Why change things? What was wrong with codependence?
A: I wrote this book because I have seen too many addicts’ loved ones turn away from desperately needed direction and support because they couldn’t or wouldn’t accept the codependence tenet that being in this situation automatically implies there is something wrong with them. Meanwhile, their chronically addicted partner, parent, or child is failing at school, getting fired from another job, or getting arrested. I have seen many good therapists lacking useful answers to help such family members and caregivers. Often, the therapist’s only choice is to rely on models such as codependence, which feels more negative and alienating than invitational. Now, with prodependence, they have another option. Prodependence recognizes the inherent grace of these caregivers, applauding and appreciating their unconditional love, their courage, and their conviction in trying to support some of the most challenged among us.
What is the major difference between codependence and prodependence?
A: Codependence is a model of human behavior based in trauma theory. To “be codependent” implies that one tends to bond deeply with those with whom interactions often mirror early traumatic deficits. Failure on the part of the active addict then serves as a trigger for the non-addicted partner to act out his or her unmet needs or abuse from childhood within this troubled adult relationship. Codependence implies that the loved ones of addicts, due to their underlying, often unconscious “childhood issues” tend to, as adults, give too much and love too much. Thus, they attract, enable, and enmesh with addicted partners. The goals of codependency treatment revolve around themes of detachment, self-actualization, becoming less needy, and working through past trauma to become more aware, less enabling, and less accepting of troubled, emotionally unavailable people. Prodependence is a model of human behavior based in attachment theory. To “be prodependent” implies that one is able to create deep, bonded adult attachments that mirror our very human, normative longings for healthy dependence and intimacy. Prodependence assumes that, when one loves and bonds deeply, it is natural and therefore non-pathological to do whatever it takes to ensure the safety and stability of those with whom one is attached. Prodependence implies that loved ones of addicts, regardless of prior history, will take extraordinary measures to keep those they love stable and to ensure the safety of their families. There is no pathology assigned to loving in prodependence. Rather, prodependence asserts that loving addicts or other chronically troubled people healthfully requires a different form of love than that with healthy adults. Loving prodependently requires support, guidance, and informed help.
When did codependence evolve into theory and practice?
A: Codependence was initially promoted in six books published between 1981 and 1989, mostly written by female therapists who worked in the addiction field. It meshed with and ultimately subsumed the pre-existing co-addiction movement. And later it broadened in the larger culture to include caregivers of all stripes, not just caregivers of addicts.
Why did codependence become so popular?
A: Codependence was an easy to understand, engaging concept, and it mirrored the culture of the era of its creation. This is explained in detail in chapters 2 and 3 of this book.
Can codependence treatment be counterproductive when working with loved ones of addicts?
A: Yes, and it frequently is. Codependence, by definition, implies that there is something wrong with the person who loves, rescues, helps, and cares for an addict. This is especially true if that person has given up essential parts of himself or herself in the process. Embracing the codependence model requires loved ones of addicts, who are already in crisis, to accept that there is something wrong with them that they need to fix. This can lead to caregivers feeling misunderstood and judged. As a result, many leave treatment before they receive the help they desperately need.
Is this book suggesting that codependency doesn’t exist?
A: Yes. Prodependence, as a concept and in practice, does not support the concept of codependence. Prodependence sees codependence as a theory that does not fully encompass the lived experience of addicts’ loved ones, nor take into account the needs of the situations they face with an active addict. Execution of the codependence model in treatment tends to alienate the people it was designed to help, as it leaves them feeling more judged than supported. Additionally, the theory of codependence has never been formalized as a clinical diagnosis. In fact, it was proposed and rejected by the American Psychiatric Association.
How does prodependence view the problem behaviors acted out by an addict’s loved ones, such as enabling, overzealously caretaking, and even raging at the addict?
A: Prodependence views all such activity as the caregiver’s “best attempt” to save a troubled loved one. It sees these behaviors as loving—though often less than ideal—efforts to save a person they care for. These behaviors are viewed as problematic only due to their ineffectiveness and potential to escalate the problems they were intended to solve. However, prodependence does not label or judge the loved one who engages in such behaviors. Instead, prodependence views these actions as a loved one’s best effort to stay connected and help in a situation that is far beyond his or her ability to remedy.
How does prodependence tackle typical challenges to treating loved ones of addicts, including emotional reactivity and enabling?
A: Prodependence considers the fact that loved ones usually lack the specialized training or education that would equip them to work with an out-of-control, addicted person. It also recognizes the immense pain and fear that comes along with witnessing a beloved family member fail. These individuals often compensate for their lack of expertise with passionate attempts to help their loved one, but, because of the lack of proper training, their efforts are often not useful and can at times be counterproductive. In prodependence, the therapist does not pathologize family members’ attempts to heal someone they love. They are not regarded as anything but loving, even when their attempts fail. The goal is to support family members by validating their love while simultaneously developing skills that help to make their loving more effective and useful. These skills include, but are not limited to, setting boundaries, caring for oneself, and, when useful, detachment.
