Codependency

Codependency (or codependence, co-narcissism or inverted narcissism) is a tendency to behave in overly passive or excessively caretaking ways that negatively impact one's relationships and quality of life. It also often involves putting one's needs at a lower priority than others while being excessively preoccupied with the needs of others. Codependency can occur in any type of relationship, including in families, at work, in friendships, and also in romantic, peer or community relationships. Codependency may also be characterized by denial, low self-esteem, excessive compliance, and/or control patterns. Narcissists are considered to be natural magnets for the codependent.

Development and Scope of Concept
Historically, the concept of codependence 'comes directly out of Alcoholics Anonymous, part of a dawning realization that the problem was not solely the addict, but also the family and friends who constitute a network for the alcoholic...in the 1990s'. It was subsequently broadened to cover the way 'that the codependent person is fixated on another person for approval, sustenance, and so on...Love Addicts'. As such, the concept overlaps with, but developed in the main independently from, the older psychoanalytic concept of the ' passive dependent personality...attaching him[/her]self to a stronger personality'.

Some would retain the stricter, narrower dictionary definition of codependency, which requires one person to be physically or psychologically addicted, such as to heroin, and the second person to be psychologically dependent on that behavior.

Patterns and Characteristics of Codependency
Codependency describes behavior, thoughts and feelings that go beyond normal kinds of self-sacrifice or care taking. For example parenting is a role that requires a certain amount of self-sacrifice and giving a child's needs a high priority, although a parent could nevertheless still be codependent towards their own children if the care taking or parental sacrifice reached unhealthy or destructive levels. Generally a parent who takes care of their own needs (emotional and physical) in a healthy way will be a better caretaker, whereas a codependent parent may be less effective, or may even do harm to a child.

Codependency does not refer to all caring behavior or feelings, but only those that are excessive to an unhealthy degree. Indeed, from the standpoint of Attachment theory or Object relations theory, 'to risk becoming dependent' may be for the compulsively self-reliant a psychological advance, and 'depending on a source outside oneself...successful, or tolerable, dependence' may be valorised accordingly.

Codependents Anonymous offers these patterns and characteristics as a tool to aid in self-evaluation.

Denial patterns:
 * I have difficulty identifying what I am feeling.
 * I minimize, alter or deny how I truly feel.
 * I perceive myself as completely unselfish and dedicated to the well being of others.

Low self-esteem patterns:
 * I have difficulty making decisions.
 * I judge everything I think, say or do harshly, as never "good enough."
 * I am embarrassed to receive recognition and praise or gifts.
 * I do not ask others to meet my needs or desires.
 * I value others' approval of my thinking, feelings and behavior over my own.
 * I do not perceive myself as a lovable or worthwhile person.

Compliance patterns:
 * I compromise my own values and integrity to avoid rejection or others' anger.
 * I am very sensitive to how others are feeling and feel the same.
 * I am extremely loyal, remaining in harmful situations too long.
 * I value others' opinions and feelings more than my own and am afraid to express differing opinions and feelings of my own.
 * I put aside my own interests and hobbies in order to do what others want.
 * I accept sex when I want love.

Control patterns:
 * I believe most other people are incapable of taking care of themselves.
 * I attempt to convince others of what they "should" think and how they "truly" feel.
 * I become resentful when others will not let me help them.
 * I freely offer others advice and directions without being asked.
 * I lavish gifts and favors on those I care about.
 * I use sex to gain approval and acceptance.
 * I have to be "needed" in order to have a relationship with others.

Codependency and narcissism
Narcissists, with their ability to 'get others to buy into their vision and help them make it a reality', are natural magnets for the '"co-dependent"...[with] the tendency to put others's need before your own'. Sam Vaknin considered that codependents, as 'the Watsons of this world, "provide the narcissist with an obsequious, unthreatening audience...the perfect backdrop"'. Among the reciprocally locking interactions of the pair, are the way 'the narcissist has an overpowering need to feel important and special, and the co-dependent has a strong need to help others feel that way....The narcissist overdoes self-caring and demands it from others, while the co-dependent underdoes or may even do almost no self-caring'.

In psychoanalytic terms, the narcissist 'who manifests such "omnipotent" behaviour and who seems to be especially "independent" exerts an especially fascinating effect on all...dependent persons...[who] struggle to participate in the "omnipotent" narcissist's power' : narcissist and co-dependent 'participate together in a form of an ego-defence system called projective identification'.

Rappoport identifies codependents of narcissists as "co-narcissists". : 'the codependent narcissist gives up his or her own needs to feed and fuel the needs of the other'.

Inverted narcissists
Vaknin - 'a self-help author who openly discusses his experiences as a person with narcissistic personality disorder' - has identified a special sub-class of such codependents as "inverted narcissists". 'If you live with a narcissist, have a relationship with one, are married to one, work with a narcissist etc. - it does NOT mean that you are an inverted narcissist...you must CRAVE to be in a relationship with a narcissist'.

