This is the second in a series of the Is This Really a Thing ? series (see Is Couple Recovery Really a Thing?)
Codependency is an ever-present concept in the language of recovery. Partners, family members, and friends of people who struggle with problematic substance and compulsive behaviors are typically automatically assigned this label. It is assumed that anybody in a close relationship with a person with an addiction is, by definition codependent. There are some upsides and some downsides to embracing the concept of “codependency” as a defined recovery area for family members. I think it is time to challenge this assumption of guilt by association, and to consider some other ways of defining recovery issues whether it is addiction, a serious medical or psychological issue, or any ongoing issue that has has created concern and worry.
Where does the Term Come From?
In a quick online search you will find some mention of the term codependency reportedly dating back to the 50’s as an outgrowth of the Alcoholic Anonymous (AA) movement. The context is that AA, which began in 1939, was instrumental in understanding alcoholism as a disease, not a moral failing. Initially wives attended AA meetings with their husbands. It became clear that spouses needed their own group, leading to the informal “wives coffee and cake” meetings, Recognizing the value of the 12-step model of AA, the Al-Anon Fellowship started in 1951 and was opened to anybody who recognized their life was impacted by somebody else’s drinking.
An Unfortunate Legacy
I wrote an article for the Encyclopedia of Couple and Family Therapy on family studies in addiction treatment, and in fact found family studies dating back to the 1930’s. The studies in the 40’s and 50’s emphasized the increasing interest in understanding the impact of the marital relationship on successful treatment, but they were primarily based on psychoanalytic concepts of neurosis and the “disturbed personality” theories to explain alcoholism and why these wives would marry an alcoholic. The gender bias and stereo-typing extended to both the alcoholic male, as well as his wife, and was because of attempts to manage underlying psychological problems. I believe this negative labeling and pathologizing of women, then later of all partners with addicted spouses, set the stage for the notion of codependency that emerged in the 1980’s, some 30 years later.
Why Language is Important
Language communicates concepts, feelings, and attributes, associations with those attributes can also create stigma, Words like alcoholic, addict, and yes, codependent, have an impact on automatic perceptions and stereotypes of the person with that label.
A person in a relationship with a partner with an addictive disorder is most likely given an automatic attribution of “codependent” as an indication of pathology and an area for recovery. I heard a story from a couple where they took their daughter to an outpatient treatment program because of the daughters substance use problems. After the counselor interviewed the daughter and met with the parents, the parents were greeted with the “diagnosis” of codependent. That was before they said anything.
On the positive side, the language emerging in the professional ranks of addiction research and in academic circles in addiction treatment and recovery has attempted to address stigma by changing language. When I submit abstracts for articles, webinars, or conference presentations for example, the guidelines consistently and emphatically emphasize avoiding words like, “alcoholic”, “addict”, and “substance abuse”. Instead, “alcohol use disorder”, “substance use disorder”, “problematic substance use” are the descriptors used.
Unfortunately, we have not done much to address the stigma for partners. It is assumed the non-addicted partner is codependent, and that is not a good thing to have.
Guilt by association is the assumption when in a relationship with a person who has a substance use disorder or compulsive behavioral problem. By definition – codependent
Options to the Singular Codependency Label
Codependency can be a useful concept when specific behaviors that are unhealthy are identified and addressed. Rather than assuming a “one size fits all”, I have found it more useful for people to define what they mean by codependent, Start with specifically naming the areas of concerns into language that describes what isn’t working.
1. Define Codependency in Behavioral Terms
- “I try to control my partner by drinking with my partner”
- “I don’t know how to take care for myself”
- “I put my needs last”
- “I don’t know how to set boundaries very well”
- “I keep trying to make things better and I’m banging my head against the wall. It’s unhealthy”
- “I’m so angry and resentful, I have turned into somebody I don’t even recognize”
2. Add or Use the Term “Secondhand Harm”
This term does not have the potentially negative stigma that codependency can imply, and does not pathologize the person. Based on the concept of secondhand smoke, the term implies that harm has occurred to the partner, and there isn’t any blame or assumptions about the person implied in that term. In my couple recovery workshops I emphasize that partners are impacted in profound ways by addiction, and that needs to be acknowledged without blame or accusation toward either of the partners. Much like the importance of talking about the impact of cancer, or any serious physical or mental health disorder, it’s important for couples to find a way to talk about that uninvited intruder into the relationship.
3. Acknowledge Post-traumatic Stress Disorder (PTSD)
Most typically, both partners have been traumatized. Addiction is a disease related to structural and fundamental changes in the brain that has hijacked the stop mechanism. We know from addiction science and neurobiology what parts of the brain are involved developing an addictive disorder. We also know addiction is treatable and preventable. The goal is to be able to talk about the impact of a disorder that has created trauma.
When a person starts to panic internally when their addicted partner in recovery is late coming home, that is not codependency, that is PTSD. Previous experience of lateness is connected in the brain with drug use and loss of control. The partner is experiencing an emotional memory that got triggered. This is more neuroscience explaining what is happening. It’s involuntary, and the mid-brain takes over because “danger is imminent”. This is not illogical, or pathological, it’s PTSD. How the person handles those feelings could lead back to previous unhealthy behaviors, but the feelings are not codependent.
Closing Thoughts and Summary
The term codependency can be useful when specific behaviors define what that word means to that particular individual. However, by expanding the recovery issues to include second-hand harm, and PTSD, then normal reactions and acknowledgement of the harm from the disorder can be acknowledged without pathologizing the person with that pain.
Two-thirds of all American families have been impacted by addiction in some way. By using language that reduces stigma and blame, more people might seek help.