 esteemed colleagues, good morning or good afternoon. My name is Sam Baknin and I'm visiting Professor of Psychology in Southern Federal University or Stovon Dome in the Russian Federation, as well as a professor of finance and a professor of psychology in SEAPS, the Center for International Advanced and Professional Studies. Today I would like to discuss the issue of codependency. As we all know, codependency is not an official mental health diagnosis, at least not within the diagnostic and statistical manual in its latest iteration, which is the fifth edition of 2013. Instead, there is something called dependent personality disorder and that has been in the diagnostic and statistical manual for almost, for well over 20 years. So this creates a great confusion regarding the terms codependent, counter-dependent, dependent, et cetera, et cetera. So perhaps before we proceed to study dependent personality disorder, we would do well to try to clarify these terms. As Lidia Nagelowska observes, we all need to be needed. We all want to feel useful and able to give. People resent the narcissist, partly because his false self, the facade he puts out to the world, is so self-sufficient. But codependence take these to a whole different level, to a new extreme. Like dependence, people with dependent personality disorder, codependence depend on other people for their emotional gratification, the regulation of their emotions and moods, reducing lepility, and the performance of both inconsequential and crucial daily psychological, or in Freudian parlance, ego functions. Codependence seek to fuse or to merge with the significant others. By becoming one with their intimate partners, codependence are able to actually love themselves by loving others. It is like loving yourself by proxy, vicariously. Codependence are needed, demanding, clinging and submissive. They suffer from abandonment anxiety and to avoid being overwhelmed by it, they cling to others and act immaturity. And in this sense, they're very reminiscent of some aspects of borderline personality disorder and some aspects of the complex post-traumatic stress disorder syndrome. These behaviors are intended to elicit protective responses and to safeguard the relationship with their companion or mate upon whom they depend. Codependence appear to be impervious to abuse. No matter how badly they are mistreated, they usually remain committed to the relationship. In extreme codependence, this fusion, this merger with the significant other, lead to in-house stalking as the codependence strives to preserve the integrity and the cohesion of her personality and the representations of her loved ones within her mind. So what I call in-house stalking is actually stalking perpetrated by the codependent on her intimate partner. This is where the co-dependence comes into play. By accepting the role of victims, codependence seek to control the abuses and to manipulate them. It is a dance macabre in which both members of the diet collaborate. It's a kind of traumatic bonding or trauma bonding. In codependency, the codependence sometimes claims to pity her abuse. She casts herself in the grandiose roles of his savior or his redeemer or his mother. Her overwhelming empathy imprisons the codependent in these dysfunctional relationships and she feels guilt, either because she believes that she had driven the abuser to mistreat her or because she contemplates more and more seriously to abandoning. There are various types of codependence. Codependency is a complex, multifaceted and multidimensional defense against the codependence, fears, and needs. So I distinguish between four categories of codependency stemming from their respective etiologies. So psychodynamic processes and psychologic etiology. So the first category is codependency that aims to fend off anxieties related to abandonment. These codependence are clingy, smothering, and prone to panic. They are plagued with ideas of reference, of French light-eating and they display self-negating submissiveness. Their main concern is to prevent their victims, friends, spouses, family members, from abandoning and deserting them or from attaining true autonomy and independence. These codependence merge with their loved ones to experience any sign of abandonment or autonomy, personal autonomy, whether real, actual, threatened, imagined. They experience these as a form of self annihilation or even amputation. They do not allow their partners to kind of separate an individual. The second category of codependency is codependency that is geared to cope with the codependence fear of losing control. By feigning helplessness and neediness, such codependence coerce their environment into ceaselessly and seamlessly catering to their needs, wishes, and requirements. These codependence are drama queens. Their life is a kaleidoscope of instability, chaos, and liability. They refuse to grow up. They force their nearest endurance to treat them as emotional or physical evidence. They deploy their self-inputed efficiencies and disabilities. They yield them and will them as weapons. Both types of, both these types of codependence, type one and type two, use emotional blackmail when necessary, guilt-trip, and when necessary, threats to secure the presence of blind complies, blind complies, all their suppliers, anything less, triggers anxiety. The third category are vicarious codependence. These are codependence who live through others, more or less like the moons reflected