Article

Diagnostic Criteria for Codependency

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Abstract

Not all alcoholics are the same but most alcoholics share common characteristics, particularly during the active stages of their disease and during early sobriety. It has become equally apparent to many therapists that not all family members of the alcoholic are the same, but most family members share characteristics in common with each other and the alcoholic, particularly during the active stages of the disease and during early sobriety. Definitions of codependency have frequently appeared in competition with each other because each attends more to one level than to the other (interpersonal versus intrapsychic). Only by acknowledging the full sophistication of the concept can one begin to come to terms with codependency. Closer study of projective identification may prove useful in promoting a better understanding of codependency while humbling those who are intent on simplistic explanations.

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... Awareness what is currently going on in their family is sometimes the most important thing for them, and they seek to have a say in key family decisions. Many authors have written about the role and importance of the need of control in wives of alcoholics [24,28,31,34,35,[42][43][44][45]. ...
... It is not uncommon for them to feel inferior to other women. Some authors highlight a strong correlation between lower self-esteem and symptoms of so-called co-dependency [15,28,43,46]. ...
... This may be accompanied by trouble sleeping, both falling asleep and getting up and sleep is sometimes shallow, intermittent. They worry about the future, whether their own and that of the whole family [32,43,[46][47][48][49]. Following the distinction introduced by Spielberger et al. [50], anxiety is here understood as an ongoing experience, more as a trait than a state. ...
... Over the past few decades, there have been growing interest in the topic of codependency; however, there is still a lack of consensus on the definition. The divergent approaches include the personality model (Cermak, 1986;Fischer & Spann, 1991), the disease model (Whitfield, 1984), the addictive love hypothesis (Peele & Brodsky, 1975) and the interactionist model (Wright & Wright, 1991). In the present study, we use the personality model, which defines codependency as a dysfunctional pattern of personality organisation and relating to others (Cermak, 1986). ...
... The divergent approaches include the personality model (Cermak, 1986;Fischer & Spann, 1991), the disease model (Whitfield, 1984), the addictive love hypothesis (Peele & Brodsky, 1975) and the interactionist model (Wright & Wright, 1991). In the present study, we use the personality model, which defines codependency as a dysfunctional pattern of personality organisation and relating to others (Cermak, 1986). Based on the personality model, Spann and Fischer (1990) created the working definition of codependency, which is the most widely used and comprehensive approach to date. ...
... (Spann & Fischer, 1990, p. 27). We committed ourselves to this definition since it acknowledges both the intrapsychic and interpersonal aspects of codependency (Cermak, 1986). ...
Article
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In this study, we interpret codependency as a dysfunctional pattern of relating to others, and based on this approach, we hypothesized an association with negative forms of dyadic coping, relationship problems and life satisfaction. A total of 246 Hungarian participants (167 females, 79 males), aged 18–72 years (M = 35.3, SD = 11.6) completed our online survey including measures of codependency, dyadic coping, perceptions of relationship, and life satisfaction. In our cross-sectional research, the Spann-Fischer Codependency Scale (SF-CDS), the Dyadic Coping Inventory (DCI), the Shortened Marital Stress Scale (MSS-R), and the Satisfaction With Life Scale (SWLS) were used. Correlational and pathway analyzes were applied to confirm our hypotheses. Codependency was associated with negative dyadic coping, while we found no measurable influence on positive dyadic coping. Individuals with higher codependency rated both their own and their partner’s negative dyadic coping more pronounced, while at the same time they characterized their relationships as more problematic. Structural Equation Modelling proved that codependent attitudes, along with the emergence of negative dyadic coping forms and perception of relationship problems, reduce a person’s life satisfaction. Overall, it can be stated that the more codependent the participants were, the more negative their own and partner’s behaviour was perceived in stressful situations and the more problematic their intimate relationship was found to be. Our results support the idea that codependency is a specific, largely stable attitude that determines a person’s perception and behaviour relating to others.
... The development of the codependency concept began in the field of chemical dependency and in the culture of twelve-step programmes (such as Alcoholics Anonymous), when it was said that codependent women unconsciously enable their addictive partners to abuse alcohol (or any other substances) [4]. Enabling is manifested by supporting the partner and instigating him/her to adopt the addictive behavioureven though the codependent person does this unconsciously [10]. ...
... Furthermore, codependency plays a significant role in the maintenance of the partner's chemical dependency. Other important characteristics of codependent individuals identified by Cermak are: 1) excessive willingness to take responsibility for (more precisely speaking, by standing in for) others and extreme caretaking; and 2) Codependents neglect their own needs and put others' needs above their own [4]. ...
... Codependent individuals were identified by the Codependent Questionnaire, which is a 36-item selfreport inventory (Cronbach's α = .86) [25] measuring four subscales that meet Cermak's [4] criteria of codependence: responsibility, control, intimacy and enmeshment. Statements are answered on a five-point scale (1 = I never feel this way; 2 = I rarely feel this way; 3 = I sometimes feel this way; 4 = I often feel this way; 5 = I always feel this way). ...
Article
Background: Little is known about the personality of codependents, despite the fact that it should be taken into consideration in the treatment of illicit drug users. Codependency has a strong positive correlation with borderline and with dependent personality disorder (BPD, DPD), which should be taken into account when trying to explain the relationships so far discovered between codependency and anamnestic data, together with psychopathological (e.g. child) abuse, depression, and insecure attachment. Aim: To identify whether ‘pure’ codependent individuals exist. By ‘pure’ codependency we mean the condition of codependent individuals without BPD and/or DPD. Methods: Our sample consisted of 131 codependents and 276 non-codependent individuals, as assessed by the Codependent Questionnaire; they were recruited in self-help groups and in the general population. Borderline and dependent traits were assessed by SCID-II. Results: According to our data, probably every 2nd codependent person meets the five criteria required for a BPD diagnosis in DSM-IV-TR, and every 7th codependent meets the criteria set out there for a DPD diagnosis. 31% of codependent individuals have borderline traits; in addition, 31% of codependents have dependent traits. On the other hand, 16% of codependent individuals seem to be classifiable as ‘pure’ codependents. Conclusions: The overlap areas between codependency, BPD and DPD have significant treatment and research implications. Since ‘pure’ codependents were identified by us, the codependency concept cannot be rejected.
... Karşılıklı bağımlılığı yüksek kişilerde depresyon belirtilerinin rapor edilmesi olasılığı yüksek olarak görülmektedir ( Cullen ve Carr, 1999;Cermak, 1986, Fischer ve ark., 1991. Bunun yanı sıra bu bireylerin anksiyete belirtileri gösterebileceği belirtilmektedir (Cullen ve ark., 1999;Dear, Roberts, 2000;Hands ve Dear, 1994;Cermak, 1986). ...
... Karşılıklı bağımlılığı yüksek kişilerde depresyon belirtilerinin rapor edilmesi olasılığı yüksek olarak görülmektedir ( Cullen ve Carr, 1999;Cermak, 1986, Fischer ve ark., 1991. Bunun yanı sıra bu bireylerin anksiyete belirtileri gösterebileceği belirtilmektedir (Cullen ve ark., 1999;Dear, Roberts, 2000;Hands ve Dear, 1994;Cermak, 1986). Ayrıca çalışmalarda karşılıklı bağımlılığın stres düzeyi ile ilişkili olduğu gösterilmiştir (Cermak, 1986;Cullen ve ark., 1999;Hands ve ark., 1994). ...
... Bunun yanı sıra bu bireylerin anksiyete belirtileri gösterebileceği belirtilmektedir (Cullen ve ark., 1999;Dear, Roberts, 2000;Hands ve Dear, 1994;Cermak, 1986). Ayrıca çalışmalarda karşılıklı bağımlılığın stres düzeyi ile ilişkili olduğu gösterilmiştir (Cermak, 1986;Cullen ve ark., 1999;Hands ve ark., 1994). ...
