05 Aug Codependency: Both Sides of the Coin
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What is codependency? From where does the term arise? How is it different from dependency? Why does it not appear as a separate pathology in the DSM-5? Like a snowball gathering dirt as it rolls downhill, the term has become so contaminated with misunderstanding that it is often shunned by the psychiatric community. But those at the chalkface of therapy have always been painfully aware of co-dependency’s many faces, whether it wears the defensive scowl of the alcoholic’s doting partner, armed with a protective shield of excuses, or the sad eyes of the desperately attentive spouse of a narcissist listlessly gobbling up the meagre scraps of attention thrown their way.
Codependency can be defined as dysfunctional helping which enables the addiction or other destructive or restrictive behaviour patterns of others. It is characterised by a reliance on other people to supply approval and validate identity with the co-dependent doing whatever is necessary to elicit that approval.
The Grassroots Rise of CoDependency
As explained in ‘Enter the Codependent,’ a chapter in my book, ‘Narcissism and Codependency: Both Sides of the Coin,’ the term co-dependency arose from the world famous alcohol support group Alcoholics Anonymous. It was used to explain the network of enabling behaviour that often accompanied an alcoholic and worked against their efforts to escape their addiction. The concept and term were accepted by the AA offshoot Al-Anon which focuses on alcoholism as a ‘family illness,’ but it was a series of books from the 1980s which really made codependency a globally recognised, if not fully understood, pathology.
The first of these works was Janet G Woititz’s ‘Adult Children of Alcoholism’ quickly followed by Robin Norwood’s ‘Women who Love too Much,’ each book reaching over 2 million in sales. This was eclipsed by Melody Beattie’s 1986 book, ‘Codependent No More,’ which was bought by around 8 million people.
Codependency and the Passive Dependent Personality
There is an overlap between co-dependents and people who would once have been described as having a passive dependent personality and this can cause the two to be confused. In fact, while Dependent Personality Disorder (DPD) is categorised as a Cluster C disorder in the DSM, co-dependency is not currently granted its own category, despite an attempt by psychiatrist Timmen Cermak to justify its inclusion in the manual back in the 1980s. Cermak’s formulation did, however, influence the adaptation of the AA’s 12-step programme by CoDA, a network of co-dependent help groups.
One of the complications with arriving at an agreed psychiatric definition of codependency is its ‘grassroots’ origin. The term originated from people’s real-life experience in the field rather than from an academic paper and the popular mainstream explosion that followed its discovery served to broaden the lay meaning of the term as to make it too ambiguous to fit the strict parameters laid down by the psychiatrists.
Another complication with codependency is that it is situational in nature, requiring another person – the addict or narcissist, for example – to realise its manifestation. Although the DSM is moving towards a more holistic view of psychiatric pathology it still tends to define psychiatric disorders as individual in nature rather than arising as part of a complex inter-relational dynamic.
Nevertheless, whether codependency warrants inclusion as a specific psychiatric disorder or is best understood as a common ‘caregiver’ personality trait taken to extremes, the fact is that it severely hampers the ability of either person to become unstuck and develop in a healthier direction.
Codependency as an Emergent Dynamic
Perhaps the easiest way to understand co-dependency is as an emergent property of two unhealthy situations. Just as water is neither hydrogen nor oxygen yet depends upon both to exist, co-dependency requires two components: a person who is dependent upon either a substance or a type of behaviour (e.g. narcissistic supply), and a second person who is dependent upon serving others to maintain their sense of self (e.g. someone with Dependent Personality Disorder or a dependent personality trait – see figure below). Just as the addict or narcissist needs their fix (whether from a shot of heroin or an influx of attention), their partner in the dynamic requires them to persist in their addiction to fulfil their own need to be needed. This is why they are said to be codependent.
Narcissism and Codependency: Both Sides of the Coin
When seeking to understand and unhook from a harmful situation it is often helpful to look at case studies of others who are in the same boat. As well as looking at co-dependency in more depth, my book, Narcissm and Codependency: Both Sides of the Coin provides this experiential angle which illustrates how co-dependency presents itself in the clinic room and the pain and destruction that it causes for people behind their often brave facade.
Narcissm and Codependency: Both Sides of the Coin is available now on Amazon (hard copy) or via Apple iTunes/iBooks (digital eBook).