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A Critical Analysis of the Co-dependence Construct

Janice Haaken

CO-DEPENDENCE is a diagnostic term that has gained increasing usage in clinical and self-help settings. While it is used to encompass a broad range of clinical phenomena, it generally refers to an identity, particularly common among women, based on caretaking and excessive responsibility for others. This paper explores the clinical implications of the co-dependence construct from both social-psychological and psychodynamic perspectives.

Co-dependence is a idiom that dependence also raises broader social has achieved tremendous currency in the questions in that it is being used increasingly popular clinical literature in recent years. by groups and individuals as a basis for self- Books on co-dependence now fill self-help definition and group identity. sections of bookstores, and therapeutic gurus promote workshops offering relief for this Constituting a unique social and clinical newly identified population of sufferers. The phenomenon, the co-dependence literature prototypical co-dependent is also described in and the many recovery groups it has the burgeoning literature on adult children of spawned are of interest because they apply alcoholics (ACOA). ACOA has become part of the Twelve step this new psychotherapeutic lexicon as well, philosophy (see appendix) and the disease indicating, particularly among women, a model of to interpersonal problems, socially recognized emotional disability as ell extending these ideas far beyond the primary as a prescribed course of recovery. ," i.e., drug and alcohol. With the Counselors and therapists draw increasingly growing public over alcoholism and on ACOA language in their therapeutic drug dependence, the concept of addiction, practices and marketing tactics, e.g., offering as both metaphor and reality, has come to specialty counseling for "ACOA's" or "co- occupy a larger and larger terrain in dependents." American popular psychology, encompassing a broad range of social and emotional ills. In clinical situations, the term co-dependence The analysis presented here criticizes the co- carries the same pitfalls as diagnostic labeling dependence literature from psychodynamic generally: the potential for reifying the and social-psychological perspectives. patient or applying labels as a substitute for careful analysis. Diagnostic categories can Psychodynamically, the co-dependence also be used defensively by therapists in literature is conceptualized in the critique responding to pressures and felt in presented here as containing insights therapeutic situations, e.g., a readiness to consistent with current psychoanalytic label demanding patients as "borderline." But theory and as paralleling the current the term co- psychoanalytic emphasis on interper-

Janice Hoaken, PhD, is an associate professor at Portland State University, Department of Psychology, Portland, OR 97207

CO-DEPENDENCE CONSTRUCT

sonal phenomena and character pathology. This The concept of the , which paper describes these parallels as well as the originally referred to patterns of interaction problematic limitations and over-incorporative associated with alcoholism, has gradually quality of the co-dependence literature. The co- expanded to incorporate all family systems based dependence literature popularizes diagnostic on "" (Middleton-Moz 1989; Richketson conceptions of interpersonal conflicts by pointing 1989; Wegscheider-Cruse 1985) or " -based to constellations of behavior, which are rules" (Bradshaw 1988). This broader conception conceived of as symptomatic of an underlying of the dysfunctional family includes a wide range mental disease with an associated set of of pathogenic dynamics and impoverished antecedent or causal deficits and a subsequent emotional interactions within the family, set of functional impairments. It is argued here particularly where avoidance of confrontation or that the extension of the disease concept of the inability to develop healthy means of addiction, popularized by Alcoholics Anonymous, resolving conflict predominate. Co-dependence to more pervasive personality and character refers to a set of counter-identifications with phenomena represents a troubling trend in the parental deficiencies. popular psychology literature. The co-dependence literature expresses the pain, I will be exploring implicit assumptions about anguish and helplessness, combined with an gender in the co-dependence literature from a overwhelming, wearisome responsibility for feminist psychodynamic perspective as well as a others that dominates the lives of many women. social-psychological perspective. I will also While there are stories of men in the co- discuss the tendency in the co-dependence dependence literature, for the most part they are literature to pathologize a feminine identity women's stories. They are stories of women who based on caretaking and to oversimplify are trying desperately to hold families together dependency conflicts. and to keep things going under seemingly impossible conditions. This literature speaks of CO-DEPENDENCE AND THE CLINICAL the emotional deprivations of women, particularly CONSTRUCTION OF FEMINITY in their relationship with men, and of the experience of finding gratification/ and a sense of Co-dependence historically describes a feminine strength through what Hochschild (1983) refers malady, but perhaps more, basically, it describes to as "emotional work" i.e., managing the feelings the emotional condition of the oppressed. While of others. some clinicians use the term co-dependence to encompass a broad range of psychopathological Beattie (1987), one of the leading writers of co- conditions (see Beattie 1987; Schaef 1986), it dependence literature, understands that the more commonly refers to an identity based on appeal of her book is not only to those in the caretaking and responsibility for: others. The co- helping professions but to women who dependent's caretaking I identity is formed out of exhaustively take care of others and feel the experience of I powerlessness; it is an emotionally deprived and depleted by these identity forged out of the adaptive necessity of efforts. She poses the following question: "Does compromise, appeasement and covert endlessly taking care of other people . . . mean, manipulation. Marlys is a good wife and mother? Or could it mean Marlys is co-dependent?" (p. 22). Beattie Co-dependence originates in a tendency, describes clients who present with an array of life particulary common among daughters in difficulties and a sense of confusion and feeling “dysfunctional" families, to overcompensate for crazy. In responding to an illustrative client. parental inadequacies by becoming parentified Beattie offers the explanation that "maybe your and by developing an excessive sensitivity to the husband is an alcoholic, and your needs of others.

