 Hi everybody, and welcome to today's presentation on codependency. Over the next hour or so, we're going to define what codependency is, identify characteristics of the codependent relationship, explore the motivations for these behaviors, because we've talked before about the fact that people do things that are rewarding, and they don't do things that are not rewarding. And when faced with two choices that are rewarding, they choose the more rewarding one. By choosing this dysfunctional relationship, it's more rewarding than the alternative. So we need to look at why that is, and try to figure out how to fix that imbalance. And then we'll hypothesize alternate healthier behaviors. So codependency can serve as an alternate addiction or a distraction. If someone is in recovery from addiction, they can also be codependent. Now not all codependents have addictions to other things. But the chances are we're dealing with very similar behaviors. We're dealing with the need to self validate, the need to escape, the need to numb the fear of being alone. Codependence may use relationships to try to deal with depression or anxiety. You know, I don't have to focus on my own depression and anxiety if I'm focused on fixing you. If I can focus on something outside of me, then I don't have the energy left to focus on my own depression, anxiety, stuff, whatever the case may be. Ultimately, codependency is a self-defeating because one of the few things that can't be controlled is the will of another person. So if you're in a relationship with someone and you're codependent and they are an addict or an alcoholic or, you know, fill in the blank, the need to try to control, the need to try to rescue them is likely going to fail. And when that fails, the person with codependency will sort of tighten the reins and try to control them more. The other person will resist more. You can see where this is going. And it ends up badly. Very rarely, if ever, do codependent relationships end up being healthy for both parties. So codependency describes a type of relationship in which one partner defines his or her worth or goodness based on someone else. So if you're in a relationship and you are such and such as wife or you are such and such as husband or you are the CEO of this company and you define yourself exclusively as that and you define your worth or goodness based on the success of that, then you may be looking at some codependent issues. And you notice I talked about being a CEO. Some people, when they become workaholics, if you want to use that term that I think has been overused, will define their entire persona, their entire world, their entire life, based on the success of this business. And if it fails, they interpret themselves as failures. So it's important to understand that codependency is one of those kind of interesting terms that we can use to identify this need to define ourselves or focus on something outside of ourselves. The codependent person often chooses relationships in which the other person needs to be rescued because then they become indispensable. If the other person needs a caregiver, if the other person needs them to bail them out of jail, if the other person needs to have them around for some reason, then the codependent feels safe. They feel secure because they don't feel like they are lovable and needed for who they are. They feel like they have to be serving a function, serving a role in order to not be abandoned. So some of the mantras that I hear when I'm working with patients who are dealing with codependency issues, I don't understand why she refuses to change. I've done everything for her. Well, because you are looking at it from your perspective. The person with codependency has certain needs that need to be met, but the person with the addiction, and we're just going to say that for right now, also has other needs. The person with the addiction may not want to change because it's too scary. They don't think they can or they don't think they deserve to be happy and healthy. Other reasons too, but those are the three big ones. So the person with codependency is not getting into the mind of the addict. They are seeing it from their perspective. They're like, well, I've done everything. So why isn't this person changing like I expect them to? Well, because you're not meeting the needs that they need to have met and they're not ready to meet those needs because you can't change another person, which takes us to helping someone who doesn't want help is an exercise in futility. So score, the first part of that is a correct statement. But what are you supposed to do if you don't help? That butt negates everything ahead of time. It says, but I'm going to help them anyway because I don't know any other alternative. So when you're working with somebody with codependency, you really want to help them see how to set boundaries and how to say, I'm here to help. Here are the things that I can do for you, but I'm not going to chase you. If you want help, you need to come and get it. And there are some caveats. If you want help from me, I'm not going to keep bailing you out of jail. I'm not going to keep supporting your substance abuse or your addiction habit. So let's look at codependency as an addiction. And some people are like, oh, no. But in reality, it meets a lot of the same criteria. In codependency, the person needs more of the same substance or activity or person. In a codependent relationship, as time passes, the codependent's identity becomes increasingly defined by the relationship with the other person. They start foregoing other activities in order to try to rescue or maintain the sobriety of the person with whom they're in a relationship, which takes a lot of time and a lot of energy. During this process, a lot of times the codependent's friends are going to see the problems before the codependent does, and they'll be like, this person's not going to change. You need to take care of yourself because you're getting worn down. You're getting sick. You're getting whatever. And the codependent's like, I got this. So eventually, the friends start backing off going, I want to help. I'm there for you, but I can't continue to support you basically injuring yourself. So then the person with codependency ends up with fewer friends, fewer supports that are healthy, but may also link up with other codependent people, and they kind of support one another in their dysfunction. When the person with codependency cannot fix the person