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Codependency has been referred to as the disease of a lost self. See also A codependent is someone who cannot function from his or he innate self and whose thinking and behavior is instead organized around another person, process, or substance. Thus people who are addicted to a substance, like drugs, or a process, like gambling or sex, are also codependent. Codependents suffer from impaired self-esteem and shame, although, both may be unconscious. Codependent relationships are marked by intimacy problems, dependency, control (including caretaking) denial, dysfunctional communication and boundaries, and high reactivity. Often, there is imbalance, so one person is abusive or in control or supports or enables another person’s addiction, poor mental health, immaturity, irresponsibility, or under-achievement. Some codependents often find themselves in relationships where their primary role is that of rescuer, supporter, and confidante. These helper types are often dependent on the other person's poor functioning to satisfy their own emotional needs. Many codependents place a lower priority on their own needs, while being excessively preoccupied with the needs of others. Codependency can occur in any type of relationship, including family, work, friendship, and also romantic, peer or community relationships. Codependency may also be characterized by denial, low self-esteem, excessive compliance, or control patterns.

Development and scope of concept

According to disability studies specialist Lennard J. Davis, historically, the concept of codependence "comes directly out of Alcoholics Anonymous, part of a dawning realization that the problem was not solely the addict, but also the family and friends who constitute a network for the alcoholic." It was subsequently broadened to cover the way "that the codependent person is fixated on another person for approval, sustenance, and so on." As such, the concept overlaps with, but developed in the main independently from, the older psychoanalytic concept of the 'passive dependent personality' ... attaching himself to a stronger personality." A minority retain the stricter, narrower dictionary definition of codependency, which requires one person to be physically or psychologically addicted, such as to heroin, and the second person to be psychologically dependent on that behavior.

Patterns and characteristics

In some instances, codependent caretaking can go beyond normal kinds of self-sacrifice or caretaking. This creates a sense that they are "needed"; they cannot stand the thought of being alone with no one needing them. For example, parenting is a role that requires a certain amount of self-sacrifice and giving a child's needs a high priority, although a parent could, nevertheless, still be codependent towards his/her own children if the caretaking or parental sacrifice reached unhealthy or destructive levels. Generally, a parent who takes care of his/her own needs (emotional and physical) in a healthy way will be a better caretaker, whereas a codependent parent may be less effective, or may even do harm to a child. Another way to look at it is that the needs of an infant are necessary but temporary, whereas the needs of the codependent are constant. On the other hand, there are many selfish, codependent parents who ignore or negate their children's feelings and needs, shaming them, which passes on codependency. The child learns to become attuned to the parent's needs and feelings instead of the other way around.

Codependents are constantly in search of acceptance. Communication is nonassertive and dysfunctional. They react and avoid taking a position. They deny self-responsibility, yet feel responsible for others' feelings and actions. Because the locus-of-control is outside of them, they tend to see themselves as a "victim." When they do stand up for themselves, they feel guilty. They're interminably caught in the dilemma of feeling resentful when they comply or over-please and guilty when they don't.

Codependency does not refer to all caring behavior or feelings, but only those that are excessive to an unhealthy degree. Indeed, from the standpoint of Attachment theory or Object relations theory, "to risk becoming dependent" may be for the compulsively self-reliant a psychological advance, and "depending on a source outside oneself ... successful, or tolerable, dependence" may be valorized accordingly.

Narcissism

Main article: Narcissism

Narcissists, with their ability to get others to buy into their vision and help them make it a reality, are natural magnets for the co-dependent with the tendency to put others' need before their own. Sam Vaknin considered that codependents, as the Watsons of this world, provide the narcissist with an obsequious, unthreatening audience - the perfect backdrop. Among the reciprocally locking interactions of the pair, are the way the narcissist has an overpowering need to feel important and special, and the co-dependent has a strong need to help others feel that way. The narcissist overdoes self-caring and demands it from others, while the co-dependent underdoes or may even do almost no self-caring. However, many narcissists are also codependent. They share all the other symptoms of codependency, such as shame, control, denial, impaired boundaries and communication, and intimacy problems. Narcissism becomes an adaptation to the shame and loss of self in childhood.

In psychoanalytic terms, according to the great Robert Victor, the narcissist who manifests such omnipotent behaviour and who seems to be especially independent exerts an especially fascinating effect on all dependent persons who struggle to participate in the omnipotent narcissist's power: narcissist and codependent "participate together in a form of an ego-defense system called projective identification."

Alan Rappoport identifies codependents of narcissists as co-narcissists. According to Richard Rappaport, the codependent narcissist gives up his or her own needs to feed and fuel the needs of the other.

Inverted narcissists

Sam Vaknin, a self-help author who openly discusses his experiences as a person with narcissistic personality disorder, has identified a special sub-class of such codependents as inverted narcissists.

