At Rehab 4 Addiction we agree that co-dependency is an addiction like any other. In fact, the scientific community has recognised co-dependency as a mental illness for more than forty years.
The DSM manual describes co-dependency as a ‘dependent personality disorder’ (DPD). Other notable DPDs include gambling addiction, sex addiction and love addiction.
While co-dependency has been hard to pin down clinically, experts have agreed that it is an excessive psychological or emotional reliance on another individual.
However, co-dependency is often encountered alongside other terms, such as interdependency: making it hard to distinguish between the two.
To distinguish co-dependency and co-dependency treatment from other psychological issues, it’s important to note key elements of the condition. Researchers have earmarked these as:
As the above symptoms indicate, co-dependent individuals with show so much devotion to the relationship they’re in, that it outweighs their psychological, emotional, and individual needs.
In a relationship marked by co-dependency, toxic behaviours such as low self-esteem, self-deprecation, people-pleasing, and high anxiety will begin to show.
This immediately contrasts with interdependency: a very different dynamic between individuals in romantic or familial relationships. Interdependent relationships consist of individuals with their autonomy and sense of self intact: nurturing the relationship without feeling the need for self-sacrifice and doing everything for the other person.
As a result, interdependent partnerships will feel secure and stable, while co-dependent relationships will feel fraught with anxiety and insecurity.
This is because, in the former situation, individuals will want to be with each other, rather than constructing a situation wherein they need each other.
As with other addictive behaviours and mental health disorders, it’s crucial to receive a formal, professional diagnosis before seeking appropriate co-dependency treatment.
However, if you’ve already searched for ways to identify or diagnose co-dependent behaviours, you may have hit a virtual brick wall regarding diagnostic tools.
In the 1980s, psychiatrists argued that the authoritative Diagnostic and Statistical Manual of Mental Disorders (DSM), should define co-dependency in its next addition.
They posited that the organisation should do this by borrowing diagnostic criteria from other, recognised conditions.
These included:
Unfortunately, instead of including co-dependency as a personality disorder, the DSM-5 rejected the argument to include it in the manual. As of today, the manual only refers to Dependent Personality Disorder and has not given co-dependency its diagnostic criteria.
However, it’s also important to note that co-dependency can be distinguished from DPD. This is because while co-dependent individuals depend on a specific person in their life, those with DPD are dependent on others in general rather than one person.
While not officially recognised in diagnostic guidelines, Co-dependency is a debilitating psychological condition nonetheless: affecting countless lives across the world. It also has a serious set of behavioural, emotional, and even physical symptoms that are important to note.
When an individual notices that their sense of worth and identity is intrinsically tied to their significant other, they may be in a co-dependent romantic relationship.
This form of partnership is characterised by dysfunctional need: wherein the co-dependent individual has an unhealthy need to be needed, and the other, also known as the enabler, comes to excessively rely on their partner.
One common example of how co-dependency plays out in romantic relationships is when substance use is involved.
For instance, a woman is in a long-term romantic relationship with a man who has Alcohol Use Disorder. By showing him unwavering affection and putting her needs before her own, she thinks she can help him achieve sobriety.
However, by giving her partner everything he requests to the point of self-sacrifice, she is engaging in enabling behaviours and unknowingly veiling his problematic behaviour.
Despite this, she’ll do anything it takes to make the relationship work at the ruin of her own mental and even physical health.
Unfortunately, co-dependency is a condition that can fester between parents and children. Such behaviours often manifest when children are taught to repress their emotions, causing dysfunctional family patterns to perpetuate.
Co-dependent parental figures often failed to have their needs met during their childhood: creating a distorted, confused sense of selfhood. Unfortunately, they’ll likely carry this unresolved trauma into adulthood and display an unhealthy attachment to their child.
Because their childhoods were also dysfunctional, co-dependent parents often view the close, controlling relationship they have with their children as completely normal. This creates a toxic cycle of behaviour whereby the child experiences unhealthy relationships when they enter adulthood.
Such situations can be exacerbated when the co-dependent parent or guardian has a co-occurring mental or physical illness.
For example, a university graduate has just received an offer to start his ideal career in another part of the UK; however, due to his mother’s psychiatric illness, he decides to take care of her by staying at home.
