Although there is no diagnosis for Co-Dependency in the DSM-V (the diagnostic manual most often used by clinicians) it can be a useful concept in understanding how some individuals involved in relationships with alcoholic or abusive spouses are often suffering from their own parallel pathological processes. Co-dependent individuals are most often female, and have extremely high instances of suffering from depression and anxiety. The criteria for Co-Dependency is as follows:
1) The investment of self-worth in controlling others in adverse situations
2) Meeting the needs of others without considering one’s own needs
3) Experiencing extreme anxiety around issues of intimacy and separation
4) Being in an enmeshed relationship with persons with personality disorders or substance abuse problems
Other related indicators include substance abuse, anxiety, depression, hypervigilance, stress-related illnesses, and compulsive behaviors.
The co-dependent person, at least on a conscious level, is repeatedly breaking boundaries to control and “save” the alcoholic from themselves. Such behaviors would include throwing full bottles of alcohol down the drain, calling in for their loved one at his or her work after a bender, or posting bail for him or her after they have been incarcerated multiple times. They complain incessantly that the alcoholic is ruining their life with his or her drinking, and believes that if their partner simply stopped the destructive behavior, their life together would be normal, healthy, and happy.
In truth, most co-dependent persons mentally decompensate when their partner is able to stop drinking successfully. Once their spouse has stopped drinking, they lose all sense of control in the relationship, which is frightening and anxiety-inducing. The chaos in the alcoholic relationship is also normative for co-dependent individuals and often addictive. Many will admit that the best sexual encounters occur in the relationship when the other partner is using or drinking and things are at their emotionally most chaotic.
How to Treat Co-Dependency
It is often said that alcoholism is a family disease, and there is much truth in this idea. Co-dependent individuals tend to respond very well to all forms of treatment, including 12 Step programs such as Al-Anon as well as psychodynamic psychotherapy. Co-dependent individuals tend to be caring, loving, people, and it is important to encourage the co-dependent person to accept psychological intervention, as their needs are so often overlooked by themselves and their spouses. Clinicians often overlook their needs as well, as they are superficially compliant and are not acting out actively like their spouses, who are more likely to garner the professional’s concern and attention.
Jennifer De Francisco, MPA, MSW, LCSW, provides psychotherapy for those suffering from codependency, alcohol dependency, and other diagnoses in the Newport Beach, Irvine, and Orange County area. Please contact her at (949) 251-8797 if you are interested in making an appointment.