Codependence–An Addiction

Is Codependence A Disorder?

Codependence is considered by many mental health experts to be synonymous with “dependence,” “dependent personality disorder,” or “love addiction.”  Despite its distinct, maladaptive traits that are common within many societies, codependence is not formally recognized as a personality disorder, nor is it listed in the current Diagnostic and Statistical Manual of Mental Disorders (DSM).  This phenomenon has been acknowledged as a condition of cyclic behavior at times resulting in abuse and dysfunction within relationships.  It disrupts the daily lives of individuals suffering from codependence, causing themselves as well as their loved ones distress, meeting the primary criteria for mental illness, as defined in the current DSM (Stein, et al., 2010).  However, some experts argue that it is actually a healthy personality trait which fosters trust and intimacy in relationships (Kwon, 2001).  Should there be further movement towards consideration of codependency as a stand-alone personality disorder included in the DSM, or would the inclusion result in over-diagnosis of healthy individuals?

There are varying perspectives on the definition and nature of codependence.  Frequently confused with dependent personality disorder, codependence is different in that dependent individuals have an excessive need to be cared for, while a codependent has an insatiable need to care for someone else (Cermak, 1986; Lion & Whitehead, 2006).  Codependents are caretakers to a fault.  They are known to sacrifice their own happiness and needs in order to ensure another person’s happiness and well-being.  Codependents also tend to be drawn to needy people because of the challenge it presents.  Likewise, needy people are drawn to them.  (Beattie, 1992).  For example, a codependent person may find themselves sticking with and caring for an alcoholic partner, even tolerating abuse, because of their determination to fix the problem.  They unwittingly become part of the problem, suffering repeated letdown and becoming resentful as a result.

Melody Beattie succinctly defines a codependent as:  “…one who has let another person’s behavior affect him or her, and who is obsessed with controlling that person’s behavior” (Beattie, p. 36, 1992).  A person suffering from codependence tends to be extremely sensitive to the moods of their peers and partners because their happiness depends on the happiness of those around them (Beattie, p.43, 1992).  As a coping mechanism, the codependent may attempt to manipulate the behavior of their loved ones using coercion, bribes, threats, and the like, because they perceive they are doing it for the other person’s benefit (Beattie, p. 38, 1992).  However, they frequently end up not only complicating the problem but also feeling used.

Though coherent symptomatic parameters have yet to be established due to lack of systematic research (Morgan, 1991), many psychology professionals can agree that codependence has come to be recognized as pattern of behavior that involves two or more people, most commonly consisting of one substance abuser, e.g., an alcoholic, and at least one enabler.  Lennard Davis, a professor at the University of Chicago, confirms that the “concept of codependence ‘. . . comes directly out of Alcoholics Anonymous, part of a dawning realization that the problem was not solely the addict, but also the family and friends who constitute a network for the alcoholic.’”  (Davis, 2008).  Therefore, codependence could encompass any of the individuals who comprise the support system of the alcoholic or drug abuser.

More recently, variations of codependent relationship styles have come to light.  Pia Mellody, a lecturer and educator specializing in codependence, coined the terms “avoidance addict” and “love addict” to describe the codependent and his or her partner, and has written extensively on the subject of love addiction.  (Mellody, 1992).  According to Mellody, the addict is “dependent on, enmeshed with, and compulsively focused on taking care of another person,” while the avoider “tries to avoid intimate connection within the relationship, usually through some addiction.”  (Ibid).  Most people use work or hobbies as an escape; however, it becomes problematic when a person habitually uses it to create distance.  This, paired with a codependent continually seeking attention from the avoider, results in an unhealthy relationship pattern of hurt feelings, abuse, and nonexistent communication.  Because the avoider has withheld communication, the codependent often becomes obsessed with the avoidant partner and they begin to project and idealize him or her.  On a day to day basis, this certainly causes frustration and distress among codependents.

