Issues With Codependent Relationships in Aftercare

Bestselling addiction author Melody Beattie did not coin the term or the concept of codependency, but she was one of its earliest writers and is largely responsible for spreading critical information about this disorder. In her book, Codependent No More: How to Stop Controlling Others and Start Caring for Yourself, first published in 1986, Beattie looks squarely at addiction but goes beyond the substance abuser to focus on the caregivers around them. It could be said that for every substance abuser, there is a struggling caregiver behind him.

Codependent No More spent three years on the New York Times bestseller list, and anyone who has read the book will understand why – substance abusers and many people in relationships with a substance abuser will feel like they are holding a mirror up to themselves. The book is not intended to serve as a self-diagnostic tool, but it may encourage readers who identify with codependency to seek counseling and any other paths that can help them take greater care of themselves.

As Beattie discusses, codependency has numerous hallmarks, including:

• Experiencing unrelenting guilt: Codependents tend to feel responsible for other people’s actions, problems, addiction issues, and even their fates.
• Being controlling: They seem to successfully run other people’s lives while their own life feels unsatisfying and unfulfilling.
• Feeling angry: Many feel personally out of control and resent that the help provided to others often does not seem to be working.
• Being at a loss for how to live a full life: Many codependents are unable to articulate what they want in life, yet have lots of ideas about what the substance abuser needs.
• Demonstrating excessive selflessness: They often throw aside most of their needs to take care of others.

As Beattie extensively discusses, codependent people are some of the most caring, loving, nurturing, and generous individuals, but codependency is an illness. It’s healthy to be generous, but giving to others while simultaneously neglecting oneself is often a sign of this disorder. Codependency is about disordered thinking and behavior in regard to others as well as how one feels about oneself. Codependents must examine their relationships not only with other people, but also with themselves.

It would be impossible and ill-advised to try to reduce codependency to a list of black-and-white characteristics; however, for the purposes of discussion, it is helpful to consider how this disorder can develop in some cases.

Sometimes codependency develops in childhood when a parent is a substance abuser.

As a child, caring for the parent can become a preoccupation and a way of life. In this case, codependency happens innocently and naturally, but it can be devastating to the codependent caregiver. One common response is for the codependent child to become a drug abuser herself or be sober but seek out relationships with a substance abuser. In this way, the codependent child who is now an adult can transfer the care of the parent to the care of an intimate partner or other significant loved one, such as a child. However, not all codependent people grew up in a setting of substance abuse.

Chronic low self-esteem may be a root cause or at least a contributing factor in developing a codependent personality.

The causes of the low self-confidence are numerous and ripe for consideration in psychotherapy or through other healing pathways.

Codependency and Recovery

Family members and loved ones who financially and emotionally support a substance abuser are often characterized as “enablers.” Codependency has a more neutral ring; “enabling” has a negative connotation that seems to suggest that enablers are not self-aware enough to understand the harmful consequences of their behavior and would rather keep treading water in unhealthy relationships than making an effort to instigate real change. They may indeed be unaware, but they should not be subject to judgment for it. Substance abuse has a way of holding everyone hostage to it. Codependency may initially be a “normal” reaction to an abnormal relationship dynamic. One of the problems with codependency, however, is that the self-neglect and focus on others become extreme overtime and can get worse if not treated.

As discussed in the New York Daily News, a person living with (or even close to) a substance abuser may develop a parallel addiction, not on a physical substance but on the intangible despair of the situation. In its coverage of the topic, the Daily News reviews an actual case of a mother who let her drug-abusing daughter move in with her, as well as the daughter’s drug-abusing boyfriend.

The daughter and boyfriend were attending Narcotics Anonymous meetings, but it may have been more of an empty gesture than a real attempt at abstinence as the couple were doing drugs at home.

Relying on the mother in this scenario as an example to discuss the larger topic of codependency, the Daily News explains that saving the daughter from her addiction had become an integral part of the mother’s self-esteem. The mother’s codependency or co-addiction was based the positive feelings associated with the times when she felt she succeeded in rescuing the daughter (e.g., during stints of abstinence). This analysis does not suggest that the mother in any way wanted the daughter to keep abusing drugs, but that the mother’s role in effectively helping her daughter’s recovery was clouded by her own codependent complex. For this reason, some addiction specialists consider untreated codependent family members to be threats to recovery.

The Aftercare Process

Although there may only be one substance abuser in a family, addiction is considered to be a “family disease.” Family members and loved ones usually play a critical role in getting a substance abuser into recovery and keeping him there. But the recovery process does not end with the completion of an inpatient or outpatient treatment program. In fact, according to the National Institute on Drug Abuse, relapse rates post-recovery are as high as 40 to 60 percent. One of the most effective ways to maintain sobriety is to follow a well-structured aftercare program. For some drug treatment program graduates, immediate residence in a sober living facility may be the healthiest option available, especially if family members or loved ones are untreated codependents.

