CHAPTER 8
Codependence: The Mirror of Addiction
In this chapter, we explore the specific nature of the disease of addiction as it is seen in family members.
As long as addiction is equated with physical dependence, all the addict appears to need to get well is to stop using the drug. The popular view of addiction is almost that simple: the reason addicts continue using their drugs, despite the inevitable painful consequences of their drug use, is that they experience withdrawal symptoms when they stop using their drugs. In this view, the problem for drug addicts is that they are physically dependent on their drugs.
This picture not only is wrong, but it commonly perpetuates addiction. The addict’s problem is not physical dependence but the crippling loss of control resulting from having fallen in love with the drug-caused high. This loss of control is the result of the chemical stimulation of the brain’s pleasure centers. The addict’s downfall is the reward the addict’s brain has found in drug use. This love affair leads the selfish brain to send out a cry for more of the drug, no matter what the costs. Once drug use stops for any reason, although physical dependence quickly ends, the addict’s brain never forgets the pleasure of getting high. That is why addicted people are never free of the risk of relapse, no matter how long they have been drug free and no matter how far behind them they put their physical withdrawal symptoms. Addiction is unrelated to any problem of physical dependence or withdrawal. The cries for more drug are as loud, or louder, after detoxification, after the experience of withdrawal is ended, as before.
Behind the brain disease of addiction lie two problems that set the stage for addiction: the character of the addict and the environment in which the drug use occurs. Now we focus on the most personal, the most controversial, and the most important aspect of the addict’s environment: the addict’s family
The modern understanding of the disease of addiction to alcohol and other drugs includes the recognition that the addict’s family members are more than passive victims of the addict’s bad and sick behavior. The addict’s family typically suffers from codependence. Codependence comes in two forms: primary codependence, which has existed from childhood exposure to addiction, usually the addiction of a parent; and secondary codependence, which develops only after close personal exposure as an adult to an addicted person, often to a spouse or a child who is addicted to alcohol or other drugs. Both forms of codependence mirror the addict.
Addicts are characteristically self-centered and irresponsible. They also often appear to be outgoing and self-confident. Codependents, in contrast, commonly appear to be self-deprecating and sometimes even shy. They typically try extremely hard to do the right thing and to please others. This behavior of codependent people contrasts with the outward behavior of active addicts, who often recklessly disregard the feelings of others. Codependents are typically unusually concerned with how they appear to others. They highly value their good reputations for hard work and selflessness. Nevertheless, they are locked into a malignant synergy with the addict. The codependent is the mirror of the addict and is equally the suffering hostage of the selfish brain. The self-centeredness of codependents is more deeply hidden but no less fundamental or troublesome than is the self-centeredness of the addict.
Many physicians, health care workers, and other human service professionals, including teachers, are codependent people who are living out their family-based roles as caregivers in their work lives. Often they found that they were unable, despite their most heroic efforts, to save their own addicted family members. Later they, usually unconsciously, try to save others through selfless, dedicated, and tireless human service work. Although this is not a bad reason to enter into a life of social responsibility, it is wise to understand our own motives and to anticipate the ways in which they can distort relationships with those being served. For example, when the best efforts of the codependent caregiver are rejected or ignored, this can repeat earlier traumatic experiences and lead to inappropriate and sometimes dangerous responses from the frustrated, overstressed codependent human service professional.
Codependence is a disease of lost selfhood, of having one’s self and self-esteem defined by someone else’s behavior. The codependent person is as hooked on the addict as the addict is hooked on the alcohol or other drug. Codependents neglect their own inner, deeper needs as they try tirelessly but futilely to fix themselves by fixing the addicted person in their lives. Codependent people have trouble thinking of themselves without thinking of their addicts. Their lives and self-concepts, to a large extent, are defined by their relationships with their addicts.
Codependence is relatively easy to see, once you recognize the disorder. When people come to me announcing that their problems are someone else’s behavior, be it addiction or something else, I am alert to this diagnosis. When people say that they would be just fine if only someone else changed, I am all but certain of the diagnosis. When people seeking my help continue talking for a long time and never mention their own needs or feelings, except as they relate to the troublesome people in their lives, I know that I am dealing with codependence, the disease of the lost self.
Codependents are in a trap from which they cannot escape. The harder codependents struggle to free themselves by trying to control the behavior of an addicted person, the more deeply they are enslaved in this family disease. Love itself pushes them ever deeper into this trap. Their behavior calls out, “I cannot let this go on. It is too painful to watch this person I love destroy himself (or herself). I must act. I must save him (or her), and you must help me do it right now. We haven’t a minute to spare!”