problems are caused by the family disease of ality disorder, dependent or alcoholism" (p. 20). She goes on to explain borderline condition. summarily that "now, if you ask Patty what her problem is or was, she will answer: “I'm co- While the co-dependence construct does not have dependent.” real diagnostic discriminative validity, the popular literature that has emerged under this idiom Beattie defines a co-dependent as "one who has clearly suggests that it articulates important let another person's behavior affect him or her themes in the lives of many—again, particularly and who is obsessed with controlling that of women. Its appeal lies in giving a name — i.e., person's behavior" (p. 31). She goes on to a conceptual container-to a broadly defined set of describe this condition as one that results from emotional ills, interpersonal pressures, and victimization but that requires "each of us to conflictual dependencies, and in providing a decide what part we played in our victimization" message of hope, that is, a path to recovery. (p. 32). Co-dependence converges with another so-called The theme of victimization is pronounced in the feminine malady, "relationship addiction" or " co-dependence literature. The assumption is that addiction," popularized by Robin Norwood (1986), victims internalize a set of rules that were who is also a proponent of Twelve-step recovery adaptive in the family of origin but cause them to groups. The co-dependence literature provides recreate their victimization as adults. Subby and more clinical elaboration of this malady, Friel (1984) define co-dependence as "an introducing a broad constellation of pathological emotional, psychological, and behavioral behaviors and etiological explanations associated condition that develops as a result of an with an identity based on caretaking and over- individual's prolonged exposure to, and practice involvement in relationships. While some use the of, a set of oppressive rules" (p. 31). Schaef terms and co-dependence 1987) links racism, sexism and homophobia to interchangeably, the latter term refers to a more the "addictive thinking" that creates general pattern of behavior, i.e., a personality codependence. The implicit idea here is that disorder based upon excessive responsibility for institutionalized oppression cultivates pathological others. Put still another way, the love addict is forms of dependency whereby both victim and assumed to be co-dependent, but the co- perpetrator, master and slave, share a common, dependent is not necessarily a love addict. impoverished emotional world. Whereas the love addict becomes over-involved in dyadic relationships, the co-dependent While the co-dependence literature focuses on may manifest her/his "disease" through a victimization, the typology is general enough to tendency to take responsibility for the feelings include anyone who is often upset or who has and well-being of others in myriad interpersonal emotional difficulties that are manifested contexts. Nonetheless, both constructs are based interpersonally. Schaef (1986) concludes that on an extension of the disease model of addiction "everyone who works with, lives with, or is advanced by Alcoholics Anonymous to conflictual around an alcoholic (or a person actively in an interpersonal dependencies. addictive process) is by definition a co-dependent and a practicing co-dependent" (p. 29). Beattie The popular appeal of these constructs for many lists dozens of problems and psychopathological contemporary women seems to be related to the conditions — from neurosis to personality apparent contradiction between objective disorder and psychotic conditions-that are all conditions approaching greater parity with men subsumed under the umbrella of co-dependence. and a subjective lag in feelings of and Cermak (1986) views co-dependence as a mixed independence. Old feminine ideals, including personality disorder that can be manifested women's identification with mothering symptomatically as , anxiety disorder, hysterical person-

