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Douglas, Jonathan J.; Minton, Henry L. 
Codependency : Innovat ion or Status Quo? 
22 Aug 93 

]7p.; Paper presented at the Annual Convention of the 
American Psychological Association (101st, Toronto, 
Ontario, Canada, August 20-24, 1993). 
Speeches/Conference Papers (150) 

MF01/PC01 Plus Postage. 

Battered Women; Family Life; Females; Feminism; 
Marital Instability; Vf Social Attitudes; Social bias; 
Social Influences; Spouses 
^Codependency 



ABSTRACT 

Codependency is a relatively new idea, emerging in 
the late 1970s within the chemical dependency treatment industry. 
However, the belief that the wife of the alcoholic is, by definition, 
disturbed, has been influential in varying degrees since the 1930s. 
The perennial influence of the codependency hypothesis suggests that 
it is a social construction which has been influenced by traditional 
assumptions about gender in our society. Feminist criticisms of 
codependency theory contend that society demands that women be 
nurturing, caring, and sensitive to others' needs — the same behaviors 
viewed in codependency as unhealthy and diseases — and feminists have 
raised several reproaches related to this view: (1) Systemic family 
therapy, some feminists declare, treats families as isolated from 
other social influences and tends to pathologist normative family 
interactions which have been socially dictated; (2) the 
Self-Defeating Personality Disorder, which bears diagnostic criteria 
similar to the Codependent Personality Disorder, implies that women 
who are battered by their mate are responsible for their own 
victimization. Recent studies have sought disassociate 
codependency with battered women. In an ongoing project, the author 
of this study will examine codependency definitions, as well as the 
experiences of codependents , using interviews and other 
methodologies. (Contains 76 references.) (RJM) 



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4. 



o 

ON 

in CODEPENDENCY: 

a 

w Innovation or Status Quo? 



Jonathan J. Douglas, M.A. 
Henry L. Minton, Ph.D. 
University of Windsor 
Windsor, Ontario 



A Poster 

Presented at the 101st Convention 
of the 

American Psychological Association 
Toronto, Ontario 
August 22, 1993 



CvJ 
O 
CD 



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Abstract 



Codependency 1 is usually described as a relatively new idea, emerging in 
the late 1970s within toe chemical dependency treatment industry (e.g., 
Schaef, 1986; Wegscheider-Cruse, 1984). In fact, the belief that the wife 
of the alcoholic is, by definition, disturbed (i.e., the Disturbed Personality 
Hypothesis; Edwards, Harvey, & Whitehead, 1973} has been influential in 
varying degrees since the 1930s. Despite their lack of empirical 
foundation, codependency theory recapitulates many of the ideas about 
the alcoholic's spouse that were developed decades earlier (Bailey, 1961; 
Edwards, Harvey, & Whitehead, 1973; Gierymski & Williams, 1986; 
Morgan, 1992). The perennial influence of these ideas, which can also be 
seen in the Self-Defeating Personality Disorder, suggests that they are 
fulfill- lg a societal imperative; feminist analysis reveals its nature. 
However, when coupled with the values of emancipation found in the 
treatment of abused women, codependency theory loses much of its 
pathologizing stigma. 



1 Codependency (also known as co-dependency, co alcoholism, and co- 
addiction) refers to an emotional, physical, and spiritual disorder 
commonly identified among the members of dysfunctional families, 
particularly those affected by substance abuse (e.g., Beattie, 1987; 
Bradshaw, 1988; Whitfield, 1989). 



Outline 

CODEPENDENCY' S SIMILARITY TO THE EARLY LITERATURE 1 

1. Assumption of Disturbance 1 

i) Early Literature 1 

ii) codependency literature 2 

2. Causing and Maintaining Alcoholism 4 

3. Emphasis on women 5 

4. Gender Role Disturbance 6 

Feminism and Codependency 7 

Feminist Critique of Systems Theory 8 

Codependency and the Self-Defeating Personality Disorder 9 

Codependency and battered Women 11 

Conclusions and future Directions 14 



4 



o 

ERJC 



4 



Codependency's Similarity 
to the Early literature 

l. Assumption of Disturbance 

ri Early Literature: 

Much of the early literature, 
based on case studies in the 
psychoanalytic tradition, implies that 
marriage to an alcoholic is sufficient 
e vidence of a character pathology 
(Boggs, 1944; Margaret cewis, 1954; 
Marion Lewis, 1937; Price, 1945; 
Whalen, 1953). 

