A
BRIEF LOOK AT THE PSYCHOLOGICAL LITERATURE:
PSYCHOLOGICAL ABSTRACTS
To prepare for writing this book the authors searched the data base
of the psychological abstracts on a compact disk. These abstracts
include articles from all sorts of psychological journals representing
the cutting edge of psychological research and new developments.
Since codependence is a new phenomenon, having surfaced by name
only in the past few years, we checked all the abstracts and pertinent
articles from January 1983 to September 1988 (inclusive). This led
to the discovery that traditional psychological literature contains
only a few references to the disease of codependence, at least by
name.
The following eight articles pertaining to "codependence" or "codependency"
were all published since 1985.
Lans Lesater et al. (1985), examined family and social problems
of clients at a community clinic, including chemical use patterns.
The survey comparing random patients and those receiving mental
health care indicates that thirty-nine percent of those receiving
mental health care had one member of the family using drugs at the
"circumstantial-situational" level as compared to thirty percent
of the total clinical group. The author concludes that chemical
use and associated problems such as codependence are significant
factors affecting families.
Sydney Walter (1986) presents a case in which the wife of a male
alcoholic learned to detach herself from herhusband's drinking.
Jean Caldwell (1986) presents guidelines for working with codependent
families and getting them ready for intervention. The author emphasizes
that challenging dysfunctional behavior in analcoholic is only successful
when combined with supporting his healthy behavior.
Neil M. Rothberg (1986) presents a family systems approach to alcoholism
by examining the dynamics working within marital subsystems, three
family-oriented models, and possible treatment and goals. Both spouses
are shown to be contributors to the alcoholic problem and both are
affected by it.
Gierymski and Williams (1986) state that wives (and probably other
members) in families with an alcoholic member are more likely to
suffer emotional problems than the families of nonalcoholics, although
the exact degree and form of their emotional problems vary and no
clear-cut entity corresponding precisely to the concept of codependence
has emerged. In short the authors express skepticism concerning
the validity of the concept of codependence.
Timmon Cermak in the Journal of Psychoactive Drugs (1986) argues
that codependence can be defined within the DSM-m criteria for mixed
personality disorder. He proposes five diagnostic criteria in the
style of DSM-m. According to Cermak the essential features of codependency
include (1) consensual investment of self-esteem in the ability
to influence/control feelings and behavior in self and others in
the face of obvious adverse consequences; (2) assumption of responsibility
for meeting other's needs to the exclusion of acknowledging one's
own needs; (3) anxiety and boundary distortions in situations of
intimacy and separation; (4) enmeshment in relationships with personality
disordered, drug dependent and impulse disordered individuals; and
(5) exhibits (in any combinations of three or more) constriction
or emotions with or without dramatic outbursts, depression, hypervigilance,
compulsions, anxiety, excessive reliance on denial, substance abuse,
recurrent physical or sexual abuse, stress-related medical illness,
and/or a primary relationship with an active substance abuser for
at least two years without seeking outside support.
Cermak takes each criterion and points out how it relates to established
DSM diseases (e.g., Dependent Personality Disorder, Borderline Personality
Disorder, Histrionic Personality Disorder).
Cermak alone in the psychological literature searched has tried
to describe codependence and present a case for its deserving serious
consideration as a disease.
Sondra Smalley (1987) discussed dependency issues in lesbian relationships.
Although not particularly helpful in describing what codependence
is, the author proposes a model that focuses on the client's intervention
in her own codependent relationship patterns.
Frederich A. Prezioso (1987) discusses spirituality as it relates
to the treatment of chemically dependent and codependent people
in a 21-28 day inpatient treatment setting. The author suggests
addressing spiritual issues using staff training sessions and weekly
staff groups, patient lectures and discussion groups, family presentations,
and individualized treatment plans.
In trying to determine what research had been done (under other
headings) on the cluster of symptoms we are calling codependence,
we checked the Thesaurus of Psychological Index Terms (1985). This
thesaurus (which contains all the subject headings under which articles
are listed in the psychological abstracts) does not contain any
references to either "codependence" or "codependency." A check of
all the articles recorded in the abstracts under the heading "dependency
(personality)" and "child abuse" (the headings relating most nearly
to what we are describing here) for the January 1983 to September
1988 period revealed that very little has been considered worthy
of inclusion in those abstracts that pertains to the identifiable
diagnosis of the disorder and symptoms we are calling codependence
and its connection with child abuse.
In all the psychological literature appearing in the Psych-Lit data
base during the period from January 1983 to September 1988 there
seems to be only one person's work (used as a reference by several
writers) that sees in the category "dependency (personality)" something
close to what we are talking about when we speak of codependence.
As a matter of fact all the references we found that related "dependency"
to the symptoms that make up what we are calling codependence cited
the same book, Neurosis in Human Growth, by psychiatrist Karen Horney
(1950). Some of her insights and descriptions of symptoms are similar
to those in this volume but evidently they were never developed
or expanded in subsequent literature in the direction we are pointing.
Horney saw healthy adults as autonomous to a great extent but believed
that ultimately all people find survival difficult without the physical
and emotional presence, support, and caring of others. Such interdependence
enables us to grow and thrive and is necessary to the realization
of individuality.
Neurosis, however, leads to seeking both fulfilLnent and a sense
of one's self from other people. Relating to others becomes increasingly
compulsive and may take the form of blind dependency, rebellion,
the need to excel, or avoidance of involvement at all costs. In
all these ways, neurotics demonstrate the importance others have
for them.
Such dependence is usually characterized by infiexibility in relating,
abdication of responsibility for one's own life, intolerance, depression,
rage, and vindictiveness when one's demands on others are not met,
indiscriminate sacrifice of one's own best interests, and a magical
belief that one will find an answer to life through others. Dependence
can be seen as a way of experiencing and relating to others that
is a part of the particular character structure Horney calls the
self-effacing solution" (in chapter 9 of the book cited).
Security, meaningfulness of life, and a sense of self are believed
by the neurotic to be attainable only through the strength and caring
of others. Therefore moving toward others may reach the point of
wishing to lose oneself and merge totally with another person. Consequently,
being lovable, helpless, self-effacing, and small is cultivated
and glorified in such people. Strength and autonomy, while sought
in a protector, are shunned and repressed in oneself. Evaluation
of oneself depends on lovableness; love, especially erotic love,
offers the promise of supreme fulfillment. The subdued helpless
part of oneself is experienced as its very essence, and one's lovableness,
loving sacrifice, and especially suffering are taken as justification
for demanding total devotion in return.
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Mellody,
Miller and Miller. Facing Codependence. HarperCollins. 1989.
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