CO-DEPENDENCE CONSTRUCT

and relational concerns, now feel ego dystonic control. However, these very attempts at for many women. In a society that prizes restoring control had the effect of preventing the competition and narcissistic self-sufficiency, the alcoholic from experiencing the uncomfortable legacy of the feminine past feels "dysfunctional" consequences of his/her own behavior. As the (see Herman and Lewis 1986). The women's spouse increasingly took over areas of the movement of the 1960s and 70s involved, alcoholic's life and functioning, the alcoholic's psychodynamically, the recovery of the powerful tendency to deny the destructiveness of his/her pre-oedipal mother of our collective, archaic behavior intensified. In AI-Anon, the organization past-a sense of goodness and strength that formed in 1951 by wives of alcoholics recovering extended beyond familial concerns to a larger in AA, this pattern of behavior is called ," social ethos. With the decline of the women's and historically it has been the wife who has movement, and a concomitant assimilation of played this role in relation to the alcoholic women into the paid work force, maternal husband. identifications for women are less apt to be experienced as an adequate internal bridge to The enabling dynamic presupposes gender external reality. dynamics within the family in which women, in the role of wives and mothers, are in the ORIGINS IN THE ALCOHOL AND ambivalent position of being both emotionally CHEMICAL DEPENDENCE FIELD protecting and potentially "castrating” or overpowering. As Chodorow (1989) has argued, Much of the literature on co-dependence comes women's near-exclusive involvement in the care out of the alcohol and chemical dependence field of young children creates a psychological legacy, (see Schaef 1986; Wegscheider-Cruse 1985; for both men and women, of both the "good," all- Whitfield 1985). The term began to appear in powerful pre-oedipal mother and the "bad," mental health literature in the late 1970s as drug devouring one. Women as mothers are associated and alcohol treatme nt programs began to focus with the regressive pleasures and fears of early more extensively on "family systems." These childhood, whereas men as fathers come to rep- programs have focused increasingly over the past resent the "reality principle" of the larger social decade on the role of family members, order. In patriarchal societies, males come to particularly parents and spouses, in maintaining repress their early identification with the mother the addict's self-destructive behavior. The and its associated dependency longings, but they movement to adopt a family systems perspective are compensated for this loss by identifying with in the treatment of alcohol and drug abuse did the rights and privileges of the father, i.e., in open up new areas of insight into the complex developing a masculine sense of . social and psychological aspects of these The girl is required to give up her infantile claims problems. to the mother without the compensating right to patriarchal power and privilege that is offered The essential insight behind the co-dependence the boy in his relinquishment of the same construct emerged out of the treatment of infantile claims (Janeway 1974; Mitchell 1974). alcoholics. Family members, typically the spouse of the alcoholic, inadvertently supported the very Family systems approaches to "enabling" in the behavior that they were ostensibly trying to con- alcoholic family generally fail to address either trol. By intervening and protecting the alcoholic— the infantile components of family members' fury e.g., lying to the alcoholic's boss, cleaning up toward the mother or the different social bases of messes, and paying unpaid bills-the spouse was power within the family. In the prototypical al- compensating for the alcoholic's irresponsibility coholic family, the father/husband may be and loss of consciously or unconsciously perceived as

