Wednesday, October 15, 2008

Family Members: Codependent or Grief Stricken?



Codependency Labels Like Codependent or Addict ~ Are they Needed?

Cottonwood de Tucson is a unique treatment approach to recovery, putting health and wellness as the central component of healing from addiction and disorders. It feels incongruent to promote people thinking about themselves as a disorder, such as when family members introduce themselves in small group situations and give themselves a title. For example, a family member may say, "My name is Cathy, I am a codependent." Titles are useful when they reflect a disorder that is chronic, progressive, and life threatening, such as the case of addiction, where using the label assists in recovery. It is not as useful when the focus of treatment is on an overused set of caring behaviors, as is the case when family members take on a label of "codependency."

The threat of loss of a relationship is a threat to one's current life balance, which creates fear and sadness. Parents, spouses, children, friends, and extended family are sources of social relationship that provide contexts within which to maintain balance. To prevent loss people engage in controlling behaviors, hyper-vigilance, and manipulation. Attempts to maintain attachment with people who are needed, or who have moved from available to unavailable, is normal. Understanding a normative reaction to loss experienced by people in social relationships is necessary: Pathologizing that reaction is harmful. In the addictions field we continue to pathologize the normative reaction to social loss with the label "codependency," putting it in the category of illness, rather than as grief work from an ambiguous loss.

The reaction to loss that is widely experienced by friends and family members of persons who are addicted to mind altering substances is profound grief. It has characteristics of flawed interactional patterns because the loss is ambiguous. If a person dies, the grief is unambiguous: the social role the deceased played is no longer occupied and the deceased cannot fulfill obligations or promises. The spouse who becomes addicted to mind altering substances often ceases to fulfill obligations or promises, but physically the social role is still occupied. "Codependency," describes a set of skills that were learned in that close relationship, become unsuccessful, and are vigorously pursued because members of the network have not yet identified and grieved their loss. To address these behaviors, fear and uncertainty need to be addressed.

Persons with emotional attachment to those who are addicted need to:

Recognize the loss of the role that the addicted person can no longer fulfill.

Grieve the loss of the original relationship.

Reorganize such that the addicted person is no longer central to the member's well being.


Identifying and grieving are the key issues in correcting "codependent" behaviors. That understanding is achieved through education, which is why the family program at Cottonwood de Tucson is so successful. Once the education has taken place, family members can:

Detach with love.

Recognize the limits of the relationship with the addicted person in their lives.

Take care of their own needs for balance and attachment in relationships where trust and balance are more available.

Learn to set limits for their own well-being.

Learn to distinguish between caring and obsession.


Codependent-type behaviors are logical responses to ambiguous and chronic attachment loss. Codependent-type behaviors are learned, and can be unlearned.

Vicki Loyer-Carlson, Ph.D., LMFT
Daniel Cook, LMSW
Ed Rusnak, MS, NCC, LISAC
Cottonwood de Tucson
4110 W. Sweetwater Drive
Tucson, AZ 85745
(800) 877-4520
www.cottonwooddetucson.com

6 comments:

  1. The connection between Codependency and Grief is an interesting one I hadn't thought of before. You mentioned this is grieving process is part of Cottonwood's Family Program. In your view, what parts of the program most facilitate this grieving?

    Thanks for the interesting Blog.

    Ryan

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  2. Your post so clearly explains what I have tried to articulate over the years as I have attended Family Programs at various treatment centers. If you are the one that suddenly finds yourself with a label of "co-dependent", this can become more of a struggle than dealing with your loved one who is no longer playing a healthy role of child, spouse, sibling, or parent. I certainly never thought for most of my adult years that I was a codependent, but suddenly I have had experts pointing out behavior that I thought of as just being a loving and caring parent as being obsessive. Some 34 years ago I went through a divorce and I used to explain to people that had my spouse died it would have been easier to cope with because there is finality to death. Labeling yourself as a widow is much easier than accepting the label of divorcee. Even in today's world the status of a widow invokes care and support, while the status of divorcee can infer some kind of failure. So, as a parent of someone in recovery, I understand my adult child will never be the same person that I knew and loved before addiction took over his life. I have grieved that loss and today I take care of myself. I am grateful for each day that I can know my child as a sober adult.

