Definition Codependency is a term for a set of problem behaviours in dysfunctional relationships. There is no common agreement about how to define this term. It is used in many different ways to describe many different experiences.
The idea of codependency was first formed by therapists working with people dependent on alcohol or drugs and their families. These therapists noticed that many of the substance-dependent people had partners with similar behaviours. The partners seemed to be unable to remove themselves from the problems of their impaired loved ones. They were bound to them by their determination to change or protect them. As a result, they became part of the problem.
It is unclear whether codependency is an illness or a normal response to being in a relationship with a substance-dependent person. But it is clear that treatment for substance dependence will not be successful unless both the substance abuser and the partner are willing to change their behaviour.
What is going on in the body? John's wife Mary has an alcohol problem that has caused her to act foolishly in social situations. She has alienated friends, lost jobs, and wrecked cars. John responds to these incidents by trying to repair the damage she has done. Then he criticises her and lays down harsh rules for her. She agrees to these rules at first. But eventually she violates them and returns to drinking. This just leads to another round of this seemingly endless pattern between them. She drinks, he fixes the problem. He criticises her and sets rules. She agrees, then starts drinking again. On and on it goes.
Why would they both continue this painful and futile pattern of behaviour? John feels anger at Mary for her drinking, but at the same time he feels better about himself. He feels good about being a helper. His focus on her problems allows him to avoid thinking about his own. She is the sick one and he feels like the healthy one. Mary may resent and feel humiliated by his criticism and rule setting. But she feels powerless to change the pattern. She returns to alcohol as a quick and easy way to feel better about herself. His behaviour gives her an excuse to return to alcohol.
Therapy for Mary can only succeed if John is willing to change his behaviour. He needs to accept that he can never really control her drinking. When he protects her from the consequences of her drinking and then treats her like a bad child, he has only succeeded in "enabling" her alcohol problem. John must stop repairing the damage Mary has done with her drinking. He needs to allow her to suffer the consequences alone. If she continues to drink anyway, he either must find a way to live with her drinking or be willing to walk away from the relationship. Treatment will succeed only if this cycle of codependent behaviour is broken.
What are the signs and symptoms of the condition? A codependent person may show some of the following behaviours:
has a high energy level
has very good organisational skills
is competent at a wide variety of tasks and able to learn new ones quickly
is loyal and willing to put the needs of others before their own
tends to overachieve
has low self-esteem
never asks, "What's in this for me?"
What are the causes and risks of the condition? We know very little about what causes people to fall into a pattern of codependent behaviour. Some believe that it is a normal response to having a partner with an alcohol or drug problem. Others believe that some people are just more vulnerable to falling into this pattern. People who see themselves as helpers may be more vulnerable. People who have grown up with parents who have drug or alcohol problems may be more susceptible. Having a codependent partner makes it unlikely that someone addicted to drugs or alcohol will be able to recover. Violence is a common problem in codependent relationships.
What can be done to prevent the condition? The best way to prevent codependency is to recognise and treat a drug or alcohol addiction as soon as possible. The longer the pattern goes on, the more difficult it is to change.
How is the condition diagnosed? Usually this pattern is better recognised by someone outside the relationship. That could be a therapist, friend, or family member.
What are the long-term effects of the condition? These relationships often last for many years, leading to very chaotic home situations.
What are the risks to others? Children in households with codependent behaviour are often severely affected. In some cases, they are physically abused or neglected. They almost always suffer long-term emotional scars as a result of their parents' behaviour. Many will recreate these experiences in their adult relationships.
What are the treatments for the condition? Treatment of drug or alcohol-dependent people almost always includes the partners and affected family members. Therapists will guide the person to change the substance-dependent behaviour. They will also help partners and family members understand how their own behaviours may be making the problem worse. They help them move to behaviours that can support recovery from substance dependence.
What are the side effects of the treatments? There are no side effects to the treatment.
What happens after treatment for the condition? Effective treatment usually leads to much better relationships and a healthier family life. But the risk of relapse from alcohol and drug dependence is high. It can be very important for people with these problems to stay involved in some type of treatment. Many people attend Alcoholics Anonymous or Narcotics Anonymous on a long-term basis. These groups are very useful in helping people maintain sobriety. Family members often find Alanon a very helpful group. This is a self-help group just for family and partners of addicts. Working with groups like Alanon can help identify and reduce codependent behaviour. Other self-help groups may be available in your local area...check with your local family doctor.
How is the condition monitored? For most people, long-term psychotherapy is not necessary. Groups such as Alanon can help people recognise when they are returning to their codependent behaviour patterns.
Author: Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 06/09/2004 Contributors Potential conflict of interest information for reviewers available on request
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