The Shortcomings of the Codependence Model
Since way back in the mid-1980s, the lone model for thinking about and treating spouses, parents, and other loved ones of addicts was codependency. Unfortunately, problematic since introduction and never validated by a DSM or ICD diagnosis, the codependence model, with its emphasis on trauma repetition, has tended toward the pre-judgment of caregiving loved ones, frequently feeding them counterintuitive, counterproductive messages like:
- You are an active part of the problem.
- Caring for the addict has made things worse.
- You are broken and defective and unworthy of a healthier relationship.
- You should have seen this coming.
- You don’t know how to love someone.
Thus, the codependency model and its practitioners work to convince a person who loves and cares for an addict that trying to help them is at best irrational, harmful, and a sign of their own dysfunction (trauma repetition). Thus, spouses, parents, and other loved ones of addicts are routinely accused of the following “problematic” behaviors:
- Making extreme sacrifices to satisfy the needs of a loved one.
- Struggling to say no, even when a loved one makes unreasonable requests.
- Covering or trying to manage another person’s problems.
- Sublimating personal needs to meet the needs of loved ones.
- Obsessing about and being overly focused on the wellbeing of a troubled loved one.
- Having poor boundaries.
People who behave in these ways, especially toward an addict, have for decades been labeled and pathologized as codependent (i.e., repeating their early childhood trauma), rather than being viewed as loved ones who are healthfully attached. To me, however, all loving actions taken in an attempt to remain attached to a troubled loved one should only be seen for what they are—valiant attempts to stay connected and provide meaningful help. When viewed this way, all those negatively attributed codependent traits fade away. What is left is a loving person in the midst of an interpersonal crisis (alcoholism/addiction) trying to make things better any way they can. Such people deserve nothing less than our validation and appreciation for their efforts.
I ask you:
- Who doesn’t make sacrifices for a person they love, especially if that person is struggling?
- Who doesn’t say yes to a family member asking for assistance?
- Who doesn’t try to help the family save face in difficult circumstances?
- Who wouldn’t sublimate his or her needs to help a struggling loved one?
- Who doesn’t worry obsessively when a loved one is struggling?
- Who hasn’t overstepped healthy boundaries at least occasionally in a misguided attempt to help a loved one?
Several years ago, recognizing the inherent shortcomings of the codependency model, I formulated an alternative approach to the treatment of families and loved ones of addicts—a model sourced not in trauma but in attachment theory. I call this paradigm prodependence. Rather than blaming, shaming, and pathologizing loved ones of addicts for loving too much, or not in the right way, or as a form of unconscious trauma repetition, prodependence celebrates their need to love and to caretake when appropriate. Prodependence views the act of loving and trying to help an addict or a similarly troubled individual heal (or to make it through the day without creating or experiencing disaster) as an indicator of healthy attachment (or at least the desire for healthy attachment).
With prodependence, there is no shame or blame, no sense of being wrong, no language that pathologizes the client. Instead, there is recognition for effort given, plus hope and useful instruction for healing. To treat loved ones of addicts using prodependence, we need not find that something is “wrong with them.” We can simply acknowledge the trauma and inherent dysfunction that occurs when living in close relationship with an addict, and then we can address that in the healthiest, least shaming way.
Interestingly, prodependence recommends and implements the same basic therapeutic actions as codependence—a fresh or renewed focus on self-care coupled with implementation of healthier boundaries. That said, the models approach this work from vastly different perspectives. Codependence, as a deficit-based trauma model, views loved ones of addicts as traumatized, damaged, and needing help. Prodependence, as a strength-based attachment-driven model, views loved ones of addicts as heroes for continuing to love and continuing to remain attached despite the debilitating presence of addiction.
Instead of blaming, shaming, and pathologizing the caregiving loved one of an addict, instead of telling that person that he or she is driven by trauma and needs to deal with that or nothing will change, prodependence says, “You’re a wonderful person for putting so much effort into helping your addicted loved one. It’s possible, however, that you’re not doing that as effectively as you might. And who can blame you for that? It’s hard to worry about loving someone in the best possible way when you’re in the middle of a disaster zone. If the house is burning down, you grab your loved one and drag that person out of the fire, and you don’t worry about whether you’re grabbing too hard or in a way that hurts. Now that you’re in therapy, though, we can slow things down and figure out how you can help the addict more effectively—in ways that might be more useful to the addict and that won’t cause you to feel so overwhelmed.”
In short, the prodependence model encourages therapists and clients to celebrate the natural and healthy human need to develop and maintain intimate connections and to provide ongoing, uninterrupted support to loved ones—even in the face of addiction or some other profoundly troubling life issue.
Many addicts try to get healthy and succeed. They get sober, they stay sober, and they slowly overcome the trauma and other issues that drive their addiction. Other addicts repeatedly try and fail to get sober. Sometimes they have no real interest in sobriety, even if they pretend otherwise. Either way, the outcome has very little, if anything at all, to do with the addict’s loved ones. An addict’s sobriety is not dependent on his or her loved ones. Recovery is the purview of the addict and no one else.
Still, loved ones of addicts often feel responsible for the safety, wellbeing, and recovery of the addict. Consider the words of Hayley, the wife of an alcoholic:
I was sure that if I could just do a better job with the house and kids, cook better meals, be better in bed, and convince him of my love for him, he would stop drinking. I honestly thought that if I could just be the perfect wife, he would sober up and everything would be OK, and we would finally be happy. What I didn’t understand was that drinking was his problem to fix, not mine.