... A kodependencia kifejezés egy kóros viszonyulásmódra utal. Azokat az embereket jelöli, akik dependensek az olyan partnerüktől vagy családtagjuktól, akik valamilyen dependenciában, például alkoholfüggőségben szenvednek (Cermak, 1986). A társfüggő személy függőségének tárgya a partner problémás viselkedésének megváltoztatása (Komáromi, 2010). ...
... Többféle elképzelés létezik a kodependenciáról. Egyesek személyiségzavarként (Cermak, 1986), mások viselkedéses addikcióként (Crozier & Hillock, 2013), vagy patológiás altruizmusként konceptualizálják (McGrath & Oakley, 2011). Feminista nézőpontból a kodependencia nem más, mint a női szerepelvárásoknak való túlzott megfelelés (Cowan & Warren, 1994). ...
... Az általunk használt munkadefiníció a következő: a kodependencia a személyiségszerveződés, vagy -működés diszfunkcionális módja, melynek tünetei lehetnek (1) a kóros kontrolligény, (2) a túlzott felelősségvállalás és gondoskodás, valamint a saját szükségletek figyelmen kívül hagyása, (3) határproblémák megjelenése az intim kapcsolatokban, (4) valamint behálózottság egy olyan párkapcsolatban, melyben a másik személy valamilyen függőségben vagy személyiségzavarban szenved (Cermak, 1986). ...
Article
Background and aims Codependence is not included in the psychiatric nosological systems. It refers to those individuals who are dependent on the dependency of their family members. Codependency and borderline personality disorder are closely related to each other, furthermore similarities are found in their etiology as well. The aim of this study is to (1) assess the aversive childhood experiences (early maladaptive schemas) and the resilience of codependent individuals, and (2) identify the main differences between codependent, borderline and healthy individuals regarding schemas and resilience. Methods The identification of the subjects was conducted by two questionnaires (Codependent Questionnaire, SCID-II). Based on the results of these questionnaires, 4 subsample have emerged: healthy controls (n=45), codependent individuals (n=47), borderlines without codependency (n=11), borderlines with codependency (n=44). All subjects were to fill out the Young Schema Questionnaire and the Connor-Davidson Resilience Scale as well. Results In two cases, we have obtained expected results. Firstly, the codependent individuals have reported significantly more early maladaptive schemas, and have achieved significantly lower scores on the Resilience Scale than the healthy controls. Secondly, codependent individuals have achieved significantly lower scores on 6 schemas and have achieved significantly higher scores on the Resilience Scale than the borderline-codependent group. Unexpectedly, codependent individuals have achieved significantly higher scores on 2 schemas (Self-sacrifice, Unrelenting standards), compared to the „pure” borderline group, however, codependent individuals appeared to be more resilient than borderline individuals without codependency. Discussion Codependency seems distinguishable from both borderline individuals and healthy controls. Based on our results, codependency can be considered as a pathological construct approximately in the middle of the healthy-borderline continuum.
... The concept of codependence first appeared with the establishment of Al-Anon in 1951, when it became evident that spouses of alcoholics were also in need of recovery ( Cermak, 1986). It soon became connected with the family therapy movement as professionals recognized chemical dependence as a family systems issue ( Gierymski & Williams, 1986). ...
... Definitions of codependence vary somewhat from author to author, mainly because of a lack of empirical agreement ( Cermak, 1986). There are also concerns about whether such a diagnostic label would even be beneficial ( Hibbard, 1987). ...
... The feeling of being out of control is matched only by the obsession with being in control. Cermak (1986) noted that codependents' self-esteem is based on their ability to control the feelings and behaviors of themselves and others. Perfectionism is one way the control problem may manifest itself. ...
Article
Codependents who are Christians often wrestle with theological as well as psychological issues in working through codependent behavior. In such cases, the church-based group can provide a unique setting for restructuring belief systems that may incorporate Scripture. This environment can also provide a safe place for self-revelation among Christians who share a community and a common faith. This article outlines an approach to the integration of scriptural and psychological principles in addressing codependence. Based on suggested biblical passages and Cermak & Brown's (1982) five core issues of codependence–-control, trust, personal needs, responsibility, and feeling–-a framework is provided for discussion and intervention in the group setting. The authors note the advantages of using this approach for both the group and the church in which it is based.
... A kodependencia csupán fogalmi kialakulásában köthetô szorosan az alkoholfüggôséghez. Már ekkoriban is feltételezték, hogy a társfüggôség nem kizárólag a partner alkoholfüggôsége miatt alakul ki (17). Az alkoholizmus feltehetôen szerepet játszhat prediszponáló, precipitáló, fenntartó, valamint súlyosbító tényezôként is a kodependencia kialakulásában. ...
... Többféle definíció és megközelítés létezik a kodependenciát vagy társfüggôséget illetôen. Megkülönböztethetünk olyan definíciókat, melyek a kodependencia személyiségzavar szintû szervezôdését hangsúlyozzák (17); míg más elképzelések szerint a kodependencia viselkedéses addikcióként konceptualizálható (10, 23). Egy újabb teoretikus megközelítés alapján a kodependencia a patológiás altruizmus sajátos formájának tekinthetô (14). ...
... Szerinte a kodependencia a személyiségszervezôdés és -mûködés, valamint a másokhoz való kapcsolódás diszfunkcionális módja. A jelenség a következôkben nyilvánul meg: kóros kontrolligény; saját szükségletek figyelmen kívül hagyása; határproblémák az intimitás és a szeparáció területén; valamint behálózottság egy olyan párkapcsolatban, melyben a partner valamilyen függôségben, személyiségzavarban, kodependenciában, vagy impulzuskontroll zavarban szenved (17). Az empirikus kutatások egy része megerôsíti a személyiségzavar-hipotézist, melyet a narcisztikus, a borderline és a dependens személyiségzavar vonatkozásában vizsgáltak. ...
Article
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The concept of codependency stems from the field of chemical dependency. Initially, codependent individuals meant women who dominated their partners and took care of them, while women actually were dependent upon their husbands. Nowadays, it has been recognized that men can become codependent as well, and its presence is not limited only to the relationship. This paper reviews the various interpretations of codependency and the empirical researches on the etiological factors of codependency. The explanatory models of codependency can be placed on a continuum of severity: psychopathology on the level of personality disorder, behavioural addiction, or excessive feminine behaviour. The etiology is mutifactorical: biological, psychological and social elements are also listed among etiology factors. The individual variability of the predisposition to care, failure of prefrontal cortex to inhibit empathic responses, a multitude of aversive experiences in a dysfunctional family (e.g. parental conflicts, emotional abuse, neglect and parentification), changes in the perception of women's role, and the emergence of substance abuse in the family could play a role in the development of codependency. Codependency is often unrecognized. Codependent individuals visit the health care system with stress-related or depressive symptoms which can mask the underlying causes, thus, it is possible that they will only receive symptomatic treatment. Through its trans-generational nature, codependency endangers children growing up in the family.
... Tras varios intentos fallidos por incluir a la codependencia como un trastorno psicológico reconocido (Cermak, 1987) o por intentar entenderla como producto de una sociedad machista (Cowan & Warren, 1994), en la actualidad el tema ha perdido popularidad, en parte debido a las diferen tes líneas de investigación que proponen ideas tan diversas sobre ella que solo dificultan el reconocerla con claridad (Dear, Roberts & Lange, 2004;Fischer, Spann & Crawfod, 1991;Mellody, Miller, A. & Miller, J., 1989). Sin embargo, pese a la poca cantidad de estudios que se realizan actualmente sobre ello, se ha logrado identificar los elementos básicos que la componen (Dear, Roberts & Lange, 2004) y los correlatos más importantes con problemas de salud mental (Fischer, Spann & Crawford, 1991), desiguald ades sociales (Cowan, 1995) e inclusive aspectos socioculturales (Chang, 2012(Chang, , 2016. ...