Inverted or "covert" narcissists are people who are ' intensely attuned to others' needs, but only in so far as it relates to [their] own need to perform the requisite sacrifice ' - an 'inverted narcissist, who ensures that with compulsive care-giving, supplies of gratitude, love and attention will always be readily available...[pseudo-]saintly'. Vaknin considered that 'the inverted narcissist is a person who grew up enthralled by the narcissistic parent...the child becomes a masterful provider of Narcissistic Supply, a perfect match to the parent's personality'.

In everyday life, the inverted narcissist 'demands anonymity...uncomfortable with any attention being paid to him...[with] praise that cannot be deflected'. Recovery means the ability to recognise the self-destructive elements in one's character structure, and to 'develop strategies to minimize the harm to yourself'.

Recovery
There are various recovery paths for individuals who struggle with codependency.

For example, some may choose behavioral psychotherapy, sometimes accompanied by chemical therapy for accompanying depression.

There also exist support groups for codependency, such as Celebrate Recovery a Christian, Bible-based group, Co-Dependents Anonymous (CoDA) and Al-Anon/Alateen, Nar-Anon, and Adult Children of Alcoholics (ACoA), which are based on the twelve-step program model of Alcoholics Anonymous. Although the term codependency originated outside of twelve-step groups, it is now a common concept in many of them.

Many self-help guides have been written on the subject of codependency. One of the first was Codependent No More by Melody Beattie, published in 1987. Beattie has since written several other books on the subject. Other authors include Pia Melody (Facing Co-dependence) and Shirley Smith (Set Yourself Free).

Harmful effects of unaddressed codependency
Unresolved patterns of codependency can lead to more serious problems like alcoholism, drug addiction, eating disorders, sex addiction, and other self-destructive or self-defeating behaviors. People with codependency are also more likely to attract further abuse from aggressive individuals, more likely to stay in stressful jobs or relationships, less likely to seek medical attention when needed and are also less likely to get promotions and tend to earn less money than those without codependency patterns.

For some, the social insecurity caused by codependency can progress into full-blown social anxiety disorders like social phobia, avoidant personality disorder or painful shyness. Other stress-related disorders like panic disorder, depression or PTSD may also be present.

Controversies

 * Going from one extreme to the other. Sometimes an individual can, in attempts to recover from codependency, go from being overly passive or overly giving to being overly aggressive or excessively selfish. Many therapists maintain that finding a balance through healthy assertiveness (which leaves room for being a caring person and also engaging in healthy caring behavior), is true recovery from codependency and that becoming extremely selfish, a bully, or an otherwise conflict-addicted person, is not.
 * Victim mentality. According to this perspective, developing a permanent stance of being a victim (having a "victim mentality") would also not constitute true recovery from codependency and could be another example of going from one extreme to another. A victim mentality could also be seen as a part of one's original state of codependency (lack of empowerment causing one to feel like the 'subject' of events rather than being an empowered actor).  Someone truly recovered from codependency would feel empowered and like an author of their life and actions rather than being at the mercy of outside forces.  A victim mentality may also occur in combination with passive-aggressive control issues. From the perspective of moving beyond victim-hood, the capacity to forgive and let go (with exception of cases of very severe abuse) could also be signs of real recovery from codependency, but the willingness to endure further abuse would not.
 * Caring for an individual with a physical addiction is not necessarily synonymous with pathology. To name the caregiver as a co-alcoholic responsible for the endurance of their partner's alcoholism for example, pathologizes caring behaviour. The caregiver may only require assertiveness skills and the ability to place responsibility for the addiction on the other.
 * Not all mental health professionals agree about codependence or its standard methods of treatment. It is not listed in the DSM-IV-TR diagnostic manual.  DSM lists "Dependent Personality Disorder.  Stan Katz & Liu, in "The Codependency Conspiracy: How to Break the Recovery Habit and Take Charge of Your Life," feel that codependence is over-diagnosed, and that many people who could be helped with shorter-term treatments instead become dependent on long-term self-help programs.
 * Some believe that codependency is not a negative trait, and does not need to be treated, as it is more likely a healthy personality trait taken to excess. Codependency in nonclinical populations has some links with favorable characteristics of family functioning.
 * The language of symptoms of and treatment for codependence derive from the medical model suggesting a disease process underlies the behaviour. There is no evidence that codependence is caused by a disease process, communicable or otherwise.
 * Some frequent users of the concept codependency use the word as an alternative to use the concept dysfunctional families, without statements that classify it as a disease.
 * Not everything promoted by recovery agencies is a demonstrable scientific fact, some of it is based on fashion and faith alone.