Bipolar 2 From Inside and Out

Posts tagged ‘psychology’

Codependency: Fact or Fiction?

Lately, I’ve been seeing articles with titles that say codependency is a myth or a hoax. They claim that the concept is not just wrong but harmful. Despite its almost 40-year history, codependency now seems invalid to many.

Codependency is defined as a mechanism whereby enablers are enmeshed with their child, spouse, sibling, or significant other to such an extent that they lose the ability to take care of their own emotional needs. The enabling also means that the person suffering from a psychological condition (originally addiction, but later other problems) does not have the motivation to work on themselves or change their behavior. In extreme cases, it means that one partner cannot tell where they end and the other begins.

My husband introduced me to the concept of codependency. He has a background in psychology and was greatly influenced by Melody Beattie’s writing. Her book, Codependent No More (published in 1986 but still selling well), his work with Adult Children of Alcoholics (ACA), and attendance at seminars on the topic have made him a staunch believer. When I told him about the articles, he scoffed. In fact, he seemed offended. It’s a basic tenet that aligns with his experience of psychology.

So, what are the objections to the concept of codependency?

First of all, it’s not a recognized psychological condition in that it’s not an official diagnosis. There are no specific diagnostic criteria, though there is a list of symptoms including fears of rejection or abandonment, avoiding conflict, making decisions for or trying to manage the loved one, keeping others happy to the detriment of self, and generally a “focus on caretaking and caring for others to the point that you begin to define yourself in relation to their needs.” Admittedly, those are largely squishy criteria (there are others), some of which overlap with officially recognized diagnoses.

Another definition states, “The codependent person sacrifices their needs to meet the demands and expectations of the other person. These individuals may also strongly desire to ‘fix’ the other person’s problems. The individual often neglects their self-care and personal growth in the process.” This was developed in the context of addiction studies, and some people object to the concept being broadened to include other circumstances.

More significant is the idea that the concept pathologizes love and support. Interdependence is the natural function of intimate relationships, and depending on each other is the ideal. Codependency theory is said to downplay helping behaviors that are essential to good relationships. In addition, codependency is often viewed as a “women’s problem,” and that reinforces patriarchal stereotypes, such as that women are “needy.” Instead, a person labeled codependent should work on overwriting old scripts of anxious attachment and other negative feedback loops.

Codependence is said to have contributed to the “tough love” movement that involved a hands-off approach to a loved one’s addiction, allowing them to experience the natural consequences of their behaviors. Tough love is discredited these days as a form of verbal abuse and a philosophy that has no basis in psychological practice, as well as reinforcing the idea that an addict must hit “rock bottom” before they are able to accept help. Tough love also promoted a model of intervention as a process involving anger, blame, non-compassionate confrontation, and the use of psychologically damaging “boot camps” for troubled teens.

Then, too, it is said that there is no research validating the concept of codependency, no way to measure it, and no effective treatment for it.

There’s another point of view, though—that codependency is a real, serious problem.

Let’s take that last point first. Research on codependency has revealed specific behaviors associated with it and the tendency to repeat those behaviors in subsequent relationships. Research has also indicated sex differences in codependency, with women being more likely to suffer from it. (It should be noted that women also dominate in diagnoses such as depression. Both genders are affected by depression and codependency, however.) As with codependency, there are statistics to report how many people suffer from depression and other conditions, but none to say how severe their condition is. Also, codependency has its roots in attachment theory, family systems theory, and trauma studies.

Treatment for codependency is quite possible. Education, individual therapy, couples/family therapy, group therapy, CBT, and DBT have all had beneficial effects. Even 12-step programs such as Codependents Anonymous are possible ways to address codependency. And, like some other disorders, codependency responds to techniques such as boundary setting, building on strength and resilience, and self-care. It also has other characteristics common to other conditions—relapses and setbacks, for example.

As for the idea that codependency pathologizes love and support, it is true that these qualities are essential to the human experience and good things in and of themselves. But when those qualities get hijacked by excessive, misdirected, and exaggerated needs, they can become pathological. After all, moderate depression and anxiety are parts of the human experience too, but when they strike with extreme manifestations, they become pathological as well. To say that all expressions of love and support are good is to ignore the harm that they can do when they interfere with those normal experiences of human interaction.

And while the concept of codependence may have started in the field of addiction studies, there’s no indication that that’s the only place where it belongs. Plenty of psychological concepts begin in one area of study and expand into others. The idea of healing the inner child may have started with trauma studies, but it now applies to other areas as well, such as grief therapy and other abandonment issues (including codependency).