... Por otro lado, Cermak (1987) y Timmen y Cermak (1986) diseñan las primer as investigaciones que tienen como objetivo principal la definición de la COD y la busqueda de criterios diagnósticos con la finalidad de incluir a la COD como un trastorno identificable en el manual diagnóstico DSM III. En su estudio, se define la COD como una entidad diagnóstica identificable o trastorno de la personalidad, que se caracteriza por una autoestima en función de la capacidad de controlar a otros, una responsabilidad exagerada de los problemas de otros en detrimento de los propios, ansiedad y distorsión de los límites personales y enmascaramiento de las relaciones asociada con la construcción de emociones negativas como la depresión y la ansiedad. ...
... Todos estos primeros esfuerzos para definir la COD fueron independientes y aislados. Como consecuencia, el constructo incluyó un espectro tan amplió de comportamientos que causó el efecto contrario a la claridad que se buscaba: la COD no solo existía en subordinación al alcoholismo o la drogadicción en general, sino que incluía síntomas asociados dire ctamente al cuidado y atención de la persona adicta (Smalley & Coleman,1987), implicaciones afectivas derivadas de la interacción (Cermak, 1987), correlatos fisiológicos que la colocaban como una posible enfermedad (Timmen & Cermak, 1986) así como daño fisiológico, emocional y psicológico (Mellody, Miller A. & Miller J., 1989). ...
Thesis
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Las relaciones interperesonales tienen un papel fundamental para el desarrollo de habilidade sociales y la salud mental. La pareja en particular, ha mostrado tener un impacto imediato en el bienestar y la calidad de vida (Viejo, Ortega-Ruiz & Sánchez, 2015) constituyeno la relación interpersonal más importante de la vida joven y adulta (Collins, Welsh & Furman, 2019). Así pues, los problemas que se sucitan en las reaciones de pareja durante la juventud pueden impactar en el desarrollo de relaciones interpersonales sanas en la vida adulta (Inclan & Hernández, 1991). La codependencia es un patron de comportamiento disfuncional en la relación de pareja que puede generar problemas afectivos tales como ansiedad o depresion (Fischer, Spann & Crawford, 1991) y que de instaurarse en la juventud podría desenvocar en un patron de comportamiento estable que no permita disfrutar plenamente ninguna pareja futura. En esta investigacion, se planteó un modelo de predicción de la codependencia a partir de los rasgos de género (instrumentalidad expresividad), los estilos y conductas de la interacción (estilos de poder y Manejo del conflicto) y el Sistema de evaluación cognoscitivo-afectivo (la autoestima y los afectos). La investigacion se dividió en tres estudios. El primero enfocado en la construcción de una escala que midiera la codependencia durante el noviazgo en la juventud a partir de un estudio exploratorio y un estudio para obtención de propiedades psicométricas. Con ello, en el segundo estudio utilizar la escala construida para evaluar los correlatos entre la codependencia y las variables propuestas en el modelo téorico, para finalmente, en el tercer estudio identificar los predictores de la codependencia durante el noviazgo en la juventud. Los resultados del estudio final arrojaron modelos de regresión significativos para cada uno de los factores de la codependencia con varianzas explicadas entre 19% y 40%. Estos resultados pueden ser la base para el establecimiento de una línea de investigación de codependencia en relaciones prematrimoniales en México, en función de identificar este patrón de comportamiento en momentos tempranos del desarrollo e intervenirlo adecuadamente.
... There is not yet any clear consensus about the definition of co-dependency -a basic problem that makes it difficult to conduct a replicable study on it. One group of authors [2] conceptualized it as a type of personality disorder, while others [4] defined it as a form of behavioural addiction. In addition, it can be classified as an extreme manifestation of feminine values and behaviour [3]. ...
... Despite the way they were originally discussed in the literature, co-dependent individuals can be found not only among the partners of substance abusers (heroin or other substances), but also among the partners of behaviourally addicted people; these include pathological gamblers, hypersexual people and/or porn addicts [2,4,13]. By permitting socially dubious behaviour, co-dependency can contribute to maintaining addictions in relatives. ...
... In other words, co-dependent individuals have an excessive need for a sense of control in order to maintain their sense of safety [17]. They take responsibility for others even if they are not asked to do so, while they neglect their own needs and do not respect their own or the other person's boundaries [2]. ...
Article
Background: Co-dependency can be conceptualized as a behavioural addiction. It can play a role in maintaining other addictive behaviours in partners or family members. In the treatment of addictions, we highly recommend that every attempt be made to better understand the phenomenon of co-dependency and its background – best viewed as a possible mental problem experienced by the partners or family members of clients with addiction. In order to understand its background, the aim of this study has been to identify the factors best able to predict co-dependency. Methods: 192 individuals were recruited. The test battery consisted of demographic variables, a co-dependency questionnaire, an interview centred on borderline traits, a screening test of dependent traits, and questionnaires about traumatic antecedents, early maladaptive schemata and parentification. Results: A linear regression model of co-dependency was identified by our study team. The factors that demonstrated their capacity to predict co-dependency were: (1) Subjugation schema/schemata, (2) Any other mental disorder diagnosis, (3) Self-sacrifice schema/schemata, (4) Gender, (5) The number of borderline traits displayed by each individual, (6) The number of early maladaptive schemata appearing in each individual’s history, and (7) Parentification. Conclusions: The aim of this study has been to define the predictive factors of co-dependency while monitoring borderline personality traits. Based on our results, the recognition and prediction of co-dependency should, from now on, be easier.
... A kodependencia csupán fogalmi kialakulásában köthetô szorosan az alkoholfüggôséghez. Már ekkoriban is feltételezték, hogy a társfüggôség nem kizárólag a partner alkoholfüggôsége miatt alakul ki (17). Az alkoholizmus feltehetôen szerepet játszhat prediszponáló, precipitáló, fenntartó, valamint súlyosbító tényezôként is a kodependencia kialakulásában. ...
... Többféle definíció és megközelítés létezik a kodependenciát vagy társfüggôséget illetôen. Megkülönböztethetünk olyan definíciókat, melyek a kodependencia személyiségzavar szintû szervezôdését hangsúlyozzák (17); míg más elképzelések szerint a kodependencia viselkedéses addikcióként konceptualizálható (10, 23). Egy újabb teoretikus megközelítés alapján a kodependencia a patológiás altruizmus sajátos formájának tekinthetô (14). ...
... Szerinte a kodependencia a személyiségszervezôdés és -mûködés, valamint a másokhoz való kapcsolódás diszfunkcionális módja. A jelenség a következôkben nyilvánul meg: kóros kontrolligény; saját szükségletek figyelmen kívül hagyása; határproblémák az intimitás és a szeparáció területén; valamint behálózottság egy olyan párkapcsolatban, melyben a partner valamilyen függôségben, személyiségzavarban, kodependenciában, vagy impulzuskontroll zavarban szenved (17). Az empirikus kutatások egy része megerôsíti a személyiségzavar-hipotézist, melyet a narcisztikus, a borderline és a dependens személyiségzavar vonatkozásában vizsgáltak. ...
... There is also a tendency in relevant literature towards generalization of the construct, which is similar to the conceptual vagueness regarding that which can be understood as " codependent " behavior. For example, it has been postulated that codependency would be present in each member of an " alcoholic family " (e.g., Wegscheider-Cruse, 1984) and would require a diagnosis of a " codependent personality disorder " (Cermak, 1986). This concept was welcomed by supporters, in that the suffering of the family members of addicts received attention in research and treatment for the first time, and the family members were entitled to a treatment of their own problems independently of those of the addict. ...
