Treating Those Labelled with Codependency

       Because codependency is not actually considered a diagnosable disorder as outlined in the diagnostic and Statistical Manual of Mental Disorders, you will not frequently see individuals for this reason alone. Many times counselors will encounter those with codependency when working with spouses of substance abuse, women in domestically violent relationships or women who self-label. Additionally, the criteria for being codependent is frequently changing and becoming broader to include many types of women. One way to help those coming to you with codependency is to first, not label them with codependency. Often times this label is perpetuated without consideration of the socio-political or environmental factors taken into account. As mentioned earlier it may not be a flaw of the women presenting with codependent behaviors, but a flaw on society for labeling those behaviors as negative.

       Another way to look at codependency is from the self-in-relation theoretical perspective. This turns the tables and looks at codependency as a positive coping technique and strength than as negative and pathological traits. In many cases this can lead to the disintegration of the necessity of the label and can provide empowerment to women. One of the main forms of treatment that was discussed was to offer empowerment to women and encourage an overall societal change of how women are labelled. In many cases some believe that wit ha societal change codependency will no longer exist, especially as such a broad catchall. While most perspectives seemed to highlight a feminist approach to counseling, it seems that many counseling techniques could be used to help women faced with this label. What seems most important is the ability to understand codependency, the good, the bad, and the ugly and work with individuals to meet their needs, not the needs of society.

Women and Codependency

       As mentioned in previous posts, women are frequently over-labelled with the term codependency despite its gender neutral nature. Unfortunately, this is often because of societal pressures for women to hold a more "submissive script." This often occurs in cultures that promote the inequality of men and women as it forces women to be oppressed. In turn this causes them to develop different ways of maintaining relationships and balance in their lives. Often times these characteristics are used to define codependency. In American culture men are encouraged to act out against women despite a historical economic dependence that women have had on men. While this mentality may be changing the characteristics have become innate. In many ways women have been shaped to maintain relationships that may not be healthy and empowering for reasons of survival.
       Oftentimes, this is not considered and individuals do not realize that codependent behaviors are coping techniques. Some researchers even argue that codependency can be defined to illustrate resiliency and hardiness in women. In general women value connectedness and relationships, while men value autonomy. Because of these values women more frequently meet the criteria for codependency as they may continue to try and maintain, repair, and perpetuate relationships with individuals. This has lead to the development of the self-in-relation theory which illustrates the value women have in terms of connectedness. In many ways individuals can see how this re-works the concept of codependency and depicts it as a difference in values system than pathology.
       Unfortunately, in American society, there is not a strong history of women's values being the normative value force of the society as a whole. In many ways this indicates why codependency has become such a popular topic and label among modern society. Because, generally speaking, women are in fact different from men, and because men seem to be the ones that hold the power, codependency is a term used to pathologize the foundations of being a woman, and a toll to maintain oppression, and therefore the status quo.

The Prevalence of Codependency

       Due to the inconsistent definition of codependency it is difficult to get a straight number on the prevalence of codependency. Some researchers believe that because of this lackadaisical attention to finding a concrete definition 96% of the female population may at one point suffer from codependency. Other researchers through controlled studies indicate that 25% of help seeking females will present with codependent behaviors and issues. Unfortunately,with such a wide range of proposed prevalence it is difficult to say how common codependency is.
       Another factor to take into account is that despite the gender neutrality of the core concepts of codependency women are much more frequently labelled with the term. Some research indicates women are twice as more likely to be viewed as being codependent. This overwhelming prevalence indicates the importance of looking at the societal factors contributing to the biased labeling of women with codependent issues.
       Lastly, individuals often labelled with codependency are those in relationships with individuals with substance abuse, domestic violence, sexual maltreatment or emotional maltreatment. This has given way to research indicating the idea that codependency is much more a coping technique that disease. Despite there being no clinical sound reason to label an individual with codependency as per the research utilized, it is something that remains in the public sphere. In this case it is important to recognize that it can be useful as it can raise awareness for the issues codependency may bring up.

What is Codependency?