These authors described a woman 
riddled with personality conflicts. She 
was seen as hostile, domineering, 
dependent (but with a strong "need to bz 
needed"), uncomfortable with her 
femininity, insecure, resentful, oral?? 
fixated, masochistic, distrustful, 
indecisive, insincere, and punitive. 

These personality problems were 
assumed to predate the marriage to an 
alcoholic. Because her husband's 
alcoholism was assumed to meet the 
wife's neurotic nee^s, her personality 
was seen as contnbuting to. both the 
marriage to an alcoholic (e.g., Forizs, 
1953) and to the alcoholism itself (e.g., 
Bullock & Mudd, 1959; Futttrman. 1953; 
Mitchell, 1959). 

Empirical support for this 
perspective was weak cr non-existent 
(e.g., Ballard, 1959). Nonetheless, this 
vision had a profound influence: 

The popular digests of 
these article.* circulated 
by various news media, 
have given the public a 
picture of the male 
alcoholic as a virtual 
victim of controlling 
females, excessively loving 
wives, or martyr-type 
mothers (Clifford, 1964, p. 
457), 

In contrast to this view, 
sociologist Joan Jackson (1954) 



suggested that the wife of an alcoholic 
was an essentially normal personality 
dealing with an extraordinary stressor. 
Through the 1960s and 1970s, empirical 
support was generated for this idea 
(Corder, Hendricks, ft Corder, 1964; 
Haberman, 1964; Kogan, Fordyce, & 
Jackson, 1963; Kogan & Jackson, 1963; 
Kogan & Jackson, 1965; Tarter, 1976). 

in 1973, Edwards et al. reviewed 
the literature, and concluded that 
Jackson's hypothesis was the more 
adequate. However, the Disturbed 
Personality Hypothesis continued to 
appear in various forms (e.g., Welsh, 
1975; Schaffer & Tyler, 1979). 
Codependency theory continues the 
tradition. 

n) Codependency Literature: 

The assumption that those 
involved with alcoholics are 
automatically disturbed is common in 
the codependency literature (e.g., 
Beattie, 1987; Bradshaw f 1988). 

The many symptoms identified 
with codependency focus nearly 
exclusively on the personality. Cermak 
(1984, 1986a,b) has atten peed to 
legitimate codependency as a 
personality disorder. Wallace (1984) 
echoed the familiar refrain that the 
neurotic needs of the codependent are 
met by marriage to an alcoholic. 
Codependency is frequently described as 
affecting one's identity and personal 
boundaries, suggesting that the most 
fundamental fabric of the self is 
damaged (e.g., Beattie, 1987; Cermak, 
1986b; Evans, 1987; Schaef, 1986). 

Some codependency theorists 
believe that the codependent's problems 
predate the involvement with the 
alcoholic (e.g., Young, 1987). Others 
believe that the problems are the result 
of living with an external stressor (e.g. 
Mend enh all, 1989). However, there is no 
debate between these positions. 

Perhaps this is because there is 
no functional difference between them. 
Whether due to personality conflicts or 



5 



an external stressor, the codependent is 
assumed to be permanently disturbed 
(Mendenhall, 1989), in constant danger 
of relapse (Gorski & Miller, 1984), and in 
need of lifelong treatment (Beattie, 
1987). 

The term "codependency" has 
been constructed as a psychiatric illness, 
and invites the stigma associated with 
other psychiatric illnesses. Beattie 
(1987) repeatedly refers to codependent 
behavior as "crazy/' with the opposite of 
"codependent" being "sane." 

One major difference sets 
codependency apart from the Disturbed 
Personality Hypothesis. The label "wife 
of an alcoholic" was clearly limited in its 
applicability. A* .<*;, codependency was 
similarly limite^ _ those in 
relationships with alcoholics (e.g., 
Wegscheider-Cruse, 1984). Since then, 
however, codependency has been 
described in epidemic proportions. 
Bradshaw (1988) suggests that every 
member of a dysfunctional family is 
codependent, and that 96% of all 
families are dysfunctional. Schaef 
(1986) suggests that society supports, 
and even demands, development of the 
disease. 