JANICE HAAKEN being "castrated" by his alcoholism. Paradoxically, not "intruding" and managing competitive the alcoholic state can represent both an strivings (Chodorow 1978; Gilligan 1982). assertion of the man's masculine sense of entitlement and, ultimately, a condition that In the enabling situation, it is noteworthy that the imparts a sense of impotence, both sexually and socially. Unconsciously, the intoxicated state also woman's failure to respond to the problems of her permits a regressive recovery of infantile alcoholic husband requires justification in terms of pleasures — a rebellion against a masculine his need for a different response. It is identity based on the renunciation of dependency understandable that many women embrace the longings (see Chodorow 1978). For the enabling construct and experience some relief in mother/wife, the husband's alcoholism evokes being told that to not respond to the demands of twin fears of having become the "devouring, the alcoholic spouse is actually more loving than castrating" mother in relation to her husband and to do so. The underlying feminine ideal of of having failed to be the good, protective mother in relation to her children. maternal sensitivity to others is preserved by a reframing of the moral issues. The family's belief that the mother is the "real" villain—the one who "enabled" the husband's The tendency for family systems therapists to alcoholism — can be over determined by archaic ignore or downplay these gender dynamics may fantasies of the omnipotent mother. The family's be related to a conservative tendency of the confrontation of the "enabler" can be based on theory itself-a tendency that has informed both its recognition of the mother's actual am- conceptions of "The Alcoholic Family." Family bivalent motivations (nurturant and systems theorists view the family as a system in unconsciously hostile) and its infantile rage much the same sense that an individual is a toward her. In addition, there may be system - an organism constituted of disappointment in her for failing to protect interdependent parts and a set of self regulating the family from the father's abusive behavior, mechanisms. The family is conceptualized as e.g., "If she had responded differently to him, he having a distinctive personality and identity would not have been so sick" based on a personal past, and as having self-

regulating mechanisms that mediate its relation The problem of enabling also points to moral to internal and external reality, i.e., that function dilemmas within the family associated with like an ego (Steinglass 1987). The assumption women's caretaking position. In her study of here is that the family, as an organism, equally gender and moral development, Gilligan (1982) concludes that females, who identify more closely benefits from or is compromised by dysfunctional" patterns of interaction. with the mother, are more likely than males to experience moral conflict in situations There is much that is useful in this conception of where they fail to provide nurturance or to the family as an interdependent system, maintain relational ties. In female development, the pre-oedipal tie to the mother is not as fully particularly when it allows family members to recognize their own unconscious contribution to relinquished as it is in male development, the disturbing behavior of another family creating a tendency in women toward more member. From this perspective, the alcoholic or flexible ego boundaries (Chodorow 1978). In the addict is no worse (or better) than the person context of moral choice, females are more apt to who vicariously supports the self-destructive require moral justification for failing to respond habit. The notion of alcoholism as a "family to the needs of others, whereas males are more apt to construct moral arguments in relation to disease" introduces a taboo against self- righteous condemnation of the alcoholic and preserving social distance, i.e., points to the social context of individual pathology. Consistent with this systems approach, Subby (1987) focuses on

CO-DEPENDENCE CONSTRUCT families, pointing to the tendency in the literature to provide too narrow a typology of alcoholic the importance of family dynamics in po- family dynamics. In finding that alcohol tentiating alcoholism: consumption is not a simple causal variable of I have no doubt that there are real genetic fac- family distress, he concludes that what is tors behind alcoholism and other forms of common to alcoholic families is the focus on chemical dependency. But I don't believe that alcohol as the family's explanation for irrational even someone who was born with all that ge- behavior. netic loading and as a result becomes alcohol- ic, would have to practice their alcoholism or The therapeutic interventions described by addiction long before they would also have to Steinglass focus on initially distinguishing find or create a new co-dependent system to support their alcoholism, [p. 12] between the family with an alcoholic member and an alcoholic family. This distinction suggests that The family systems model, however, obscures an underlying set of personality variables differences in ego strength and power and mediates alcohol use in the family. "Family minimizes the conflictual aims of family alcoholism" suggests interactive and personality members. The family is a socially constructed dynamics potentiated by and organized around institution, with economic and affinitive bases for alcohol intoxication. both interdependence and conflict. It is quite unlike an individual organism in that the family While the family systems approach to alcoholism has no superoridinate ego or self that organizes has opened up new avenues of insight and clinical its conduct. Many family systems theory models intervention, it limits understanding of the draw extensively on organismic metaphors that emotional and interpersonal complexity of can blind theorists to the conflictual and socially alcoholism and other addictive processes. As constructed dimensions of family life and Scharff and Scharff (1987) have argued, systems family dynamics. approaches to family therapy provide means of quickly organizing the problem and actively Steinglass (1987) provides an analysis of the intervening. But in doing so, they often sacrifice alcoholic family that draws on systems theory important clinical material of diagnostic and while challenging the tendency in systems theory prognostic significance (Friedman 1980). When a to oversimplify family phenomena. He concludes hypothesized disease process with unitary that the alcoholic family is one where alcohol- symptoms and progressive stages is combined related behavior becomes central to both the with a family typology of alcoholism, the differ- family's identity and its self-regulating capacities. ing and specific ego strengths, object relational A central finding of his study is consistent with capacities, and psychopathology of individual the shift in the alcoholism literature from family members become obscured. For example, understanding alcoholism as a discrete some alcoholics are able to sustain empathic ties behavioral syndrome to an emphasis on with their children, and some cannot. Some are interactive and personality dynamics. Steinglass abusive when drunk, and some are not. These found that the level of alcohol consumption per are important clinical distinctions that are lost in se was not associated with disturbing family dy- the joining of the disease model of alcoholism namics or with individual pathology within the with family systems perspectives. family. It was in association with social/behavioral aspects of alcoholism— PSYCHODYNAMIC IMPLICATIONS OF CO-DEPENDENCY i.e., when alcohol use became associated with unpredictable and destructive behavior-that the There are problematic implications, both family identity became "alcoholic." In etiologically and therapeutically, in contradistinction to the co-dependence literature, however, Steinglass stresses the heterogeneity of alcoholic

