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Codependency
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Codependency is a term for a set of problem behaviors 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 behaviors. 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 behavior.
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 criticizes 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 criticizes 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 behavior? 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 behavior gives her an excuse to return to alcohol.
Therapy for Mary can only succeed if John is willing to change his behavior. 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 behavior is broken.
What are the causes and risks of the condition?
We know very little about what causes people to fall into a pattern of codependent behavior. 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.
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Author: Michael Johnson, MD Reviewer: Gail Hendrickson, RN, BS Date Reviewed: 09/28/01
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