sunlight. They sacrifice themselves in order to glory in the accomplishments of their chosen talents. They subsist on reflected light, as I said, on second hand, applause, and on derivative achievements and accomplishments. They have no personal history, having suspended their lives, their wishes, preferences, and dreams in favor of another's. They live by proxy. They live vicariously. They live through another, a parasitic existence. One subtype of such codependence is what I call inverted narcissists. The inverted narcissists is a form of covert narcissists. It is a codependent who depends exclusively on narcissists, a narcissist codependent. If you're living with a narcissist, if you have a relationship with a narcissist, if you're married to one, if you're working with a narcissist, et cetera, this does not mean that you're an inverted narcissist. To qualify, so to speak, as an inverted narcissist, you must crave to be in a relationship with a narcissist regardless of any abuse inflicted on you by him. You must actively seek relationships with narcissists and only with narcissists, no matter what your bitter and traumatic past experience has been. You must feel empty and unhappy in relationships with any other type of person. Only then, and if you satisfy the other diagnostic criteria or dependent personality disorder, only then can you be safely labeled an inverted narcissist. So this is an example of a vicarious codependent, the category three. And category four is codependent or borderline narcissists. These are narcissists who oscillate between periods of clinging and other codependent behavior patterns which they interpret as intimacy, and eras of aloofness, detachment, and emotional neglect, and abandonment which they regard as legitimate and only possible manifestations of their personal autonomy and need for space. They also tend to form with their intimate partner a shared circumstance or a shared psychotic disorder, the affiliate do. These are all outcomes of their overwhelming and all-pervasive abandonment anxiety. They either smother their partner in an attempt to forestall desertion, or they preemptively abandon sheep, thus avoiding hurt and maintaining an illusion of control over the situation. They say, I walked out on her, I dumped her, not the other way around. The codependent deploys strategies such as merger, becoming one with her intimate partner, while renouncing all personal autonomy and all independence of both of them, up to a point of shared circumstances. Another strategy is co-extensivity, the ventriloquist defense, insisting to the partner mind-reads her and acts in ways that reflect her inner psychological states and moods. And then there's the classic strategy of shifting, ever-shifting or shape-shifting boundaries using behavioral unpredictability and ambient uncertainty to induce paralysis and a paralyzing dependence in the partner. There's another form of co-dependence that is so subtle that it eluded detection until very recently, and that's counter-dependence. Counter-dependence rejects and despises authority and often clashes with authority figures such as parents, spouses, the law. They are consummations. The sense of self-worth and their very self-identity are premised on and derived from, in other words, dependent on. These acts of bravura and defiance, they are personal autonomy militants. Counter-dependence are fiercely militantly independent, controlling, self-centered and aggressive. Many of them are antisocial and they use projective identification. They force people to behave in ways that buttress and affirm their view of the world and its expectations. These behavior patterns are often the result of a deep-seated fear of intimacy. In an intimate relationship, the counter-dependent feels enslave, ensnared, captive. Counter-dependence are locked into an approach avoidance repulsion or repetition compulsion. The hesitant approach is followed by avoidance of commitment and then another stilted approach and so on. These people are lone wolves and they're very bad team players. Counter-dependence is a reaction formation. The counter-dependent dreads his own weakness. He seeks to overcome these weaknesses by projecting an image of omnipotence omniscience, success, sub-sufficiency and superiority. Most classical overt narcissists are, in effect, counter-dependence and, of course, all psychopaths. Their emotions and needs are buried at the scarpage which had formed and coalesced and hardened during the years of one form of abuse or another. Grandiosity and sense of entitlement, lack of empathy, overwinning hotness, overwinning hotness usually hide knowing insecurity and a fluctuating sense of self-worth. Another situational co-dependence. Some patients develop co-dependent behaviors and traits in the wake of a life crisis, especially if this crisis involves an abandonment and resulting solitude. So, in the wake of a divorce or an emptiness, one wants children embark on their own autonomous lives or live home or together. Such late-onset co-dependence fosters a complex emotional and behavioral chain reaction whose role is to resolve the inner conflict by ridding oneself of the emergent, undesirable, co-dependent conduct. Consciously, such a patient may, at first, feel liberated, but unconsciously, being abruptly dumped and lonesome, has a disorienting and disconcerting effect akin to intoxication. Many patients rush headlong and indiscriminately into new relationships. Deep inside, this