Societal Codependency and Enabling Issues

Introduction

While there are various schools of thought regarding codependency, the general consensus is that a codependent person is one who perpetuates dependence of another person on the abuse of a chemical substance such as narcotic drugs or alcohol [WHO]; and thus standing on the way of recovery of this person from this addiction (ARB, 2007).

The codependent person lengthens the period of addiction of the person through the mechanism of enabling; this is through either making excuses for the behavior of the person, by cushioning these people from experiencing the consequences of their behavior or through direct control of the addicted person. This situation has potential for physical, psychological and social ill-effects for both the dependent and the codependent parties.

Contrary to chemical dependency, that only affects only the addicted party in regards to health and social harm, codependency causes harm to both the parties in the relationship; as such, this is a very serious condition.

Codependency has been characterized into a set of behavior that can point to a situation standing in the way of recovery of an addicted person; such include having an attitude of absolute control over the life of the dependent party, a sense of distrust by the codependent party over interaction that the addicted person may be having with other people; and thus hyper-vigilance and fussing over the needs of the person. The codependent party is usually permanently worried over the welfare of the addicted person; and may, with time develop physical illness caused by stress; such include hypertension, ulcers and heart disease (Rice, 1996).

In addition to this, the codependent party is more often that not diagnosed with clinical depression; this is attributed to the sentiment of frustration at their inability to change the person and end the addiction; combined with love for the person (Wiseman, 1991). The codependent party also frequently changes their mind, line of thought or opinion to conform to that of the dependent person; especially in regards to the reasons of their dependency, and their ability to end it; in a manner of speaking, the person takes to accepting the excuses of the addicted person as truth despite their common sense and consistence telling them otherwise; for example, in a marriage where the husband is an alcoholic, the wife may take to saying that the husband is ill in periods where he has hung-over from an episode of drunkenness. This also applies to the feeling of shame over the conduct of the person; and the inclination to make excuses for the conduct of such.

In such a family setup, such a codependent person will have managed to diffuse the tension created by an event in the short-term; whoever, as the dependent party will engage in such activity in the future, the long-term outlook is not favorable as the situation is only bound to get worse; this is because the dependent party will only be encouraging (thus enabling) the dependent party to remain in addiction.

In a relationship where one party enables the dependence of another, the ‘enabler’ may resist the recovery of the dependent person from the addiction as it threatens his/her position as stable and responsible partner in the union, and may unconsciously stand in the way of the recovery of such.

Codependence is a treatable condition; the first step however for successful resolution of the condition involves the person recognizing that they have the condition, accepting it and seeking help to resolve it. Treatment involves seeking psychotherapy which may be individual, group or both. In addition to this, the person may receive chemical therapy for treatment of physical and psychological illness that has been caused and accompanies the codependence.

It is prudent to mention that codependence is not synonymous with care giving. A close relative to a person with a chemical addiction will most definitely be inclined to give care to such a person during the period where the effects of chemical abuse are severe; or when the after-effects cause physical incapacitation. This should not be classified immediately as pathology. As such, a caregiver may not require the rigorous treatment indicated for a codependent person; and the less comprehensive assertiveness training may be sufficient to set the stage for the recovery; such would enable the caregiver to let the addict take more responsibility and manage (and end) their dependency (Affleck et al, 1987; Moos, Finney & Cronkite, 1990).

In situations that are not categorized as being pathological, codependency has been shown as resulting in favorable outcomes in a family setup (Layne et al, 1998); as such, some schools of thought do not view codependency as a pathological condition; and as such, does not require formal therapy. On the contrary, this school views the condition as a favorable personal character whose extent goes too far in a situation of chemical addiction. Such example is that where a person survives a tragedy or life threatening condition; and gains a positive personality change or experience changes in priorities; additionally, other persons caring for such survivors experience a similar effect (Affleck, Tennen & Rowe, 1991). The initial classification of codependence as a disease has resulted in the language surrounding it suggesting a patho-physiology; this has not been substantiated. As such, several users of the concept opt to discuss it as a family dysfunction rather that a medical condition.

Since its recognition as an important concept to the recovery, the subject of codependency has generated a large volume of both scientific and lay work; additionally, many programs have been developed as supports for others aimed at treating recovery. The benefits of joining these programs as a solution for codependency and as advertised by the providers or facilitators are yet to be documented by empirical scientific studies. Such claims are based on fashion or faith (Gordon and Barrett, 1993; Kaminer, 1992).