... Moreover, the core hypotheses of the model, e.g., a strong tendency toward partner centering on the part of partners of alcoholics, could not be empirically proven (Galliker, Grivel, Klein, & Schendera, 2004). Finally, the desire expressed in the 1980s for the establishment of a codependent personality disorder (Cermak, 1986) could not withstand empirical examinations in the DSM and was consequently rejected (Klein, 2002). In contrast to this are clinically relevant impairments of family members that are well supported, although not dependent on the concept of codependency. ...
Article
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In this paper, using the indirect method the total level of alcohol consumption in Russia for the period from 1980 to 2005 is assessed. The total level of alcohol consumption varied greatly over the course of the period examined: it fell sharply in the mid-80s, rose sharply at the end of the 80s and the first half of the 90s, then declined until 1998 after which it began to rise again. The level of unrecorded alcohol consumption in Russia in the period being examined almost doubled. Overall, the feasibility of this paper is that it presents alternative assessments of the total level of alcohol consumption in Russia.
... Bu durum, alkol bağımlısı bireylerin yakınlarına, bakım verenlerine, özellikle de eşlerine (kadınlara) atfedilen "eş bağımlılık" (co-dependency) kavramının da çıkış noktasıdır (Sakarya, 2008). Eş bağımlılık yaklaşımının öncülerinden kabul edilen Cermak (1986), alkol, madde gibi kimyasal bağımlılıkların bir aile hastalığı olduğunu ileri sürmüş ve aile sisteminin taşıyıcı özelliğine atıfta bulunarak bağımlı kişinin birlikte yaşadığı aile üyeleriyle arasındaki bağıntı üzerinden eş bağımlılık kavramını tanımlamıştır. İngilizcedeki "co-dependency" kavramı için dilimizde önce "karşılıklı bağımlılık" sözcüğü tercih edilmişse de zamanla "eş bağımlılık" sözcüğünün bu kavramı daha iyi karşıladığı düşünülmüştür. ...
... This is also the point of origin of the co-dependency attributed to the relatives and caregivers of alcoholics, especially their wives (Sakarya, 2008). Accepted as one of the pioneers of the co-dependency movement, Cermak (1986) stated that chemical dependencies such as alcohol and substance abuse were family diseases. He defined the concept of codependency through the family members living with the addicted person. ...
Article
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The aim of this study is two-fold. It first seeks to compare marital adjustment, co-dependency, marital power, depression, anxiety, and stress in wives of both alcoholics and non-alcoholics. Subsequently, the study endeavors to determine those variables that predict marital adjustment of women in both groups. This study was conducted with a total of 100 women, of which 50 were wives of alcoholics and the remaining 50 were wives of non-alcoholics (i.e., the comparison group). Data for the study were collected using the Demographic Information Form, Marital Adjustment Test, Codependency Assessment Tool, Depression- Anxiety-Stress Scale, and Couple Power Scale. Hypotheses were tested using an independent samples t-test and two separate regression analyses for both groups. The findings showed there to be significant differences in all the main variables between the two groups. Participants in the group consisting of wives of alcoholics were less marital adjusted and had higher levels of depression, anxiety, and stress compared to those in the comparison group. Furthermore, wives of alcoholics tended to be more co-dependent and had a lower selfperception of marital power than did those in the comparison group. The regression analyses indicated that in both groups, marital adjustment was predicted only by marital power processes. In light of the study’s results, it would be beneficial to include spouses in addiction treatment.
... B. postuliert, dass Co-abhängigkeit bei jedem Mitglied einer "Alkoholikerfamilie" vorläge (z. B. Wegscheider-Cruse, 1984) und die Einführung der Diagnose einer "co-abhängigen Persçnlichkeitsstçrung" gefordert (Cermak, 1986). ...
... B. eine besonders ausgeprägte Partnerzentrierung von Partnerinnen Alkoholkranker konnten empirisch nicht nachgewiesen werden (Galliker, Grivel, Klein & Schendera, 2004). Schließlich konnten auch die in den 80er Jahren erhobenen Forderungen nach Etablierung einer co-abhängigen Persçnlichkeitsstçrung (Cermak, 1986) im DSM empirischen Über-prüfungen nicht standhalten und wurden folgerichtig nicht akzeptiert (Klein, 2002). ...
... debido a la personalidad de uno de los miembros de la pareja o de ambos [e.g. sus estilos de apego o sus rasgos de personalidad bordelinde o narcisistas] (Dodge, Ward & Wilkiewitz, 2010;Timmen & Cermak, 1986;Wells, Glickauf-Hughes & Brass, 1997). Sin embargo, existe otra aproximación en donde se toma en consideración que las relaciones interpersonales y, por extensión, la COD puede explicarse a partir de costos y beneficios percibidos por los miembros de la pareja. ...
... Poder usar la teoría de la interdependencia para la predicción de la COD, facilita el acercamiento sus posibles causas situacionales, propias de la interacción y no de la personalidad del individuo, nutriendo el conocimiento acerca su aparición y funcionamiento más allá de los modelos tradicionales que suponían su origen en el estudio retrospectivo de la infancia (Fagan-Pryor & Haber, 1992) o el estudio de la personalidad del codependiente (Dodge et al., 2010;Timmen & Cermak, 1986). El uso del modelo de la interdependencia aplicado a la COD puede proveer de elementos para diseñar intervenciones centradas en la modificación de comportamientos de interacción, en función de prevenir la aparición de patrones codependientes en alguna de las personas involucradas en la relación. ...
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La codependencia se estudia tradicionalmente como rasgo de personalidad, sin embargo, existen sugerencias sobre su posible explicación desde modelos más sociales. Usando el modelo de interdependencia se propone su predicción a través del del manejo del conflicto y los estilos de poder. Para ello, participaron 571 adultos (M = 20.20 años, DE = 1.93) quienes respondieron escalas de manejo del conflicto, estilos de poder y codependencia. Se encontró evidencia a favor del modelo de interdependencia ya que el manejo del conflicto no colaborador en la pareja, y la acomodación y evitación en el codependiente, en conjunto con estilos de poder negativos, son predictores de la codependencia. Se discute la aplicabilidad de la teoría de interdependencia como modelo para explicar la codependencia, así como los beneficios para el entendimiento del inicio y antenimiento de los patrones codependientes.
... Bu durum, alkol bağımlısı bireylerin yakınlarına, bakım verenlerine, özellikle de eşlerine (kadınlara) atfedilen "eş bağımlılık" (co-dependency) kavramının da çıkış noktasıdır (Sakarya, 2008). Eş bağımlılık yaklaşımının öncülerinden kabul edilen Cermak (1986), alkol, madde gibi kimyasal bağımlılıkların bir aile hastalığı olduğunu ileri sürmüş ve aile sisteminin taşıyıcı özelliğine atıfta bulunarak bağımlı kişinin birlikte yaşadığı aile üyeleriyle arasındaki bağıntı üzerinden eş bağımlılık kavramını tanımlamıştır. İngilizcedeki "co-dependency" kavramı için dilimizde önce "karşılıklı bağımlılık" sözcüğü tercih edilmişse de zamanla "eş bağımlılık" sözcüğünün bu kavramı daha iyi karşıladığı düşünülmüştür. ...
... This is also the point of origin of the co-dependency attributed to the relatives and caregivers of alcoholics, especially their wives (Sakarya, 2008). Accepted as one of the pioneers of the co-dependency movement, Cermak (1986) stated that chemical dependencies such as alcohol and substance abuse were family diseases. He defined the concept of codependency through the family members living with the addicted person. ...