kind of patient has always dreaded being lonely, not alone. Following the divorce, the death of a significant other or an intimate partner, passing away of parents or other loved ones, children relocating to college, following similar episodes of dislocation, the patient suppresses this dread because she possesses no real effective solutions and antidotes to her sudden solitude. And she has developed no meaningful ways to cope with it. We are taught that denied and repressed emotions often reemerge in camouflage, as it were. The dread of ending up on alone is such that the patient becomes co-dependent in order to make sure that she never finds herself in a situation like this. Never finds herself alone. Her co-dependency is a series of dysfunctional behaviors that are intended to fend off abandonment and loneliness. And still, patients who develop situational co-dependence, unlike classic life-long co-dependence, are fundamentally balanced and strong personalities who cherish their self-control. So they always keep all their options open, including the vital option of going alone yet again. They make sure to choose the wrong partner and that they spectacularly expose his egregious misconduct so that they can get rid of them and of the newly acquired co-dependency with good conscious and at the same time. So, to reiterate, the situational co-dependent is characterized by a deep-set fear of being lonely, an abandonment anxiety, a form of attachment disorder, as an underlying dormant inner landscape. This lurking abandonment anxiety is awakened by life's tribulations, divorce and emptiness, death of one's nearest endears. At first, the newly found freedom is exhilarating and intoxicating, but this feel-good factor actually serves to enhance the anxiety. The inner dialogue goes something like this. What if it feels so good that I will opt to remain by myself for the rest of my days? This prospect is terrifying. So a conflict erupts, internal conflict between conscious emotions and behaviors, liberation, joy, pleasure signal, and a nagging unconscious anxiety. I'm not getting any younger. This can go on forever. I've got to settle down, find appropriate mate, not to be left alone. I shouldn't get addicted to being alone. To allay this internal tension, the patient comes up with situational co-dependency as a coping strategy to attract and bond with a mate so as to forestall abandonment. Yet, the situational co-dependent is ecodistonic. She is very unhappy with her newfound co-dependency, though at this stage, she is utterly unaware of all these dynamics. She runs contrary. Her co-dependency runs contrary to her primary nature as accomplished, assertive, self-confident person with a well-regulated sense of self-worth. She feels the need to frustrate this new set of compulsive addictions, her co-dependency, and to get rid of it because it threatens who she is and who she thinks she is, her identity and self-perception. Surely she is not the clinging, mottling, weak, out-of-control type. All her life, she has known herself to be strong, a good judge of character, intelligent, and in control. Co-dependency does not become her. But how could she get rid of this new co-dependency? Well, in three easy steps. She chooses the wrong partner unconsciously and obviously it leads again to being alone. She proves to the satisfaction that he is the wrong partner for her. She gets rid of him, thus re-establishing her autonomy, her resilience, self-control and demonstrating credibly that she is co-dependent no more. To make matters clear, co-dependency is a much disputed mental health quite pseudo-diagnosis. We are all dependent to some degree or we all like to be taken care of. When is this need judged to be pathological, compulsive, pervasive, and excessive? And who decides? Clinicians who contributed to the study of this disorder use words such as craving, clinging, stifling, both the dependent and her partner. They use words such as humiliating, submissive, but these are all subjective terms, either culture bound or represent value judgments. They're open to disagreement. They're open to differences of opinion. Moreover, virtually in all cultures and societies, dependency is encouraged to varying degrees, especially in women. Even in developed countries, many women, the very old, the very young, the sick, the criminal and the mentally handicapped are denied personal autonomy. They are legally and economically dependent on others and could be authorities. Thus dependent personality disorder is diagnosed or even such behavior does not conform to social or cultural or moral. Co-dependences they are sometimes known are possessed with fantastic worries and concerns. They are paralyzed by their abundant anxiety and fear of separation. And this inner turmoil renders them indecisive. Even the simplest everyday decision becomes an excruciating ordeal. They go back and forth, approach avoidance. This is why co-dependents rarely initiate protests or do anything of their own. Co-dependents typically go around eliciting constant and repeated reassurances and advice from myriad sources. And this recurrence solicitation of SACOR is proof that the co-dependent seeks to transfer responsibility for his or her life to other people, whether they have agreed to assume this responsibility or not, it's coercive, it's blackmail. This recoil and studious avoidance of challenges may give the wrong impression that the dependent is intimate or insipid, yet most