2. Causing and Maintaining Alcoholism 

Proponents of the Disturbed 
Personality Hypothesis commonly held 
that the wife of the alcoholic caused or 
maintained the alcoholism, as it suited 
her own neurotic needs (e.g., Forizs, 
1953; Futterman, 1953). 

In codependency literature, a 
similar idea is seen in the concept of the 
"enabler," who protects the alcoholic 
from the consequences of his actions 
(Mapes, Johnson, & Sandler, 1984; 
Wegscheider, 1981). The concept of 
"enabler" is so similar to the concept of 
"codependent" as to be nearly 
indistinguishable from it (Whitfield, 
1984). 

The enabler has been described as 
not only maintaining the drinking, but 
contributing to its development 



(Whitfield, 1984). Miller & Millman 
( 1989) describe the enabler as a 
"common cause" of alcoholism. 

3c Emphasis on Women 

In the early literature, the 
emphasis on women is quite blatant. 
Very little work was done on male 
spouses of alcoholics, while the phrase 
wife of an alcoholic essentially became 
the label for a personality disorder. 

The emphasis on women in the 
codependency literature is much more 
subtle. Most authors use the 
conventional "him or her" to indicate 
that codependents can be male or 
female. However, this apparently non- 
sexist language obscures the actual 
gender distribution of alcoholics and 
codependents. 

Alcohol abuse is 2-6 times more 
prevalent among males (DSM-ni-R, 
1987). Further, most men married to 
alcoholics leave, while most women 
married to alcoholics stay (Gomberg, 
Nelson, & Hatchett, 1991). Among the 
spouses of alcoholics, the majority \rill 
be women. 

Women are also more likely than 
men to come into contact with the label 
"codependent." Women are more likely 
to seek therapy, and therefore, to be 
diagnosed by an authority. Eighty-five 
percent of the market for self-help books 
consists of women (Kaminer, 1990), and 
most of the members of Al-Anon and 
similar groups are women (e.g., Cutter & 
Cutter, 1987). Women are more likely to 
identify themselves as being Adult 
Children of Alcoholics (e.g., Hinz, 1990). 
Without question, the majority of people 
identified as codependents will be 
women. 

4. Gender ~ ole Disturbance 

Froaa the time of the earliest 
articles on the wife of the alcoholic (e.g., 
Lewis, 1937), she and her husband were 
viewed as having reversed their gender 



2 

6 



roles* The alcoholic was seen as 
feminine for being out of control, 
dependent, and an inadequate provider 
for the family, while the wife was seen as 
masculine for attempting to control her 
husband, punishing him, and taking over 
his responsibilities In the home. 

The theme of the weak, 
inadequate man and the domineering, 
aggressive woman appeared repeatedly 
in the literature {e.g., Whalen, 1953; 
Ballard, 1959). Traditional gender roles 
were accepted as healthy, and a major 
goal of intervention with the alcoholic's 
family was to restore the male to familial 
control (e.g., Boggs, 1944). 

By 1975, the wives were seen as 
being too masculine and too feminine. 
Welsh (1975) conducted an MMPI study 
of wives of alcoholics. The wives, Welsh 
said, conform to "a stereotype of being 
submissive, yielding, weak, self-pitying, 
soft, hesitant, constricted, dependent, 
'bitchy,' fault finding, complaining, and 
conformist' (1975, p. 52). She also 
described their behavior as obnoxious 
and aggressive, alternating with demure 
femininity used to gain sympathy. 

In the codependency literature, 
this ambivalence about gender roles has 
continued. Concern with the control 
over the family by the codependent has 
persisted (Burnett, 1984). However, 
both domineering and submissive 
behaviour can be evidence of 
codependency (e.g., Beattie, 1987). The 
feminine roles of caring and nurturing 
and the masculine roles of power and 
control have both been described as 
addictive; Schaef (1986) suggested that 
unliberated women and unenlightened 
men are both codependent. Still, the 
classic codependent continues to be the 
nurturant caretaker who puts aside her 
own needs. 

