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04-26 A family disease: Why good intentions of codependency don’t help

A family disease: Why good intentions of codependency don’t help

The term “codependency” is frequently used in the substance abuse literature as a way to describe the enabling behaviors exhibited by the spouses and children of alcoholics (COAs). In 1986, Timmen Cermak, M.D., president of the National Association for Children of Alcoholics (NACOA) and assistant clinical professor of psychiatry at the University of California, San Francisco (UCSF), proposed codependency as a mental disorder for the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III, American Psychiatric Association, 1980), but his proposal failed to gain much traction in the psychiatric community. Since then, there has been a wide discrepancy and lack of a clear definition or understanding of the term ever since.

What is codependency?

Codependency is often cited as a fairly common experience among the family members impacted by the substance abuse or dependence of a loved one. Originally, codependency was used to describe the tendency of a person who was either in a relationship or living with the person. The wives of alcoholic men were first recognized as exhibiting particular caretaking and enabling behaviors that allowed her alcoholic husband to continue drinking without consequences or harm.

Later, researchers described codependency as a type of one-sided, emotionally destructive and abusive relationship with a partner who is emotionally unavailable due to mental or physical illness or an alcohol or drug use problem. At its very core, codependency affects a person’s self-esteem, sense of self or identity, and ability to have a mutually satisfying relationship with another person. More specifically, people with codependency tend have a painful dependence on others for approval, safety, identity and self-worth.

Symptoms of codependency

A person who has codependency often has good intentions, but feels an exaggerated sense of responsibility for taking care of others, doing more than his or her share all of the time, and having an incessant need to control others, be approved and recognized by others, and hold onto relationships, even when they are harmful, so that they may avoid perceived or actual abandonment.

Daniel Harkness, Ph.D., L.C.S.W., a professor at Boise State University, stated that some of the most frequently cited symptoms of codependency include the following:

  • Low self-worth and self-esteem
  • Intense and unstable relationships
  • Chronic feelings of boredom and emptiness
  • Need for approval, acceptance and affection from others
  • Unable to tolerate being alone
  • Subordinating one’s own needs

Other characteristics of people with codependency include:

  • Exaggerated sense of responsibility
  • A tendency to confuse love and pity
  • A tendency to get hurt when others fail to recognize their efforts
  • Sense of guilt when asserting themselves
  • Lack of trust in self and others
  • Chronic anger
  • Lying or dishonesty
  • Fear of being alone or abandoned
  • Rigidity or difficulty with change
  • Difficulty identifying feelings, communicating and making decisions

How do people develop codependency?

Codependency is considered to be a learned pattern of behaviors in a person’s relationships that arises in a dysfunctional family of origin and in relationships involving mental illness, substance abuse or dependence, or chronic physical health problems. Individuals who develop codependency often have a compelling need to provide care for another person (e.g., caretaking) and to do what they can to make their partner, mother, daughter, brother or co-worker not leave or abandon them. This type of caretaking and enabling behavior often allows the family member or friend to continue to abuse alcohol or drugs.

The existence of alcohol abuse or dependence, or a similar issue, in the family of origin, romantic relationship, or a co-worker, friend or family member, can contribute to the development of codependency. This is because people who are in dysfunctional families or other types of relationships are more likely to communicate with and relate to one another in inappropriate and ineffective ways, which can promote the development of one-sided relationships.

People who have alcohol use problems increase the likelihood that their spouse, children, parents, grandparents and other family members will develop relationship problems such as codependency. At the same time, a person with alcohol abuse and dependence will also be more likely to experience codependency in their relationships with others. People who have codependency and do not receive treatment, unfortunately, can eventually develop alcohol or drug use problems and other types of destructive behavior in an effort to numb or reduce the painful emotional consequences of this painful dependence on another person who has alcohol dependence and is emotionally unavailable.

Sovereign Health Rancho San Diego provides adolescents ages 12 to 17 with comprehensive behavioral health treatment services for teen alcohol abuse and dependence, substance abuse, mental illness and co-occurring disorders. We individualize treatment to meet each adolescent’s needs. For more information about how families are affected by codependency or about our programs offered at our Rancho San Diego facility for adolescents, please contact our 24/7 helpline for further assistance.

Check back regularly for updates on the Alcohol Awareness Month series from April 1-30, 2016 at Facebook or Twitter and by searching for #AlcoholAwareness and #SovTalk.

About the author

Amanda Habermann is a writer for the Sovereign Health Group. A graduate of California Lutheran University, she received her M.S. in clinical psychology with an emphasis in psychiatric rehabilitation. She brings to the team her background in research, testing and assessment, diagnosis and recovery techniques. For more information and other inquiries about this article, contact the author at

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