On the other hand, enabling has dual definition depending on the situation [Elinewberger.com]. There are many situations where enabling is a positive attribute both for a single family unit and the society at large. In the situation of chemical dependency and codependency, enabling has the effect of perpetuation the problem even further [Elinewberger.com, ARB, 2008]. As such in this situation, the enabler takes undue responsibility and/or blame; and makes excused and/or accommodations for the unfavorable conduct of the other person. It is important to note that in the part of the enabler, no malice is intended; and indeed that the enabler wishes to help the dependent person and attempts to do it how they know best; other motivations for codependency are insecurity or fear.

The codependent party usually has the misconception that some of their actions are for the benefit of the dependent one; for in the example of the alcoholic husband and the codependent wife, the latter might take some measures such as calling in sick for the drunken husband at work. As such, she will have shielded her husband from the repercussions of not attending work without a good reason. Additionally, she might make the habit of giving excuses for some of the behaviors that her husband is engaging in such as offending people or assaulting them during one of the drunken stupors. As such, the wife will have prevented the husband from taking responsibility for these actions; and she will be, in a manner of speaking, cleaning up the mess in his wake. The consequence of this is that the enabled person will not develop psychologically; the person will not view his/her condition as affecting other people and will not take responsibility for his/her addiction (and life). In addition, the psychology of the enabler will also be negatively affected and will eventually develop into pathological codependency.

More often that not, the enabler has weak personal boundaries thus allowing other people, and particularly the enabled person to infringe and take advantage of this albeit unconsciously, to perpetuate the dependency. The enabler also usually has low self esteem and has serious problems with being assertive when interacting with other people in the social unit.

Enabling usually has a subtle beginning with both parties responding to each other during their interaction; with time such develops to levels that require professional intervention to remedy. For example, in the first instance, a child may demand to eat ice-cream for breakfast; the initial natural reaction by the parent would be to deny this request. The child goes ahead to throw a tantrum- the parent has two choices, either to maintain the earlier decision or to give in to the antics of the child; if the parent unfortunately makes the latter choice; s/he has set the stage for development of enabling. This is because the child will have learnt that by throwing a tantrum, s/he can manipulate others to give in to all of his/her demands. This will also have effects of missing the opportunity for the child to learn delayed gratification; and will have less respect of authority of any form. Additionally, the child will have learnt the skill of effectively breaching the personal boundaries of other people s/he interacts with.

While the parent will have achieved a short term goal, that is, getting the child to calm down, the long-term effects of this enabling will be undesirable. As such, the feeling of satisfaction that the enabler gets is not worth the future trouble that the situation will precipitate. Alternatively, avoiding enabling a dependent person will result in some difficulty; however, such a person will have gained an opportunity to develop further psychologically and hopefully to pull themselves out of their harmful dependency.

Society and codependences

In today’s society, there are numerous opportunities for the development and perpetuation of codependent relationships as many practices result in development of social values that eventually result in a dependency. Some of them include

Materialism; many of today’s practices and beliefs emphasis on ownership of materials things; and individual worth is measured by how much one has accumulated these things. As such, a person comes to believe that they are valuable because of how much money they have rather than who they are. When faced with a problem that money cannot solve, the person may degenerate into a relationship that is potentially harmful.

Perfection; today, perfection is seen as a situation which one can achieve if they tried hard enough; these include the family, physical appearance, academics and profession. The truth of the matter is that one can never be perfect; indeed, while one can excel in one area, this is usually at the expense of another. As such, such a person, who is bound to fail in the quest for perfection, has difficulty accepting (them)-self, resulting into a codependent relationship.

Separation of emotions and rational thought; today’s society emphasizes on ‘thinking’ rather that ‘feeling’; and many scenarios are descried as if these two processes are independent; and as if the former is superior to the latter. As such, it is easier for a codependent person to deny their emotions since they perceive them as not being important; and they try to rationalized issues even though their feelings tell then otherwise.