Feminism and Codependency 

Feminists have been among the 
most vocal opponents of the theory of 
codependency. They are concerned that 
women who are displaying the 



behaviours of a well-socialized female are 
prominent contenders for the label (e.g., 
Krestan & Bepko, 1990; van Wormer, 

1989) , as they are for other labels of 
pathology (Franks, 1986; Rorbaugh, 
1979). Although society demands that 
women adhere to the archetype of the 
woman as nurturing, caring, and 
sensitive to others' needs, the same 
pattern of behaviours is censured as 
unhealthy and diseased (Frank & Golden, 
1992; Lawler, 1992). According to 
codependency theory, the answer to 
women's problems resides within 
themselves, not in social action 
(Webster, 1990), thus depoliticizing their 
struggles (Brown, 1990; in Lawler, 1992). 

However, a number of feminists 
recognize some value in the construct. 
For example, recovery from 
"codependency" can help women to 
recognize their own needs, deal with 
some of the conflicting demands placed 
on them, reduce their isolation, and 
legitimize their experiences (Asher, 
1992; Haaken, 1990; Krestan & Bepko, 
1990; Webster, 1990). And the women 
may be politicized simply by being 
brought together to share their common 
experiences (O'Gorman, 1991). 

Feminist Critique of Systems Theory 

Feminists have also expressed 
concern with systemic family therapy, 
which holds that each member of the 
family affects all the other members 
(Bowen, 1974). This formulation has 
been an important rationale for 
codependency theory (Bradshaw, 1988; 
Wegscheider, 1981; Harper & Capdevila, 

1990) . 

By treating the family as isolated 
from other social influences, systems 
theorists may fail to see how cultural 
forces affect the typical "dysfunctional" 
family, with its overinvolved mother and 
peripheral father (Goldner, 1985; 
Taggart, 1985). Roles are assumed to 
emerge within the family system; 
therefore, gender is not seen as a 
determinant (Bograd, 1986). Normatiw 



7 



family interactions which have been 
socially dictated are pathologized 
(Bograd, 1987). 

Taken to extremes, systems 
theory can blur the distinction between 
victim and victimizer (Taggart, 1985). 
Responsibility for violence may be taken 
from battering men, as the violence can 
be seen as only one move in a game in 
which the wife is a powerful player 
(McCaimell, 1986). Similarly, wives 
would have to share the responsibility 
for the drinking of alcoholic husbands 
(Penfold, 1989). 

codependency and the 
Self-Defeating Personality Disorder 

When the revision to the DSM-in 
was underway, feminists vigorously 
objected to the inclusion of some new 
diagnostic labels. One of these was the 
Masochistic Personality Disorder, or as it 
later came to be known, Self-Defeating 
Personality Disorder (SDPD) (Franklin, 
1987). Because of the ardent protest 
against the diagnosis, it was relegated to 
an appendix of the DSM-III-R. 

SDPD's diagnostic criteria bear a 
striking resemblance to Cermak's 
criteria for the Codependent Personality 
Disorder (see pp. 11-12). Specifically, 
both diagnoses describe people who are 
self-effacing, disinterested in their own 
needs, extremely sensitive to the people 
around them, and who respond with 
guilt, anger, hurt, and manipulation 
when faced with relationship issues. 
Both appear to apply more frequently to 
women than to men. Both diagnoses 
refer in particular to those who are 
dependent on relationships which are 
unlikely to fulfil their needs. Indeed, 
DSM-III-R lists as an example of SDPD "a 
woman [who] repeatedly chooses to enter 
relationships with men who turn out to 
have Alcohol Dependence and to be 
emotionally unavailable..." (p. 372). thus 
describing the quintessential 
codependent. 

Kass, one of the authors of the 
only empirical study on the Masochistic 



Personality Disorder which predated its 
inclusion in DSM-III-R (Kass, Mackinnon, 
& Spitzer, 1986; in Caplan, 1987b), 1 
described another self-defeating 
archetype: "...the martyrish mother who 
always arranges to get the short end of 
the stick and whose manipulative, 
resentful, long-suffering manner reflects 
a P rofound lack of self-esteem ,, (Science , 
iy86, p. 328). Again, the parallels 
between SDPD and codependency are 
readily apparent. 