Article
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Bu çalışmanın amacı, eşi alkol bağımlısı olan ve olmayan kadınların evlilik uyumu, eş bağımlılık, evlilik gücü, depresyon, anksiyete ve stres açısından karşılaştırılması ve her iki grup için evlilik uyumunu yordayan değişkenlerin belirlenmesidir. Bu çalışma, eşi alkol bağımlısı olan (50 kişi) ve eşi alkol bağımlısı olmayan (50 kişi) toplam 100 kadının katılımıyla gerçekleştirilmiştir. Çalışmanın verilerini toplamada Kişisel Bilgi Formu, Evlilikte Uyum Ölçeği, Eş Bağımlılığı Belirleme Ölçeği, Depresyon Anksiyete Stres Ölçeği ve Çift Güç Ölçeği kullanılmıştır. Çalışma hipotezleri, bağımsız örneklemler için t-testi ve her iki gruba yönelik olarak ayrı ayrı gerçekleştirilen regresyon analizleriyle test edilmiştir. Bulgular, iki grubun tüm temel değişkenler (evlilik uyumu, eş bağımlılık, evlilik gücü, depresyon, anksiyete ve stres) bakımından anlamlı olarak farklılaştığını açığa çıkarmıştır. Daha açık söylemek gerekirse bu çalışma eşi alkol bağımlısı olmayan kadınlara kıyasla eşi alkol bağımlısı olan kadınların evlilik uyum düzeylerinin daha düşük, eş bağımlılık düzeylerinin daha yüksek, evliliklerinde kendilerine ilişkin güç algılarının daha zayıf olduğunu ve depresyon, anksiyete ve stres belirtilerini daha yoğun gösterdiklerini ortaya koymaktadır. Çalışma kapsamında gerçekleştirilen regresyon analiziyle yalnızca güç süreçleri değişkeninin her iki grupta da evlilik uyumunu pozitif yönde yordadığı saptanmıştır. Belirtilen sonuçlardan yola çıkarak bağımlılık tedavilerinde eşlerin de bu sürece dâhil edilmesinin faydalı olacağı öngörülmektedir. Ayrıca bu çalışmanın ülkemizde oldukça az sayıdaki araştırmanın odaklandığı eş bağımlılık ve evlilik gücü konularında yararlı bilgiler sağladığı düşünülmektedir.
... Estos patrones se cristalizan en el matrimonio, en donde los estudios sugieren que la COD se mantiene debido a la personalidad de uno de los miembros de la pareja o de ambos [e.g. sus estilos de apego o sus rasgos de personalidad bordelinde o narcisistas] (Dodge, Ward & Wilkiewitz, 2010;Timmen & Cermak, 1986;Wells, Glickauf-Hughes & Brass, 1997). Sin embargo, existe otra aproximación en donde se toma en consideración que las relaciones interpersonales y, por extensión, la COD puede explicarse a partir de costos y beneficios percibidos por los miembros de la pareja. ...
... Poder usar la teoría de la interdependencia para la predicción de la COD, facilita el acercamiento a sus posibles causas situacionales, propias de la interacción y no de la personalidad del individuo, nutriendo el conocimiento acerca su aparición y funcionamiento más allá de los modelos tradicionales que suponían su origen en el estudio retrospectivo de la infancia (Fagan-Pryor & Haber, 1992) o el estudio de la personalidad del codependiente (Dodge et al., 2010;Timmen & Cermak, 1986). El uso del modelo de la interdependencia aplicado a la COD puede proveer de elementos para diseñar intervenciones centradas en la modificación de comportamientos de interacción, en función de prevenir la aparición de patrones codependientes en alguna de las personas involucradas en la relación. ...
Article
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La codependencia se estudia tradicionalmente como rasgo de personalidad, sin embargo, existen sugerencias sobre su posible explicación desde modelos más sociales. Usando el modelo de interdependencia se propone su predicción a través del manejo del conflicto y los estilos de poder. Para ello, participaron 571 adultos (M = 20.20 años, DE = 1.93) quienes respondieron escalas de manejo del conflicto, estilos de poder y codependencia. Se encontró evidencia a favor del modelo de interdependencia ya que el manejo del conflicto no colaborador en la pareja, y la acomodación y evitación en el codependiente, en conjunto con estilos de poder negativos, son predictores de la codependencia. Se discute la aplicabilidad de la teoría de interdependencia como modelo para explicar la codependencia, así como los beneficios para el entendimiento del inicio y mantenimiento de los patrones codependientes.
... This represents a serious problem in South Korea, since 19% of the 78.5% of adults older than 19 years who drink alcohol are problematic drinkers (Ministry of Health and Welfare, 2006). Many studies on difficulties experienced by spouses of alcoholics since the 1960s have demonstrated their very severe codependency (Cermak, 1986; O'Gorman, 1993; Smalley, 1984) and mental health problems, including depression, anxiety, obsession, interpersonal sensitivity, hostility and so on (Bailey, Haberman, & Alksne, 1962; Cheong & Yeon, 1982; Lee, 2000). Problems such as family conflicts and poverty caused by the husbands' alcoholism can be the main causes of the wives' suffering, and can result in the wives' losing meaning in their lives and experiencing despair and hopelessness (Kang, 1995; Lee, 2001). ...
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Purpose This study aimed to identify the effectiveness of a newly developed group therapy, called the logo-autobiography program, in improving meaning in life and mental health in the wives of alcoholics. Methods The program was developed in four steps: literature review, pilot program development, pilot study and detailed program structuring. The pilot program was developed by combining a modified guided autobiography program with logotherapy. A non-randomized controlled trial was conducted with a pre- and post-test design. The instruments chosen for the study were the Purpose in Life (PIL) test and the Symptom Checklist-90-Revision (SCL-90-R) to measure the meaning in life and mental health. Data were collected between November 2006 and March 2007 from 19 subjects in the experimental group and 21 subjects in the control group, who were all wives of alcoholics from four South Korean cities. Results The score for meaning in life was significantly higher in the experimental group than in the control group (p = .047). Also, the scores for somatization (p = .001), interpersonal sensitivity (p = .008), depression (p = .003), hostility (p = .002) and global severity index (p = .001) were significantly lower in the experimental group than in the control group. Conclusion This study indicated that the logo-autobiography program enhanced both meaning in life and mental health in alcoholics' wives, which suggests that the program would be very beneficial to this population. Furthermore, it might be suitable for improving mental health in families and communities that suffer from psychological trauma and meaninglessness.
... Those suffering with codependency have boundary and control issues, low self-worth as well as physical, emotional, and psychological consequences. Individuals suffering with codependency are susceptible to stress-related medical problems as well as psychological problems (Cermak, 1986b;Crothers & Warren, 1996;Hughes-Hammer, Martsolf, & Zeller, 1998a, 1998bO'Brien & Gaborit, 1992;Wegscheider-Cruse & Cruse, 1990;Whitfield, 1991). The concept of codependency has expanded past the addiction field. ...
Article
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Overeating is a common eating disorder and often leads to obesity and to significant physical, emotional, and social problems often warranting nursing care. Codependency has expanded beyond the chemical dependency field and describes the dysfunctional pattern of behavior of an individual in a relationship with another person or from survival in a dysfunctional family of origin. The psychological and behavioral factors surrounding overeating are noted frequently in the literature but are not emphasized in most overeating treatment programs. Anxiety, depression, anger, and compulsivity are the psychological problems often linked with overeating and codependency. The purpose of this study was to test the Codependency-Overeating Model (COM) by examining the relationship between overeating and codependency, anxiety, depression, anger, and compulsivity. The variables were measured with the Overeating Questionnaire, Codependency Assessment Tool, and Symptom Checklist-90-R. This study used a model-testing correlational design with 567 students recruited from a Mississippi community college. Pearson’s product–moment correlations noted weak correlations between age and anxiety (r = .12), age and depression (r = .20), age and compulsivity (r = .20), codependency and anxiety (r = .12), and codependency and anger (r = .16). No significant correlations were noted between overeating and codependency, anxiety, depression, anger, or compulsivity. Although the predictive relationships were not verified in the model, several important ways to minimize limitations in future studies were identified. The development and testing of the COM was the beginning step in pursuing a solid understanding of overeating and codependency and a catalyst for worthwhile future research.