with the substance issues, when they can't control them, the codependent experiences extreme anxiety or depression because that is who they are. If they can't control that, they don't have anything else to focus on, and being alone, being still, focusing on themself is just terrifying and excruciatingly painful in some cases. So this withdrawal from not being able to focus on the other person results in a lot of anxiety, fear of abandonment, a variety of things. Spending more time thinking about engaging in or recovering from the behavior. Codependents are always hyper-vigilant to other people's behavior and obsess about what they are or not doing. So the person with codependency is going to look for clues that their relationship is going south, that the other person is beginning to relapse, that the other person is struggling. They're hyper-vigilant. They need to focus their attention outside of themselves in order to not focus on all the stuff that they're avoiding dealing with, but they also need to focus on all those little clues to make sure they're not abandoned. And it's just this constant fear of being all alone and failing to live up to someone else's expectations. Codependents spend large amounts of time rescuing or covering up for the other person or fixing it. If Jim Bob doesn't go to work, the codependent may make an excuse to his boss that he was sick and couldn't come in today. Calling for him, even though Jim Bob's not even at home, she may not even know where Jim Bob is, but she calls in sick for him so he doesn't get in trouble at work. Codependents will bail people out of jail. Codependents will give their significant others a place to live. If we're talking about a parent, for example. You can come stay with me, get your act together. And the person with codependency really has the best intentions of supporting the addict. The addict, for whatever reason, may not be ready to recover or may not be able to recover with the tools they're being given. So we need to remember that. The addict's recovery is not about the codependent. The addict will not recover for mom. The addict will not recover for spouse. The addict will not even recover for children. The addict has to recover because they feel they deserve better. And in order to be a good spouse, a good parent, a good child, the addict needs to get their crap together for themselves first. So it's not about the codependent, but the codependent takes it personally. He's not changing for me. I've done everything. I've given up everything. I've blah, blah, blah. And he's still doing the same things. Why is he so miserable? I'm giving him everything. And again, we need to get into the mind of the addict and go, because it's not about any of that stuff. It's about what's going on in the addict's own head. The codependent gets exhausted taking care of the other person, but can't stop because they rely on the other person to tell them they're okay, they're worthwhile. They are good enough, smart enough, and gosh darn it, people like them. But the codependent often doesn't have the ego strength to say, I am Donnelly Snipes. The codependent will say, I am Haley's mom or I am so-and-so's employee. They don't identify themselves because they don't know who they are. They are a summation of a bunch of roles that they take on. Codependency, as an addiction, the people forego other interests in order to maintain the relationship or the addiction. In codependency, the relationship is the drug of choice. When their significant other is doing well, they are doing great and they feel wonderful. They're walking on sunshine. When their significant other is not doing well, it rips the rug right out from under them because they can't control it, they fear abandonment, and they may be considering that they're choosing the addiction over me. Why? Why am I so unlovable that they're choosing this over me? For the codependent, having the significant other in their life makes them feel okay or whole. And one of the things I talk about in my book is making cookies, I love cookies. But when you make cookies, you can have sugar cookies and you can have chocolate, both wonderful on their own. You put them together, you make chocolate chip cookies. A third wonderful thing. But apart, they're both whole. In a codependent relationship, it's more like combining flour and eggs. You know, you can't use just flour or just eggs to make a dessert. No. But because it requires a whole bunch of other things and they have to go together in order to make something cohesive. The egg makes the flour cohesive, kind of like the codependent tries to hold the relationship together. We don't want a relationship where people have to depend exclusively on each other for existence. They can bolster each other. They can make something new and awesome, but they need to be able to be okay independently. The relationship takes the place of self-love because in most cases, the person with codependency doesn't love themself. They don't care about themself enough to put their needs above the needs of other people who may be struggling. And this is a really difficult concept for a lot of people in early recovery to kind of wrap their heads around because they're like, well, the person was hurting and I didn't want them to hurt. And my response back to them is, you saw yourself in them. You saw them hurting and it reminded you of how you've hurt and you wanted to fix them. You wanted to make it stop hurting because you can't stop your own hurt. And a lot of times understanding that they're seeing a reflection of themselves in the other person goes a long way to helping people understand their motivation. Like an addiction, the person with codependency continues the relationship despite negative consequences. Codependence are not just woohoo, let's walk on sunshine. This is a great relationship. It's all roses and wine and whatever. In a codependent relationship, there are more bad days than good. They struggle with depression, this sense of hopelessness and hopelessness because they can't fix or control the other person. They're terrified, there's a lot of anxiety that the person's going to leave. They get angry that the other person will not change for them and they may start resenting the other person for quote, taking advantage. So there's a lot of stuff that goes into that. When we talk about cognitive restructuring, then we start looking at identifying the things you can and cannot control to empower the person with