The feminist response to SDPD 
was largely concerned with the effects of 
the label c battered women (Franklin, 
1987). Rotewater (1987) and Walker 
(1987) note that the behavior of the 
SDPD and of battered women may be 
quite similar. Because many women are 
not immediately identified as victims of 
abuse, they believe that the DSM-m-R's 
disclaimer (i.e., that people responding 
to abuse should not be so diagnosed) is 
useless. 

The diagnosis of SDPD has the 
effect of implying that women are 
responsible for their own victimization, 
and that any problematic behaviors in 
the victim are the cause of her 
victimization, not the reaction to it 
(Rosewater, 1987). 

Many of the SDPD's critics point 
out that the diagnostic criteria mimic 
the behavior demanded by society of 
women (Walker, 1987; Caplan, 1987a,b). 
Franks (1988) notes that girls are 
generally brought up to be dependent 
and compliant; when they are adults, the 
expectations suddenly change, and they 
are expected to be independent and 
achievement-oriented. When adult 
women continue with the self-denying 
behavior which, as children, they were 
socialized to display, they are labelled as 
disordered (Caplan, 1987b). 

Codependency and Battered Women 

Different philosophies have 
brought different meaning, and hence, 
different responses, to the problems 



4 

8 



described by the terms codependent (or 
se\f-defeatei) t and battered woman. 
Although those who use these labels 
describe the behavior of their clientele 
in strikingly similar terms, their beliefs 
about the nature of these problems 
varies greatly. 

The predominant perspective on 
battered women emphasizes that the 
battering is in no way her fault, and that 
any problems she is experiencing are a 
result of the abuse, not the cause of it 
(Ieda, 1986). Her complete recovery 
from these problems will follow the 
cessation of the victimization, especially 
if she receives some form of intervention 
(Walker, 1987). 

By contrast, the codependent is 
seen as having a permanent condition 
demanding lifelong recovery (Gorski & 
Miller, 1984; Seattle, 1987), is often 
described as personality disordered 
rather than as responding to external 
realities (Young, 1987), and is viewed as 
contributing to the alcohol abuse 
(Murphy, 1984; Miller & Millman, 1989), 
How can these differences in perspective 
be resolved when the a woman is 
battered by an alcoholic husband? 

Two works which deal with 
battering and codependency bear a 
striking similarity in their approach to 
the issue. In a brief article on treatment 
issues with battered wives of alcoholics, 
tJndquist (1986) describes both 
codependency and the reaction of 
battered women as a normal response to 
a severe external stressor. 

The other work, Abused no more 
(Ackerman & Pickering, 1989), is a more 
extensive self-help guide for women 
whose husbands are abusive, alcoholic, 
or both, Ackerman 6c Pickering (1989) 
label abused women as "codependent," 
but do not describe codependency as a 
disease, a personality problem, or as a 
permanent stress reaction. Instead, 
they describe codependency as a natural 
reaction to the stress of living in either 
abusive situation. 

Ackerman & Pickering (1989) see 



both the wife of the alcoholic and the 
wife of the abuser as victims of male 
domination, The authors note, "...there 
is no such thing as a non-abusive 
alcoholic relationship" (p 87). 

Their greater sensitivity to the 
situation in which these women find 
themselves can be seen in how they deal 
with the issue of; "enabling:" 

Enabling is a delicate issue, To 
say that a victim enables is to 
blame the victim. We do not 
mean that victims contribute to 
their own victimization. Enabling 
does not lead to or cause 
victimization as much as it allows 
it to continue once it starts. 
(Ackerman & Pickering, 1989, p. 
107* 

Frank and Golden (1992) warn 
against using the label of codependent 
with battered women, which they 
defined as a personality disorder. 
However, when codependency is 
connected to emancipatory values such 
as those in the abuse treatment field, it 
can lose its permanency, its conception 
as a disease, its construction as a 
personality disorder, and much of its 
pathologizing stigma. The response to 
' codependency" has the potential to 
empower the woman by offering her 
control over her own life* 