the notion of an underlying congruence erature and the interpersonal approach to among addictive processes-whether those psychopathology that has gained currency with processes refer to substances or to interpersonal the ascendance of and) relationships. While a review of the debates on within psychoanalysis (see addiction falls outside the scope of this paper, the Greenberg and Mitchell 1983). Both the psychiatric literature does suggest that there are psychoanalytic literature and the co-dependence no clearly identifiable dynamics nor consistent literature stress the interactive manifestations of etiological factors underlying drug or alcohol psychopathology and primitive mechanisms of dependency (Meyer 1986; Mirin 1984; defense, e.g., and projective iden- Rounsaville et al. 1987). Further, regardless of tification. The co-dependence literature how one conceives of the regressive component describes a compulsive tendency to attempt to of chemical or alcohol addiction, there are myriad maintain emotional stability and a sense of well- problems in extending these formulations to the being by maintaining contact with someone who interactive pressures and dependencies of rela- is out of control. tionships. In some formulations addiction implies a regressive retreat from the object Inherent to this dynamic conception of co- relational world, with the drug becoming dependence is the psychoanalytic notion of the substitute object. But the women who are projective identification. Projective identification described in the co-dependence literature do not refers to interpersonal dependencies and achieve the euphoria that might be expected in a interactive processes based on the primitive logical extension of addiction theory. Whatever defense of splitting (for discussion, see Meissner the pathology that underlies these conflicted 1980). The good self preserves a sense of attachments, it exists in a world of real goodness and wards off knowledge of disturbing, objects that make demands requiring some bad-object representations by maintaining capacity for , ego functioning and contact with an externalized bad object. For the normal dependency despite the pathology. co-dependent, this external object is the alcoholic, drug addict, or abusive partner, who is However, it can be granted that there is a certain identified with and conforms to the disturbing phenomenological congruity to compulsive forms projections. The split-off ego functions that un- of desire, whether the object is alcohol, drugs, or derlie these anguished interpersonal de- people (Peele and Brodsky 1975; Simon 1982). pendencies can be manifested by shifting To describe something or someone as addictive valences in the dependency ties as well. The is to express the power of infantile longings and abused partner, who is initially emotionally the emergence of an archaic split between dominated by and dependent up on the abuser, exciting and persecutory objects. Falling in love begins to assume control by taking over the ego has been described as an intoxicating state, and functions of the abuser. alcohol has been described as a faithful lover. In both experiences the euphoria of union contains In important respects, however, the the memory of an idealized, gratifying, codependence literature differs from psycho- comforting object, along with the heightened analytic formulations of these processes and the derived from it. It also awakens the means of resolving conflict between good and experience of infantile and the bad self and object representations. Whereas sense of terror and loss when the exciting, "bad" projective identification refers to a primitive object is withdrawn. mechanism of defense central to particular character pathologies, the co-dependence There is a notable congruence between construct is used as a label for a broad range of the ideas voiced by the co-dependence lit- conditions and as a basis for individual and group identity. A key difference here is that the co-dependence literature fails to