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  3. Vicki Loyer-CarlsonOctober 29, 2008 at 11:49 AM

    Hi Ryan,

    Thanks for your comment. An early task in family program is to normalize the family members' experiences through sharing in a multi-family group situation. During family member check-in open grieving is frequently stimulated by the question, "How have you been impacted by your member's behavior?" Members begin sharing their story of what they have lost in their relationship with their member. Trust, money, and safety are frequently mentioned, but also hopes, dreams, plans, and peacefulness that is no longer available in the relationship is shared and actively grieved.

    The grieving among the many families in the room begins the process of letting go of the ideal and accepting the real. This transition occurs before noon on the first day of family program. The next four days the families continue constructing their stories of what has happened, and what is happening in their lives. They identify what they have lost, and create visions of what is possible in the relationships with their members. They address their own role expectations for their members that are incompatible with what their members provide (boundary ambiguity). Structured communication helps to implement a new interactional process influenced by the new boundary clarity.

    Vicki Loyer-Carlson, Ph.D., LMFT

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  4. When I told my family members about what I was learning while at Cottonwood June/July 2006 and August/Sept they were upset at me for dragging them into "my problem" then as I started to explain I wann't blamming them I was recognizing what my role my thought process was at certin points in my life. They began to understand why I was at such a dark season in my life and that I was turning to them for understanding. I was using them to enable my addictions, blamming them and not taking responsibilty for my actions. I fell hard while hitting my bottom actually losing my wife my house and a life that was full of love and happiness that I was not able to see because of my addictions. Cottonwood gave me tools that I use to keep me focused on my recovery tools that I thought I did not need after my first stay at Cottonwood but now know, to stay alive I need to surround my self with friends and people who care about me. I need to stop taking care of everyone else and take care of my self first. I will for ever be greatful to the staff there who welcomed me with open arms and a kick when I needed it...Cottonwood is a magical place "just let the process work"

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  5. I agree with Vicki that the grieving process is stimulated on Monday morning when families connect with each other and talk about the losses they have experienced in their lives. I think another important part of this process, which Vicki alludes to, occurs when the family members have the opportunity to speak their truths and tell their family members how they have experienced the losses. By doing this, they increase their own understanding of the loss that has been felt and begin to use the new understanding to accept the relationship changes. This process is done through a structured therapeutic communication exercise (Listwork) that takes place on Wednesday and Thursday of the family program. During these exercises the family members talk about what the loss means and what they need in order to grieve those losses and move forward. The opportunity to practice using the newly learned communication skills to articulate their boundaries helps to change expectations. I believe this change in expectations helps to reduce the boundary ambiguity that has been experienced in the past. As is fundamental to family systems thinking, “the whole is greater than the sum of its parts”. At Cottonwood de Tucson it is not just one single intervention that we do during family week: all of the experiences put together result in change.


    Daniel Cook MSW,LMSW

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  6. I grew up in an alcoholic family. My father was an active alcoholic for most of my life. So it is safe and realistic to say my family was dysfunctional. Modern parlance would label my mother, myself and my brother as independent. My brother became an alcoholic, went into recovery but has not worked the program for years. I developed and was dysfunctional"labelled" with an anxiety disorder and later major depressive disorder which resulted in several hospitalizations. I have been in treatment for many years. My father has since died. Mostly, less than two months ago, my mother passed away and I am having a verycdifficult time. It seems that this loss has been really knocked me off balance more so than my fathers passing. My father I am so proud to say was sober ten prior to his death and we had had the opportunity to heal and forgive in our relationship. Needless to say however their remained many patterns behavior within the family dynamics that remained e destructive, or at least negative. It seems to me that the loss of a codepependent family member is a far greater challenge for me. I have this enormous grief and sadness but even greater fear anxiety and I feel so very unsafe. I am looking for reading material that may help. Understanding is so very important to me. My brother is no support. I would value any suggestions.

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