Conclusions and Future Directions 

Codependency is a social 
construction which is molded by 
political structures, value systems, and 
historical context (cf, Gergen, 1985), 
The theory has been influenced by 
traditional assumptions about gender in 
our society. However, those who 
identify themselves as codependent 
often experience their recovery as 
liberating (e,g,, Asher, 1992), 
Codependency theory rides a razor's 
edge between emancipation and 
oppression, 



5 



9 



In my ongoing dissertation 
project, the subjective definitions and 
experiences of codependents will be 
examined, using semi-structured 
interviews and g-methodology 
(Kitzinger, 1987). Pilot interviews 
already completed have demonstrated 
that even members of the same Al-Anon 
group can have widely divergent ideas 
about codependency, corroborating an 
earlier study (Asher ft Brissett, 1988). 

Codependency is an unusual 
diagnostic entity. Its adherents and 
experts typically are not professionals, 
but those who identify the disease in 
themselves (Schaef, 1986). Yet 
codependency has been constructed with 
much the same form, substance, impact, 
applicability, and assumed validity of 
any other personality disorder. 
Codependency is likely influenced by the 
same assumptions about human nature 
and the same value systems as any 
mainstream diagnosis. 

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vodependert personality 
Disorder 2 

Continual investment of self-esteem in the ability to 

influence /control feelings and behaviour in self and others in the 

face of obvious adverse consequences 

Assumption of responsibility for meeting other* s need? .o the 
exclusion of meeting one's own needs 

Anxiety and boundary distortions in situations of intimacy and 
separation 

Enmeshment in relationships with personality disordered, drug 
dependent and impulse disordered individuals 

Exhibits (in any combination of three or more): 

-Constriction of emotions with or without dramatic outbursts 

-Depression 

-Hypervigilance 

-Compulsions 

-Anxiety 

-Excessive reliance on denial 
-Substance abuse 

-[Exposure to] recurrent physical or sexual abuse 
-Stress-related medical illnesses 

-A primary relationship with an active substance abuser for at 
least two years without seeking outside support 



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Self-defeating Personality 
Disorder 3 

A pervasive pattern of self-defeating behavior, beginning by early 
adulthood and present in a variety of contexts. The person may 
often avoid or undermine pleasurable experiences, be drawn to 
situations or relationships in which he or she will suffer, and 
prevent others from helping him or her, as indicated by at least five 
of the following: 

(1) chooses people and situations that lead to disappointment, 
failure, or mistreatment even when better options are clearly 
available 

(2) rejects or renders ineffective the attempts of others to help 
him or her 

(3) following positive personal events (e.g., new achievement), 
responds with depression, guilt, or a behavior that produces 
pain (e.g., an accident) 

(4) incites angry or rejecting responses from others and then feels 
hurt, defeated, or humiliated (e.g., makes fun of spouse in 
public, provoking an angry retort, then feels devastated) 

(5) rejects opportunities for pleasure, or is reluctant to 
acknowledge enjoying himself or herself (despite having 
adequate social skills and the capacity for pleasure) 

(6) fails to accomplish tasks crucial to his or her personal 
objectives despite demonstrated ability to do so, e.g., helps 
fellow students write papers, but is unable to write his or her 
own 

(7) is uninterested in or rejects people who consistently treat him 
or her well, e.g., is unattracted to caring sexual partners 

(8) engages in excessive self-sacrifice that is unsolicited by the 
intended recipients of the sacrifice 

The behaviors of A do not occur exclusively in response to, or in 
anticipation of, being physically, sexually, or psychologically abused 

The behaviors in A do not occur only when the person is depressed 

12 



IS 



1 .Another si !arity is SDPD's lack of adequate empirical support (Caplan, 
1987a,b, 199 Caplan eventually concluded that the warm reception 
which the Am rican Psychiatric Association gave to the SDPD, despite its 
extremely weak empirical foundation, could best be explained by the fact 
that the Association's membership is 86% male (1991). 

2. Reprinted from Cermak (1986b, pp. 16-17). 

3. Reprinted from DSM-III-R (American Psychiatric Association, 1987, pp. 
373-374). 



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