CO-DEPENDENCE CONSTRUCT control or the experience of being with someone who is out of control. differentiate between extreme pathologies and those neurotic conditions which afflict people The transformation of alcoholism and with some real object relational capacity and ego other addictions into disease categories strength. There is little attention in the co- did have its progressive aspects, permit- dependence literature to specific developmental ting the moral neutralization of chemical factors associated with greater or lesser degrees dependence so that it could be understood of ego integration and object relational psychologically and therapeutically. As capacity. long as these problems were understood to be the result of moral weakness or lack By focusing exclusively on pathology- of self-discipline, the distance between the e.g., assuming that co-dependents are un- alcoholic and the rest of humanity seemed able to develop emotional "boundaries" mysteriously vast and beyond human ca- (Schaef 1986, p. 48) - the co-dependence pacities to bridge. literature fails to identify positive identifi- cations and developmental experiences And yet, Twelve-step programs do offer that often co-exist with the pathology. a moral interpretation of addiction along- Just as psychotherapists who focus exclu- side the disease model. Even though the sively on pathology can make the patient alcoholic is not seen as morally responsi- feel "sicker" than he/she is, the co-depen- ble for the disease, alcoholism, like Origi- dence literature tends to cast the reader nal Sin, requires spiritual redemption and into a chaotic world of bad object and self divine intervention. Just as the concept of representations without adequate recog- Original Sin liberates the believer from nition of the problems attendant to emo- personal responsibility for his/her "fallen tionally assimilating these warded-off as- state" while at the same time making the pects of the self. "sinner" responsible for seeking salvation, so too the AA disease model shifts the PSYCHODYNAMICSOFTHE TWELVE-STEP moral ground from the alcoholism (a dis- PATH TO RECOVERY ease for which the alcoholic is not re- With few exceptions, the co-dependence sponsible) to the alcoholic's responsibility literature promotes Twelve-step programs to seek recovery through a Twelve-step or recovery groups and argues that such program. groups are essential to "breaking through The first step in recovery groups is to the denial" associated with the "disease" acknowledge that one has lost control— of co-dependence. Whereas the early Alco- that the destructive compulsion has taken holics Anonymous and Al-Anon litera- over and is beyond personal attempts to tures focused on a shared but circum- regain mastery. Whatever the object of scribed set of problems associated with the compulsion—alcohol, food, drugs, or alcoholism, the unifying basis of contem- relationships with people—the message is porary recovery groups such as Adult that the individual feels out of control be- Children of Alcoholics (ACOA) is much cause he/she is suffering from a progres- broader and more defining of the self. The sive disease, a pernicious condition that groups are organized around a self-diag- can only be arrested by following the nosed, shared personality disorder origi- Twelve-step path to recovery. This re- nating in a dysfunctional family under- quires a conversion experience in which stood in a particular way. A central basis the sufferer turns his or her life and will for the appeal of Twelve-step programs for over to a "Higher Power," whose guidance those who identify with the co-dependence is sought in the moral awakening that fol- literature is their provision of a means of lows from the conversion experience. emotionally containing and conceptualizing the In Twelve-step programs, the disease experience of being out of concept of alcoholism operates psychody- namically much as the concept of the "devil" does in fundamentalism. (For relat-

