Codependency

The term codependency is most often identified with Alcoholics Anonymous and the realization that the Alcoholism was not solely about the addict but also about the family and friends who constitute a network for the alcoholic.[5]

The term “codependency” most likely developed in Minnesota in the late 1970s from “co-alcoholic”, when alcoholism and other drug dependencies were grouped together as “chemical dependency.”[6][7]

The term “codependent” was first used to describe how family members and friends might interfere with the recovery of a person affected by a substance use disorder by "overhelping".[8] Application of the concept of codependency was driven by the self-help community.

Psychologist Janet G. Woititz's book Adult Children of Alcoholics came out in 1983 and sold two million copies while being on the New York Times bestseller list for 48 weeks. She was associated with the "Adult Children of Alcoholics" group.

Marriage and Family Therapist Robin Norwood's Women Who Love Too Much, 1985, aimed to help women who were addicted to men who offered little love in return, and sold two and a half million copies.[9]

In 1986, Psychiatrist Timmen Cermak wrote Diagnosing and Treating Co-Dependence: A Guide for Professionals. In that book and an article published in the Journal of Psychoactive Drugs, Cermak argued unsuccessfully for the inclusion of codependency as a separate personality disorder in the Diagnostic and Statistical Manual of Mental Disorders, DSM-III-R.[10] He found that the condition could affect people close to people with any mental disorder, not just addiction.

Melody Beattie popularized the concept of codependency in 1986 with the book Codependent No More which sold eight million copies.[11] Drawing on her personal experience with substance abuse and caring for someone with it, she also interviewed people helped by Al-Anon. She released new editions in 1992 and 2022.[12] Beattie's work formed the underpinning[13] of a twelve-step organisation called Co-Dependents Anonymous, founded in 1986.[14] (The group has since developed it's understanding of the condition independently.)

Psychotherapist Darlene Lancer[15] wrote Codependency for Dummies in 2012, with a second edition released in 2015. She also wrote Conquering Shame and Codependency: 8 Steps to Freeing the True You in 2014. These books detail her understanding of the condition she developed over many years of delivering marriage and family therapy.

Codependency has no established definition or diagnostic criteria within the mental health community.[16] It has not been included as a condition in any edition of the DSM or ICD.

The United States National Library of Medicine defines the condition as "A relational pattern in which a person attempts to derive a sense of purpose through relationships with others."[17]

Melody Beattie writes, "The obvious definition [of codependency] would be: being a partner in dependency. This definition is close to the truth but still unclear." She goes on to give her definition: "A codependent person is one who has let another person's behaviour affect him or her, and who is obsessed with controlling that person's behaviour."[18]

Timmen Cermak writes, "Co-dependence is a recognisable pattern of personality traits, predictably found within most members of chemically dependent families, which are capable of creating sufficient dysfunction to warrant the diagnosis of Mixed Personality Disorder as outlined in DSM III." He goes on to be more specific, defining the traits commonly found in self-suppressing supporting partners of people with chemical dependence or disordered personalities, and providing a DSM-style set of diagnostic criteria.[19][20]

According to Darlene Lancer, "A codependent is a person who can’t function from his or her innate self and instead organizes thinking and behavior around a substance, process, or other person(s)."[21] Lancer includes all addicts in her definition. She believes a "lost self" is the core of codependency.

The well recognised condition dependent personality disorder refers to people who feel a strong need to submit and cling to one or more other people. The similarly well recognised condition narcissistic personality disorder includes those with a strong need to control other people.

Co-Dependents Anonymous "offer no definition or diagnostic criteria for codependence",[22] but does provide a list of "patterns and characteristics of codependents"[23] which can be used by laypeople to self-diagnose. This organisation believes that people who are codependent place a lower priority on their own needs, while being excessively preoccupied with the needs of others. Codependency can occur in any type of relationship, including family, work, friendship, and also romantic, peer or community relationships.[24] The organisation believes that codependency is a form of addiction.[22]

Under theories of codependency, the codependent partner in a relationship is often described as displaying self-perception, attitudes and behaviors that serve to increase problems within the relationship instead of decreasing them. It is often suggested that people who are codependent were raised in dysfunctional families or with early exposure to addiction behavior, resulting in their allowance of similar patterns of behavior by their partner.[25]