Codependency and chemical dependency

Abuse of chemicals is a major problem both in the developed and developing world; various steps have been taken to mitigate this both to prevent and reverse the harm that this dependency has on the individual and to prevent societal problems that arise and are associated with this dependency. Additionally, many civil authorities are desperately seeking to offload some of the immense and growing burden on their respective healthcare system; and view health problems caused by chemical dependency as a possible area where the burden can be reduced.

It is usually easier to control the use of some of the substances involved in addiction since they are illegal, such as narcotic drugs, and legal repercussions of possessing these substances often results in the interruption of their use for example during a period of incarceration, thus breaking the addiction (at least for the period). It is, however, often more difficult to control addiction from completely legal substances, such as alcohol, as it require a personal effort without the intervention of civil authorities.

As such, alcoholism remains a major problem in the united states and indeed the world; initial figures put the number at 10million over two decades ago in the united states alone (Woodside, 1982). Of bigger interest, however, is the fact that during this period, there were over 28million people who were family members of a family with at-least one alcoholic; these figures are very conservative since they represent only the people who formally sought help for this condition through various government and community bodies in the country.

From these figures and considering that other chemicals have not been factored in, the sheer (combined) magnitude of the effects of the fall-out of an individuals dependency on his/her immediate family; and the interaction between the dependent person and the immediate family has created an interesting subject for study; and has resulted in generation of a lot of information regarding this issue.

A lot of work, for example has been done on the subject of addiction on alcohol; and some of the well known trends today were documented. A good example is the disproportionately high incidence of alcoholism among sons who had alcoholic fathers (Cotton, 1977; Goodwin, 1976; Tarter, Hegedus, Goldstein, Shelly, & AIterman, 1984); and the increase incidences of truancy in adolescents with alcoholic parents (Schuckit and Chiles, 1978). The tendency of wives with alcoholic husbands to opt for treatment for a variety of psychosomatic complaints caused by the situation in the family (Cocores, 1987); and the common occurrence of depressive symptoms in the female relatives of male alcoholics (Goodwin, Schulsinger, Knop, Mednick, & Guze, 1977); are other well known patterns. Similar works have been done from dependencies based on other chemicals.

Many studies are however based on clinical samples, that is, they only study situations where the dependent person and/or the family has formally sought help in a medical facility; as such, the external validity of the outcomes is questionable- additionally, such studies lacks the benefits of having a credible control group.

The occurrence and the effects of substance abuse both to the individual and the family have been attributed and associated with many things; some of these include similar or previous abuse by other members of the family especially the parents; family stressors such as a dysfunctional marriage between the two principles, lowering of the socioeconomic status, and inconsistent expression of affection and/or discipline. Of all the factors surrounding chemical dependency, the concept of codependency appears to be relatively new.

As mentioned before, subject has generated many scientific and lay publications; the latter in particular have been pivotal in shaping the perception of the public regarding the subject. Many of them, mainly targeted at consumers who have experienced, either in childhood or marriage, a situation where there was a person with a chemical (or any other) codependency , and who now find themselves in a dysfunctional relationship; and have linked this to their previous experiences.

Among the earliest works regarding codependency were developed in the context of alcoholism; whereby the condition was described as a situation where the behavior of the immediate family and/or friends of a person addicted to alcohol tended to encourage such a person to persist in his/her dependent state (Cocores, 1987). The term itself was however coined among the circles of Alcoholic Anonymous and its satellite programs targeted at more specific groups within the persons seeking to end their dependence through the program such as adult children of alcoholics. From then, the term and discussions surrounding the condition have been widely featured in psychological literature. However, a lot of the information was for a long time not based on empirical study to show or explain codependence. The term has been adopted to as a catchphrase to describe a situation where a person is involved in a continuous dysfunctional relationship that does not seem to be improving both for the person and the other party which is causing the problems; as such, the term has also been used on relationships that are not necessarily afflicted by substance abuse; but that have another issue such as physical abuse.

Due to the large amount of non-scientific opinion regarding the issue in the public domain, and the motivation from some quarters to make financial gains out of selling either literature or providing services that claim to resolve codependency issues, the definition of the term is more often than not determined by the product that such person/organization is seeking to sell.

Some of the commonly cited symptoms of codependency include having turmoilous relationships; having a constant feeling of not to be left alone, and taking drastic steps to prevent this; a feeling of lost purpose and emptiness; giving up ones ambitions and personal needs for those of which they have a dysfunctional relationship with; an elevated desire to be accepted and loved; low self esteem and being in a constant state of denial (Schaef, 1986; Wegscheider-Cruse, 1984; Woititz, 1983).