... Definitions of codependency, though inconsistent, often imply themes of caretaking, rescuing, taking responsibility for others, pleasing others, and intense focus on the needs and behaviors of others. The term codependency has been used to portray family members as dysfunctional (Hands & Dear, 1994), suffering from a disease (Wegscheider-Cruse, 1984), having an addiction themselves (Whitfield, 1989), or suffering from a personality disorder (Cermak, 1986). Such assertions of pathology convey messages of blame, inadequacy, powerlessness, guilt, and shame (Bennett, 1995; Harkness & Cotrell, 1997). ...
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The issue of responsibility in the treatment of substance abuse and other problem behaviors is examined. A distinction is made between responsibility which involves accepting what one does to oneself, and contributions which include all the influences in the environment, both past and present, that have made substance abuse an attractive option. Several case examples are offered to illustrate how the distinction between responsibility and contribution can add clarity to family interventions, enhance personal responsibility-taking, and diminish blaming and fault-finding.
... Éstas conductas facilitadoras serían consideradas por los codependientes como necesarias para preservar un vínculo afectivo con el dependiente, a expensas de involucrarse en una relación de dependencia y explotación (Black, 1982). Es por ello que se postuló que así como el alcohólico depende del alcohol, el familiar codependería emocionalmente del alcohólico (Andrade y Ospina, 2012;Cermak, 1986). ...
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La codependencia sería un patrón disfuncional de relacionarse con los demás, que se ha descripto en familiares de dependientes de sustancias psicoactivas y de enfermos crónicos, que se caracterizaría por la dependencia emocional, la focalización extrema en el otro y el descuido hacia sí mismo. Objetivo: presentar resultados del proceso de construcción y validación de un instrumento para evaluar codependencia. Método: Se administró la Escala Argentina de Codependencia a una muestra por conveniencia de 347 sujetos entre 15 y 80 años, de Mar del Plata. Análisis: se utilizó AFE (método de extracción ejes principales) y se determinó el número de factores con Análisis Paralelo. Se evaluó la consistencia interna mediante Alfa de Cronbach. Se estimaron estadísticos a nivel del ítem. Resultados: se conservaron tres factores. La consistencia interna de la escala total y de las tres subescalas fue satisfactoria. Los familiares de personas dependientes al alcohol o drogas y de personas con otras enfermedades crónicas presentaron medias significativamente más altas en sus puntajes de codependencia que las del grupo de población general.
... Despite its multiple interpretations, attempts are made to objectively define and measure COD. Seen as a dysfunctional condition that effects all dimensions of life, as per the biopsychosocial lens, COD is a preoccupation with others to the extent that the self is lost or abandoned (Whitfield, 1991).The criteria for COD include unsuccessful yet continued attempts to control others, assumptions of responsibility for others to the exclusion of oneself, enmeshment and blurred boundaries, anxiety, depression, denial, emotional restrictions, and involvement in a primary relationship with a substance dependent individual for at least two years (Cermak, 1986b). Attempts to control others may manifest in areas like working, eating, cleaning, or perfectionism (Koffinke, 1991). ...
Article
Background: The risks of behavioral addictions are well documented. There are biological, medical, social, spiritual, psychological, and safety risks to the individual as well as risks, like ripple effects, to the family and friends with whom the individual with behavioral addictions lives. The phenomenon of collateral damage from addictions, especially alcoholism and substance dependence, is well documented. Aims and methods: A selected review of the literature reveals little regarding the risks of collateral damage, in particular codependence, from behavioral addictions on non-addicted family and friends. Results: This article theoretically posits the existence of codependence to those with two well documented and researched behavioral addictions, hypersexual and gambling disorder, using the biopsychosocial lens. Conclusions: Addictions professionals are encouraged to revisit the literature on codependence and consider its influence on family and friends of those with behavioral addictions when providing services.
... Family members themselves are thought to be suffering from a pathological conditioncodependency -and therefore in need of some form of treatment. Some authors (Cermak, 1986;Subby,1987;Wegsheider-Cruse, 1985;Wright & Wright, 1991) make reference to co-dependence as a personality deficit, while some others (Shaefer, 1986;Young, 1987) have described it as a disease. ...
... In recent years, the construct of codependency has been associated with exposure to any chronic stressful events within the family environment such as physical, sexual, emotional abuse, neglect or excessive trauma 4 . Codependency is defined as "a pattern of painful dependence on compulsive behaviors and on approval from others in an attempt to find safety, self-worth, and identity" 5 . ...
... Only one researcher, thus far, has fought for the inclusion of codependency in the Diagnostic Statistical Manual (DSM). Cermak (1986) challenged the construct of codependency arguing for its diagnostic validity; that is the ability of professionals to diagnose patients as codependent through the DSM's criteria for codependency. He argues that codependency can be defined within the DSM for the diagnostic category of Mixed Personality Downloaded by [Heather K. Terrell] at 12:17 08 May 2012 ...
Article
Codependency has been found to originate in many different environments, namely the family of origin. The most popularly researched environment is the family of origin that exhibits substance abuse. However, little research has clearly demonstrated that codependency is most prevalent in children of substance abusers. Previous research has not examined how codependency is correlated with perceived interparental conflict. This study examined the relationships among codependency, interparental conflict, and substance abuse in the family of origin. Results of this study found that codependency in adulthood was related to perceived interparental conflict in the family of origin, but was not related to the family of origin that exhibited substance abuse.
... In the earlier times, co-dependency was viewed as a condition of chemical dependency. Later, scholars tend to view it as a psychological condition of people who are in relationship with alcoholics or drug addicts (Cermak, 1986). Thus, the concept was used by drug and alcohol counsellors to describe those individuals, who make relationships with substance abusers, fail to leave them even after it becomes clear that the relationship is damaging one (Frank and Golden, 1992). ...
Conference Paper
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... There may be many dysfunctional relationship patterns among family members which may directly or indirectly enables the addictive behaviors (Cermak, 1986). The quality of relationships between family members especially the bond between the parent children subsystems found to have significant influence on drug use among family members. ...
Article
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Addictive behaviors are found to be more prevalent among some families in various forms. Although many explanations are provided, there may be various factors and forces associated with family in the initiation, maintenance and recovery of addictive disorders. Modelling, poor parenting skills, structural and relationship issues, support, sociocultural frame work and socio economic status of the family may play different roles in various aspects of addictive disorders. Comprehensive understandings of such factors are important to deal with the problem of addictive behaviors in various stages and also for prevention. An appropriate concern and participation of family may lead to better outcomes. Key words: addictive behaviors, substance use, role of family, prevention of addictive behaviors, treatment of addictive behaviors. Introduction:
... A variety of theories have been proposed to explain the phenomenon of co-dependency. Cermak [13] saw co-dependency as a personality disorder. In contrast, Wegscheider-Cruse [14] assumed that anyone could be co-dependent and thus co-dependency should be classified as a separate clinical entity versus a consequence of reactive behaviour [9,15]. ...
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Background: Much literature is devoted to describing the psychosocial situation of patients with a substance use disorder and the course of their families and healthy partners. Couples where both partners have a substance use disorder are less well described and even less often studied. Method: This study described the psychodynamic and symptomatology, as measured by the Brief Symptom Inventory (BSI), of five concordant couples treated simultaneously as inpatients at the same specialized substance use disorder ward. Results: The psychodynamic characterization of the couples revealed that the female was often the organizer, whereas the male was either the motivator or the lackey. In addition, the female was often emotionally dependent on the male. Most individuals showed symptom reductions from pre- to post-treatment, although the men seemed to benefit to a greater extent than the women. Moreover, the patients did not necessarily desire couples therapy. Conclusion: Treating couples concordant for substance use together in the same inpatient setting is unusual, but possible. The dynamics of couples in drug rehabilitation should be further investigated taking into account possible gender differences.