Addiction has long been established as a disorder.  Whether non-substance addictions such as love, relationship or sex addictions are likewise disorders is controversial.  (Katehakis, 2011).  It is only logical to consider codependence similarly, as it produces the same behaviors as substance addiction in that the codependent craves the feelings of being in love to the extent they engage in self-destructive behavior to get what they want.  Timmen Cermak states in his book, Diagnosing and Treating Co-Dependence, “Although codependency is not as dramatically or directly life threatening as chemical dependence, it is potentially just as fatal.”  (Cermak, 1986).  Compounding the issue, codependents believe their partner is responsible for providing their “drug” of choice.

Cermak, as well as several codependency experts, have for decades supported the idea that codependence should be included as its own standalone disorder in the DSM.  Melody Beattie first introduced the word “codependence” to the public in 1986 in her book, Codependent No More, and continues to spread awareness and self-help techniques.  Beattie’s promotion of codependency as a disorder has been key in its condition being taken more seriously.  Celebrity radio personality and addiction specialist, Dr. Drew Pinsky (“Dr. Drew”), frequently speaks about love addiction publicly, endorsing works by Beattie and Mellody.  Dr. Drew has perhaps been the most instrumental person in recent years to help the mainstream population recognize codependence and to de-stigmatize seeking professional assistance for it.  These experts agree that codependence is a serious and unhealthy addiction, and that therapeutic treatment is recommended for the addict to recover.

Despite the criticism that the current DSM has eroded “the distinction between psychopathology and normal behavior” (Stein, et al., 2010), not having clear criteria for diagnosing those with problematic symptoms relating to codependence could be a hindrance to thousands who might benefit from systematic treatment, specifically, acquiring the skills to maintain healthy relationship boundaries and to care for themselves.  With further research and establishment of clearer diagnostic criteria, society can be further educated about codependence, and individuals may find it easier to seek assistance in breaking their maladaptive cycles.

References

Beattie, M. (1992).  Codependent no more, how to stop controlling others and start caring for yourself.  Minnesota: Hazelden Publishing & Educational Services.  pp. 36, 38, 43

Cermak, T. L. (1986). Diagnosing and treating co-dependence; a guide for professionals who work with chemical dependents, their spouses and children. minneapolis, Minnesota: Johnson Institute Books.  p. 34.  Retrieved from http://books.google.com/books?id=8IRt8bYu8kgC&pg=PA61&source=gbs_selected_pages&cad=3

Davis, Lennard J. (2008). Obsession: A History. London: University of Chicago Press. p. 178. ISBN 0-226-13782-1. (Retrieved March 4, 2013, from Wikipedia http://en.wikipedia.org/wiki/Codependency#cite_note-Davis08-3)

D. J. Stein, K. A. Phillips, D. Bolton, K. W. M. Fulford, J. Z. Sadler and K. S. Kendler (2010).  What is a mental/psychiatric disorder?  From DSM­IV to DSM­V.  Psychological Medicine, 40, pp. 1759­1765 doi:10.1017/S0033291709992261

Katehakis, A.  (2011).  Straight talk about sexual compulsivity.  The link between adult attachment styles and sex and love addiction.  Is sex and love addiction really an attachment disorder?  Psychology Today:  Sex, Lies & Trauma.  (Retrieved from http://www.psychologytoday.com/blog/sex-lies-trauma/201109/the-link-between-adult-attachment-styles-and-sex-and-love-addiction)

Kwon, S. (2001).  Codependence and interdependence:  Cross-cultural reappraisals of boundaries and relationality.  Pastoral Psychology, Vol. 50, No. 1.  Human Sciences Press, Inc.

Lion, N. & Whitehead, G.  The relationship between codependency and borderline and dependent personality traits.  Alcoholism Treatment Quarterly, Vol. 24, Number 4 (January 2007), pp. 55-77, http://0-ejournals.ebsco.com.opac.sfsu.edu/direct.asp?ArticleID=44AFA1C1333109856FFD

Mellody, P. (1992). Facing love addiction.  New York: Harper Collins.  p. 7

Morgan, J.P.  (1991).  What is codependency?  Centers for Psychotherapy and NorthShore Psychiatric Hospital, Slidell, Louisiana.  Journal of Clinical Psychology, Vol. 47, No. 5 (September 1991)

Nevid, J. S. (2009). Psychology concepts and applications. (3 ed.). Houghton Mifflin Company.

~ by splenectomy on March 27, 2013.