The Twelve Step programs, based on Alcoholics Anonymous (AA), have faced the problems of the addict’s family for more than fifty years. These fellowships, described in Chapter 11, have developed a time-tested approach to the family problems of addiction. The approach is built on the mutual-aid program Al-Anon, the fellowship program that helps families of alcoholics. The central idea behind this approach is the concept of codependence. Addicts are often strong personalities. Their addictive behaviors outwardly dominate their families. Because such awful things happen to addicts over time, it is inescapable for families to center their lives around the addicts and the destructive dramas they create in family life. Family members come to believe that almost all of their problems can be traced to the addicted person. They think that if the addict would only get well, would only stop drinking and using drugs, then the other members of the family would be well also. Salvation, it appears, is just around the next corner. All that is needed is for the alcoholic or drug addict to become alcohol-free or drug-free.
Addiction is a far larger problem than the reward caused by the drug high. Addiction is a disease of the entire self. It is a disease of values. Addictive disease afflicts not only the addict but the addict’s family. It is not merely a disease of the addicted person but a disease of those who care for the addicted person.
As people in Al-Anon have learned more about how to help the families of alcoholics, they have learned that alcoholism is often a multigenerational disease. Many of the spouses of alcoholics and addicts themselves grew up in families that were dominated by alcoholism and other addictions. This may seem puzzling. If people grew up in families dominated by the pain of alcoholism or addiction, why did they not learn from their experiences and be sure not to repeat them? Why would the child from such a family marry someone who repeated the same painful pattern? Some early psychiatrists observing this common pattern of repetition concluded that the spouses of alcoholics were inherently masochistic, that they found perverse satisfaction in being victimized by alcoholics.
Later, a better understanding of this mysterious repetition developed. People who grew up in families dominated by addiction and other dysfunctional behaviors developed their own characters around the deeply held belief that if they could live their lives right in their own marriages, by controlling the addict’s behavior, then the addict would not be an addict at all. By their work and their love in their own marital families, they thought they could solve this deadly problem that they had not been able to solve in the family in which they grew up. As children growing up, they often felt a hidden shame about their parents, their homes, and, ultimately, themselves. Codependents concluded, unconsciously, that they could overcome their hidden shame by finally solving the problem of addiction in their spouses or their children.
Many children, destined to become codependent adults, could not bring their friends into their homes because of the embarrassment they felt when their friends saw their alcoholic parents. When they went out to find a mate, they sought, usually without being aware of the process, someone who had many of the characteristics of their alcoholic parent. They loved that parent especially, and wanted as children to be able to make life right for that addicted parent, to live out the family romance they dreamed of with a happy home for both parents and children.
The future codependents acted as if they believed that this time, in their own marriages and with their own children, it would all work out the right way. They would work it so that their own spouses and children would not become alcoholics or addicts, and in doing that they could overcome the shame that they felt, first in relation to their addicted parent and then as a deeply rooted part of themselves as failures at the most important challenge of their lives, their efforts to save an addicted parent or sibling. The underlying belief of these budding codependent people was that their self-worth, their self-esteem, was dependent on what their addicted spouse or child did or did not do. Further, they believed that through selfless work and love, and whatever else it took, they could control their spouse’s or their child’s addictive behavior.
Sometimes the spouse was an active alcoholic, but more often, the spouse was, at the time of courtship, a budding addicted person who had characteristics of the addicted parent but who had not yet developed the full syndrome of addiction to alcohol and other drugs. In some cases it appeared as if the codependent spouse acted in ways that unwittingly promoted the developing of addiction, for example, by making drug or alcohol use easy or by making excuses for early problems that arose from the excessive use of drugs or alcohol. Another all-too-common pattern was for the person who grew up in an alcoholic or drug-addicted family to develop his or her own addiction to alcohol and other drugs, thus repeating the role of both parents simultaneously—the addicted spouse and the enabling spouse.
This story of codependence in the family life cycle seldom had a happy ending. The most common pattern was for the development of addiction in the spouse of the codependent person. As the addiction worsened, the codependent spouse sought to improve the addict’s behavior in an anxious, ever-worsening cycle of failed control. First the codependent worked to control the addict with love and, when this failed, with bribery and manipulation, and finally with anger, resentment, and ultimately a punishing withdrawal of affection. The codependent spouses acted as if they could feel good about themselves only if their addicts got well. Usually, the addiction just got worse. Family life progressively deteriorated into recriminations, wounded pride, and anger, deepening the codependent person’s shame and feelings of failure. The codependent person became isolated and demoralized as his or her greatest childhood pain was repeated as an adult.
The addicted family member felt victimized by this progressively more extreme behavior of the codependent spouse. He or she felt that the spouse was trying to control him or her and that the spouse did not understand or respect the addict. The addicted family member felt that he or she was being hounded by a mean spouse who had become a parole officer bent on shaping his or her life to meet the spouse’s own excessive needs. The addict used the anger and resentment he or she felt as one more good excuse to drink alcohol and use other drugs. The addict’s behavior, and often his or her words, said, “You made me do it by your nagging and by your suspicions.” The same process often has been played out by parents of addicted children, sometimes when the children were teenagers, sometimes when they were adults. In these cases, the codependent parents sought to control their addicted children in fruitless, self-defeating ways.