ed discussion, see Antze 1987.) What underlying personality disease shared by all characterizes fundamentalism is not only sufferers. According to the literature, it particular ways of thinking about God originates in all sufferers in an equivalently and Scripture but the extent of one's belief understood, repressive, addictive family in the devil, the devil and hell are full ri- system, it progresses in an equivalent vals with God in the religious cosmology. way toward ultimate self-destruction, and The appeal of both fundamentalism and it requires the same redemptive solution. Twelve-step programs is similar: the hope The person who attempts to hold the fam- of connecting with a source of goodness ily together is the same as the alcoholic and benevolent control amidst a world who abandons it; the person who depends dominated by chaotic, destructive forces. upon drugs for a sense of well-being is the Both belief systems permit a mystical same as the one who depends upon people transformation of bad feelings and experi- for the same feelings. There are no vic- ences into good feelings of peace and well- tims and therefore no perpetrators in this being. God comes to represent the longed- no-blaming world of moral equivalents. for object of comfort and hope — the object While the co-dependence literature does that has failed the believer in reality but reject the repressive moral categories of the that he/she hopes to recover through faith past, it provides a morally and psychologically and relinquishment of personal will. The impoverished substitute world devoid of the complexity of experience is reduced to tensions inherent in differentiated some basic unifying ideas, and anxiety is consciousness. warded off by following a set of prescribed steps. The self-help groups that draw so extensively In the co-dependence literature, the an- on the co-dependence literature do offer guish of conflicted dependency is trans- comfort and hope to individuals who share a formed through a form of reaction forma- common experience of feeling overwhelmed tion, i.e., defensive transformation of the and out of control. The groups provide a place feared or hated object into its opposite. and language for talking about emotional pain Many co-dependence authors argue that in society that provides little space for such conflicted attachment must yield to a release. Recovery groups reduce the sense of state of detachment, and that "when con- and aloneness so common in American fronted by a foe, praise him bless him, let society and convey hope and a commonality of him go" (Norwood 1988, p. 264). There is purpose through which members can transcend an emphasis on the transformative power the limits of individual experience (Cutter and of emotional surrender as "we allow life to Cutter 1987). happen instead of forcing and trying to control it" (Beattie 1987, p. 66). The dis- On the other hand, the contemporary co- turbing sense that something important dependence literature and the recovery is missing—either within oneself or with- groups that draw on this literature path- in one's life experience—is warded off by ologize caretaker dilemmas and vastly renouncing conflict and doubt. "Detach- oversimplify problems of human dependency ment means accepting reality-the facts and interdependency. The message that "co- . . . the natural order and destiny of things dependents" must disinvest in unrewarding in this world. . . . We believe in the right- relationships is particularly compelling for women ness and appropriateness of each mo- today, who continue to carry the traditional ment" (Beattie, p. 66). burdens of care-taking responsibilities and whose entry into the paid work force has, to some CONCLUSION degree, intensified these burdens. While Co-dependence is presented in the popu- women have gained some measure of autonomy lar clinical literature as a condition that and freedom from enforced dependencies upon has varying symptoms but is based on men and family life, condi-

CO-DEPENDENCE CONSTRUCT ing. But as clinical work has become in- creasingly guided by narrowly defined tions of daily life have not permitted a real specialties on the one hand, and by ad hoc emancipation from the old division of do- eclecticism, such as co-dependency mod- mestic and emotional labor. The old social els, on the other, the potential for broad- contract between the sexes has unraveled, based theorizing has diminished. Clini- and as yet new forms of reciprocity and cians who are not anchored in broad-based healthy interdependence between men traditions backed by well-developed theo- and women haye not been sufficiently re- ries are tremendously vulnerable to clini- alized. The co-dependence literature vast- cal trends and popular literature that ly oversimplifies these problems of depen- "pull it all together" conceptually. The dency and interdependency, on both the co-dependence label becomes a broad con- social and individual levels. ceptual container into which myriad life The construct of co-dependence em- difficulties and internal and external pres- braces much of humanity in a common sures are placed. The message is compel- psychopathological net. While this clini- ling because it seems to provide both the cal concept articulates concerns that are therapists who draw on the co-dependence common to many in our society and literature and the individuals who identi- points to the need for sociological and cul- fy with the "disease" deliverance from the tural explanations for psychopathology, it difficult task of separating out what is in- assimilates far too much in attempting to ternal from what is external, and what is offer one simple construct to explain the healthy and emotionally useful from what multifarious existential, social and psy- is pathological and emotionally destruc- chopathological bases of human emotion- tive in worrisome, conflictual, interper- al suffering. sonal relationships. We do need theories and ideas that speak to core human dilemmas and to the commonalities in human emotional suffer-

Appendix THE TWELVE STEPS OF ALCOHOLICS ANONYMOUS 1. We admitted we were powerless over alcohol [in groups for co-dependents, "relationships" or "people" is substituted for alcohol]. 2. Came to believe that a Power greater than ourselves could restore us to sanity. 3. Made a decision to turn our will and our lives over to the care of God as we understood Him. 4. Made a searching and fearless moral inventory of ourselves. 5. Admitted to God, to ourselves, and to another human being, the exact nature of our wrongs. 6. Were entirely ready to have God remove all these defects of character. 7. Humbly asked Him to remove our shortcomings. 8. Made a list of all persons we had harmed, and became willing to make amends to them all. 9. Made direct amends to such people wherever possible, except when to do so would injure them or others. 10. Continued to take personal inventory and when we were wrong promptly admitted it. 11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry it out. 12. Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics [or, to "other co-dependents"], and to practice these principles in all our affairs. REFERENCES

