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Codependency

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Codependency or Codependence describes a pattern of detrimental behavioral interactions within a dysfunctional relationship, most commonly a relationship with an alcohol or drug abuser.[1] In general, the codependent is understood to be a person who perpetuates the addiction or pathological condition of someone close to them in a way that hampers recovery. This can be done through direct control over the dependent, by making excuses for their dysfunctional behavior, or by blunting negative consequences. These actions are described as enabling.

Codependence is not listed in the DSM IV, and critics have suggested that codependency as commonly defined is not a mental disorder.[2] Others describe codependency as a psychological disease.[3]

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. Codependence is often accompanied by clinical depression, as the codependent person succumbs to feelings of frustration or sadness over their inability to improve their situation.

  • tendency to place the needs and wants of others first and to the exclusion of acknowledging one's own
  • continued investment of self-esteem in the ability to control both oneself and others
  • anxiety and boundary distortions relating to intimacy and separation
  • difficulty expressing feelings
  • excessive worry how others may respond to one's feelings
  • undue fear of being hurt and/or rejected by others
  • self-esteem dependent on approval by others
  • tendency to ignore own values and attempt to adhere to the values of others

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, such as Co-Dependents Anonymous (CoDA) and Al-Anon/Alateen, Celebrate Recovery, Nar-Anon, and Adult Children of Alcoholics (ACoA), which are based on the twelve-step program model of Alcoholics Anonymous. Although the term codependency originated outside of twelve-step groups, it is now a common concept in many of them.[4]

Many books have been written on the subject of codependence. Pia Melody (Facing Co-dependence) and Shirley Smith (Set yourself Free) Melody Beattie was one of the first to describe such behaviors. She is the author of Codependent No More among many other volumes.

Controversies

  • Caring for an individual with a physical addiction is not necessarily synonymous with pathology. To name the caregiver as a co-alcoholic responsible for the endurance of their partner's alcoholism for example, pathologizes caring behaviour. The caregiver may only require assertiveness training skills and the addict accountability in taking responsibility for managing their addiction, or not[5][6].
  • Not all mental health professionals agree about codependence or its standard methods of treatment [7]. 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 [8].
  • 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.
  • Some frequent users of the concept codependency use the word as an alternative to use the concept dysfunctional families, without statements that classify it is a disease.[9]
  • 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.

See also

References

  1. ^ http://www.merriam-webster.com/dictionary/codependency
  2. ^ Rice, John Steadman (1996). A Disease of One's Own. p. 19. ISBN 1-56000-241-7.
  3. ^ Cermark, T (1984). "Children of alcoholics and the case for a new diagnostic category of codependency". Alcohol Health and Research World. 8: 38–42.
  4. ^ Collet, L (1990). "After the anger, what then? ACOA: Self-help or self-pity?". Networker: 22–31. {{cite journal}}: Unknown parameter |month= ignored (help)
  5. ^ 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
  6. ^ Moos, R.H., Finney, J.W., & Cronkite, R.C. (1990) Alcoholism treatment: Process and outcome. New York: Oxford University Press.
  7. ^ Gomberg, E.L. (1989). On terms used and abused: The concept of codependecy. Drugs and Society, 3, 113-132
  8. ^ 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
  9. ^ Codependency / Dysfunctional Families
  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

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.
  • Robert Hemfelt, Frank Minirith, Paul Meier (1989) Love is a choice: The definition book on letting go of unhealthy relationships
  • How Enabling Behavior Relates to Codependency