A lot of the evidence to support the concept of codependency appears to be anecdotal; since the pathway of development has not been subject to scientific consensus. Due to the lack of a theory to clearly define the problem, and in addition to the fact that many lay person have delved into the issues thus generating a lot of noise that is difficult to separate from empirical material, it is easy to explain the immense popularity of the concept.

It is safe to assume that the natural reaction of many people faced with a situation whereby a loved-one is enslaved by a debilitating chemical dependence would easily be classified as a codependency, as such a person would not be expected to be completely objective due to the emotional ties they have with the addict. The point, however, where such a reaction becomes morbidity is arguable (Rotunda et al, 2003).

The universal agreement, however, is the loss of self esteem by the codependent person; a situation that inevitably results in such a person denied their personal ambitions and needs in favor of those of the dependent person. Such has been recognized in children in a family whereby one or both of the parents are substance abuser; in such cases the effect is so profound that such a child will give up their will completely to that of such parents (South et al, 2003).

Such a person, may it be a child or a spouse, is trapped in a dysfunctional relationship which they perceive as normal; and they learn to respond accordingly to abusive or manipulative behavior intended to elicit caring reaction. This mechanism has been used to suggest that grown female children of dependent parents are attracted to men who tend to go into substance abuse similar to their parents. This is explained by the hypothesis that such a person can only define their self worth through the lens of a dependent person; and that they enter into this relationships to define themselves (South et al, 2003). Such a person will be inclined to ‘help’ the dependent person by responding to their every need up-to and past the point where the relationship becomes manipulative and/or abusive. This would mean that in such a scenario, the dysfunction did not start with the inception of the relationship but came with one or both of the parties as part of the arc of a vicious cycle from their respective families.

Treatment of codependency

Traditionally, and expectedly, the major focus on energy in the treatment of chemical dependency has been the addicted person; and with a concurrent (more or less) ignorance of the effects of this condition to the persons around him/her, especially the family members (Rotunda et al, 2003). This is largely due to the failure by the medical professionals to acknowledge that the interaction of such a person with those in his/her vicinity has had profound and negative effect on them (Johnson, 2003). Notwithstanding the fact that these people may not be having the dependence themselves, more often that not, they develop behavior patterns that are harmful both to themselves and to other people who they might enter into a close relationship with in the future. As such, when treating a case of chemical dependency, it is prudent to treat the family as a unit (Guajardo et al, 2004).

The unique structure of a family, whereby people have strong emotional ties; and are naturally inclined to take care of one of their own if s/he is afflicted with any condition offers fertile ground for the development of codependency.

Recognizing codependency

The first step for the treatment of any disease is recognizing that it is present; this is both for the person who is giving the treatment and the one receiving (South et al, 2003). As with any other disease, there are groups of people who are disproportionately represented in cases of codependence; and that are designated as being high-risk. Among the most important of these is spouses married to persons who are chemically dependent. Others include people recovering from chemical dependence and adult children of parents who were substance abusers. Among this group is a unique set of people; medical professionals working with chemically dependent people; continuous and/or repeated contact with addicts may lead to development of codependency in a health worker as easily as it would in a member of the person’s family (Rotunda et al, 2003).

Some of the characteristic that one should look out for in order to detect a codependency include the following:

Low self esteem and External Referencing

It is important to note that codependent persons are also addicts. In a manner similar to which people who are dependent on a chemical substance end up using the chemical again just to get the pleasurable feeling, codependent persons get their ‘high’ from the feeling of self-worth they get when they enable a person with an addiction. In addition, these people learn or opt to ignore their internal feelings and opinions; and respond to external cues only (South et al, 2003).

Clinging relationship

A person observing a dysfunctional codependent relationship may wonder why one of the parties is not quitting since such a situation is inevitably psychologically and/or physically harmful. However, in the true sense, each of the parties in a codependent relationship is a slave of the other; the enabler, usually gains a sense of security and being needed even though such sentiments can only have poor results in the long run (Rotunda et al, 2003).

