Meaningful You

Voices of contemporary psychoanalysis

"Codependent" No More?

Codependence, alcohol addiction and the Twitterization of a term

What is codependence? What was it? And do we still need it? Image: Flickr/ValerieEverett
This blog curates the voices of the Division of Psychoanalysis(39) of the American Psychological Association. Darren Haber, MFT, psychotherapist in Los Angeles, submits this post.

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Is it time to retire the word “codependence?” It seems to me that the term has worn out its welcome over its thirty-odd years of usage, warranting a gold watch and a walk into the sunset.

The term was hatched long ago, in the Adult Children of Alcoholics program (ACA.)  Participants wisely observed that their painfully dissatisfying relational patterns could be linked to a traumatizing alcoholic upbringing, which thrust unwieldy loads onto their shoulders and demanded they parent the alcoholic, incapacitated parents.  These “parentified” children were forced to abandon their own developmental needs in a climate of deprivation that became “normal.”  The child’s questioning or protesting this arrangement brought punishment or scorn, with threats of annihilation or exile, cocooning these sequestered needs in shame, guilt and self-doubt.  The very existence of these needs – essential to selfhood – was dangerous to the system, and most unwelcome.  The parental motto was, “do as I say and not as I do,” essentially turning the child’s affective world into a forbidden zone.

The word “codependent” in early usage appears to have included these childhood contexts, wherein a child learns the language and rigid rules of a dysregulated alcoholic system; ACA and Al-anon found a safe setting wherein ACAs could finally voice their truth, bolstered by the pioneering work by John Bradshaw, Pia Mellody, Claudia Black and others.             

But along the way, due in part to the sound-biting and Twitterization of our culture, the word has become something of a “label” or catchphrase, rather than an indicator of a relational pattern or process; one hears only a mere nod to earlier  traumatic experiences.  It has also become a cliché.  This is why I speak in my practice of “trauma-based relating” or “PTSD-type feelings” in discussing the patient’s current experiences; more often than not, their very human pain has been dissociated, with intellectualization the first line of defense.  To say too early or quickly, “well forget your partner, let’s focus on your codependence,” runs the risk of re-enacting the shame spotlight, ignoring the original, abusive context and ways in which it is being unconsciously re-enacted in the present. 

To hand a dissociated patient a tidy checklist of codependent “symptoms” or behaviors too hastily, without exploring or merely giving lip service to the underlying emotional injuries that led to these behaviors, runs the risk of pushing aside yet again long-buried perceptions, feelings and beliefs formed by trauma.  Intellectually, the patient may understand that their partner isn’t really the problem, but their emotions – based on actual earlier abandonments – may say otherwise.  Protest and despair has to find a voice.  The therapist’s exclusive focusing on new thoughts and behaviors – a subtle or overt insistence that the patient “focus on herself” or “stop enabling” or “surrender control” etc. – replicates an arrangement where an authority figure provides an agenda, meant in this case to ensure the therapist comes away feeling effective, or good-enough.

We can live without drugs and alcohol, but we are (I believe) relational at heart, and people are more complicated than substances.  The refrain from Al-anon just mentioned, “we keep the focus on ourselves,” may be helpful in terms of self-empowerment and permission to heal on the one hand, though it risks reinforcement of a belief which says “you’re not allowed to criticize; shut up; your misery is your problem.”  We therapists, of course, do not want to add fuel to the fire of self-reproach.  But most who suffer from traumatic addictive upbringings default to self-blame anyway; to encourage a new patient to practice balanced self-reflection is, in most cases, like asking a beginning French student to translate Sartre.  To hear a therapist offer bullet points, however kindly, may activate an archaic filter which translates everything as “you’re not doing it right.” It may take a while until long-held beliefs start to shift, especially those forged in the searing fire of abandonment, shame and denial.

In the long run, of course, this shift is the goal: to surrender, live in acceptance, find the courage to change the things one can (oneself, not others)….but such bromides must be introduced carefully, with attuned timing, in a way the patient finds meaningful –  lest they become yet more standards or performance-tasks imposed from without.  It is easy to underestimate just how risky it is to connect to one’s feelings, if doing so has been historically lethal.

Take, for example, these random examples from recent mainstream blogs (my comments in italics):

  • “Codependents have fuzzy or weak boundaries.”  Yeesh, who wants to be ‘weak’? Again, most relationally traumatized children were never taught healthy boundaries to begin with.
  • “Codependents are often bossy.”  This is one way of putting it.  Another is that children in traumatizing family systems are often given insanely inappropriate amounts of responsibility, without any of the true authority needed to fulfill same. 
  • “Codependents are in denial; they don’t face their problems.”  Ouch!  Wake up, codependents, and smell the friggin’ coffee!  Yet my clinical experience reveals that they may face them too much: all of the time, at once, without mercy; they are always in the dock, guilty as charged. 
  • “Codependents try to control others.”  See ‘bossy’ comment above.  Most folks in this position were never shown or role-modeled appropriate levels of responsibility or emotional freedom.  To surrender control is to ask the person to risk a terrifying chaos.
  • “Codependents are rescuers/enablers.”  For many, “rescuing” was imperative every minute of every day in their most formative, vulnerable years.  To avoid rescuing was to risk literal abandonment.

This is not to say that there isn’t value in what’s quoted here, or that compressed self-help bullet-points, or recovery literature which aims to “keep it simple” is never helpful.  To the contrary.  Some take to it like a duck to water.  But this isn’t the lion’s share of my clinical experience.  What has proved most helpful over the years is close, attuned exploring and sustained validation of the patient’s long-neglected and “forbidden” emotional experience, a way of defining what “enabling” really means to the patient in a non-shaming, inspiring way.  It may mean many things in many different contexts, and a sudden, drastic cut-off is not the same as “detaching with love.”

For better or worse, many patients don’t take to recovery right away, if at all; I do a disservice to glibly call them “resistant” or say to myself, “I guess they want to stay codependent.”  This strikes me as perpetuating the “you’re not doing it right” mentality, a “either/or” dichotomy that helped create toxic shame in the first place.  It ignores the relational handcuffs these folks were forced to wear from the beginning.

These handcuffs are the result of circumstances which rob the child, with her adult responsibilities, of any real influence over decision-making: responsibility without power, a perfect recipe for cognitive-dissonance and dissociation.  In fact the child is shamed, ridiculed and/or neglected if they (like an adult) want to give voice to any actual pain that may rock the boat, or have influence over the “rules” that might allow more flexibility or efficiency in the system.  The rules are there, most of the time, to serve the self-protective caretakers and their addiction.  I recently realized that patients who “rock the boat” in therapy, by not following my suggestion to stick with a recovery program, deserve commendation rather than a well-intentioned correction. 

Patients tend to feel supported when they their choice is explored and understood in an expanded contextual framework, not diverted – again, however kindly – into a healthier “standard” so that the therapist can feel he is providing proper guidance.  What that guidance is supposed to look like will be co-determined in the therapy according to the specifics of the relationship in question. 

This therapist, at least, will inevitably misstep, leaning in too far forward, or back, and the patient will find herself facing uncomfortably familiar feelings of intrusion or abandonment; the therapy will get a bit messy, both of us in a pickle.  This is where the true work begins, since every time we re-connect after an impasse or breach leads to the ever-so-slight loosening of those handcuffs.    

Kristi Pikiewicz is managing editor of the American Psychological Association's Division of Psychotherapy DIVISION/Review.

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