To quote William Shakespeare, “What’s in a name?” Well, Mr. Shakespeare, in the mental health field, quite a bit! Correctly labeling mental health disorders is powerfully important to the person in their pursuit of seeking help to overcome their problems.
Even with the potential for misuse, such terms are required by the researcher, educator, practitioner and, most importantly, the patient to understand, identify and seek help for a specific mental health-related condition. Diagnoses or mental health terms, when not experienced as derogatory or belittling, have inherent power to lead distressed and suffering people to seek professional help, which has the capacity to be psychologically healing, transformational and even life-saving. Conversely, mental health terms that carry negative stereotypes or connote weakness and feebleness can cause grievous personal and psychological harm.
Like other misunderstood and misused psychological expressions, “codependency” has taken on a life of its own. Once it went mainstream, it was haphazardly and conveniently reshaped to fit our mainstream vocabulary. Since its introduction in the 1980’s, its meaning has unfortunately devolved to describe a weak, needy, clingy and even emotionally sick person. To some, it incorrectly is interpreted as a dependent person who is in a relationship with another dependent person. Thirty years later, the term “codependency” has become a caricature of its original meaning. This is so much the case that many therapists refrain from using it in clinical settings.
To understand the development of the term “codependency,” it is important to trace its origins. In 1936, Bill W. and Dr. Bob created the Alcoholics Anonymous (AA) movement. Prior to AA, alcoholism was attributed to a weakness in character and lack of personal motivation to stop it. Thanks to Bill and Dr. Bob, alcoholism was redefined as a disease over which the individual had little to no control. From AA, other 12-Step groups came into being. Thus started the myriad other life-enhancing and life-saving 12-Step groups.
In 1951, Lois W., wife of Bill W., and Anne B. founded Al-Anon, a 12-Step recovery program for the families and significant others of the alcoholic. It addressed the other side of the alcoholism coin – the suffering family members who, like the alcoholic, felt their lives were out of control and littered with obstacles and losses. According to the Al-Anon website (2013), “Al-Anon is a mutual support group of peers who share their experience in applying the Al-Anon principles to problems related to the effects of a problem drinker in their lives. It is not group therapy and is not led by a counselor or therapist; this support network complements and supports professional treatment.”
By the 1970s, alcohol treatment providers began to consider the limitations of the one-dimensionality of the medical treatment model, which typically just treated the alcoholic (treating the disease). As treatment centers began to embrace the emerging practice of treating alcoholism within the context of social networks and family relationships, partners of the alcoholic, or the co-alcoholic, and other family members were included in the treatment process. This practice yielded lower incidents of relapse and longer periods of sobriety.
Since drug addictions and alcoholism shared more similarities than differences, beginning in the early 1980s, various drug treatment programs adopted the term “chemical dependency,” as it better reflected the similarities between alcoholism (alcohol addiction) and other drug addictions. With a unifying diagnostic term, treatment for all chemical/drug addictions coalesced into a unified treatment paradigm, “chemical dependency.” To fit in with the changes, “co-alcoholism” was updated to “co-chemically dependent.” Being too much of a mouthful to say, it was shortened to “co-dependent.”
Early on, the term “codependency” described a person’s compulsive predilection to be in relationships with chemically dependent partners. According to S. Wegscheider-Cruise (1984), a person was considered codependent if they were (a) in a love or marital relationship with an alcoholic, (b) had one or more alcoholic parents or grandparents, or (c) were raised within an emotionally repressed family. Soon, “codependency” became the standard diagnostic term used for the chemically dependent individual’s partner or other individuals who enabled a chemically dependent friend/loved one. Hence, addiction treatment centers began to regularly provide treatment and/or support services to the partners of the addict and their family members. The primary focus of codependency treatment was to support the codependent during the treatment process, while facilitating care and understanding about their enabling role in the problem, or disease.
By the mid-1980s, thanks to many key advances within the chemical dependency and addiction treatment fields, the term codependency took on a more broadly understood meaning. It evolved to describe a person who was habitually attracted to or in a relationship with a narcissist and/or an addict. Codependents were understood to be people-pleasers who would reflexively sacrifice and care for others who would not care for them in return. They felt powerless to resist relationships with addicted, controlling and/or narcissistic individuals. It became evident that codependents came from all walks of life and were not necessarily only in relationships with addicted individuals.
Thanks to codependency authors like Melody Beattie, Claudia Black, John Friel, Terry Kellogg and Pia Melody, just to name a few, the term codependency finally saw the light of day. It came out of the closet and was no longer considered a shameful secret for which there was no help. These early books helped change the world’s attitude towards the partners of addicts or narcissists, who were no longer viewed as weak and defenseless victims who were powerless to leave their harmful and dysfunctional relationships.
Next came the plethora of media depictions and satires of codependency. Whether it was on “Saturday Night Live” or in People Magazine, by the late 1990’s, the term lost its original meaning and clinical purpose. In my 2013 book, “The Human Magnet Syndrome: Why We Love People Who Hurt Us,” I took great pains to specifically and operationally define codependency. What follows is my concise definition of codependency.
Codependency is a problematic relationship orientation that involves the relinquishing of power and control to individuals who are either addicted or who are pathologically narcissistic. Codependents are habitually attracted to people who neither seem interested nor motivated to participate in mutual or reciprocal relationships. Hence, the partners of codependents are often egotistical, self-centered and/or selfish. Typically, codependents feel unfulfilled, disrespected and undervalued by their relationship partner. As much as they resent and complain about the inequity in their relationships, codependents feel powerless to change them.
Thanks to many other committed writers and clinicians, codependency is still on the forefront of modern and cutting-edge mental health and addictions treatment. Understanding what “codependency” means and where it came from helps to keep hope alive for the partners of both addicts and narcissists.