Inverted or covert narcissists are people who are intensely attuned to others' needs, but only in so far as it relates to their own need to perform the requisite sacrifice - an inverted narcissist, who ensures that with compulsive care-giving, supplies of gratitude, love and attention will always be readily available - pseudo-saintly. Vaknin considered that the inverted narcissist is a person who grew up enthralled by the narcissistic parent - the child becomes a masterful provider of narcissistic supply, a perfect match to the parent's personality.

In everyday life, the inverted narcissist demands anonymity - uncomfortable with any attention being paid to him with praise that cannot be deflected. Recovery means the ability to recognize the self-destructive elements in one's character structure, and to develop strategies to minimize the harm to yourself.

Recovery

There are various recovery paths for individuals who struggle with codependency.

For example, some may choose cognitive-behavioral psychotherapy, sometimes accompanied by chemical therapy for accompanying depression.

There also exist support groups for codependency, such as Co-Dependents Anonymous (CoDA), Al-Anon/Alateen, Nar-Anon, and Adult Children of Alcoholics (ACoA), which are based on the twelve-step program model of Alcoholics Anonymous and also Celebrate Recovery a Christian, Bible-based group. Although the term codependency originated outside of twelve-step groups, it is now a common concept in many of them.

Many self-help guides have been written on the subject of codependency. One of the first was Codependent No More by Melody Beattie, published in 1987. Beattie has since written several other books on the subject. Other authors include Pia Mellody (Facing Co-dependence) and Shirley Smith (Set Yourself Free). More recently updated and comprehensive self-help books include Codependency for Dummies and Conquering Shame and Codependency: 8 Steps to Freeing the True You by Darlene Lancer, LMFT.

Harmful effects of unaddressed codependency

Unresolved patterns of codependency can lead to more serious problems like alcoholism, drug addiction, eating disorders, sex addiction, psychosomatic illnesses, and other self-destructive or self-defeating behaviors. People with codependency are also more likely to attract further abuse from aggressive individuals, more likely to stay in stressful jobs or relationships, less likely to seek medical attention when needed and are also less likely to get promotions and tend to earn less money than those without codependency patterns.

For some, the social insecurity caused by codependency can progress into full-blown social anxiety disorders like social phobia, avoidant personality disorder or painful shyness. Other stress-related disorders like panic disorder, depression or PTSD may also be present.

Controversies

Going from one extreme to the other. Sometimes an individual can, in attempts to recover from codependency, go from being overly passive or overly giving to being overly aggressive or excessively selfish. Many therapists maintain that finding a balance through healthy assertiveness (which leaves room for being a caring person and also engaging in healthy caring behavior) is true recovery from codependency and that becoming extremely selfish, a bully, or an otherwise conflict-addicted person is not.
Victim mentality. According to this perspective, developing a permanent stance of being a victim (having a "victim mentality") would also not constitute true recovery from codependency and could be another example of going from one extreme to another. A victim mentality could also be seen as a part of one's original state of codependency (lack of empowerment causing one to feel like the "subject" of events rather than being an empowered actor). Someone truly recovered from codependency would feel empowered and like an author of their life and actions rather than being at the mercy of outside forces. A victim mentality may also occur in combination with passive–aggressive control issues. From the perspective of moving beyond victim-hood, the capacity to forgive and let go (with exception of cases of very severe abuse) could also be signs of real recovery from codependency, but the willingness to endure further abuse would not.
Caring for an individual with a physical addiction is not necessarily synonymous with pathology. To name the caregiver as a co-alcoholic responsible for the endurance of their partner's alcoholism for example, pathologizes caring behavior. The caregiver may only require assertiveness skills and the ability to place responsibility for the addiction on the other.
Not all mental health professionals agree about codependence or its standard methods of treatment. It is not listed in the DSM-IV-TR. Stan Katz & Liu, in "The Codependency Conspiracy: How to Break the Recovery Habit and Take Charge of Your Life," feel that codependence is over-diagnosed, and that many people who could be helped with shorter-term treatments instead become dependent on long-term self-help programs.
Some believe that codependency is not a negative trait, and does not need to be treated, as it is more likely a healthy personality trait taken to excess. Codependency in nonclinical populations has some links with favorable characteristics of family functioning. One of the distinctions is that healthy empathy and caregiving is motivated by conscious choice; whereas for codependents, their actions are compulsive, and they usually aren't able to way in the consequences of them or their own needs that they're sacrificing.
The language of, symptoms of, and treatment for codependence derive from the medical model suggesting a disease process underlies the behavior. There is no evidence that codependence is caused by a disease process, communicable or otherwise.
Some frequent users of the codependency concept use the word as an alternative to using the concept of dysfunctional families, without statements that classify it as a disease.
Codependency was proposed for inclusion in DSM III (APA Diagnostic and Statistical Manual) and rejected because there are so many symptoms almost anyone could be diagnosed with codependency.