BRADSHAW, J. -Heating the Shame That Binds You. MIRIN, S. M. Substance Abuse and Psychopatholo- Pompano Beach, FL: Health Communications, gy. American Psychiatric Press, 1984. 1988. MITCHELL, J. On Freud and the distinction between CERMAK, T. L. Diagnosing and Treating Co-Depen- the sexes. In J. Strouse, ed„ Women and Analysis. dence. Minneapolis: Johnson Institute Books, Grossman Publishers, 1974. 1986. NORWOOD, R. Women Who Love Too Much. Simon CHODOROW, N. The Reproduction of Mothering: Psy- and Schuster, 1986. choanalysis and the Sociology of Gender. Univer- NORWOOD, R. Letters from Women Who Love TM sity of California Press, 1978. Much. Pocket Books, 1988. CHODOROW, N. Feminism and Psychoanalytic Theo- PEELE, S„ and BRODSKY, A. Love and Addiction. ry. Yale University Press, 1989. New American Library, 1987. CUTTER, C.. and CUTTER, H. Experience and change RICKETSON, S. C. The Dilemma of Love: Healing Co- in AI-Anon family groups: Adult children of alco- dependent Relationships at Different Stages of holics. Journal of Studies on Alcohol (1987) 48:29- Life. Pompano Beach. FL: Health Communica- 32. tions, 1989. FRIEDMAN, L. J. Integrating object-relations under- ROUNSAVILLE, B. J., DOLINSKY, Z. S., BABOR, T. F., standing with family systems intervention in cou- and MEYER, R. E. Psychopathology as a predictor ples therapy. In J. K. Pearce and L. J. Friedman, of treatment outcome in alcoholics. Archives of eds.. Family Therapy: Combining Psychodynamic General Psychiatry (1987) 44:605-13. and Family Systems Approaches. Grune & Strat- SCHAEF, A. W. Co-Dependence: Misunderstood and ton, 1980. Mistreated. Harper & Row, 1986. GILLIGAN, C. In A Different Voice: Psychological SCHAEF, A. W. When Society Becomes an Addict. Theory and Women's Development. Harvard Uni- Harper & Row, 1987. versity Press, 1982. SCHARFF, D., and SCHARFF, J. S. Object Relations GREENBERG, J. R„ and MITCHELL, S. A. Object Rela- Family Therapy. Jason Aronson, 1987. tions in . Harvard Univer- SIMON, J. Love: Addiction or road to self-realization, sity Press, 1983. a second look. American Journal of Psychoanaly- HERMAN, J. L., and LEWIS, H. B. Anger in the moth- sis (1982) 42:252-62. er-daughter relationship. In T. Bernay and D. Can- STEINOLASS, P. The Alcoholic Family. Basic Books, tor, eds.. The Psychology of Today's Woman: New 1987. Psychoanalytic Visions. Analytic Press, 1986. SUBBY, R. Lost in the Shuffle: The Co-dependent Re- HOCHSCHILD, A. R. The Managed Heart: Commer- ality. Pompano Beach, FL: Health Communica- cialization of Human Feeling. University of Cali- tions. 1987. fornia Press, 1983. SUBBY. R.. and FRIEL, J. Co-Dependency, An Emerg- JANEWAY, E. On 'female sexuality.' In J. Strouse, ed., ing Issue. Pompano Beach, FL: Health Communi- Women and Analysis. Grossman Publishers, cations, 1984. 1974. WEGSCHEIDER-CRUSE. S. Choice-Making for Co-de- MEISSNER, W. A note on projective identification. pendents, Adult Children and Spirituality Seek- Journal of the American Psychoanalytic Associa- ers. Pompano Beach, FL: Health Communica- tion (1980) 28:43-68. tions, 1985. MEYER, R. E. Psychopathology and Addictive Dis- WHITFIELD, C., Alcoholism, Other Drug Problems, orders. Guilford Press, 1986. Other Attachments, and Spirituality: Stress Man- MIDDLETON-MOZ, J. Recovery: An interview with agement and Serenity During Recovery. Balti- Jane Middleton-Moz. Journey (1989) 1:1-6. more: The Resource Group, 1985.