Dot is the wife of an alcoholic. When she and her husband met and married, she knew that he drank, but she didn't know how much, because he kept much of this behavior hidden. As their marriage progressed, she became more aware of his drinking, and she started to find empty pill bottles in the trash — prescription opioids that didn't belong to her or her husband.
Dot loves her husband and has no interest in leaving him, so she’s done what anyone who loves her partner would do — she’s tried to manage the problem by controlling his drinking and pill abuse and prevent him from driving while intoxicated. Sadly, life for Dot has become less about her needs and more about “managing the situation."
Despite Dot’s best efforts, her husband recently got arrested for driving while impaired. His attorney encouraged him to get treatment. At the same time, Dot decided to see a therapist for advice on how to help her husband. The therapist heard Dot's story and immediately said, “Wow, you’re a classic co-addict. You’re an enabler and a caretaker, and you need to go to CoDA (Codependent’s Anonymous) to deal with your problem.”
Guess what? Dot never went back to therapy, and she never went to a CoDA meeting. Instead, she feels hurt, angry, ashamed, and confused about why the therapist blamed her for her husband’s addiction. So instead of seeking support that could help her walk through a difficult time, she has retreated to her marriage, and she now speaks only to her husband about her feelings. Of course, as an addict who is (understandably) keen to maintain the status quo, he is of little help.
Moving Beyond the Codependency Label
Prodependence is a term I have created for use in a forthcoming (2018) book, co-written with Dr. Stefanie Carnes, to help loved ones of addicts. I use this term to describe healthy interdependence in the modern world. Essentially, prodependence occurs when attachment relationships are mutually beneficial — with one person’s strengths filling in the weak points of the other, and vice versa — and this mutual support occurs automatically and without question.
The term prodependence is, rather obviously, a play on an older term with which most readers will probably be familiar — codependence. Codependence occurs when one person tries to control the actions of another, in the guise of helping. so that he or she can feel better about himself or herself and the relationship with that other person.
The codependency concept came into vogue in the mid-1980s, mostly with the publication of three specific books: Janet Woititz's Adult Children of Alcoholics (1983)1; Robin Norwood's Women Who Love Too Much (1985)2; and Melody Beattie's Codependent No More (1986)3. Based on these works, the 12-step fellowship Codependents Anonymous was born, with its first meeting taking place on October 22, 1986.4
One of the best explanations of the early codependency movement, especially in relation to addictions, appears in the foreword of the 2003 edition of Pia Mellody’s book, Facing Codependence. There, Andrea Wells Miller and J. Keith Miller write:
"It was actually the families of alcoholics and other chemically dependent people who brought [codependency] to the attention of therapists in treatment centers. These family members all seemed to be plagued with intensified feelings of shame, fear, anger, and pain in their relationships with the alcoholic or addict who was the focal point of their family. … One irrational aspect was that most of the family members had a deluded hope that if they could only be perfect in their 'relating to' and “helping” the alcoholic, he or she would become sober — and they, the family members, would be free of their awful shame, pain, fear, and anger."5
This statement recognizes and summarizes the feelings that many loved ones of addicts experience. They mistakenly think, “If I can just control the other person’s addiction in some way, everything will turn out the way I’d like.” That belief is the crux of codependence in its purest form.
Unfortunately, the concept of codependence has morphed into a negative, pathological-sounding label, indiscriminately applied to almost any person who tries to help an addicted loved one. So instead of being encouraged to care for yourself as well as your addicted loved one, you are encouraged to care for yourself instead of your addicted loved one. Basically, there seems to be a consensus that you really can love and care for someone too much. That is not what the progenitors of the codependence concept intended. But it’s what we’ve got.
Today, if you are the spouse, parent, sibling, or friend of an addict, you’ve almost certainly had perfectly loving people tell you to step away from the relationship, to stop rescuing, to stop enabling, to “detach with love,” and to “stop being so codependent.” If you’ve experienced this, you’ve likely asked, “How can I possibly abandon a person I love, especially in his or her time of need?”
