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concept_of_codependency.docxConcept of codependency: blaming the victim or pathway to recovery?
Alternate Title:
comment on B. G. Collins
Authors:
Favorini, Alison
Source:
Social Work; November 1995, Vol. 40, p827-830, 4p
Physical Description:
Bibliography
Document Type:
Article
Subjects:
Social work with women Feminist criticism Codependency Psychiatric social work Interpersonal relations Codependents Pathological psychology Addictions Addicts Social workers Social services
Abstract:
A commentary on B. Collins's “Reconstructing codependency using self-in-relation theory: A feminist perspective,” which appeared in Social Work, vol. 38, 1993, pp. 470-476. The writer examines Collins's synopsis of the definitions of codependency and descriptions of behavior and characteristics connected with it and declares them to be consistent with what she has read on the subject. She states that although documentation exists that stress-related health problems are common in spouses of alcoholics, Collins is correct in maintaining that the extension of the disease concept from addiction to codependency is inappropriate. However, she contends that Collins's article is a frequently misleading analysis and critique of the concept of codependency and outlines how this is so with reference to previous studies on codependency, the origin of codependency, and the help that social workers and self-help movements can provide to codependents.
ISSN:
00378046
Accession Number:
508574272
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Concept of Codependency: Blaming the Victim or Pathway to Recovery?
Contents
3. Social Workers and Self-Help Movements
4. Conclusion
5. References
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Section:
Points & Viewpoints
"Reconstruing Codependency Using Self-in-Relation Theory: A Feminist Perspective" (Collins, 1993) was a thought-provoking and well-written but frequently misleading analysis and critique of the concept of codependency. As the second author of one of the articles Collins cited as part of her argument (Jacob, Favorini, Meisel, & Anderson, 1978), I felt compelled to respond. Our article was written 16 years ago and, therefore, predates the popularization and perhaps the formulation of the codependency construct. The studies we reviewed typically assessed the presence of psychopathology using measures such as the Minnesota Multiphasic Personality Inventory (Hathaway & McKinley, 1951) and did not look for codependent behavior specifically. This is an important distinction glossed over by Collins.
In the 15 years since our article was published, a great deal has been learned about addicted family systems that suggests the prevalence of impaired problem solving and communication; physical, emotional, and sexual abuse; and lasting negative consequences for the children of these families. Certainly, to locate the pathology of such a system in the addict's spouse is, as Collins contends, "blaming the victim." However, as an adult child of alcoholics (ACOA), I can testify personally to the value of the concept of codependency in the recovery process of surviving family members. Therefore, I would like to respond to several points in Collins's article.
Collins's summary of the definitions of codependency and descriptions of behavior and characteristics associated with it are consistent with what I have read on the subject. The hallmark trait is caretaking behavior--the codependent individual will meet the needs of another before meeting his or her own needs and will do this consistently. Collins suggests that the term "codependency" is applied primarily to women and that the behaviors described result in large part from societal prescriptions of appropriate coping behavior for women. However, authors writing on this subject do not limit the term's application to women. Because most addicted individuals have been male (this is changing), women may have more often shown this pattern, but it is not limited in theory or in reality to women.
Use of the term "sick" to label this behavior does seem extreme, but most of the writings I have seen directed to ACOAs and those recovering from codependency are primarily supportive and caring and do not convey a tone of blaming the victim. Although there is documentation that stress-related health problems are common in spouses of alcoholics, I agree with Collins that extension of the disease concept from addiction to codependency is inappropriate.
Collins actually cites no studies directly testing the existence of codependence. Tweed and Ryff (1991) and Seefeldt and Lyon (1991) both assessed ACOA characteristics but did not focus specifically on codependence. The latter source is a conference paper unavailable to this writer. Tweed and Ryff compared higher-socioeconomic-status, demographically matched ACOAs and non-ACOAs (according to the Children of Alcoholics Screening Test) on 10 self-report measures of psychological distress and well-being, personality, and psychological development. Well-being assessment was included to examine resilience.
ACOAs were significantly more depressed and anxious but did not differ on the other eight measures. However, the younger part of their sample were all college students, and the measures used do not adequately tap the concept of codependence, nor is the term used in their article. The ACOAs had significantly more often received psychiatric treatment and were significantly more concerned that they might have eating or alcohol problems; they also more often reported emotional abuse in childhood. Furthermore, all measures were self-reported, allowing denial and social desirability to operate. Kaufman's (1985) review of the literature, cited by Collins to support her position, analyzed family system dynamics in substance-abusing families and included a discussion of "coalcoholism," similar to codependency. Kaufman described dynamics akin to those of the codependent model.