The son would ideally like to put his own needs and career first but opts for a small local job outside of his chosen career path so that he won’t have to risk telling his mother that he’s leaving.
This situation is one in need of comprehensive co-dependency treatment.
While these behavioural issues can manifest outside of substance abuse, it isn’t uncommon for those who require co-dependency treatment to have a close relationship with an addiction sufferer. It’s also important to note that co-dependency was originally identified by family members of those struggling with alcohol use disorder.
However, while many people assume co-dependency and addiction occur in romantic partnerships, it manifests in many types of relationships.
Co-dependent individuals can be the close adult family members or significant others of individuals using drugs, romantic pairings where both parties are addicted, and children of people who are abusing a substance.
Regarding the latter situation, often the children of people who are addicted to alcohol and/or drugs become codependent.
This is particularly apparent in cases of a severe substance use disorder, where the child feels the need to take on a caretaker role to protect their chronically ill parent.
In romantic relationships, particularly when an individual is in a codependent relationship with an AUD victim, both individuals may experience multiple negative effects as a result of the situation.
For example, an otherwise healthy individual could risk developing a substance or behavioural addiction, or risk losing relationships outside of their co-dependent situation.
However, perhaps the most commonly diagnosed instance of co-dependency interacting with addiction is when someone takes on the role of the “caretaker” in their family.
The caretaker will absorb the SUD victim’s issues, thereby becoming an enabler and offering ways to mask their behaviour rather than confronting the problem via formal co-dependency treatment.
Oftentimes, co-dependent behaviours result from a historically dysfunctional family unit, where one or more individuals are demonstrating symptoms of this condition.
Therefore, co-dependency is often associated with environmental factors: making it beneficial for those suffering from co-dependency to remove themselves from triggering environments and enter residential treatment.
Residential co-dependency treatment, otherwise known as inpatient treatment, describes a situation wherein patients live temporarily at a rehabilitation clinic.
Rather than sleep at home and attend therapy in their own time, patients will check into their comfortable accommodation, receive three meals a day, and undergo all their treatment on-site.
This comprehensive recovery environment suits a variety of more severe co-dependency cases where the sufferer would benefit from being away from their loved ones to temporarily focus on themselves.
Residential care is also optimal for those with a history of substance abuse, co-occurring mental health disorders, or an unstable home environment that could negatively impact their recovery.
During their inpatient co-dependency treatment plan, patients will create and follow a daily routine to help them regain a sense of self.
This means that any elements of their co-dependent relationship can be put to the back of their mind: allowing time for practising self-care, and undertaking bespoke therapies.
A typical daily schedule for a patient in residential codependency treatment includes a range of therapy: including individual sessions, behavioural therapy, group workshops, and time for recreational or holistic activities.
Patients will also receive a range of additional support during their stay: including classes on nutrition and self-care, alongside access to a range of world-class facilities.
However, for individuals looking to enter inpatient co-dependency treatment, it’s vital to take note of the potential cost. In the UK, patients requiring residential treatment must often go private: a venture that can cost thousands depending on how long they must rehabilitate.
Fortunately, various affordable clinics and rebab centres for behavioural addictions such as co-dependency exist in the UK. To start your unique recovery journey via inpatient co-dependency treatment, simply reach out to our team here at Rehab 4 Addiction.
Whether it be financial worries or concerns over being able to maintain their daily responsibilities, inpatient care isn’t always an option for everyone. Instead, individuals seeking recovery can opt for outpatient co-dependency treatment: a method allowing patients to live at home and attend pre-arranged therapy sessions in their spare time.
Before starting their recovery programme, individuals will meet with a consultant psychiatrist, either at an NHS-run department, or a private rehabilitation clinic.
They’ll assess the severity of their co-dependency condition and design a bespoke course of therapy. This often includes behavioural interventions alongside community-based group support sessions.
In addition to the flexibility, individuals have within their treatment programmes, outpatient care has various other benefits. Of these, the main advantage for many individuals is that services are free at the point of contact via the NHS.
This makes co-dependency treatment a viable option for those without the financial means to fund private rehab.
