregiver and the survivors.

[edit] See also

[edit] References

1 Although “codependent” is not a diagnostic category in the DSM IV, I have chosen to include it because individuals who identify with the label consider it to be an emotional disorder (Irvine 1999).

  1. ^ "Lexicon of alcohol and drug terms published by the World Health Organization". http://www.who.int/substance_abuse/terminology/who_lexicon/en/. Retrieved on 2009-02-10. 
  2. ^ Codependency: Enabling Addiction, addictionrecoverybasics.com 2007
  3. ^ a b Rice, John (1996). A Disease of One's Own: Psychotherapy, Addiction and the Emergence of Co-dependency. pp. 58; 47-53. ISBN 1-56000-241-7. 
  4. ^ Wiseman, Jacqueline (1991). The Other Half: Wives of Alcoholics and their Social-Psychological Situation. p. 210-238. ISBN 0-202-30383-7. 
  5. ^ "Codependency (Psychology)". Medical Subject Headings. National Library of Medicine. 2009. http://www.nlm.nih.gov/cgi/mesh/2009/MB_cgi?mode=&term=Codependency+(Psychology)&field=entry. Retrieved on 2009-03-08. 
  6. ^ Affleck, G., Tennan, H., Croog, S., & Levine, S. (1987) Causal Attribution, perceived benefits, and morbidity following a heart attack. Journal of Consulting and Clinical Psychology, 55, 29-35
  7. ^ Moos, R.H., Finney, J.W., & Cronkite, R.C. (1990) Alcoholism treatment: Process and outcome. New York: Oxford University Press.
  8. ^ Gomberg, E.L. (1989). On terms used and abused: The concept of codependecy. Drugs and Society, 3, 113-132
  9. ^ LAYNE A. PREST, MARK J. BENSON, HOWARD O. PROTINSKY 'Family of Origin and Current Relationship Influences on Codependency' Family Process Volume 37 Issue 4 Page 513Issue 4 - 528 - December 1998
  10. ^ Gordon, J.R., Barrett, K.(1993) The Codependency Movement: Issues of Context and Differentiation. In Baer, J.S, Marlatt, A. & McMahon, R.J. (eds.) Addictive Behaviors Across the Life Span. Newburry Park: Sage
  11. ^ Kaminer, W. (1992). I'm Dysfunctional, You're Dysfunctional: The Recovery Movement and other Self- Help Fashions. New York: Vintage
  12. ^ Affleck, G., Tennen, H. & Rowe, J. (1991) Infants in crisis: How parents cope with newborn intensive care and its aftermath. New York: Springer-Verlag

[edit] Further reading

  • 'A Brief History of Codependence and a Look at the Psychological Literature', in: P. Mellody e.a., Facing Codependence, New York etc.: HarperSanFrancisco, 1989, ISBN 0-06-250589-0, 207-217 (= Appendix).
  • 'Cluster C Personality Disorders', in: Diagnostical and Statistical Manual of Mental Disorders DSM-IV, Washington: American Psychiatric Association, 4th ed. 1994, ISBN 0-89042-062-9, 662-673.
  • 'Codependence', in: Benjamin J. Sadock & Virginia A. Sadock (eds), Kaplan & Sadock's Comprehensive Textbook of Psychiatry on CD, Philadelphia: Lippincott Williams & Wilkins, 7th ed. 2000, ISBN 0-7817-2141-5, 20703-20707.
  • Anonymous Co-Dependents Anonymous, Phoenix: Co-Dependents Anonymous, 1st ed. 1999, ISBN 0-9647105-0-1, 3-6.
  • Aday, J. B., Jr. (1995). An analysis of codependency in adult males: A comparison of adult males from chemically dependent families with adult males from nonchemically dependent families. Dissertation Abstracts International: Section B: The Sciences and Engineering.
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