Poor keeping of personal boundaries

A codependent person usually looses most of his/her individuality; and cannot separate the lives and existence from that of the person they are related to. Additionally, these people project the emotions of the dependent person rather than their own; more often that not, such a person is not aware of this situation; but they may be slightly aware that some of their desires have been repressed. However, they easily justify this repression for the sake of their dependent partners (Rotunda et al, 2003).

Impression management

It is important to note that while the relationship is going on, the codependent person is acutely aware that the situation is not ideal; and they sincerely would like their partner to overcome their dependence (but may unconsciously stand in the way of such recovery so as to maintain their position) (Guajardo et al, 2004). Since they cannot manage to singularly execute this, they result to impression management.

This involves taking steps to present themselves to the society as having a good relationship devoid of any troubles. It also manifests as lying about or making excuses for the behavior of the dependent person; and trying to control such a person more in issues that would show a bad picture than in ending his/her dependency.

Mistrust of perceptions

A person who is codependent on another with a chemical dependence tends to mistrust their own impression of a certain scenario regarding their relationship unless these are confirmed by those of another person. This is even in situations where such a scenario would have naturally elicited such an impression from an average person. The codependent may abandon a correct line of thought for another suggestion that may be grossly misleading (South et al, 2003; Rotunda et al, 2003).

Caretaking

A combination of two previously mentioned characteristics that is low self esteem and being externally oriented contribute to another characteristic; caretaking. The codependent person seeks to cater for every need of the dependent person; and at the expense of the persona welfare of the former. The dependent person is not allowed to care for themselves thus cementing further their dysfunctional relationship (Rotunda et al, 2003).

Addictions

A codependent person may develop an addiction of his/her own. This may be a chemical dependency similar to that of their partner. On the other hand, these people may become addicted to other forms of release such as food; however, the mechanism of addiction is the same. If such an addiction is diagnosed it is important to treat such an occurrence as a condition by itself giving it enough merit; and allocating enough time and resources for such treatment.

Feelings

In a dysfunctional codependent relationship, all the feelings expressed are premeditated at the expense of suppressing the expression of others; as such, feeling of compassion will be readily expressed and those of anger, disappointment, frustration or sadness are ignored (South et al, 2003). Families in a dysfunction relationships afflicted by alcohol addiction often complain of living in an environment were feelings are frozen. As such, the magnitude of the reality of the situation is never fully appreciated.

The road to recovery

Professional therapy

As mentioned before, the most important step of recovering from codependency is accepting that one has the condition; and agreeing to seek professional help to remedy the situation. Treatment off codependency ideal involves a combination of both professional therapy and self care (Guajardo et al, 2004).

As mentioned before, not all medical professionals agree with the concept or the construct of codependence (Wegscheider-Cruse, 1984); additionally, due to the relative newness of the concept and the facts that the theory surrounding it has not been fully developed, it is inevitable that not all medical professionals may have sufficient knowledge and/or experience in dealing effectively with the condition. It is therefore uttermost importance that when choosing a therapist, to select the one who has the required expertise to handle both the individual and the family for maximum benefits (Johnson, 2003).

There are four general stages of treatment and recovery from codependence:

1. Denial stage; in this stage, the codependent person refuses to acknowledge that they are in a relationship with the dependent person that is harmful both for themselves, the addict; and other members of the family of present. As such, the person will deny that they have a problem. Some individuals may go even further and deny that a state of chemical dependency exists in his/her home.
2. Acceptance stage; the codependent person starts to see that the situation that he/she is living in with the dependent is actually harmful. Additionally, the person acknowledges that some of his/her behavior patterns have contributed significantly both to the development of the codependent relationship and the perpetuation of the dependent state of the addict; and takes responsibility for these events. More importantly, the person that s/he can no longer manage his/her current situation; and that outside (and preferably professional) intervention is unavoidable.
3. Core issues stage; this involves shedding of some of the responsibilities that the codependent person had given him/herself; and giving more independence to the dependent party to run their own lives. This stage requires the person to accept that they cannot control the conduct of others; thus allowing them to let go.
4. Reintegration stage; as mentioned before, one of the trapdoors that lead to codependency is seeking self-worth that is otherwise missing. This stage aims at restoring this self-worth; key to this is letting them see that they don’t have to earn this self-worth by letting other people exploit them; and that it is innate in every person if they just learn to appreciate themselves better.