Many professionals working in the field of addiction have recognized this pattern in families and have developed techniques for helping families afflicted by alcohol and drugs to get well through use of the Al-Anon program. The first step on the road to recovery is to recognize that addiction in the addict is not simply physical dependence or even merely a result of alcohol or drug use. The addict’s disease is a disease of the self, rooted in the addict’s self-centered sensitivity, and sustained by dishonesty. Getting well for the alcoholic or drug addict means genuinely caring about others and becoming honest. The same is true for the codependent person, whose dishonesty, like his or her own self-centeredness, is usually deeply hidden.
Echo was a mythological Greek goddess condemned by Hera, the jealous wife of Zeus, never to speak except to repeat what was spoken to her. Echo fell in love with Narcissus, a young man with beauty to match her own. Because Narcissus scorned those who loved him and never returned their love, Nemesis, the goddess of righteous anger, condemned Narcissus to fall in love with his own reflection, which he saw in a pool of still water. When he fell, literally, for the face he saw in the pool, he drowned. The story goes that out of grief after the death of Narcissus, Echo lost her physical substance so that all that is left today of this wounded, grief-stricken beauty is the sound of her voice in caves and canyons endlessly repeating sounds made by others.
This story, related to codependence by Timmen L. Cermak, M.D., captures the horribly common, mutually destructive relationship of the addict and the codependent. The narcissist is locked in a fatally flawed affair of the heart with an echo who is unable to speak his or her own mind. What is the key to release the lock that binds these two doomed, ancient lovers? The most powerful antidote is for both the addict and the codependent to disengage, to let go of the other, and to focus honestly and openly on their own unique and personal needs. Paradoxically, the way toward real closeness for families dominated by addiction lies through the neglected door to independence for all of the trapped, pathologically entangled parties.
For the codependent person, recovery means giving up on the dream of fixing the addict and, instead, going about his or her own life, whether or not the addict gets well. It means “detaching with love.” Anger and resentment are not appropriate or helpful, although they are certainly understandable, and, at some stages of the process, they are inescapable. The simple understanding that the codependent person cannot be responsible for the addict is the start to recovery. Codependents can manage only their own lives with effort, but they cannot manage their addicts’ lives, no matter how hard they try. In working with codependent people, I encourage them to find and develop themselves. They need to restructure their views of themselves and their whole lives in ways that do not reflect the behavior or character of their addicted family members. They need to figure out what to do to become themselves, and to give up on fixing the addict. If they focus on fixing the addict, they are continuing in their codependence. Unlike Echo, they need to find their own voices and stop repeating the sounds of others.
Many codependents see this goal of having a good life for themselves to be insufficient to make the changes that need to be made. It seems to them to be selfish, a very serious, negative charge for most codependent people. After years of false starts, I have found an effective suggestion for these basically good but trapped people: “You need to be independent and to live your own life to save your addict. By continuing what you have been doing, you make his (or her) life worse.” At least in the early stages of recovery from codependence, this goal is more appealing to many codependents than the goal of living a good life for themselves no matter what the consequences for the addict. Ultimately, of course, codependent people have to become their own selves to meet their genuine needs, not to save their addicts, if they are to recover from this tragically crippling disease.
For the addict, detachment with love means “first things first.” This means doing what the addict has to do to achieve and then to maintain sobriety. It means that the addict must stop trying to either please or manipulate codependent family members. It means letting go of a destructive, magical dream of people living for and through one another, for both the addict and the codependent. For codependent people, first things first means letting go of the lifelong dream of fixing the addicts and settling down to the far less exciting, but far more achievable, goal of living their own lives.
These ideas sound both paradoxical and easy. They are paradoxical, but they are not easy. It is rarely, if ever, possible for codependent people to manage their feelings and their lives unless they go to Al-Anon meetings to understand the disease concept of addiction and to find support and specific techniques to get well by becoming themselves. Remember the saying, “You alone can do it, but you cannot do it alone.” This is as true for overcoming codependence as it is for overcoming addiction. Alone, the addict and the codependent are helplessly in the grip of the disease of addiction. Releasing each other, they can begin the long, hard, wonderful road to recovery.