However, co-dependent individuals who have the option to return home via their outpatient programmes might find it detrimental to their recovery.
Their home environment might be rife with relapse triggers: such as people or situations that spur on their co-dependent behaviours. As such, individuals need to consult a professional before committing to one style of co-dependency treatment.
Whether they’re starting treatment on an outpatient or residential basis, co-dependent patients will need to undertake therapy to try and identify the reasons behind their condition.
Through a combination of behavioural interventions and continued counselling, most individuals can learn to regain their lost sense of self, regain their independence, and become less co-dependent.
A person can learn to become less co-dependent and regain a sense of self and independence in their own lives. Oftentimes, professionals will suggest working with a therapist long-term as co-dependent behaviours are often cultivated over several years.
Alongside practising and applying healthier behaviours, therapists can help individuals address family-centric or childhood issues that caused co-dependent techniques to form.
In many cases of co-dependency, damaging behavioural cycles have their origin in or are exacerbated by, the family unit. For the co-dependent individual to achieve recovery, their family, friends, and loved ones also need to change their behaviours and heal in their way: which is where FBT becomes an indispensable tool.
FBT sessions have the power to teach family members healthier interaction techniques and interrupt dysfunctional patterns of communication present at the time of treatment. By tackling issues such as this, FBT workshops reduce the impact that co-dependent behaviours have on extended family, children, and parents.
Such techniques are facilitated by experienced therapists working through rehabilitation clinics or specialised family therapy programmes.
They can assist each family in tackling the root causes of their co-dependent behaviours, build ways of supporting one another, and curb enabling behaviours through developing positive coping mechanisms.
At the end of their FBT programme, which can be weeks or months in length, the aim is for the family to have learnt new ways of supporting one another. In the case of co-dependency and addiction, this can mean the family has learnt to detach themselves from a loved one’s addiction.
For everyone involved, a healed familial unit helps break the damaging co-dependency cycle and reduces the risk of behavioural relapse.
Family Behavioural Therapy is an umbrella term for a wide variety of family-centric psychotherapies: many of which are used to treat co-dependency issues.
After evaluating the unique problems and needs faced by a particular family, FBT therapists will assign one of the following techniques:
While focusing on a different type of relationship, Couples therapy is essentially a more focused form of FBT. It emphasizes individuals in intimate partnerships that have become co-dependent or those in co-dependent marriages.
This form of psychotherapy aims to interrogate and heal any parts of an intimate relationship that have become co-dependent while equipping both parties with the tools to regain their sense of identity.
As such, for co-dependence therapy to work, both individuals must engage in the therapeutic process: including completing any homework assigned to them.
There are also varying therapeutic timelines for patients to choose from. While short-term couples therapy may be for between one and three sessions, long-term couples therapy may occur for between 12 and 24 sessions.
Oftentimes, longer programmes are optimal for those who have been in a relationship for many years, and who have unresolved past trauma informing their co-dependency issues.
During sessions, therapists utilise many strategies, some borrowed from different forms of counselling, to help couples resolve their co-dependency issues. Some of these include:
When people think of therapy for mental health illnesses, they often picture a scene that has become synonymous with CBT: one of a patient sitting on a couch and describing their past trauma.
In reality, there’s a lot more that goes into Cognitive Behavioural Therapy and utilising its techniques to treat co-dependency.
CBT treatment aims to, in a personalised way, teach the co-dependent individual how to recognise personal problems and separate them from another person/other people.
Throughout a CBT programme, typically several weeks in length, patients will recognise and change co-dependent thought patterns, beliefs, and behaviours.
Part of the reason for CBT’s success in treating this issue is that many co-dependent individuals have cognitive distortions (negative or irrational thought patterns) fuelling their condition. Behavioural therapies such as CBT help co-dependent individuals recognize these cognitive distortions and replace them with more helpful, realistic ways of thinking and viewing themselves.
For example, a co-dependent individual is prone to the belief that having any self-interest is inherently selfish.
As such, they’ll feel immense shame or guilt when they experience the normal urge to partake in self-care: causing them to fixate on the needs of a partner, parent, or child.
