The Codependent Addict

By Scott McCann

     While medical recognition of Codependency as its own separate disease is a little more than three decades old. The recognition of interdependence of drunkenness and kinship dates back to between 1446 and 1406 BC in the book of Genesis where Noah, drunken was sheltered by his son Ham and in anger cursed his grandson Canaan and made him a servant to his uncle Shem. 1

    "Behind Every Good Person is a Woman (Man)" is a saying that also applies to today's alcoholic or addict. Unless the chemically dependent person is a complete recluse or hermit there will always be others involved and affected by the addict's disease. These other people can be classified into three groups. 1) The spouse or significant other, 2) children, siblings and parents and 3) employers, friends, physicians and therapists. Along with the chemically dependent, these three groups create a quadrant of players all focused on the chemically dependent person.

    The spouse covers up when the addict is too sick to go to work. The children run and hide when Mom/Dad comes home drunk. The siblings distance themselves. The Grandparents take care of the children when the addict is in rehab or prison. The employer puts up with long lunches and low productivity. The "friends" support the addict's denial and the therapist tries to find the inner child while their patient is intoxicated.

    The "Big Book" of Alcoholics Anonymous which first appeared in April, 1939 recognized the existence of these other groups in chapters 7 through 10.2

    Amidst these three groups, however, may be another addicted or maladjusted person that is completely overlooked. We're talking about the Codependent. This most commonly is the spouse or significant other, but not exclusively. But three questions arise when discussing Codependency. 1) How prevalent is this condition? 2) Is it a disease of addiction? 3) Is it a disabling condition causing consequences?

    Dr. Timmen Cermak, MD, answers the first question:

"For every chemically dependent person, it's estimated that there may be as many as five to ten co-dependents"3

    The second question is more difficult to answer. This is because there is no single definition of Codependency or criterion for testing for Codependency. On the other hand, chemically dependent people can be physically tested with breath, blood or urine samples. Their pathological behavior can be observed; i.e., blackouts, drunk driving arrests, lethargic or violent conduct, physical ailments, denial and so forth. Add to this the predictable, progressive and disabling effects and you have a definition a chemically dependent addict.

    Sharon Wegscheider-Cruse, provides a definition for Codependency. She describes it as:

"a specific condition that is characterized by preoccupation and extreme dependence emotionally, socially and sometimes physically on a person or object. Eventually, this dependency on another person [or object] becomes a pathological condition that affects the co-dependent in all other relationships"4

    The key words in this definition are "pathological condition". Add to this denial by the Codependent and you start to build a disease definition.

    Dr. Cermack, provides a more clinical psychiatric corollary of the disease:

"Co-dependence is a recognizable pattern of personality traits, predictably found within most members of chemically dependent families, which are capable of creating sufficient dysfunction to warrant the diagnosis of Mixed Personality Disorder [or MPD] as outlined by in DSM III"

    Finally is it a debilitating condition causing consequences?  For this we turn to studies by Dr. Max Schneider, MD.5

    Dr. Schneider, found that when treating alcoholics for gastritis and other related physical ailments that the spouses, children and others involved with the alcoholic had similar, higher occurrences, of gastric problems. He began to study the relationship of physical and emotional ailments shared by alcoholics and others. He found a high correlation in many areas.

    Gastric problems such as gastritis, esophagitis, pancreasitis, and peptic ulcers. Eating problems such as mal-absorption / malnutrition in the alcoholic and bulimia and anorexia in the spouse, sugar imbalance in both.

    Cardiovascular problems such as hyper tension, irregular heart beat and stroke. Urinary track problems, like irritable balder, prostratis, and bed wetting by the Codependent

    Problems with sexuality, such as intimacy, performance, blocked feelings, blood flow and changes in sex organs. Nervous and emotional problems, such as anxiety, concentration, memory, sleep disorders, headaches, fatigue, impaired judgement, denial, grief and finally suicide and murder-suicide.6

    Melody Beattie in her book, Codependent No More provides an extensive list of Codependent Characteristics very similar to Dr. Schneider's list of nervous, emotional and sexual problems.7

    I believe we have developed a substantial foundation to support the concept that Codependency is a disease of addiction. The preferred "drug of choice" is another person. The euphemistic term often heard describing the Codependent's behavior is a "dry drunk". Observing their behavior, especially in advanced cases, one might ask the question; "Are they on something?" In reality, you might wish they were taking a substance, for it is easier to do an intervention on a drunk than a Codependent.

    It is now time to focus on treatment. It is not just enough to treat the chemically dependent person with a 28 day inpatient program. The spouse and others need to be evaluated and prescribed a plan of treatment. This may be participating in the addict's recovery treatment or by developing a separate therapy strategy more specific to the Codependent.

    Left untreated the Codependent develops their own set of addiction patterns, independent of the chemically dependent person. The Codependent can be just as manipulative as the drunk and without somatic chemical impairment can be more convincing. They control when and how the addict is treated. Often time they will sabotage recovery by talking the addict out of treatment or therapy. Should the addict be successful in their treatment and recovery, the Codependent is now faced with the dilemma of their own addiction. Many times the Codependent will leave the addict to find another human fix. This behavior can be seen in the recidivism of bad or abusive relationships.

    Throughout this article we have described the Codependent's drug of choice as a chemically dependent person. This person may also be a gambler, sex addict, anorexic, bulimic, overeater or have an obsessive-compulsive disorder. It may also be an animal or object(s).

    For a greater understanding of addiction, please read the series of articles by Dr. Michael Stone MD, and "Enablers", which describes the different roles others may play in the addict's recovery. Both can be found in

Diagnosing and Treating Codependence

Codependent No More 

1 Genesis 9:20 - 9:25
A little more than a decade later Al-Anon was formed. Consisting predominately of wives of alcoholics, they found that they too were adversely affected and needed a 12-Step program similar to AA.
Diagnosing and Treating co-dependence; A guide for Professionals Who Work with Chemical Dependents, Their Spouses, and Children; Hazelden Publications, 1986
4 Sharon Wegscheider-Cruse; Choicemaking Health Communications Inc., Pompano Beach, Florida, 1985
Medical Aspects of Co-Dependency video, St. John's Hospital, Orange, California, 1986
6 Some experts believe that the recent experience in the US of mothers drowning their young children in lakes and bath tubs or throwing them off bridges into the river is the result of PTSD or untreated Codependency.
7 Codependent No More, pages 42 to 52, Hazelden Publications, 1987

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