If you can think of it, I probably tried it. But nothing I did worked. He just kept on drinking, and his life—our life—continued to fall apart. I found myself trying to manage and control one crisis after another while micromanaging every aspect of his life. I continued to do this even when I knew it was making me miserable. I just couldn’t stop. I was too afraid of the consequences. I worried that if I didn’t stop him from drinking, he might get another drunk driving and go to jail for many months, or he might drink and drive and kill someone and go to jail for many years, or he might drink and drive and kill himself. Then there was the fear that if I pushed him too hard to get sober, he would get angry and leave me. Still, I couldn’t stop yelling and screaming and manipulating and fixing and doing all sorts of other things to control the addiction. Eventually, I was so busy trying to manage his life that I wasn’t living my own.
Hayley’s desire to bond with and care for her husband, coupled with her anxiety about being alone and unloved, caused her to try to control aspects of her husband’s life that were not hers to control. She meant well, but she tried to do too much. Her lack of boundaries and attempts to manage her husband and his alcoholism were a far cry from the healthy, prodependent interaction that he (and she) needed. In time, her “protection” became a prison in which she and her husband were confined.
Hayley, rather obviously, needed help with healthier boundaries. However, like many loved ones of addicts, she didn’t understand that many of her efforts to care for her husband were counterproductive. She did not understand that by enmeshing, enabling, and trying to control, she took away her husband’s sense of responsibility, along with his ability to make decisions and solve problems, learn from his mistakes, grow as a person, and achieve sobriety, recovery, and healing.
Rather than point this out to Hayley, perhaps diagnosing her as a classic codependent, I complimented her on her fortitude and for sticking with her husband even in the face of addiction. Then we talked about how tiring and emotionally draining this was for her. Eventually, I suggested that there might be some better, more effective, and less draining ways for her to care for her husband, letting her know that would likely involve setting some boundaries.
To this, Hayley responded as many loved ones of addicts do, saying, “I’ve done that. I’ve set boundaries and he’s broken them. Over and over. It doesn’t work. He won’t change his behavior just because I set a boundary.”
I smiled at Hayley’s response. Loved ones of addicts often seem to think that setting boundaries is about putting limits on the addict’s behavior. And inevitably they’ve learned, as does anyone who has tried to control the behavior of another person, that this does not work. At all. Because other people don’t want to be controlled by us any more than we want to be controlled by them.
This means that a caregiver’s boundaries should focus on his or her own behavior, not the addict’s. I explained this boundary basic to Hayley using my two favorite analogies for boundaries. The first analogy is that healthy boundaries are about staying in our own hula hoop, meaning the only things we can control or that we should try to control are the items within our immediate space—the things that fit within our hula hoop. The second analogy is that we must sometimes look at a situation that’s out of control and say, “Not my circus, not my monkeys.” If a problem is not of our making, then it’s probably not ours to control or fix, and we should step back from it.
I also explained to Hayley that the purpose of healthy boundaries is to facilitate healthy relationships, not to shut relationships down. Healthy boundaries are not about keeping other people out, they’re about letting other people safely in. If other people are behaving in ways that are safe for us, we can choose to let them in. If they are behaving in ways that are not safe for us, we can choose to keep them out. Their behavior belongs to them; our choice belongs to us.
Lastly, I let Hayley know that when properly implemented, healthy boundaries prevent enabling, enmeshment, and unwarranted attempts at control. In this way, boundaries protect caregivers from bad behavior by the addict, and, just as importantly, they protect the addict from bad behavior by the caregiver. In time, with healthy boundaries, a caregiver and an addict can establish and maintain healthy interdependence (i.e., prodependence) in their relationship.
That said, boundaries are not a one size fits all proposition. Boundaries that are helpful in some relationships could be very unhelpful in others. Recognizing this, I generally ask loved ones of addicts, such as Hayley, to answer the following questions before attempting to define and implement healthy boundaries.
- How deeply mired in addiction is your loved one? Does the addiction completely control the addict’s life and thought process, or can the addict still (at least occasionally) make intelligent, rational, well-reasoned decisions?
- Would pulling back and letting the addict face the consequences of the addiction be helpful in terms of motivating his or her recovery?
- What would those consequences likely be? Are those consequences something that you and the rest of the family can live with?
- What aspect of the addiction frightens you most? What aspect of the addiction do you most want (and try) to control? Is this a fear that you can rationally and legitimately release?
As you can see from these questions, sometimes pulling back on control is the right thing to do. Other times, it might not be. And sometimes the difference between the two is not entirely clear. That is the difficulty faced by loved ones of addicts, and sometimes the process of finding what works and what doesn’t is a matter of trial and error. Moreover, what works and what doesn’t work may change over time as the addict starts to recover and become more accountable.
As a therapist, my job is to facilitate the process of setting and maintaining prodependent boundaries while keeping the client motivated, hopeful, and on-task. No matter how frustrated I may at times get with a client’s seeming inability to implement healthy boundaries, I need to remember that telling the caregiving loved one of an addict to “just stop enabling and controlling” is approximately as useful as telling an addict to “just stop using.” So, not at all. A better, more prodependent approach is to help the caregiver build healthy interdependence and connection with the addict over time by establishing boundaries that are healthy and workable for that person in that relationship at that time. No more, no less.
For more information about prodependence in general and prodependent boundaries in particular, visit my website, Prodependence.com, or check out my recently published book, Prodependence: Moving Beyond Codependency.