As discussed in a scholarly article on sober living homes published in the Journal of Psychoactive Drugs, the earliest models began in the 1830s. Religious organizations ran these facilities, which makes sense in view of the fact that in the past substance abuse was considered less a matter of biology than moral weakness. But even back in 1830s, it was well understood that a recovering substance abuser needed an optimally healthy and supportive living environment. Today, sober living homes are the most current residential recovery model. A common characteristic of such homes is that everyone agrees that sobriety is a number one priority and is dedicated to achieving that end. In a family home setting, although everyone may be in agreement that the substance abuser needs to maintain abstinence, the members may not have the skills to properly support that goal.

The Role of Shame in Codependency

In codependent persons, internal feelings of shame – whether conscious or unconscious – can manifest outwardly in the form of being controlling, excessively caretaking, and being nonassertive. Working on shame in therapy can be instrumental to healing the codependent.

In modern psychology, there are three main theories of shame:

• The psychoanalytic approach: Infants who experience a disruption in the attachment process to the mother or primary caretaker may feel unwanted and unaccepted as early as 2.5-3 months of age and then carry these feelings forward into life in the form of shame.
• The cognitive model: Starting as early as 18-24 months, feelings of failing to meet rules and standards or not “measure up” can be internalized in the form of shame and develop into a sense of being a failure.
• The functional view: This approach is Darwinian and sees shame as serving a social and evolutionary function of teaching a person how to fit into society and act morally.

As Lancer describes, shame can cause family members to become stuck in unhealthy patterns, possibly because they feel they are not worthy of having a healthy family life. But when it comes to drug abuse in a family, it is particularly dangerous to remain stagnant. The threat of overdose and even death is always a worry. But how can codependent persons who are weighted down with shame and concern for a substance abuser lift themselves into a healthier mindset? Will the substance-abusing loved one benefit collaterally from this change?

Help for Codependents Helps Recovering Loved Ones

Many treatment programs, in recognition of the vital role families play in the recovery process, offer family therapy on site.

This form of group therapy brings together the recovering substance abuser and loved ones as a therapist guides them to discuss and work on the family dynamics that may be underlying the addiction. Programs for family members vary among treatment facilities, but some also offer individual psychotherapy (or encourage family members to work with an independent therapist), workshops, educational events, and social gatherings. These programs understand that healing the family helps to heal the substance abuser. While family therapy can have short-term achievements, it is also a long-term process, like recovery itself.

See Related: Co-Dependents Anonymous

According to the Huffington Post, many codependents grew up in dysfunctional families, were the caretakers in those families, and unwittingly replicate their role in the families they create in adulthood. Although addiction tends to act as a black hole, drawing all the family’s energy, resources, and time into it, codependent family members must see the great utility in taking care of themselves in order to help heal everyone. Codependent people in a relationship, in any capacity, with a substance abuser must understand that they are not being selfish if they focus on their own needs, including having to heal longstanding feelings of shame, low self-esteem, and the wounds of personal trauma.

Codependency is a relationship problem, but it starts with an internal problem with one’s self. To the extent that a codependent person realizes that he is worthy of helping himself, healing can occur.

According to Lancer, the following steps can be instrumental to recovery from codependency:

• Release old ways of being and reacting. Codependents who learn to let go of the need to control, please others, and obsess about others’ perceptions can turn much needed attention to their needs and lead a more autonomous life.
• Raise awareness. Bringing mindfulness to one’s actions and reactions can lift codependency out of the darkness of self-misunderstanding, which helps to perpetuate it.
• Learn self-acceptance. Therapy is not about making external changes but accepting oneself and seeing what changes organically follow; they are most often healthy and self-affirming ones.
• Take action. Work on translating the lessons learned into affirmative steps to make healthy changes; for instance, a codependent can overcome his inability to have his needs met by voicing those needs and not backing down from these requests.

During rehab, a substance abuser works with a team of addiction professionals to learn new tools for healthy communication and living. As the recovering substance abuser is undergoing a process of change, it can be harmful to the recovery process if everyone else around her stays the same. Codependent loved ones require their own rehab in the form of therapy and working on self-affirming behaviors.A substance abuser entering rehab can serve as a signal for family members to also seek help. Everyone in this process is worthy of this important self-help. As much as family can undermine recovery, they can also help to make it long-lasting. It’s a matter of how much everyone is willing to honestly evaluate their role in the addiction, their own co-addictions, and how committed they are to making effective changes to heal themselves and the family dynamic.

At Orlando Recovery Center, our team of expert addiction specialists and support staff understand the essential role family plays in recovery. We offer the greatest privacy to our clients while making the rehab process transparent enough to keep loved ones aware of the recovering person’s progress. Call us today to learn more.