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What is co-dependency? How do I know if I am co-dependent, and what can I do about it?

Co-dependence is a concept that developed after the disease model of alcoholism took hold in the 1960s. Until then, the focus of treatment was on the alcoholic patient and excluded the family. At that time, the spouse was labeled as the chief enabler, which included trying to control the alcoholic's behaviors, picking up the pieces from the adverse consequences of the alcoholic's behaviors, or rescuing the alcoholic from the adverse consequences. It was discovered in addiction treatment centers that not only did the individual suffering from the addiction need treatment, but his or her family members needed treatment as well. In treating the alcoholic or drug addict, the clinicians noticed that the family members had specific characteristics and behaviors in common.

Co-dependence a maladaptive coping pattern in family members who are closely related to a substance abuser or experience a prolonged exposure to the behaviors of the alcoholic- or drug- dependent person(s).

The characteristics of co dependency include low self-esteem, self-defeating behaviors, distorted thinking, problems in expressing feelings, difficulties with relationships, and the disowning of ones own needs in order to respond to external demands (being a martyr).

The co-dependent is not sick because of the alcoholic's behaviors but because he or she is attracted to the alcoholic. The attraction is because of the codependent's own defense mechanisms that were developed during childhood. These behaviors may be either passive or aggressive and are reactions to childhood trauma. The characteristics of co-dependency include low self-esteem, self-defeating behaviors, distorted thinking, problems in expressing feelings, difficulties with relationships, and the disowning of one's own needs in order to respond to external demands (being a martyr). People who are at risk for co-dependency include spouses of addicts, recovering addicts, adult children and grandchildren of addicts, professionals in caretaker roles, such as nurses, families with a secret, and people raised in a co-dependent family. Codependent families have unwritten rules that encourage self-deception and manipulation. The rules include the following:

• Don't feel — just smile.

• Always be perfect.

• Don't embarrass the family.

• Loyalty is everything.

• Don't have fun.

• Don't ask for help.

• Don't tell family secrets.

If you are a spouse of an addict, come from an alcoholic family, are a professional caretaker, or come from a family who has a secret that family members hide from themselves and each other but everyone knows about, you may be at risk for being a co-dependent. Treatment for codependency includes helping the codependent do the following:

• Express your feelings and own up to your own reality.

• Acknowledge your needs and wants.

• Grieve the past and accept your family's dysfunctional behaviors, while seeing their assets.

• Identify your strengths and build on them to enhance your self-esteem.

• Develop healthy relationships.

• Refrain from rescuing other people, especially at one's own expense.

• Learn to communicate clearly and directly.

Many programs for co-dependents also follow the AA's 12 steps. Many books about co-dependency are available to the general public. Recovery from codependency involves an increased self-awareness, as well as more open and honest expression of feelings, recognizing one's own needs with a focus on self-care and self-nurturing. Individual psychotherapy and/or counseling may help the codependent accomplish this. Joining a 12-step program is also beneficial. Developing healthy relationships with others and with a higher power, as in all of the 12-step programs, can provide a greater sense of self during the recovery process. If you think you may be a co-dependent and you tend to rescue others at your own expense, deny your own thoughts and feelings, and feel that your life has become unmanageable because of the unhealthy relationships that you are involved in, seek out a support group. Support groups include Al-Anon, Alateen, Co-Dependents Anonymous (CoDA), and Adult Children of Alcoholics Organization (ACoA), which are 12-step programs in the tradition of AA but are designed for the family and friends of alcoholics. They offer the necessary support for these individuals regardless of whether their loved one is recognizing their problem and is in treatment. In fact, these programs are especially beneficial to those whose family member remains in denial, as they are especially in need of support and guidance during these initial stages of intervention. There are obvious overlaps between AA, CoDA, ACoA, Alateen, and Al-Anon. Try them all out before deciding which group has the strongest fellowship and the most frequent meetings in your community.

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