A Critical Analysis of the Concept of Codependency

Until relatively recently, "codependency" was a term used in the chemical dependency field to describe the "enabling" behavior of the partner of an alcoholic. The concept has now been extended to all kinds of families, and the term "addiction" is applied to everything from relationships to overspending. As noted by Wetzel (1991), "The phenomenon has swept the country in cultlike fashion.... It seems that the addiction industry is an addiction itself, one to which even feminists have not been immune". Although it is clear that many people have been helped by their involvement in the codependency movement, the concept itself raises broader social questions and needs to be critically evaluated. According to some, the concept of codependence, although seductive, may he dangerous (Brown, 1990). This article critiques the concept of codependency by addressing the problems associated with conceptualizing interpersonal behaviors as addictions. It discusses the validity of the diagnosis of codependency, the pathologizing of characteristics associated with women, generalizations about alcoholic families that focus on pathology, and the tendency of the codependency movement to encourage separation from rather than connection with the family of origin. Definition of Codependency Codependency is described by enthusiastic adherents as a primary disease present in every member of an addictive family, often worse than the disease itself, with its own physical manifestations. It is viewed as a treatable diagnostic entity (Gierymski & Williams, 1986). Although men can theoretically be codependent, the literature refers almost exclusively to women as having the disease. Schaef (1986) maintained that the disease has an onset, a definable course, and a predictable outcome. The origins of the disease are thought to be found in early childhood, at which time such people learn a tendency to enter into addictive relationships. Some have stated emphatically that codependency qualifies as a personality disorder under Axis lI of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition--Revised (DSM-III-R) (American Psychiatric Association, 1987), noting that dependent personality disorder describes many prominent features of codependency (Cermak, 1984; Kitchens, 1991). Critique of the Concept of Codependency The trend to medicalize codependency has consisted of defining it as a disease, developing a list of criteria for diagnosis, and providing expensive treatment for the disease (van Wormer, 1989). This labeling of a wide variety of behaviors as addictions is known as the "diseasing of America." Application of the Disease Model to Interpersonal Problems The extension of the disease concept of addiction to interpersonal behaviors is troubling. In "process addictions," in which no chemical substance is involved, the addictire phenomenon is supposedly an interpersonal process that mimics drugs in its effects on people (Brown, 1990). As described by Brown, the "process-addicted" person experiences a craving, is willing to incur losses to obtain the object, gets high on the process, and suffers withdrawal symptoms on separation from the object. Asher and Brissett (1988) suggested that "the process of becoming codependent is the result of a convolution of the illness metaphor and labeling process", which involves defining the person's behavior as deviant by self and others and medicalizing the alleged deviance. According to Gus Napier, a noted family therapist, it is "ridiculous" to label codependency as a disease, because it is a culturally conditioned response of an overfunctioning person in relationship with an underfunctioning person (Meacham, 1990-1991). More severe critics point out that applying the disease model to interpersonal problems trivializes the truly addictive behaviors associated with chemical dependency (Waiters, 1990). Brown (1990) noted that extending the concept of addiction to experiences that are painful, but not life-threatening, demeans the experiences of those who are dependent on alcohol and other drugs. …