What does all this add up to? I think my husband and the proponents of codependency theory have a point. The fact that it hasn’t been sufficiently studied doesn’t mean that it doesn’t exist, just that it is a comparatively recent idea compared to other conditions and pathologies. It has demonstrable effects on relationships and makes logical sense. If two people become enmeshed, their behaviors are likely to become warped and dysfunctional. In fact, dysfunction is one of the hallmarks of codependency. It explains relationship dysfunction in a way that few other concepts do. It may not be the only relationship hazard, but it checks a lot of the boxes.

Sure, the term codependency has been overused, especially in the type of pop psychology promoted by assorted self-help articles and books. But so have other psychological concepts and societal problems. Just because gender studies has had limited usefulness in analyzing male and female communication styles doesn’t mean that it has nothing to tell us.

So, do I think that the concept of codependency is a myth? No. Do I believe that it’s a “hoax,” as some have claimed? Again, no. Is the concept itself toxic? Does it imply that love and support are invalid? No. Is it overused by people who don’t understand it? Certainly. Does codependency deserve more study and practice before we discard it? Definitely.

I’ve seen codependency working in people’s lives. Anecdotal evidence isn’t sufficient to prove its reality, of course, but it’s a starting point for further exploration by professionals. Just because something doesn’t appear in the DSM, a notoriously changeable document, doesn’t mean it’s not real.

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Mental Health

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Language Lost

There are many words that are specific to psychology, including diagnoses, symptoms, and therapeutic techniques. Many of those terms, however, have worked their way into general conversation. Some think this is a good thing as it makes society more aware of the language we as psychiatric patients use. Others object to this use of language. They see it as diluting the meaning of the terms.

Two of the most common words that have made this shift are bipolar and OCD. Instead of diagnoses, they’re often used as descriptions of people or things that are thought to share the characteristics of the disorders. “The weather is bipolar this month.” “Beth’s house is really tidy. She’s so OCD.” These usages are, of course, inaccurate. Weather can’t have a psychiatric disorder, and a neat house is not enough to diagnose a person with OCD.

The thing is, people aren’t using them literally. Weather being bipolar is a metaphor. It conveys the idea that the weather is changeable, seemingly randomly. Calling weather bipolar expresses the concept more vividly, which is probably why it has become so popular. Calling someone OCD is an exaggeration used for effect. They’re saying that Beth is not just neat, but excessively neat. The people who use these expressions don’t have any real idea of what the terms mean. They’ve just heard them used and have only a vague, superficial idea of what they mean.

Spoons is another metaphor gone astray. Originally, it was used to describe the depletion of energy that someone with an “invisible illness” feels when they’re required to do more than they’re capable of on any given day. Spoons are a variable commodity. The neurodivergent or physically challenged never know how many “spoons” they will have at the beginning of a day and when they’ll run out of them. It’s a very powerful metaphor which makes it easier to understand the concept.

Nowadays, however, it’s used by people who don’t face these challenges to mean simply “I’m tired” or “I’m done for the day.” But these people don’t have a widely varying amount of energy at the start of each day. Oh, they may be more or less tired depending on the quantity and quality of their sleep. But they don’t begin with so few spoons that getting out of bed requires an enormous expenditure of spoons that depletes them for the rest of the day.

The word triggers is not a metaphor, but a word that has weakened over time. In psychological terms, a trigger is something that brings back vivid memories and sensations of a traumatic incident. The person who is triggered cannot control their reactions and will experience the event as if it were actually occurring in real-time. In its new meaning, a trigger is anything that a person doesn’t like or causes them to be uncomfortable. This discomfort is minor and fleeting, and does not cause sensory overload. People who use “triggered” this way betray a deep misunderstanding of the term and often make fun of the concept altogether.

These and other terms like neurodivergent and spectrum are also frequently misunderstood or misused. Some are still being defined and arguments about what they really mean often occur.

People who use the words in their specific, technical sense sometimes speak of “reclaiming” them. They are offended by the perceived misuse of the various terms and want to restrict them to their original, technical meanings. They want other people to stop using them in their new senses. They feel the new usage cheapens the words.

The thing is, language doesn’t work that way. Once a word or phrase has “escaped into the wild” and is being used with a different shade of meaning, there’s no getting it back. No matter how much you try to educate people about the “real” meaning of the word, most people will not even realize they are using it “wrong” and won’t stop using it in the new sense. In fact, the first dictionary definition of bipolar is “having or relating to two poles or extremities,” not the disorder. The non-psychiatric sense of OCD as an adjective hasn’t made it to the dictionary yet, but it’s only a matter of time now.

Personally, I can think of things a lot more heinous than describing me and the weather the same way. Is it ignorant? Yes. Is it insulting? Probably. I just think it’s a waste of time correcting one person at a time or trying to educate the masses about it. Millions of people are still going to do it, and there are more important things to educate them about.

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Mental Health

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