With no consensus as to how codependency should be defined, and with no recognized diagnostic criteria, mental health professionals hold a range of opinions about the diagnosis and treatment of codependency.[33] Caring for an individual with a physical addiction is not necessarily treating a pathology. The caregiver may only require assertiveness skills and the ability to place responsibility for the addiction on the other.[34][35] There are various recovery paths for individuals who struggle with codependency. For example, some may choose cognitive-behavioral psychotherapy, sometimes accompanied by chemical therapy for accompanying depression. There also exist support groups for codependency, such as Co-Dependents Anonymous (CoDA), Al-Anon/Alateen, Nar-Anon, and Adult Children of Alcoholics (ACoA), which are based on the twelve-step program model of Alcoholics Anonymous, Celebrate Recovery and Life Recovery a Christian 12 step Bible-based group.[36] Many self-help guides have been written on the subject of codependency.

It has been proposed that, in attempts to recover from codependency, go from being overly passive or overly giving to being overly aggressive or excessively selfish. Therapists may seek to help a client develop a balance through healthy assertiveness, which leaves room for being a caring person and also engaging in healthy caring behavior, while minimizing selfishness, bully, or behaviors that might reflect conflict addiction.[34][35] Developing a permanent stance of being a victim (having a victim mentality) does not constitute recovery from codependency. A victim mentality could also be seen as a part of one's original state of codependency (lack of empowerment causing one to feel like the "subject" of events rather than being an empowered actor). Someone truly recovered from codependency would feel empowered and like an author of their life and actions rather than being at the mercy of outside forces. A victim mentality may also occur in combination with passive–aggressive control issues. From the perspective of moving beyond victim-hood, the capacity to forgive and let go (with exception of cases of very severe abuse) could also be signs of real recovery from codependency, but the willingness to endure further abuse would not.[34]

It is theorized that unresolved patterns of codependency may lead to more serious problems like alcoholism, drug addiction, eating disorders, sex addiction, psychosomatic illnesses, and other self-destructive or self-defeating behaviors.[37] People with codependency may be more likely to attract further abuse from aggressive individuals (such as those with BPD or NPD), more likely to stay in stressful jobs or relationships, less likely to seek medical attention when needed and are also less likely to get promotions and tend to earn less money than those without codependency patterns.[37] For some people, the social insecurity caused by codependency may progress into full-blown social anxiety disorders like social phobia, avoidant personality disorder or painful shyness.[37] Other stress-related disorders like panic disorder, depression or PTSD may also be present.[37]

Codependency is not a diagnosable mental health condition, and there is no medical consensus as to its definition.[16] Without clinical definition, the term is easily applicable to many behaviors and has been overused by some self-help authors and support communities.[38]

In an article in Psychology Today, clinician Kristi Pikiewicz suggested that the term codependency has been overused by the general populace and labeling a patient as codependent can be confusing and may even shame them rather than help them focus on how their traumas shape their current relationships.[39]

Others have stressed an awareness that codependency is a theory, and that there is no evidence that codependence is caused by a disease process.[40] Attachment theory may be a more helpful model for understanding and dealing with attachment in adults.[41] Codependency does not refer to all caring behavior or feelings, but only those that are excessive to an unhealthy degree.[34] Some scholars and treatment providers assert that codependency is an overresponsibility and that overresponsibility needs to be understood as a positive impulse gone awry, and that responsibility for relationships with others needs to coexist with responsibility to self.[42]

• Cermak M.D, Timmen L., Diagnosing and Treating Co-Dependence: A Guide for Professionals Who Work with Chemical Dependents, Their Spouses, and Children (Professional Series), 1998, Hazelden Publishing, Minnesota, ISBN 978-0935908329
• CoDA, Co-Dependents Anonymous, 1997, CoDA Resource Publishing, Phoenix, ISBN 978-0964710504
• Beattie, Melody Codependent No More: How to Stop Controlling Others and Start Caring for Yourself, 1986, Hazelden, Minnesota, ISBN 978-0894864025
• Whitfield M.D., Charles L.,Healing The Child Within: Discovery and Recovery for Adult Children of Dysfunctional Families, 1987, Health Communications, Inc., Florida, ISBN 978-0932194404
• Lancer, Darlene, Conquering Shame and Codependency: 8 Steps to Freeing the True You, 2014, Hazelden, Minnesota, ISBN 1616495332

Look up codependency in Wiktionary, the free dictionary.

• Codependency support: general at Curlie
• Codependency support: co-alcoholic at Curlie
• Codependency support: borderline personality disorder at Curlie