Codependency – When Caring Becomes Self-Destructive

Don't we all know someone in a codependent relationship? Your best friend who has to help get her new boyfriend back on his feet (six months later!). Your aunt who stays with an abusive, alcoholic third husband. Your colleague who "takes care" of his supervisor who insists his staff work 80-hour weeks.

Many of the characteristics of codependency sound like good qualities – caring, nurturing, unselfish and devoted. Some codependent behaviors are well-intentioned. But people in codependent relationships can quickly spiral into destructive, dysfunctional patterns of behavior.

What is Codependency?
Mayo Clinic psychiatrist Daniel Flavin, M.D. says, “The term "codependency" was coined more than 20 years ago by authors who studied the negative impact of drug and alcohol use on families. Since then, use of the term has been expanded to include a pattern of psychologically unhealthy behaviors that are learned by individuals as a way of coping with a family environment marked by ignored or denied emotional turmoil.”

In the addiction context, the “codependent” is the person – spouse, partner or family member who is in a relationship with someone who is abusing alcohol and/or drugs. This person is often in the role of “enabler.” Enabling behavior includes making excuses for the substance abuser - often to work or extended family members, indirectly (or sometimes overtly) making alcohol or drugs available and complicitly allowing that person to remain in the cycle of destructive behavior. For years in the addiction treatment field, the focus was on how the codependent affected the quality of the addict’s recovery. As Dr. Flavin stated above, now the definition of codependency has broadened to include the often self-destructive behaviors involved in any significant relationship, not just those with substance abusers

How Do People Develop Codependency?
Most often codependency begins in dysfunctional families. Dysfunctional families may have a member(s) with addiction problems, but there could also be chronic mental or physical illness or physical, emotional or sexual abuse. The dysfunction often develops when family members are suffering from anxiety, anger, emotional/physical pain or shame that is denied or not acknowledged by the family.

In these situations, the codependent behavior is learned and adaptive. Codependents learn to suppress and ignore their feelings and focus on the more “deserving” family member. It is not hard to see how this behavior translates to relationships outside the family. Often afflicted with very low self-esteem and self-worth, codependents enter into one-sided, sometimes abusive relationships.

In 1987, Melody Beattie wrote a ground-breaking book, Codependent No More. In it, she advocated for the codependent in a relationship with a substance abuser to focus on their own health and well-being. Her belief was that the codependent “deserved” and had as much right as the addict to get into recovery get better. She has since written many books on the subject.

What are some of the Characteristics of Codependency?

• A need to control others
• Problems with intimacy and boundaries
• Difficulty making decisions
• An unhealthy dependence on relationships
• An exaggerated sense of responsibility for the actions of others

For a more of this list, see Mental Health America’s (formerly National Mental Health Association) pages on codependency.

Are You Codependent?
Here’s a quick Codependency Test. An important aspect of codependency is the severity or frequency of the accompanying behaviors. I often ask my own patients this question,

“Is what you're doing impeding your normal functioning: are you able to work, interact in a healthy way with people you care about, attend to your physical and emotional needs, etc.?”

If your functioning is sub-par and/or if you identified with the majority of questions on the test, you might consider getting professional help from a trained therapist who treats codependency issues.

What other help is available?
Long associated with Alcoholics Anonymous and other 12-step, self-help groups, Al-anon focuses on recovery for people in relationships with substance abusers, including addressing codependency. More specifically, Codependency Anonymous focuses on help for codependents.So educate yourself about codependency and how destructive it can be. There is help available through trained therapists, books and self-help groups.