... La codependencia (COD) es un constructo en desarrollo dentro del ámbito científico. Entre sus principales campos de estudio se encuentran las observaciones clínicas (Cermak, 1987;Timmen & Cermak, 1986), los estudios de género (Cowan & Warren, 1994) y las investigaciones acerca de la dinámica de pareja (Knudson & Terrell, 2012). En cada una de estas perspectivas, se han generado medidas y definiciones que han contribuido en la identificación de características para comenzar a definirla con claridad. ...
Article
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Codependency is commonly associated with married adults, and instruments of measurement, which focus on a certain age group and type of relationship. However, it has been found that codependency can also arise in premarital relationships during youth, at which stage, there are no specific scales that measure this phenomenon accurately. Therefore, the purpose of this research was to build a codependency scale for young people with premarital relationships. An instrumental study was conducted, with a non-experimental design where they participated 319 young people (M=20.99, SD=1.8) with a dating relationship of at least one year. Based on an exploratory factor analysis, a scale with 7 factors was found: interpersonal control (α=.91), relational damage (α=.92), self-sacrifice (α= .85), rescue orientation (α=.89), emotional dependence (α=.90), external focus of attention (α=.82) and wear (α=.83), which explain 67.64% of the variance. The results allow us to observe factors coinciding with the international literature (interpersonal control, self-sacrifice and external focus of attention) and new factors such as the effect of culture, type of relationship and stage of life (relational damage, rescue orientation, emotional dependence and wear), in addition to a valid and reliable scale for measuring codependency in premarital relationships amongst youth.
... Nieczęsto badani wskazywali też na poświęcenie polegające na pełnym podporządkowaniu się partnerowi. całkowite podporządkowanie się woli drugiej osoby może oznaczać sytuację współuzależnienia, która nie jest powszechna w bliskich związkach (najczęściej współwystępuje z chorobą alkoholową partnera) (Cermak, 1986;Covan Warren,1994). Analiza uwzględniająca lącznie wszystkie rodzaje poświęceń nie wykaza|a istotnych rożnic międzypłciowych, odnotowano zaś różnice w zakresie róznych jego rodzajów. ...
... Codependency has been defined as "a pattern of relation to others characterized by an extreme focus outside the self, lack of open expression of feelings, and attempts to derive a sense of purpose through relationships" (Spann and Fischer 1990, p. 27). This affective disorder was identified around 60 years ago as the result of years of studying interpersonal relationships in families of alcohol abusers, and the term "codependent" was used to describe persons living with, or in a relationship with an addicted person (Cermak 1994;Hopkins and Jackson 2002;Lindley et al. 1999;Malloy and Berkery 1993). According to this perspective, in the attempt to control him or her, the codependent was believed to develop an addiction to the partner's substance abuse (Peled and Sacks 2008). ...
Article
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Working within the framework of the Bowen’s Family Systems Theory and using data from 318 non-clinical participants, the present study assessed a model in which codependent behaviors were predicted by dyadic adjustment in couple relationships and differentiation of self. Results indicated that the dimensions of differentiation of self (I-position, emotional reactivity, emotional cutoff, fusion with others) were more important in explaining the codependent behavior compared to the dimensions of dyadic adjustment (dyadic satisfaction, cohesion, consensus, affective expression). These results suggest the importance of considering the dynamics and outcomes of the process of differentiation of self both in research and in counselling and clinical practice with individuals, couples, and families.
Article
ACKNOWLEDGMENTS I want to express my great appreciation to Judith L. Fischer, chairperson of my committee, for her expert guidance and gentie support from the inception of this research project I also appreciate the significant contributions of the other committee members. Dr. Jean Scott and Dr. Nancy Bell. I am grateful to Carol Jean Schoenrock for her expert help in reviewing the original scale, for her assistance in collecting the student sample data, and mostly for her understanding and inspiration throughout this research experience. I am grateful to Leigh Mires for her belief in me and encouragement throughout this project. I am deeply grateful to my parents, Jimmie and Norma Spann, for the undying faith and acceptance they have given me throughout my life and throughout this latest educational endeavor. Finally, I thank my friend Anna Wegleitner, my siblings, and many other supportive friends who have been truly interested and helpful in many ways during this experience. 11 CONTENTS
Chapter
Stigma associated with substance use disorder (SUD) is well documented but less well described for family members of those struggling. Through a variety of mechanisms, including closeness, unusualness, and blame, family is implicated through stigma by association. This is especially true for parents as there is an assumption of poor parenting and poor “family values” by both those outside the family and parents themselves, resulting in poorer mental and physical health outcomes for families, as well as social isolation and a lack of help seeking. There is also the presence of specific stigmatizing language associated with families, including labels such as “codependent” and “enabling,” which further isolate families. Broader dissemination of evidence-based family approaches such as Community Reinforcement Approach and Family Training (CRAFT) could help shift stigmatizing understanding and attitudes, as could the development of peer-to-peer coaching utilizing evidence-based strategies.
Chapter
Self-stigma in addiction occurs when individuals with substance use disorders (SUDs) experience shame based on mythological stereotypes in public stigma, as well as from their own sense of what they take to be shameful about addiction. This process leads to changes in identity in line with negative stigmatising stereotypes. The main source of the shaming process comes from public stigma where powerful others impose upon the individual with SUDs a social world (an ambience) containing false and distorting attitudes and beliefs that are internalised and lead to harmful effects, including further substance use and self-sabotage. A second source of self-stigma is the private shame that individuals feel based on accurate recognition of their situation. This may generate the motivation to heal but typically only when it occurs in a supportive context where public stigma is absent and acceptance by others is present. With the barrier of public stigma removed, or at least lowered, the individual with SUDs will stop self-stigmatising based on the damaging mythology around addiction and so may be given the support he or she needs for self-compassion, and in particular self-trust, in order to recover.
Article
In this article, the authors review the current conceptual and empirical literature from a variety of disciplines dealing with the construct of connectedness. A working definition of connectedness is provided along with a discussion of its multidimensional nature and major characteristics. Its relationship with a variety of other variables is also presented. Particular attention is given to gender and cultural considerations in the experience and operationalization of connectedness. Recommendations for counseling, assessment, and research related to connectedness are provided.
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Misuse of alcohol and drugs is widespread in modern society with the associated emotional and physical tolls on individuals, couples, and families. Yet, many therapists do not assess nor address substance misuse when clients do not identify it as a presenting problem. This article presents an overview of the literature on key aspects of couples and substance use and makes important clinical recommendations for mental health professionals who work with couples that struggle with substance use.
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Unlabelled: The purpose of this study is to assess the internal consistency of the subscales of the Hungarian Version of the Codependent Questionnaire (CdQ, Roehling & Gaumond, 1996). Thus, a reliable measurement of codependency for professionals become available in Hungary. The Hungarian Version of the Codependent Questionnaire enables professionals to identify codependent individuals. Methods: Our sample (N=137) was recruited from the general population and from self-help groups (82 individuals); and patients with borderline personality disorder (55 individuals) were recruited as clinical control group. The reliability of the questionnaire was assessed by Cronbach's alfa and principal component analysis. In addition, in order to investigate the latent structure, factors analyses and hierarchical cluster analysis were used. Results: Based on our results, the Cronbach's alfa values of the subscales of 'control', 'reliability' and 'intimacy' indicate appropriate reliability, however, the subscale of 'enmeshment' indicates poor reliability. The originally assumed factor structure is not supported by the results of the statistical analyses. The subscales are not separate from each other, which is also indicated by the correlations of the total scores of the subscales. Conclusion: The reliability of the Hungarian Version of the Codependent Questionnaire is nearly identical to the original data, except for one subscale ('enmeshment subscale'). Based on these results the Hungarian Version of the Codependent Questionnaire is considered to be reliable. Besides the Hungarian adaptation, the strength of this study is the investigation of a clinical sample. The use of the questionnaire is recommended without the subscale of 'enmeshment' and further 5 items, and it is suggested to use as one scale.