Still, plenty of people — family, friends, clergy, and even therapists — will try to convince you that caring about a person you’ve been close to for a very long time (perhaps his or her entire life, if you’re a parent or a sibling) is somehow irrational on your part, and counterproductive for both you and the challenged individual. Very probably, these well-meaning folks have suggested therapy, interventions, and participation in support groups like Al-Anon and CoDA as a way for you to fully and completely detach from what they think is a bad situation that’s taking you away from your own needs, goals, and personal fulfillment, while keeping your loved one mired in the problem.
As an addiction and mental-health treatment specialist who has worked for decades with addicts and their families, I admit that in the past I have espoused this outdated and potentially harmful opinion. This is the stance I was taught to take, both in school and in my continuing professional education. In trainings I was told, “If a loved one cannot emotionally detach from an active addict, that person will be dragged down into the murky depths of despair. Thus, loved ones must be coached to let go.” So when I saw spouses, family members, and friends refuse to distance themselves from an active addict, I told them they were enmeshed and codependent, and encouraged them to detach.
Unfortunately, this tactic ignores the ways in which human beings are wired for survival.
Human beings are meant to work together, not to go it alone. Think back to prehistoric times when people lived in tribes. If we went hunting, we went in a group; otherwise, we were as likely to be eaten as to eat. And hunting trips could take a very long time, so other members of our tribe stayed behind in the cave and tanned hides to keep the group warm, gathered nuts and berries to eat, collected sticks for fire, and maybe even did some rudimentary farming.
For thousands of years, this type of communal living was our standard for survival and our brains evolved in ways that encourage interpersonal bonding. Thus, we are evolutionarily wired to be dependent upon others. We enter the world reliant on others for shelter, nutrition, and emotional support, and these core requirements do not change as we grow older. What keeps us healthy as infants and children also keeps us healthy as adults.
Yet somehow, as we move into adulthood, our intrinsic need for emotional connection (i.e., love) gets discounted, despite the fact that people who spend their lives “apart from” rather than “a part of” do not function as well as those who feel emotionally connected. In fact, an immense amount of mental and physical health research shows that isolated/separated individuals suffer both emotionally and physically.6 Conversely, people who place a high value on developing and maintaining meaningful connections tend to be happier, more resilient, and more successful.7 They even tend to live longer.8 So, emotionally intimate connections are as essential as more obvious needs like food, water, clean air, and shelter. Without healthy dependency and connection, we may survive physically (for a while), but we won’t be as healthy or as happy as we could be.
Importantly, this deeply ingrained need for emotional connection does not abate simply because a person with whom we feel an intimate bond is challenged with an addiction or some other serious issue.
I think about it this way: If your spouse, child, sibling, or best friend was diagnosed with cancer and needed your help with doctor’s appointments, household chores, and maybe even his or her finances, would you walk away from that person? Most likely not. And nobody would blame you or label you or try to pathologize you for temporarily pushing your own needs to the side. But when you try to help an addict in a similar fashion, people will label you in all sorts of ways—and tell you to stop.
That is the wrong approach. Instead of being confrontational with spouses and others who love and care for addicts, we need to be invitational. We need to meet them where they are and teach them not to walk away, but to support in healthier, more prodependent ways. Rather than preaching detachment and distance over continued bonding and assistance, as so many therapists, self-help books, and 12-step groups do, we should celebrate the human need for and the pursuit of intimate connection, using that as a positive force for change.
Rather than labeling and pathologizing the supporters of challenged individuals when they refuse to abandon their caregiving roles, we should encourage them to continue their pursuit of love and emotional intimacy as best they can. At the same time, we can provide an outline for developing and maintaining healthy, prodependent boundaries — margins within which caregivers can love unconditionally, while not enabling or doing things their loved one could and should be doing for himself or herself. In so doing, we will create a fresh paradigm for useful and healthy support, an evolved prism through which caregivers can examine, evaluate, and improve their daily lives despite the oftentimes debilitating presence of an addiction.
