In today’s world, one of the least flattering qualities one can assign, or receive from, peers and acquaintances is that of being “codependent.” This is one of the popular terms used today in a relationship-conscious and psychologically-minded society to identify a trait that suggests that that person so identified is likely to be too “needy” and lacking in self-confidence and sufficient backbone. Not a quality anyone would aspire to become to say the least. While I would agree that anyone with these qualities, so to speak, would be worthy of pity and possibly even contempt it is the seemingly sudden emergence of this phenomenon and the association between dependence and the qualities by which it is defined today that troubles me. While we could explain its popularity, at least to some degree, on how pedestrian the assignation of psychological judgments and diagnoses are thrown around today, thanks to the internet (everybody is a psychologist just as everyone today is an amateur physician, thanks to WebMD), I think it is nonetheless significant and compels me to examine which judgments have become salient and how the ways that they are used to define who people are, in relationships or otherwise, reflects the world we live in, viz., who we people, as a whole, have become.
Codependency vis a vis Dependency While the term, “dependency” has been around a long time, “codependency” is a relative newcomer and the two are easily confused. The word, “codependent,” is a misnomer inasmuch as a literal interpretation denotes interaction even though it is an adjective generally assigned to a person. Some professionals, such as Sharon Martin, LCSW, (The difference between dependency and codependency, PsychCentral, September 21, 2018) have attempted to explain the difference as essentially having to do with whether the self-efficacy of the individuals involved are enhanced or impaired by the nature of the relationship that exists between them. Associating codependency with loss of autonomy is also implied when Martin underscores as a central tenet that one should not rely on their partner for self-esteem. A healthy relationship founded on mutual reliance that isn’t sacrificed to a loss of autonomy or, if you will, self-sovereignty, is what Martin calls “interdependency.” Experts often, however, make the distinction on the basis of whether it refers to an individual or a relationship. A person who is predominantly dependent, for example, lacks autonomy such as in a willingness to make decisions or to take risks as well as the ability to tolerate being alone. A codependent person, on the other hand, fosters a relationship in which their partner is encouraged to become exceedingly reliant on them to the detriment of their partner’s autonomy. These two terms, as you can see, are not mutually exclusive as many people fit the bill in both categories. Part of the problem when using these concepts, therefore, stems from both a lack of specificity as well as agreement with regard to what these terms actually mean. More importantly, in my mind, is how as in Sharon Martin’s blog on this topic a cultural bias is revealed that assigns greater value to independence and autonomy for personal growth purposes as opposed to collective qualities such as self-sacrifice, altruism, and what the personality psychologist, Raymond Cattell, once called “comentation,” i.e., the tendency to conform to conventional ways of thinking and behaving. While it is probably generally agreed that the ideal person would embody a “healthy” balance of both, the semantic meaning assigned to dependency and codependency versus autonomy, and even narcissism, with respect to their relative status suggests that the value assigned to each isn’t. The Bivalent Nature of Dependency Dependency as a clinical phenomenon was first identified as a personality disorder by the American Psychiatric Association in their second edition of the Diagnostic and Statistical Manual published in 1968 (in their first edition, published in 1952, it was given the name “inadequate personality.”) It has stood the test of time as a classifiable “mental disorder.” The latest edition of the DSM defines dependent personality disorder as “an excessive need to be taken care of, submissiveness, clinging, needy behavior due to fear of abandonment, difficulty making decisions without input, reassurance, and advice from others, and requiring others to assume responsibilities which they should be attending to” (American Psychiatric Association, 2013). Standing alone, the clinical description of this disorder belies the bivalent qualities that dependency connotes. The word, “dependency,” derives etymologically from the late Middle English term meaning literally “hanging from something” which is now obsolete. As is the nature of semantics, meanings evolve often as metaphors and in accordance with the relative value assigned to those metaphors within their respective historical and cultural contexts. The early history of the meaning of “dependency” reflects how its assigned value had evolved from denoting “a state of deriving existence, support, or direction from another” in the mid-15th century, to meaning “reliance, confidence, and trust” by the early 16th. Within the span of less than a century the meaning of the word had shifted from that which resembles its clinical, more pejorative, use today to one that constitutes a virtue necessary for healthy human relationships to develop. In my clinical practice, I try to correct this cultural bias by explaining dependency’s bivalent nature when pertinent in my work with patients. While in some circumstances it can, as is popularly understood, foster an unhealthy relationship that negates one’s power and identity as well as enabling one’s partner’s destructive habits it may also play an integral role toward establishing trust, the bonding of emotional investments that are reciprocal in nature, and demonstrating confidence in one’s partner that fosters self-esteem. Interdependency as an Antidote in an Alienating World While individualism served its purpose that sailed the ships to explore and colonize the world