Practice notes

Codependency and addiction

I feel like I don’t really understand the term “codependency.” What do you think of it?

Diagnostic and pseudo-diagnostic terms generally don’t really help me think, either on my own or together with patients/clients. This is particularly true with terms like “addiction” and “codependency,” which mean so many different things to so many different people and which feel to me almost like shields intended to protect against thought, rather than lamps to illuminate.

I like “impaired self-reference” as an alternative to “codependency,” but that feels a bit… clinical, a bit abstract. I often hear myself saying to certain patients, “You’re very worried about what X feels and thinks,” or, “We keep talking about what X is feeling, but it seems much harder to get a handle on what you are feeling.” Or, “it seems like your feelings and experience are almost completely a function of what you imagine others are feeling.” This feels much more experience-near to me than conceptualizing something as codependence. 

Similarly, with “addiction,” I find that conceptualization much less useful than one which understands someone in the throes of “addiction” as:

A) finding a recurrent feeling state(s) (sadness, fear, powerlessness) or tone (unpleasantness, goodness) intolerable, 

B) having identified a behavior that produces an alternative, less intolerable – and usually temporarily euphoric – feeling state,

C) but that is ultimately maladaptive because of 

1) its costs, and

2) the barrier it presents to addressing the underlying feelings.

My thoughts. Words can help, when they bring us closer to someone’s experience. They help less when they defend against that.