In an intriguing review and synthesis of family systems theory with the codependency model, Sheridan and Green (1993) hypothesized that families of alcoholics differ from other families in cohesiveness, adaptability, and competence (that is, successful task performance while supporting individual growth). Confusion over boundaries and roles, issues of control, and rigidity of rules and expectations stifle the individuation of family members and impair their self-esteem. Codependency is defined as lack of self-definition and the seeking of identity through external relationships. The authors cited many supporting empirical studies, including two that reported a tendency for ACOAs to be overresponsible for others and underresponsible for themselves (Black, Bucky, & Wilder-Padilla, 1986; Jackson, 1984/ 1985). In a discriminant function analysis of data from 55 recovering ACOAs in clinical and self-help programs, 33 nonrecovering ACOAs, and 39 adult children of nonalcoholic parents, Sheridan and Green correctly classified 69 percent of the respondents with five significant predictor variables--family of origin competence, family of origin cohesion, individuation from parents, desire to control others, and self-esteem. ACOAs reported more family-of-origin problems with cohesion (either enmeshment or disengagement) and competence and were less individuated, more controlling, and lower in self-esteem. Although the study is limited because of the middle-class sample and sampling methods, the variables that emerged as significant predictors are indicative of codependent traits and behavior patterns in ACOAs and support the codependency model.
Although Collins suggests otherwise, most writers addressing codependency do acknowledge that codependent behaviors are developed as a way to survive in an addictive or dysfunctional family and note that these behaviors become dysfunctional when continued into adulthood. Needing to always be in control and having a strong care-giver orientation are some of the more common adult sequelae. Most spouses of alcoholics or other drug addicts grew up in families where drugs or alcohol were abused and have developed enabling behaviors that attract addicted individuals.
Anyone who doubts the existence of codependent behavior patterns should visit ACA (Adult Children of Alcoholics), CODA (Codependents Anonymous), or Al-Anon meetings to witness the grip these behaviors have. I agree with Beattie (1987, 1990) that it is a lifelong struggle to overcome these ingrained behaviors. It is important to acknowledge the diversity of ACOAs and spouses of alcoholics, but it is wishful thinking to assert that living in such a family does not exert a lasting effect that may fall short of diagnosable psycho-pathology but can have persistent negative effects on personal and work relationships.
The emphasis on nurturing the relationship to self is key to recovery because the codependent has always put herself or himself last. This self work must be done before the person can have a mutual relationship of the type discussed by Collins. I recommend Mellody and colleagues' (1989) Facing Codependence for its discussion of how the self has been damaged in abusive and dysfunctional families. Blaming and boundary violations are extremely common in families of drug addicts, and the victims must heal their damaged selves. Groups such as ACA, CODA, and Al-Anon help to do this by providing a supportive and nonjudgmental forum for sharing. As Woititz (1983) said, "Children of alcoholics guess at what normal is" (p. 4). It is very healing for survivors to learn that there are others like them who understand and who will not cast aspersions on their experiences or behavior but will gently support them in trying to change their lives. To recover, ACOAs and spouses must understand how their own behavior and attitudes toward self have kept them in an addictive relationship. Those who do not learn from the past are doomed to repeat it.
Once the victims' self-esteem and boundaries are stronger, they are then able to form healthy relationships with others without being victimized again. Collins misinterprets authors on the subject when she says they do not encourage relationships and that they interpret "relational strengths as pathology" (p. 475). It is enmeshed, enabling, and destructive relationships that must be avoided, not all relationships:
Freedom begins with being open to love. The dilemma of abandonment is a choice between painful intimacy or isolation, but the consequence is the same--we protect ourselves by rejecting the vulnerable inner-child and are forced to live without warmth or love. Without love, intimacy and isolation are equally painful, empty and incomplete. (ACA, no date)
Social Workers and Self-Help Movements
As a feminist, I can understand Collins's efforts to reinterpret codependent behavior from a feminist perspective and power theories. Society's denial of victimization has helped entrap spouses and children, but this is changing, and one of the main reasons is the self-help movements that Collins apparently encourages social workers to eschew. She raises an interesting point by asserting that authors on codependence (and the 12-step movement) seek to avoid discussing the injustices of the context in which codependent relationships occur.
The 12-step movement, which is closely linked to the codependency model, has been ardently apolitical so as to keep its appeal broad and to focus only on recovery from addiction, one reason the movement has flourished and survived for decades. Another reason for downplaying the societal context is that blaming outside circumstances is a classic denial strategy in addictive families. Excessive blaming interferes with taking responsibility for one's own life.
Authors like Bradshaw (1988) and Mellody et al. (1989) do discuss and promote equality in relationships, but they do not frame this primarily in a feminist context. However, all these authors seek to help clients and their readers recognize abuse of power in those to whom they relate. This is politics writ small. Social workers treating clients participating in self-help groups might help them to see the larger political context. It would be a mistake for social workers to see 12-step groups and the codependence model as antifeminist. Bradshaw, Mellody et al., and Whitfield (1989) explicitly encouraged their readers to be assertive about their rights. There is less emphasis on trying to change the world, because overcontrolling behavior is frequently prominent in these clients. For this reason, "letting go" is stressed, but this should not be confused with being unassertive or permitting further victimization.