Robert Weiss LCSW, CSAT-S is a digital-age intimacy and relationships expert specializing in infidelity and addictions. He is the author of several highly regarded books. Currently, he is Senior Vice President of National Clinical Development for Elements Behavioral Health, creating and overseeing mental health and drug rehab programs for more than a dozen treatment facilities. For more information please visit his website, robertweissmsw.com, or follow him on Twitter, @RobWeissMSW.
Woititz, J. G. (1990). Adult children of alcoholics: expanded edition. Health Communications, Inc.. Norwood, R. (1986). Women who love too much: When you keep wishing and hoping he'll change. Simon and Schuster. Mellody, P., Miller, A. W., & Miller, J. K. (2003). Facing codependence: What it is, where it comes from, how it sabotages our lives. Harper Collins. Irvine, L. (1999). Codependent forevermore: The invention of self in a twelve step group. University of Chicago Press. Mellody, P., Miller, A. W., & Miller, J. K. (2003). Facing codependence: What it is, where it comes from, how it sabotages our lives, pp. xv and xvi. Harper Collins. Hawkley, L. C., Masi, C. M., Berry, J. D., & Cacioppo, J. T. (2006). Loneliness is a unique predictor of age-related differences in systolic blood pressure. Psychology and aging, 21(1), 152; House, J. S., Landis, K. R., & Umberson, D. (1988). Social relationships and health. Science, 241(4865), 540; Kiecolt-Glaser, J. K., Malarkey, W. B., Chee, M., Newton, T., Cacioppo, J. T., Mao, H. Y., & Glaser, R. (1993). Negative behavior during marital conflict is associated with immunological down-regulation; Psychosomatic medicine, 55(5), 395-409; Caspi, A., Harrington, H., Moffitt, T. E., Milne, B. J., & Poulton, R. (2006). Socially isolated children 20 years later: risk of cardiovascular disease. Archives of Pediatrics & Adolescent Medicine, 160(8), 805-811; Thurston, R. C., & Kubzansky, L. D. (2009). Women, loneliness, and incident coronary heart disease. Psychosomatic medicine, 71(8), 836; Hawkley, L. C., Masi, C. M., Berry, J. D., & Cacioppo, J. T. (2006). Loneliness is a unique predictor of age-related differences in systolic blood pressure. Psychology and aging, 21(1), 152; Hawkley, L. C., Thisted, R. A., Masi, C. M., & Cacioppo, J. T. (2010). Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults. Psychology and aging, 25(1), 132; among other studies. Vaillant, G. E. (2008). Aging well: Surprising guideposts to a happier life from the landmark study of adult development. Little, Brown; Johnson, S. (2008). Hold me tight: Seven conversations for a lifetime of love, p 26. Little, Brown. Coyne, J. C., Rohrbaugh, M. J., Shoham, V., Sonnega, J. S., Nicklas, J. M., & Cranford, J. A. (2001). Prognostic importance of marital quality for survival of congestive heart failure. The American journal of cardiology, 88(5), 526-529; Luo, Y., Hawkley, L. C., Waite, L. J., & Cacioppo, J. T. (2012). Loneliness, health, and mortality in old age: A national longitudinal study. Social science & medicine, 74(6), 907-914; Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: a meta-analytic review. PLoS medicine, 7(7), e1000316; Patterson, A. C., & Veenstra, G. (2010). Loneliness and risk of mortality: A longitudinal investigation in Alameda County, California. Social science & medicine, 71(1), 181-186; Perissinotto, C. M., Cenzer, I. S., & Covinsky, K. E. (2012). Loneliness in older persons: a predictor of functional decline and death. Archives of internal medicine, 172(14), 1078-1084; among other studies.