bringing prosperity and cultural advancement to the West during the High Renaissance and Age of Enlightenment from our vantage point today, in hindsight, we realize how much its virtuosity was defined by the purposes it served delimited by their time and cultural context. We might identify post-World-War-II America as a turning point on which the virtues of individualism have been transformed ironically into what has become more of a malady. Many books since have been published on this topic, perhaps none more prescient than Riesman, Denney, and Glazer’s mid-century classic, The Lonely Crowd (1950) which observed that change was afoot with regard to how the sources and nature of the average American’s identity was going through a major transformation. According to the authors the traditional principles and ethics that had anchored self-development to character, such as egalitarianism, altruism, honesty, industry, etc., were being replaced by an “outer-directed” focus that is more self-conscious, status-seeking, and materialistic. Without the internalization of the enduring values that are necessary to bind individuals together communally, individualism conceivably degrades into a society more fragmented by the strains of competition, consumption, and idolization of the self. In an effort to address concerns associated with these societal trends, the German-born Israeli-American sociologist, Amitai Etzioni, proposed in his book, The New Golden Rule (1996), the concept, liberal communitarianism, as an alternative both to the libertarianism that has gained popularity amongst the political right as well as the pitfalls of previous efforts in recent history when communitarian systems degraded into totalitarian governments. Etzioni’s vision proposed, among others, a society governed by the rights of individuals that are limited by what serves the common good and one that is regulated by an interdependent consortium of checks and balances that renders them accountable. Robert Putnam’s landmark, Bowling Alone: The Collapse and Revival of American Community (2000), attempted to explain how the historical and cultural changes that have taken place since the mid-20th century have created a society increasingly isolated and bereft of communal interest. Putnam identified the concept, “social capital,” as the solution whereby investment in relationships that share common interest, goals, reciprocal engagement, and time spent in shared spaces may restore the sense of community that has been lost. In her recent article in the Opinion section of The New York Times (March 9, 2023), titled, “Can We Put an End to America’s Most Dangerous Myth?” author Allissa Quart makes an appeal to “release people of the shame about the need for others.” According to Quart, Americans suffer from a destructive ethic that it is a virtue to do things on our own without help. As an antidote, she proposes that we learn the “art of dependence” such as accepting help with grace, cultivating the skill to lean on others, and to a realization of the myth of the so-called self-made wealthy and successful person. Quart recommends and practices active measures such as starting mutual aid groups, joining support groups, counseling peers, and acknowledging those who are generous with their support. Codependency Contra Narcissism Sharon Martin’s blog on codependency is one of the legion articles and books on the topic written today which is an indicator of how prevalent and distressing this phenomenon exists in our relationships today. They attempt to distinguish healthy from destructive relationships on the basis of how much one should give in any given relationship as well as the importance of preserving a sense of autonomy and individual identity. While these books share many helpful insights and practical steps there remains a bias with respect to the concept of codependency that is not only a reflection of the values of the society in which we live but also, if not addressed properly, may contribute to the social conditions that lead to codependency in relationships in the first place. In other words, disparagement of dependency in deference to autonomy and self-esteem in relationships, however it may be done with the best of intentions, unwittingly espouses a social value that ultimately may be harmful or what we call iatrogenic. The psychologist, Philip Cushman, identified this problem in the practice of psychotherapy as “the lifestyle solution.” We as psychotherapists ultimately do our patients a disservice if in the treatment of their symptoms and problems we fail to be cognizant of the world in which we live and how it may contribute to these problems by the values it promotes that may constitute the source of these problems. Not to do so is tantamount to putting a band-aid on a problem before sending our patients back into the world that is responsible for creating their injury. Every relationship constitutes a dynamic between two or more individuals that elicits patterns of behavioral and emotional reactions that perpetuate themselves indefinitely. In a society that has become increasingly bereft of the institutions and values that have successfully held individualism in check in the past, the privileging of autonomy over responsibility and self-esteem over caring, whether it be in advertising or in the therapist’s office, can only exacerbate the narcissistic trends and cynicism that have plagued our society in recent decades. The logic behind how this problem is created in relationships is that the dynamic counterpart to narcissism is codependency and the solution as we have been promoting, i.e., self-esteem and autonomy over caring, dependency, and values such as communal and interpersonal responsibility, only creates a vicious circle by which it becomes self-perpetuating. As long as narcissism remains a problem that is prevalent it will continue to cast a long shadow offering false promise of safe harbor from the dread of isolation and inadequacy, the conditions that both foster codependency and link these two dysfunctional states together.
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