Primary codependent people are more likely to need long-term treatment as well as long-term attendance at Twelve Step meetings, usually Al-Anon. Many codependent people themselves become addicts, if not to alcohol or drugs, then to other addictive behaviors, as they have become addicted to the addict in their relationship. Thus, in addition to attending Al-Anon meetings, many codependent people find it useful, in their efforts to meet their own needs, to go to meetings dealing with whatever addictions from which they personally suffer. Because most primary codependent people grew up in homes dominated by alcohol and drugs, they often benefit from attending Adult Children of Alcoholics (ACOA) meetings. These additional meetings are often essential to the development of a stable life, but it is also important that codependent people, like addicts, keep in mind the rule, “First things first.” That means keeping attendance at Al-Anon meetings high on the priority list, as it means for addicts and alcoholics keeping their attendance at Narcotics Anonymous and Alcoholics Anonymous at the top of their priorities.
For secondary codependents, people whose codependence developed when they were adults in relationship to alcoholic or drug-addicted spouses or children, the treatment of codependence is usually less intensive and less prolonged. It may be enough to go to Al-Anon meetings for a period of time without any intensive therapy. For people suffering from secondary codependence, finding out what is wrong (the syndrome of addiction and the central role of the codependent person), along with what to do about it (detach with love), is sometimes all that is needed to get moving in the direction of real and lasting recovery.
Addiction is an old diagnostic label. Codependence is a new word and a new idea. Addiction, following the lead of AA and consistent with a rapidly growing body of neurophysiological research, has been redefined in recent years. When addiction was thought to be simple pharmacology, the family was irrelevant. Once addiction was understood to be an enduring way of living, rooted in biology and shaped by the characters of addicts interacting with their specific environments, it suddenly became clear that the family was the most important environment for addiction. The family was also the most important engine of change for addiction. Just as recovery was a great gift for the addict, so was recovery a great gift for the codependent. Recovery for the codependent means finding, and fulfilling, the lost self.
These two faces of addiction show the role of codependence, the family side of the addiction coin. Jane tells a positive story of tough love in her family. With regard to Earl, I know little about his family except that they failed totally to help him. In fact, the “help” they offered appeared to him only to make his disease worse.
Jane
Jane came to me for depression when she was thirty-five years old, a married lawyer with three children. As part of my initial interview, I asked her about her childhood. Among other stories, she told me how she had grown up in an affluent family and gone to private schools, doing reasonably well until she was a junior in high school. Her grades fell as she got heavily into marijuana and other drugs. “School only mattered to me as a place to be with my friends and to talk about partying,” she said. Her parents caught on when they were called in to talk with her principal about the fall in her grades and her newly insolent behavior in the school. For over a year, her parents took her to a counselor and tried to help Jane with “her problems.” Then, in an act of self-preservation, since Jane’s bad behavior was spreading to her younger brother, her parents said, “No more. Either you go to school and do your work, or you are out of this house.” She told this story with pride, saying, “That was the kick in the behind I needed. I knew I didn’t want to live on my own and I knew they were serious.” She turned her life around, stopped using drugs, graduated with good grades, and did well in college and law school. She told me that many of her drug-using friends were not so fortunate. Some of them had failed in high school and college; a few even continue to use drugs now. “I learned a lesson that will help me with my own children when the time comes,” Jane said. “I knew that my parents were on my side, and, deep down, I knew they were right. I just feel sorry for my friends who did not have parents who cared enough to take charge.”
Earl
At an NA meeting, Earl, a young black student at the local community college, talked about how he used the NA program: “I did everything wrong in my life, it seemed to me. I was tossed out of my parents’ home, and I was arrested three times and sent to prison twice. I was in two long-term addiction treatment programs, and each time I just blew it all off, figuring I was a whole lot smarter than those fools. I came from a good family. The more everyone tried to help me, the worse I got.
“Then I met Jesse, a home boy I had used dope with for years, and he looked happy and healthy. I was amazed because I looked and felt so terrible. He told me it was not so hard to stay straight if he went to an NA meeting every single day and worked the program. He took me along with him. At first I didn’t say anything at meetings, but then I started to talk up a little. I saw a guy I liked and I talked to him, but I couldn’t seem to get my words out. So he asked me, ‘Hey, man, are you asking me to be your sponsor, or what?’ I said I guessed I was, and he said ‘yes.’ That was the smartest move I ever made. That guy understood me because he had done all the dumb things I had done. All of a sudden, a lot of things people had been telling me for years sort of fell into place, and I understood what they meant. I could understand things like getting up in the morning and getting to work on time, being honest, and thinking about other people instead of just feeling sorry for myself.
“So now I have seven months of clean time. I feel better than I ever thought I could feel. People see me and they say, ‘Hey, man, you are looking strong,’ and that makes me feel good.”
Family members cannot make addicts well by their caring or their love. Family love that includes codependence usually lowers the bottoms of addicts, inadvertently and paradoxically, but completely understandably, creating more suffering for both the addict and the family. The release from this trap lies in a creative disengagement based on an understanding of the complementary relationships of the addicted person and the echo of that person in the codependent family members.