dependents are neither. They are often fired by repressed ambition, energy and imagination. It is their lack of self-confidence that holds them back. They don't trust their own abilities and judgment. Absent and inner compass and a realistic assessment of their positive qualities of the one hand and a realistic assessment of their limitations of their limitations on the other hand, dependents are forced to rely on crucial input from the outside. Realizing this, their behavior becomes self-negating. They never disagree with meaningful others, they never criticize them. They're afraid to lose their support and emotional lack, nurturance, but also their calibration, their place in the world. Knowing and realizing what's right and what's wrong crucially depends on equal some others. They don't have self-regulation, they are dysregulated. Consequently, the co-dependent wants himself or herself and bends over backwards to cater to the needs of his nearest and dearest and satisfy their every whim, every wish, expectation and demand. Nothing is too unpleasant or unacceptable if it serves to secure the uninterrupted presence of the co-dependent's family influence and the emotional sustenance that she can extract from them. The co-dependent does not feel fully alive when she is alone. She feels helpless, threatened, ill at ease and childlike. This acute discomfort drives the co-dependent to hope from one relationship to another. And even sometimes lead to promiscuity. The sources of nurturance are interchangeable to the co-dependent being with someone, with anyone, no matter who, is always preferable to solitude. Well, parents of co-dependence had taught their offspring to expect only conditional transactional love. The child is supposed to render a service or fulfill the parent's wishes and dreams in return for affection and compassion, attention and emotion, and so on. Inevitably, the hurt child reacts with rage to this unjust, capricious, arbitrary, conditional mistreatment. With no recourse to the offending parent, this fury is either directed outwards to others who stand in for the great parent, or inwards. The former solution yields a psychopath or a passive-aggressive, negativistic personality disorder. And the second solution, internalizing the aggression, results in a masochist or in a person with depressive illness. Similarly, with an unavailable parent, the child reserve of love can be directed inward at himself and yield a narcissist, or it can be directed outward towards others and create a co-dependent. All these choices, retired personal growth, result in arrested development and are ultimately self-analyzing, self-defeating at least. In all four paths, the adult plays the dual roles of a punitive parent and a maternal child who is unable and unwilling to grow for fear of incurring the wrath and the abandonment of the parent with whom he had merged so thoroughly, so early on. When the co-dependent merges with the lack of children, she interprets her new-found attachment and bold as a betrayal of the punitive parent. She fully anticipates the internalized parent's disapproval and dreads its self-destructive disciplinary measures. In an attempt to placate this implacable divinity, she turns on her partner and lashes out at him, thus establishing where her true loyalties and affiliation rest with the internalized parent, not with the new-found love. Concurrently, she punishes herself as she tries to preempt the merciless onslaught of her sadistic parental interjects and superego. She engages in a monocle of self-destructive, reckless and self-defeating behaviors. Acutely aware of the risk of losing her partner owing to her abusive discontent, the co-dependent experiences extreme abandonment anxiety. She swings wildly between self-effacing and clinging, being a doormat, behaviors on the one hand, and explosive, vituperative invectives on the other, the former being the manifestations of her eternal child and internal child and the latter expressions of her punitive parent. Such abrupt shifts in effect in contact are often misdiagnosed as the hallmarks of a mood disorder, maybe bipolar disorder, but when dependent personality disorder is diagnosed, these pendulum tectonic upheavals are indicative of an underlying personality structure rather than of any biochemically induced perturbations. Akin to addiction, dependence on other people fulfills important mental health functions. First, it is an organizing principle. It serves to explain behaviors and events within a coherent narrative, a fictional story, a frame of reference. I acted this way because I'm dependent. Second, it gives meaning to life. Third, the constant ups and downs satisfy the need for excitement and thrills. Fourth, and most crucially, the addiction and emotional ability places the dependent at the center of attention, allows her to manipulate people around her to do her bidding. Indeed, co-dependence is convinced that she cannot live without her dependence. This is a subtle and important distinction. She cannot, she can survive without him or her, without her intimate partner, but she believes profoundly erroneously as it happens that she cannot go on living without her addiction to her partner. She's in love with love, not with a partner. She experiences her dependence as her best friend, her comfort zone, as familiar and warm and fitting as an old pair of slippers. She is addicted to and dependent on her dependence, but she attributes the source of his