It would be prudent that when treating the codependent person, treatment be instituted to initiate the recovery of the chemically dependent person. As such, the codependent would have to deal with less of a burden of caring for the person during and after treatment (Johnson, 2003). Additionally, the risk of these two people relapsing into their harmful relationship will be reduced.

Self care

As mentioned before, treatment involves an aspect of self care; these are the steps that a person should take individually so as to improve the outcome of the therapy; and to completely break from the harmful relationship. Such include the following:

1. Detachment; as mentioned before, in a codependent relationship, the boundaries separating the individuality of the person are usually weak; and easily and frequently breached by the exploitative dependent person. One of the crucial events that must take place for effective recovery is the reinforcement of this boundary and the rebuilding of the individuality of the person. As such, the person will learn the extent to which s/he should intervene to help the addict; thus giving him/her more time to work on personal recovery.
2. Removing the victim image; also due to weak personal boundaries, the individuality of the codependent person merges with that of the addict; thus they view themselves as also suffering from the harmful effects of the chemical; that is, they view themselves as victims. For effective recovery to take place, it is important for this image to be shed completely. The person should learn to sympathize rather than empathize with the addict.
3. Independence; the codependent person must learn to live a life independent from that of the addicted person; and must be able to take care of such a person without being sucked into a dysfunctional relationship which will cripple the intended recovery of the addicted person (South et al, 2003).
4. Reconstruction of the individuality; as mentioned before, the individuality of the codependent party tends to deteriorate at the expense of that of the dependent person; and that the feelings and desires of the latter are expressed in the stead of those of the former. As such, it is important for the codependent person to reconstruct his/her personality. They must revive their dreams, reclaim their desires and learn to express their persona feelings.
5. Accepting the reality; also mentioned previously is the characteristic of a codependent relationship whereby the enabler tends to deny the existence of a problem such as substance abuse in his/her family. One pillar of self care and recovery from codependency is accepting that there is a problem; and more importantly, that such a problem has no ‘silver bullet’ that will solve it instantly (Rotunda et al, 2003); and that for sufficient recovery of both the dependent and codependent person, a lot of work has to be done and many sacrifices made.
6. Feelings; in order for a human being to be complete, they must express their feelings, both negative and positive. In a dysfunctional relationship with codependence, especially if chemical dependency is involved, the feelings are ‘frozen’, such that a party can only express one set of feelings, usually the positive ones so that such a relationship can work (Guajardo et al, 2004). For the complete recovery of a codependent person, it is important that they rediscover their feeling and accept them despite of what others might think of them.
7. Setting personal recovery goals and meeting them; the period of recovery of a codependent person involves profound transformation from a self-destructive way of life to that of rediscovering ones individuality and reclaiming of personal emotions. This involves changing the purpose of living for such a person from living for the sake of the dependent person to living for their own sake. In order to maximize on building of self esteem, it is important to set realistic goals of personal development which when achieved not only help such a person, but give him/her a sense of accomplishment.

The process of self-care does not require active professional involvement; however, a therapist may give the codependent advice on how to go about it (Johnson, 2003). Alternatively, one may opt to join one of the many non-professional programs that support self-care processes (Guajardo et al, 2004; Johnson, 2003). A good example is the Twelve Steps Program; this was created by Alcoholics Anonymous and has been very helpful to people recovering from dependencies or codependences through moral support.

Conclusion

Codependency is a serious condition; its seriousness arises from the fact that perpetuation of a codependent relationship is not only harmful to the codependent party, but it is also harmful to the dependent one. This is especially so in situations where a person is chemically dependent; in this scenario, the immediate family carries a disproportionately high risk of codependency and enabling symptoms. Since codependency stands in the way of recovery of a chemically dependent person, s/he will continue to deteriorate and may even die from the effects of the chemical; on the other hand the codependent may be harmed physically and/or psychologically from the relationship.

Codependence is treatable and full recovery is possible with rigorous professional therapy, self-care and moral support. The first step, however, to recovery is recognizing the signs and symptoms of the condition and seeking help to remedy the situation. Denial would only stand in the way of recovery of both the codependent and the dependent.

Once this crucial step is taken, the codependent can now objectively focus on turning their life around, rebuilding their individuality and reevaluating their self worth. As such, they are able to live more independent and rewarding lives.

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