To help co-dependency victims view themselves and others more healthily, CBT therapists utilise some strategies, some of which include the following:
Those participating in group therapy sessions for co-dependency are offered a safe space in which to express their feelings. In groups of between 6-12 people, patients get the opportunity to discuss their co-dependent experiences with those who understand more than anyone.
Under the guidance of a licensed therapist, those undergoing co-dependency treatment come together to discuss common issues, provide and receive support, and learn new coping skills from others.
Depending on the treatment setting, group therapy can take place weekly, bi-weekly, or every day in a residential rehab environment. Sessions usually run for 1-2 hours.
When recovering from co-dependent behaviours, there are myriad long-term benefits of receiving group support therapy. Firstly, attending workshops will reduce the feelings of isolation that often develop in those suffering from co-dependency and conditions such as anxiety.
Sessions provide a sense of community and allow patients to cultivate long-lasting friendships with their peers.
Moreover, group support therapy provides a safe space for free social interaction under the close guidance of a therapist. They can help facilitate conversations and participation, which is particularly important for those who have trouble interacting with others, or who suffer from social anxiety alongside co-dependency.
The presence of a therapist also encourages individuals to open up about experiences that they might otherwise be too afraid or nervous to talk about: thereby aiding the recovery process.
By being more open to sharing their experiences, patients may illuminate the underlying issues that inform their co-dependency: free from the pressures of a one-to-one therapy session.
Finally, group support therapy often involves giving positive feedback and holding individuals accountable for their previous actions. This can help motivate them to change and stay in co-dependency treatment.
Alternative Therapies are a cornerstone of co-dependency treatment, as they allow for the formation of new hobbies, creative interests, and ways to relax.
Co-dependency causes its victims to lose their sense of self and sacrifice any hobbies or interests they once had to serve the needs of others. As such, therapies that encourage patients to carve a new identity are welcome additions to recovery programmes.
Alternative Therapies differ from traditional psychotherapies in that their focus is not on cognitive re-framing, but on improving an individual’s well-being. Patients can achieve this by looking after their physical, emotional, and spiritual health as a cohesive whole, rather than focusing on one group of co-dependency symptoms.
Alternative Therapies are integrated into recovery programmes using many different approaches. Some of these include:
Offering online and phone meetings alongside traditional in-person workshops, Co-dependents Anonymous (CoDA) is a 12-step recovery programme aiming to help individuals recover from co-dependency issues.
The common purpose among those in the fellowship is to cultivate healthy relationships, with members becoming “increasingly honest with ourselves about our personal histories and our codependent behaviours.”
Individuals who are interested in joining their local fellowship group can find their nearest meeting point using the CoDA Meeting Locator, after which it is suggested they call the contact person to confirm the location, date, and time of the meeting.
Sessions usually include five and twenty-five people, last one hour or a half hours, and follow a specific format.
In their quest to facilitate recovery from co-dependency, CoDA meetings utilise a 12-step programme: using the guiding treatment principles originally started by Alcoholics Anonymous.
The 12 steps allow individuals to start removing co-dependent behaviours from their everyday life and replace them with a sense of meaning and purpose.
By following the 12-step model, individuals can build the following emotional and mental practices as part of their co-dependency treatment:
In an ideal world, co-dependency treatment would occur in an inpatient rehabilitation centre away from problematic environments.
However, each situation is different, and some co-dependent individuals cannot take the time out of their schedules, or simply do not have the funds to undertake residential care.
Fortunately, there are steps co-dependent individuals can take on their own to overcome their negative cycles of behaviour.
Following the “Four A’s” for co-dependency treatment and recovery is an optimal starting place for both the co-dependent individual and their loved ones.
The steps are as follows:
1. Abstinence. This first point refers specifically to co-dependent relationships wherein one or both parties are engaging in self-destructive substance misuse. In these situations, recovery can only be achieved when the individuals stay sober and cease their drug and/or alcohol consumption.
2. Awareness. For lasting recovery to happen, effective co-dependency treatment starts with awareness. By acknowledging that they are in a co-dependent relationship and becoming aware of the problem, sufferers can begin to make important and lasting changes.
3. Acceptance. Accepting the reality of a situation may be hard, but it is the only way to achieve recovery. When co-dependent individuals accept that their current behaviours cause them unhappiness, they can understand the changes that must occur for them to lead a happier, more fulfilling life.