dependence to her boyfriend, to her maid, spouse, children, parents, anyone who happens to fit the bill in the plot of her narrative. But these people come and go. Her addictions remain intact. They are interchangeable. Her addiction is immutable. So extreme cases of co-dependency dependent personality disorder, borderline personality disorder, they require professional help. Luckily, dependencies, dependencies are spectrum and most people with dependent traits and behaviors are clustered somewhere in the middle. They can help themselves by realizing that the world never comes to an end when a relationship does. It is the dependence in you, in the patient that reacts with desperation, not the patient herself. And next, the patient can analyze her addiction. What are the stories and narratives that underlie the addiction? Does she tend to idealize an intimate partner? And if so, can she see him or her in a more realistic light? Is she anxious about being abandoned? Why? Has she been traumatically abandoned in the past as a child perhaps? She should write down the worst possible scenario. The relationship is over. She is abandoned. Is her physical survival at stake? Or, of course it's not. She should make a list of the consequences of the breakup and write next to each one what she can do and intends to do about it. And so, armed with this plan of action, she is bound to feel safer and more confident. And she must share her thoughts, ideas and emotions with friends and family. Social support is indispensable. One good friend is sometimes worth a hundred therapy sessions and this is a secret that we should keep between us or we'll all go on and on. Clinging and smothering behaviors are the unsavory consequences of a deep set existential, almost mortal fear of abandonment and separation. But the codependent to maintain a long-term, healthy relationship, she must first control her anxieties head on. This can be done by a psychotherapy. The Therapeutic Alliance is a contract between patient and therapist which provides for a safe environment where abandonment is not an option. And thus, where the client can resume exploring and personal growth and form a modicum of self-autonomy. In this, the psychiatrist may wish to prescribe anti-exotic medication. Transference should be encouraged in certain cases. Self-help is also an option. Meditation, yoga, the elimination of any and all addictions such as vocalism, binge eating, feelings of emptiness and loneliness, the core of abandonment anxiety and other dysfunctional attachment styles. These feelings can be countered with meaningful activities and be altruistic, charitable and with true stable friends who provide a safe haven and are unlikely to abandon the patient and therefore they constitute a holding, supportive and nourishing environment. The codic pendants reflexive responses to their inner turmoil are self-defeating and counterproductive. They often bring about the very outcomes she fears most. But these outcomes also tend to buttress her worldview. The world is hostile about to get hurt. These are negative automatic thoughts which can be easily and profitably tackled in a variety of cognitive behavioral therapies. She needs to sustain her cut and zone, abuse and abandonment her familiarity, at least I know the ropes and how to cope with them. And this also is a form of complex negative thought. This is why she needs to exit this realm of mirror fears and fearsome mental tumors. She should adopt newer vocations, new hobbies, meet new people, maybe relocate, move to a new place, engage in non-committal, dispensable relationships and in general take life much more lightly. Some codic pendants develop a type of militant independence as a defense against their own sorely felt vulnerability, dependence. But even these daring rebels tend to view the relationships in terms of black and white and infantile psychological defense mechanism not as splitting. They tend to regard the relationships as either doomed to failure or as everlasting. And they tend to regard the intimate partners as both unique and indispensable, soulmate, twin or completely interchangeable and objective. These of course are misperceptions, cognitive deficits grounded in emotional maturity and thought and personal development. All relationships have a life expectancy. A sell-by could be for or expiry date. No one is irreplaceable or completely interchangeable. Codependence problems are rooted in a profound lack of self-love and absence of object constancy. She regards herself as unloved and unlovable when she is all by herself. Yet clinging codependent and counterdependent, firstly independent, defined, intimacy, retarding behaviors, all these can be modified. If you fear abandonment to the point of phobia, I advise you to adhere to a regime of therapy and a series of steps which can be easily implemented and I'll list it on my website. Having implemented this mini-therapy, you should then seek longer-term therapy in a structured therapeutic alliance. Codependency can be overcome, can be cured if you wish, can be altered and changed into a much healthier pattern of attachment, bonding and relationships. So I advise you to head to my website, www.narcissistic-abuse.com and there's a search engine there, type the word codependent and you will find a mini-therapy, mini-therapy itself administered regime, which should be perhaps a first aid kit in your case. Thank you for listening. I wish you a very good conference.