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We are beginning to recognize that co-dependence is a disease in its own right.
The History and
Development of the
Concept of Co-Dependence
Since the concept of co-dependence has evolved so recently, we have not yet seen an integrative theory developed about it. Co-dependence has the beauty of being a "grass-roots" idea. That is to say, people who admit to having the disease themselves and are in the process of recovering from it are developing theories about co-dependence, not professionals who have only a "left-brain" interest in the disease. The awareness of the dynamics of co-dependence comes directly out of the struggle, the pain, and the elation of working through an illness and beginning to know that there is another way to live and be with others.
This process of understanding and evolving a theory about a disease from within is not foreign to the chemical dependency (or CD) field. In the CD field, the persons most trusted are those who can honestly say, "I know how you feel" -- those who, themselves, are struggling (and have struggled) internally with the ravages of alcoholism and admit it. In the field of mental health, on the other hand, practitioners generally do not admit to having any problems and are seen as less effective if they have to admit to some of the problems with which they work.
At this point in its development, co-dependence is understood and used almost exclusively within the field of chemical dependency. Most professionals and lay people who are not somehow involved in the CD field know little or nothing about this disease and its treatment. Ifirmly believe, in fact-as many others have suggested (among them, Sharon Wegscheider -- Cruse, Jael Greenleaf, Charles Whitfield, to name a few) -- that most mental health professionals are untreated co-dependents who are actively practicing their disease in their work in a way that helps neither them nor their clients. The ignorance of the mental health profession about this disease has resulted in costly, longrange, and ineffective treatment for co-dependents. It has, however, kept the professional's pockets lined, and it has probably served to perpetuate her or his own co-dependence.
The Chemical Dependency Field
As I understand the development of the concept of codependence within the CD field, it has been employed in relation to the treatment of the alcoholic. We all know that prior to the development of the disease concept of alcoholism, the alcoholic was considered a bad, weak person who just had no willpower. Alcoholism was a disease from which the individual recovered in isolation from the family and usually only with the support of other "drunks." As Virginia Satir developed her concepts of family therapy, Vernon Johnson, Sharon Wegscheider-Cruse, and others began to look at alcoholism as a family disease, and the entire field opened itself to the awareness that the alcoholic was not the only person affected by the disease. It became clear, in fact, that the entire family was affected and that each member played a role in helping the disease perpetuate itself.
Since many of the initial contributions in the CD area came from people who were themselves recovering alcoholics, the emphasis in treatment continued to be on the recovery of the alcoholic and on describing elements that would impede that recovery. It was accurately believed that alcoholics would have less chance of staying sober if they returned to untreated families, which would enable them to drink by making excuses for them and by otherwise continuing to practice their own co-dependence. Hence, CD counselors began working with families to serve the recovery of the alcoholic. Since the entire family had revolved around the alcoholic and the disease, it was not difficult to convince the family to continue focusing upon the alcoholic. So the family members dutifully learned about the disease of alcoholism and were told that they were sick. Exactly how they were sick and how they were to recover remained a mystery.
I want to emphasize here how much, historically, the initial treatment of the family focused all of its energies on the alcoholic. The term enabler, for instance, which is used in chemical dependency circles to describe the person-usually the spouse-who subtly helps support the drinking, is obviously oriented toward the alcoholic. The focus in working with the enabler was on helping her or him learn not to help perpetuate the disease in the alcoholic; little was done to help the enabler recover from her or his disease. Those providing this focus were usually recovering alcoholics, who had a vested personal interest in alcoholism per se.
There then was a time when the terms enabler and co-dependent were used almost interchangeably. The enabler/co-dependent was usually the spouse of the chemically dependent person, and there was tacit recognition that other members of the family were also co-dependents. However, the focus of treatment remained primarily on the alcoholic, on the spouse secondarily, and on the children least of all, a procedure that simply replicated the experience of the sick family itself. Family members were often described as co-dependent to the alcoholic, and their disease was not understood as a disease process in its own right. Even though Al-Anon (the major support group for co-dependents) says that the co-dependent needs to focus upon her or his own disease, much of the actual focus is on how to live with an alcoholic.
I think the next phase in the development of this concept was recognizing that the enabler, or co-dependent, was also in a great deal of pain and needed help. Concurrently with this phase was the realization, statistically, that children of alcoholic families tended to become alcoholics and/or develop serious problems adjusting to life. We began to see that the disease process was perpetuating itself and that it functioned on a larger scale than we had previously thought.Co-Dependence. Copyright � by Anne Wilson Schaef. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.