I urge readers of Collins's article and this column to read the authors discussed; attend ACA, CODA, or Al-Anon meetings; and form their own opinions on this subject. Social workers should not discourage clients from using a resource until they understand it thoroughly.
Social workers cannot form a definitive opinion founded on a limited database. It is apparent that more research is needed on codependency. As researchers, we must humbly bear in mind that our studies on related subjects have often shown conflicting results, and it can take decades for a clear picture to emerge. The construct of codependence must not be applied wholesale as an explanation for most behaviors or social problems (see, for example, Schaef, 1986). It must be more clearly defined to permit operationalization into appropriate measures accurately reflecting behavior patterns. Collins has done us a service by encouraging us to examine this concept more critically. Only then can research proceed and provide policy and clinical guidance on the issue.
Meanwhile, social workers can draw on other sources of knowledge such as the books discussed, clinical experience, and self-help meetings to form a basis for whether and how they will use the co-dependence construct and related self-help groups in working with clients. Finally, perhaps social workers can see our concept of empowerment in the following passage:
In childhood our identity is formed by the reflection we see in the eyes of the people around us. We fear losing that reflection .. . . thinking the mirror makes us real and we disappear or have no self without it. The distorted image of family alcoholism is not who we are. And we are not the unreal person trying to mask that distortion. In ACA we stop abusing a substance or losing ourselves in another. We stop believing we have no worth and start to see our true identity, reflected in the eyes of other adult children, as the strong survivors and valuable people we actually are. (ACA, no date) .
Adult Children of Alcoholics. (no date). Newcomer's packet. New York: Author.
Beattie, M. (1987). Co-dependent no more. New York: Harper & Row.
Beattie, M. (1990). Co-dependents' guide to the 12 steps. Englewood Cliffs, NJ: Prentice Hall.
Black, C., Bucky, S. F., & Wilder-Padilla, S. (1986). The interpersonal and emotional consequences of being an adult child of an alcoholic. International Journal of the Addictions, 21, 213-231.
Bradshaw, J. (1988). Bradshaw on: The family. Deerfield Beach, FL: Health Communications.
Collins, B. (1993). Reconstruing codependency using self-in-relation theory: A feminist perspective. Social Work, 38, 470-476.
Hathaway, S. R., & McKinley, J. C. (1951). The Minnesota Multiphasic Personality Inventory manual (rev. ed.). New York: Psychological Corporation.
Jackson, J.G.W. (1985). The personality characteristics of adult daughters of alcoholic fathers as compared with adult daughters of nonalcoholic fathers. (Doctoral dissertation, U.S. International University, 1984). Dissertation Abstracts International, 46(1), 338B.
Jacob, T., Favorini, A., Meisel, S., & Anderson, C. (1978). The alcoholic's spouse, children and family interactions: Substantive findings and methodological issues. Journal of Studies on Alcohol, 39, 12311251.
Kaufman, E. (1985). Family systems and family therapy of substance abuse: An overview of two decades of research and clinical experience. International Journal of the Addictions, 20, 897-916.
Mellody, P., with Miller, A. W., & Miller, J. K. (1989). Facing codependence. San Francisco: Harper & Row.
Schaef, A. W. (1986). Co-dependence: Misunderstood--Mistreated. San Francisco: Harper & Row.
Seefeldt, R., & Lyon, M. (1991, April). An attempt to validate ACOA characteristics in a clinical sample. Paper presented at the annual convention of the American Association of Counseling and Development, Reno, NV.
Sheridan, M. J., & Green, R. G. (1993). Family dynamics and individual characteristics of adult children of alcoholics: An empirical analysis. Journal of Social Service Research, 17(1-2), 73-97.
Tweed, S., & Ryff, C. (1991). Adult children of alcoholics: Profiles of wellness amidst distress. Journal of Studies on Alcohol, 52, 133-141.
Whitfield, C. (1989). Co-dependence: Our most common addiction--Some physical, mental, emotional, and spiritual perspectives. Alcoholism Treatment Quarterly, 6, 19-36.
Woititz, J. (1983). Adult children of alcoholics. Deerfield Beach, FL: Health Communications.
Accepted September 1, 1993
~~~~~~~~
By Alison Favorini
Alison Favorini, PhD, is associate professor, School of Social Work, Wayne State University, 4756 Cass Avenue, Detroit, MI 48202.
Source: Social Work, November 1995, Vol. 40, p827, 4p Item: 508574272
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