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It is fascinating to view the expansion of our journal reaching wider range of readers and authors. This year we got submissions from authors based in different parts of the world. The current issue publishes research reports, literature reviews and articles focusing on issues of gender around sexual harassment, matriarchy, son-preference, women's movements, and co-dependency. Abstract This article is an attempt to review various approaches towards co-dependency including pathologising characteristics associated with women as a social entity. A critique from feminist perspective, role of unequal distribution of power and resources is discussed alongside the power strategies of control exercised in intimate heterosexual relationships. As co-dependency has been observed to promote an identity based on powerlessness and co-dependency model increases separation from the family of origin rather than association, an empowerment approach to support the clients is discussed with implications for the future practice.
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Research indicates self-esteem reflects many factors in a person’s life, such as relationships with parents or parent figures, attachment types, experiences of worth enhancement, ethnicity, generation, and cultural values. However, debate continues on whether self-esteem is simply a reflection of Western culture and may not be a universal factor of human nature. This research was undertaken to understand how four persons of diverse ethnic, gender, and age categories may each perceive the self from reading the same story. First, the authors offer a brief overview of how self-esteem is viewed and explore a few cultural, gender and age aspects of self-esteem. They then present our pilot study with the methodology, results, and discussion, and offer implications for mental health counselors.
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This entry examines several prominent popular (“pop”) psychology diagnoses. Codependency, Stockholm syndrome, behavioral addictions, and eating disorder variants are reviewed, along with research supporting and questioning their diagnostic validity.
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Now more than ever, substance abuse has become an epidemic within the community. There is a need to understand the common definitions and terminology that are used within the field, as well as understand the evolution of such concepts. This chapter will provide an introductory explanation as to what defines a drug, psychoactive drugs, and drugs with addiction potential; a brief history of the concept of addiction; a contemporary definition of addiction, related terminology, co-occurrence, and recovery; and a discussion of the differences between professional treatment and mutual help/12-step fellowship groups.
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The health of family and friends affected by another person's substance use and/or gambling is an undervalued health issue. These relationships are rarely explored as caregiving. Research on caregivers suggests leisure is important for improving, maintaining, and protecting their health. Guided by feminist social constructionism, this article explores how women caring for people harmfully involved with alcohol, drugs and/or gambling experience leisure in Nova Scotia, Canada. Data were collected from ten women though semistructured interviews. Examples of caregiving are provided. Three themes demonstrate the results: loss of leisure, negotiation of leisure, and leisure as escape. Understanding the women's experience of leisure in this caregiving relationship has important implications for their health.
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Substance use disorder is known to adversely affect both the user as well as his or her family members. A consequence of chemical dependence on family members is co-dependence. Co-dependence is associated with an excessive focus on the needs and behaviors of the person with substance use disorder. Most studies in the field of drug-related problems in Iran have focused on the substance user, while few studies have been carried out on the family members. A qualitative case study approach was employed to explore characteristics of co-dependence among wives of persons with substance use disorder in Iran where substance use disorder is a notable social harm. Purposive snowball sampling technique was used to identify 11 Iranian wives of individuals with substance use disorder. The data were collected through in-depth, face-to-face interviews, non-participation observation, and document analysis. Data were analyzed using the constant comparative method. The analysis yielded five main characteristics of co-dependence among wives of persons with substance use disorder, namely: Denial, enabling behavior, low self-worth, enmeshed self, and weak spiritual relationship with God. The findings showed that except for a weak spiritual relationship with God, most of the characteristics of co-dependence among the participants were similar to the traits of co-dependents found in previous studies conducted outside Iran.
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Purpose This paper aims to adapt the medical phenomenon of Munchausen syndrome by proxy (MSBP) to an organisational context. Specifically, MSBP serves as a novel metaphor to describe the tendency for the organisation and the leader to perpetuate cycles of illness and therapy. Design/methodology/approach A conceptual metaphor is proposed based on the clinical description of MSBP. A perpetual feedback model emphasises a constant cycle of illness and therapy among leaders and organisations, often fabricated by a narcissist through destructive management. Findings The metaphor presented suggests that the role of deception is important for understanding why therapeutic approaches are often unnecessary, highly disruptive and administered by a destructive leader who possesses the power to alienate or dismiss non-corroborative organisational members. The implications of continuously passing illness between the leader and the organisation are a state of organisational disequilibrium and the manufacture of depersonalised, ill members. Originality/value This conceptual paper adds to the growing body of literature on behavioural strategy and contributes to the fields of organisational psychology, organisational analysis, management and employee relations.
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Healthcare workers are frequently a target of patients' violent behaviour. Increased workplace violence towards health care professionals has been reported by several studies. The purpose of the present study has been to identify the prevalence of violence towards employees in the Slovenian drug addiction rehabilitation centre network. Methods: For the purpose of this study, a non-experimental sampling method was employed, using a structured questionnaire answered by rehabilitation centre employees (n = 54). Data were analysed by means of descriptive statistics, correlation analysis and linear regression, with a significance threshold of p < 0.05. Results: Employees in the Slovenian drug addiction rehabilitation centre network are subject to a high risk of violence. In the last 12 months employees were most often faced with verbal abuse (83.3%), while one in 5 became the target of physical violence (22.2%), which indicates that work-related risks are not being properly managed. Conclusion: This study could serve as a basis for a comprehensive approach to managing violence within the drug addiction rehabilitation centre network, while it also provides clear pointers to guidelines for the design of further research. Some Slovenian psychiatric health care facilities have already introduced certain measures in this field, leading to reductions in workplace violence that demonstrate that the incidence of aggressive outbursts by patients can be reduced.
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Background This study aimed to determine the moderating effect of personality traits on the relationship between living with an addicted man and codependency. Methods We selected 140 women (70 wives of addicted men and 70 wives of non-addicted men) through convenience sampling method and asked them to complete Spann-Fischer Codependency Scale and NEO-Five Factor Inventory. Findings Codependency score was significantly higher among addicted men’s wives. In addition, for these women, there was a strong positive correlation between codependency and neuroticism as well. Multiple regression analysis confirmed the significant interaction effects of being an addict’s wife and personality traits of neuroticism, openness and agreeableness on codependency. Conclusion Not all addicts’ wives experienced codependency; women with a high level of neuroticism and low level of openness and agreeableness were more vulnerable to the stress of living with an addict and to codependency.
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L'auteur tente d'expliquer pourquoi l'identification projective introduite par Melanie Klein et reformulee par Bion, a jete tant de confusion dans le champ de la psychotherapie dynamique. Il s'agit d'un concept qui decrit un mecanisme a la fois intrapsychique et interpersonnel. L'identification projective a ete definie tantot en soulignant ses effets sur le self, tantot en soulignant ses effets sur l'objet cible. En fait, c'est un concept qui inclut tout autant le self qui projette et re-introjecte que l'objet externe qui introjecte le contenu projete. Concu pour rendre compte du comportement des sujets regresse, c'est un terme egalement necessaire pour comprendre les relations intimes entre partenaires normaux, comme les phenomenes de transfert et de contre-transfert, ainsi que les interactions conjugales et familiales. Une comprehension du proces dynamique designe par ce terme est indispensable a l'appreciation de la complexite des relations aussi bien duelles que de groupes