       Codependency initially started out as a term to label the spouses of the chemically dependent. In this way the term means someone who is manipulated or controlled by a spouse with a pathological condition. The individual themselves was not actually defined with a pathological condition. As time goes by the term has been more broadly and broadly defined. In the popular sense codependency is now descriptive of any women in a dysfunctional relationship.
       Unfortunately, the term is utilized inconsistently, is not reliably measured and is frequently used as an oppressive factor most commonly to women. Despite the downfalls of the term researchers are getting closer and closer to legitimizing the terms and some have gone as far to try and find empirical support for making it a new personality disorder.
       Codependent behaviors are often described as a woman who depends on the needs or control of another, puts her priorities lower than that of another person, low self-esteem, excessive compliance and denial. Often times particularly in mental health settings feminine attributes all too easily fit the abstract mold of codependency. In many cases this can lead to victim-blaming, in which the client will see themselves as the problematic source of their behaviors. In other words a wife may be blamed for her codependency rather than the poor relationship her and her husband. This in due course often causes women to internalize codependency and an increase in women blaming the downfalls in their lives as a result of innate codependent behaviors.
       In many cases codependency is self-labelled and there is little to no empirical research that it is a disorder in and of itself. Despite these finding many individuals in the public including clinicians and client will utilize the label of codependence. Most research indicates that rather than being a disease codependence is often a coping technique that women use in order to maintain the sanctity of relationships and to create some form of stability in their life.

Bibliography

Cowan, G. & Warren, L.W. (1994). Codependency and gender-stereotyped traits. Sex Roles, 30(9/10),
       631-645.
In this article the authors completed a research study analyzing the relationship between gender, stereotyped traits and codependency measures. The researchers found that codependency overlaps with negative female stereotyped traits that can be witnessed in both men and female behaviors, and that codependency shows less overlap with valued feminine traits. In other words codependency focuses on negatively valued feminine traits, not all feminine traits.

Granello, D.H. & Beamish, P. M. (1998). Reconceptualizing codependency in women: A sense of
       connectedness, not pathology. Journal of Mental Health Counseling, 20(4), 344-358.
In this article the authors outline the current definition of codependency, which is not concretely defined and has been used to mean several different things, particularly in relation to women, and seek to find a reconceptualization of the term that can actually create empowerment in women. By doing this the authors feel it will decrease the pathologizing of women's behaviors. The authors proposed looking at codependency in terms of the self-in-relation theory, which outlines the need for women to value connectedness and relationships over the more typical male autonomy that our society values.

Martin, A.L. & Piazza, N. J. (1995). Codependency in women: Personality disorder or popular descriptive term? Journal of Mental Health Counseling, 17(4), 428-440.
The authors of this article set out to try and find a more concrete definition of codependency in women. In the past many researchers have suggested making codependency a personality disorder. This study set out to see if accepted diagnostic criteria would indeed warrant the necessity for an additional personality disorder. While all subjects in the study had been diagnosed with codependency, they were not considered to have an separate personality disorder. Rather researchers found that codependency was better used as an indicator for other personality disorders. The researchers found that codependency may be much more of a coping technique or adaptive response mechanism, than disorder.

Noriega, G., Ramos, L., Medina-Mora, M.E., & Villa, A.R. (2008). Prevalence of codependence in young
       women seeking primary health care and associated risk factors. American Journal of 
       Orthospsychiatry, 78(2), 199-210.
This article set out to outline some of the etiological factors contributing to codependency in women. These factors may be due to familial concerns, such as in the cases of substance abuse or domestic abuse, and may be perpetuated by submissive scripts for women created by societal forces. This study was completed to examine the prevalence of codependency among women seeking help.

van Wormer, K. (1995). Codependency: Implications for women and therapy. In M. Babcock & M.C.
       McKay (Eds.), Challenging codependency: Feminist critiques (117-128). Toronto, ON, Canada:
       University of Toronto Press.
This chapter outlines the meaning of the term codependency and takes a historical view of the use of the term. The chapter highlights the socio-political roots in sexism the term takes and how this has affected the treatment of women in the mental health field. This chapter looks at the teachings of Alcoholics Anonymous and the family systems approach when working with women labelled with codependency. Lastly, the chapter highlights the importance of using non-sexist therapy when working with these clients.