4. Action. While an important part of co-dependency treatment, the above points can only take an individual so far in their recovery. To make lasting changes, action must be taken: including decreasing behaviours that enable addiction, increasing behaviours that support a healthy relationship, and improving overall communication.
While many co-dependent individuals willingly enter treatment for their condition, just as many people deny the pleas made by their loved ones to accept help.
They might refuse to believe that they are in a co-dependent relationship, or fear that entering treatment would be too emotionally taxing.
It’s in these cases that arranging an intervention is beneficial for everyone involved. Interventions are powerful tools in convincing suffering individuals to seek co-dependency treatment.
While families cannot enter someone into treatment against their will, they can implement an intervention to sympathetically convince them otherwise.
Rather than confronting the co-dependent individual, friends and family can express their concerns and how they care deeply about the individual’s welfare. These discussions should be conducted in a safe, non-judgmental environment such as a private clinic or doctor’s office.
After expressing their thoughts and concerns about their loved one’s co-dependent behaviours, they are encouraged to provide specific examples of how co-dependency is affecting not just the individual, but everyone in their orbit.
After being presented with these examples, it is hoped that the co-dependent person will cease denying that they need help, and realise that they must access treatment.
Furthermore, concerned family members seeking to host an intervention are encouraged to seek a licensed professional. Utilising the support of an interventionist maximises productivity during meetings and increases the chances of an individual accepting co-dependency treatment plans.
They’ll do this by creating an Intervention Team, helping the family to formulate a plan, educating participants about co-dependency treatment and behaviours, and helping friends and family members establish healthy boundaries.
A co-dependency disorder means the sufferer cannot experience a truly loving and caring relationship with another. Co-dependant sufferers place the needs of their partner before their own.
In the 1970s co-dependency was known as ‘co-alcoholism’. This was because wives of male alcoholics displayed behaviour that could only be described as ‘irrational’.
These wives devoted their lives to their husbands, even enabling their substance misuse. These wives had a little-to-no sense of self-worth, often subjecting themselves to their abuse at the hands of their husbands.
But strangely these wives did not wish for their husbands to change.
In fact, many of these wives sabotaged their spouses’ attempts to defeat alcoholism. Many of these wives believed they alone held the key to their husbands’ problems, a condition is now known as a ‘Messiah Complex’.
Co-dependency is a progressive disorder, often developing over many years. Co-dependency sufferers tend to suffer from other mental disorders, including substance misuse.
Fast-forwarding to the twenty-first century, co-dependency now covers a broad range of relationships involving caregiving.
This includes:
If you suspect you or a loved one may suffer from co-dependency then you may wish to learn the symptoms of this disorder.
Below we list the symptoms of co-dependency:
At Rehab 4 Addiction we do not advocate self-diagnosis of any of the disorders we treat, including co-dependency.
Please contact us today at 0800 140 4690 for a more thorough assessment. Each assessment is conducted by a qualified counsellor.
Alternatively, complete the enquiry form and a member of our team will contact you shortly.
Now you’re aware of codependency’s symptoms you may wish to learn how Rehab 4 Addiction is able to help you. Fortunately we offer a comprehensive treatment programme tailored specifically for the needs of co-dependency sufferers.
Treatment programmes are conducted on an outpatient or residential basis. We generally recommend a residential treatment programme given the high rates of success this variety of treatment affords.
Before your treatment begins a thorough pre-admission assessment takes place. This assessment is generally conducted by a counsellor over the telephone.
If you opt for residential treatment a thorough psychiatric assessment takes place. This is conducted by a qualified psychiatrist. If you suffer from substance misuse your treatment commences with a detox.
Following this, you take part in a structured intense programme of psychotherapy. Therapy aims to treat the mental aspect of co-dependency.
Once treatment draws to a conclusion a full aftercare plan is put in place. This helps you avoid returning to co-dependent behaviours once rehabilitation has concluded.
Call Rehab 4 Addiction for free on 0800 140 4690 to claim your assessment conducted by an experienced counsellor. Alternatively, complete the enquiry form a member of our team will call you back shortly.
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