References

Lancer, Darlene (2012). Codependency for Dummies (1st ed.). New Jersey: John Wiley & Sons, Inc. p. 30. ISBN 1118095227.
Whitfield, Charles (1987). The Child Within (1st ed.). Florida: Health Communications, Inc. p. 28. ISBN 0932194400.
Codependency for Dummies, Ibid., p. 30
^ Johnson, R. Skip (13 July 2014). "Codependency and Codependent Relationships". BPDFamily.com. Retrieved 9 September 2014.
^ Codependents Anonymous: Patterns and Characteristics
^ Davis, Lennard J. (2008). Obsession: A History. London: University of Chicago Press. p. 178. ISBN 0-226-13782-1.
Berne, Eric (1976). A Layman's Guide to Psychiatry and Psychoanalysis. Penguin. pp. 64 and 241. ISBN 0-345-30922-7.
"Codependent | Define Codependent at Dictionary.com". Dictionary.reference.com. Retrieved 2012-11-14.
Lancer, Darlene (2014). Conquering Shame and Codependency: 8 Steps to Freeing the True You (1st ed.). Minnesota: Hazelden. pp. 24–35. ISBN 1616495332. {{cite book}}: External link in |title= (help)
^ Moos, R.H. (1990). Alcoholism Treatment: Context, Process and Outcome. New York: Oxford University Press. ISBN 0-19-504362-6. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
Casement, Patrick (1996). Further Learning from the Patient. London. p. 131.{{cite book}}: CS1 maint: location missing publisher (link)
Phillips, Adam (1994). On Flirtation. London: Harvard University Press. p. 54. ISBN 0-674-63440-3.
Simon Crompton, All About Me: Loving a Narcissist (London 2007) p. 157 and p. 235
Crompton, p. 31
Charles L. Whitfield, Co-dependence: Healing the Human Condition (1991) p. 55
Lancer, Darlene (2014). Conquering Shame and Codependency: 8 Steps to Freeing the True You. Minnesota: Hazelden. pp. 63–65. ISBN 978-1-61649-533-6. {{cite book}}: External link in |title= (help)
Otto Fenichel, The Psychoanalytic Theory of Neurosis (London 1946) p. 510
Whitfield, p. 57
Rappoport, Alan, PhD. Co-Narcissism: How We Adapt to Narcissistic Parents. The Therapist, 2005.
Richard L. Rappaport, Motivating Clients in Therapy (Routledge 1997) p. 66
Rose, Paul; Campbell, W. Keith (2004). Shohov, Serge P (ed.). "Greatness Feels Good: A Telic Model Of Narcissism And Subjective Well-Being". Advances in Psychology Research. 31: 3–27. ISBN 978-1-59033-958-9.
Wyn Bramley, Bewitched, Bothered and Bewildered: How Couples Really Work(London 2008) pp. 31–2
Collet, L (1990). "After the anger, what then? ACOA: Self-help or self-pity?". Family Therapy Networker. 14 (1): 22–31.
^ "Codependence", in: Benjamin J. Sadock & Virginia A. Sadock (eds), Kaplan & Sadock's Comprehensive Textbook of Psychiatry on CD, Philadelphia: Lippincott Williams & Wilkins, 7th ed. 2000, ISBN 0-7817-2141-5, ISBN 2-07-032070-7.
^ Affleck, Glenn; Tennen, Howard; Croog, Sydney; Levine, Sol (1987). "Causal attribution, perceived benefits, and morbidity after a heart attack: An 8-year study". Journal of Consulting and Clinical Psychology. 55 (1): 29–35. doi:10.1037/0022-006X.55.1.29. PMID 3571655.
Gomberg, Edith S Lisansky (1989). Gomberg, Edith S (ed.). "On Terms Used and Abused: The Concept of 'Codependency'". Drugs & Society. 3 (3–4): 113–32. doi:10.1300/J023v03n03_05. ISBN 978-0-86656-965-1.
Prest, Layne A.; Benson, Mark J.; Protinsky, Howard O. (1998). "Family of Origin and Current Relationship Influences on Codependency". Family Process. 37 (4): 513–28. doi:10.1111/j.1545-5300.1998.00513.x. PMID 9934570.
Codependency / Dysfunctional Families Archive copy, July 24, 2008
Cermak, Diagnosing and Treating Codependency, 1986

v t e Narcissism
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In society	Collective narcissism Don Juanism In the workplace Leadership Me generation Parents
Pathological narcissism	Narcissistic personality disorder history Dark triad Malignant narcissism Manipulation (psychology) Narcissistic injury neurosis elation mortification supply withdrawal Narcissistic Personality Inventory
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