Does prodependence say that there is nothing wrong with the loved ones of an addict, even when they exhibit problematic traits?
A: Prodependence implies that such loved ones of addicts are caught up in circumstances, such as witnessing the emotional decline of a beloved family member, that would naturally overwhelm anyone. Thus, there is nothing “wrong” with them, in terms of relating to the addict, regardless of their personal history. They are trying as best they can to survive and to help their family to survive extraordinary, overwhelming circumstances. What these caregivers require from early treatment is validation for the love and care they have given, in addition to supportive and clear directions about loving their troubled family member in healthier ways. That said, loved ones of addicts may in fact have underlying trauma and other issues that they might eventually want to address. (See the next three questions for more on this topic.)
What about trauma? Don’t many spouses of addicts have early childhood trauma?
A: Yes, many spouses of addicts, much like addicts themselves, have had early or later-life traumatic experiences. In fact, these similar histories, both conscious and unconscious, are frequently part of what has bonded these people to one another. And some partners may act out elements of past trauma in the acute stages of the addict’s problems. This is unsurprising, considering the extremely stressful and overwhelming circumstances addictions produce. That said, many spouses of addicts and alcoholics lack any traumatic history of their own. Either way, initial therapy and treatment for partners of addicts, utilizing the prodependence model, does not seek to investigate such issues. Instead, the intention is to address the problems that these partners are currently attempting to solve.
How does prodependence view and treat past trauma in partners of addicts?
A: Prodependence sees an addict’s partner as being in crisis when beginning treatment. Therefore, all treatment is intended to help this individual resolve his or her immediate crisis. After the crisis has been addressed, the client is encouraged to examine his or her personal history with the therapist, should he or she display an interest. However, prodependence does not bind the reactions of someone living with an active addict to his or her past. Asking a partner to address trauma—or even to examine his or her own history—early in the recovery process can actually be abusive, as doing so implies an innate fault with the caregiver. Thus, early in the partner’s treatment this is not a priority.
What happens when a partner of an alcoholic or addict appears so emotionally disabled that he or she is actively interfering with the process of healing the addiction?
A: If the partner is unable to be soothed, supported, or redirected in early addiction treatment, this simply implies that he or she needs care that is separate and apart from his or her relationship with the addict. These are often familiar and diagnosable conditions—exhibited as a result of living under profound stress—such as depression, anxiety, or the triggering of traumatic events in the partner’s past. As these individuals heal, their treatment can then be integrated into overall addiction family care.
What about the apparent need of “codependent” people, in general, to self-actualize and grow, independent of their relationships and bonds?
A: Prodependence, coming from an attachment-based perspective, says that all of us are deeply dependent on one another for emotional survival and, further, that this is a good thing. Mutual, deep, and enduring dependencies from womb to tomb is how humans survive and thrive; as such, relationships should never be regarded as inherently pathological. Prodependence celebrates rather than pathologizes deep emotional dependency. It regards healthy, deeply bonded relationships of all kinds as key to an individual’s self-actualization. Enmeshment is viewed merely as an inadequate attempt at loving. An individual practicing enmeshment requires new skills to improve his or her relationships.
What about those who are so needy and desperate in close relationships that they become unable to function without one? Aren’t they deeply codependent?
A: For several decades, the Diagnostic and Statistical Manual of Mental Disorders (the DSM) has had a fully fleshed out, criteria-based diagnosis for people who are so emotionally limited and impaired that they “cling” to other people for their own emotional stability. It’s called Dependent Personality Disorder. Sadly, DPD and codependence are often conflated.
What kind of treatment should be offered to loved ones of addicts? Don’t they still need help with boundaries, self-care, and managing their situations?
A: Any loving person in a meaningful relationship with an active addict is, by definition, in need of support. He or she likely needs encouragement toward both greater self-care and establishing healthy boundaries with their troubled loved one. However, no loving person in a meaningful relationship with an active addict should be asked to doubt the nature of his or her love, or to question his or her own emotional stability, in order to be taught such skills and to be given the support that he or she deserves.
What do you say to the millions of people who have embraced the concept of codependence? Where does prodependence leave these individuals?
A: Taking the path of self-exploration and personal growth is a positive thing that strengthens individuals and society. I am certain that many of those who have embraced codependence have become better people for having done so; that is to be applauded. I would simply ask such individuals to reconsider the concept of “loving too much,” as I think the phrase is demeaning. For example, you may love in the wrong ways for the wrong reasons. You may love in ways that don’t achieve the result you seek. You may love and lose. You may love and hurt. However, you can never feel too much love, express too much compassion, or exhibit too much empathy. Claiming this is possible is counterintuitive to the realities of healthy human attachment and bonding. I also think it worth noting that a deepened intimacy with our partners and family members allows us to achieve a higher form self-actualization than is otherwise possible.