Codependency

Melody Beattie (1987) popularized the concept of codependency in self-help literature (Starker 1990). She defined codependency for the lay reader: "A codependent person is one who has let another person's behavior affect him or her, and who is obsessed with controlling that person's behavior" (Beattie 1987, p. 36). She notes that the expression has been used as "alcohol treatment center jargon" and "professional slang," and acknowledged that the term, as it was used, had a "fuzzy definition."

The popularization of the term codependency has had both positive and negative consequences for the fields of psychotherapy and family therapy. On the positive side of the ledger, the self-help literature in general, and the popular usage of the term codependency in particular, have been helpful in raising public awareness of the complex interrelationships which take place within alcoholic families. They have provided, in relatively simple and understandable terms, an appreciation of the role that everyone assumes in a family where a severe psychological disorder such as alcoholism occurs. For example, wives may "cover" for their alcoholic husbands' inability to keep up with the everyday demands of the home and workplace due to their excessive drinking. Children may take on age-inappropriate tasks, such as making sure that the house is locked at night because the alcoholic parents are too inebriated to do so (this is known as the parentification of children in the family therapy literature [Haley 1976]). In essence, no one in an alcoholic family is immune from the devastating effects which alcohol has upon them, and the contribution to the maintenance of an alcohol problem that others in the family may inadvertently take on. Indeed, enhancing a general understanding of these complex family behaviors is no small contribution to the realm of public education.

However, the widespread usage of the term codependency frequently has resulted in misunderstanding and misuse of the expression by the general public, as well as some imprecision by professional mental health practitioners in clinic settings. With regard to the lay public, Barbara Fiese and Douglas Scaturo (1995) conducted group discussions with adult children of alcoholics (ACOAs) in an effort to understand the difficulties that they confront in parenting their own children, given their own problematic upbringings. In these group discussions, there was a frequent misuse of professional jargon by the ACOAs that often led to misunderstandings of the complex and painful life experiences that the group members were trying to convey to one another. The circuitous use of jargon seemed to prevent group members from communicating with one another in clear, commonly understood language. The use and misuse of such jargon also appeared to short-circuit group discussion by promoting a presumed commonality of family life experience that may or may not have been accurate. Group members responded to the jargon used by others prematurely—without waiting to discover whether actual life experiences were comparable between them. Overall, the use of professional jargon by these lay people appeared to diminish the degree of coherence in their discussions.

Even more problematic is that the widespread generality of the concept's usage has contributed to some degree of imprecision by practicing psychotherapists. The treatment of codependent family dynamics is considerably more complex than the lay concept of codependency might suggest. Scaturo and his colleagues (2000) have discussed several complexities in the family treatment of codependency that require a precise understanding and knowledge of the concept. The first involves the proper therapeutic confrontation of codependent behavior by the psychotherapist in family therapy with this dimension. Briefly, the confrontation of the codependent spouse's contribution to the chemically dependent behavior of the alcoholic involves the complex therapeutic task of "(a) acknowledging and validating the well-intended nature of the codependent's responses, and (b) assisting the codependent spouse in finding new ways of being useful in the family in order not to deprive them of their helping role within the family" (Scaturo et al. 2000, p. 68). A second issue involves making the proper therapeutic distinction between codependency and the "normal" nurturant behavior of a parent or spouse. In short, codependent patients in treatment may engage in inappropriate self-criticism and characterize ordinary and necessary care-taking behaviors in family life as unhealthy "codependency," and it is the therapist's responsibility to assist them in making proper distinctions. Thus, how mental health care professionals understand the concept of codependency has implications for the treatment of these family dynamics as well as how these concepts are understood by codependent patients and their families in treatment.