codependency. We build self-esteem to help allay the fear of being alone. So it's not so uncomfortable to be by yourself. But it's also, we wanna help people develop other healthy relationships which codependents often don't know how to do. They don't know how to develop a relationship because they don't feel worthy. If you can't go into a room and say, hi, I am so-and-so and I'm awesome in a bag of chips, it's hard to meet people. So there's a lot of social skills, relationship skills and self-esteem work to be done. Then dealing with the anger and resentment. Remember that anxiety and anger are kind of the emotional correlates of the fight-or-flight response. And in the anxiety, the person is dreadfully afraid of being abandoned. And the anger and the resentment are that person's reaction to saying, how dare you, I am going to bully you into doing what you need to do. So we need to look at this and help people understand how the codependent relationship is really negatively impacting them. Yes, there are good days. Even for the person with clinical depression, there are good days. There are more bad days, but there are good days. And we don't wanna just romanticize the one good day out of the month and say, because a lot of times the codependent will say, well, last Tuesday, my significant other went to meetings and went to work and came home and had dinner with the family and yadda, yadda, yadda. And my response would be, okay, that was last Tuesday. That was eight days ago. What have happened in the intervening seven days? Oh, well. Um. Socially, the loss of healthy friends and or the replacement with other codependent friends who are also depressed, anxious, angry, and resentful. You see, we're kinda creating this storm around ourself. Physical issues, when people are under stress, they lose sleep, they get muscle aches, they get sick easier, they age faster. There's a whole host of things that can go into the stress-related impact on the person's body. And occupationally, a codependent spends so much time figuring out how to rescue and taking time off to rescue their significant other that they often have poor performance at work. So let's look at some common characteristics between what we think of as our characteristic addicts and our characteristic codependents, which I'm making the argument again, that they are pretty much one in the same. It just manifests differently. The addict may be addicted to substances, gambling, sex. The codependent is addicted to a relationship. Both of them have low self-esteem. If you've worked with addicts or codependents, I don't think you're gonna say, no, my clients have great self-esteem. No, they don't. There's a sense of unworthiness. So working on that self-esteem, so they don't need other people to validate them. They can validate themselves and they can be okay saying, you know, this is who I am. Like it or hate it, that's your choice. Depression and anxiety, both groups of people really struggle with hopelessness, helplessness and fear. Some of our basic fears, denial, I'm not denial, that's grief. Fear of rejection, isolation, failure, the unknown and loss of control. When these are tapped into, we tend to have this guttural or primal fight or flight reaction. Now you don't necessarily have to act on that. You know, you can identify it and let the feeling pass. You do not have to act on every feeling, but it is important to recognize that this anxiety, you know, let's talk about failure, rejection and loss of control. If you're in a relationship with someone with a significant other who has an addiction and they relapse or they continue using, you're not in control of them. They're rejecting your offers to help or your efforts to help and you're failing to fix them, which in reality, they can only fix themselves. And yes, they may be rejecting your offers for help, but is it about you or is it about them? And most of the time it's about them. And failure, we need to look at how this relationship is constantly stoking the internal fears or our natural fears. And you know, podcasts and classes that I do on characteristics of people with addictions, we talk about their need to control things, their fear of abandonment, their lack of self-esteem, their sense of helplessness and hopelessness because they don't know how to cope with life on life's terms at this point in time for one reason or another. A lot of times they have some coping skills, they have some characteristics about themselves that they like, we need to build on those. Fear of abandonment, most people with addictions rely on others to tell them they're okay. They rely on others to validate them. They rely on others to tell them how they think. If they grew up in a household where there was an addict, they were taught to don't talk, don't trust, don't feel. And they've carried that into adulthood. So they don't know how to engage in a healthy relationship and they don't even know how to have a relationship with themselves because they've learned not to trust themselves and they've learned not to pay attention to their own feelings, let alone the feelings of others. They're just constantly hyper vigilant and trying to smooth things over, walking on eggshells. The relationship becomes the addict's primary focus in codependency, in addictions, it's whatever the addiction is. This becomes the addict's best friend. It's the one thing that doesn't abandon them. It's the one thing that can at least distract them if not numb the pain, which leads them to minimize, deny, blame, throw focus to protect this addiction. The person with codependency will minimize how bad the relationship is. They'll deny that the person has started using again or has started hitting them or whatever the case may be. And they may blame others for the significant other's failure. Well, if his boss wasn't such a jerk, then he wouldn't have to drink. Or such and such, his mother is just making life absolutely unbearable on us. And then both addicts and codependents have stinking thinking. These cognitive distortions, all or none thinking, overgeneralization and personalization being three of the big ones. Overgeneralization is when you take one thing and you take it out of context. So it's not just the fact that you turned in a test in your math class and you failed. You turn that into being I'm stupid and anytime I turn in a test, I'm going to fail. That's overgeneralization. Personalization is when everything's personal. Somebody walks down the hall and they scowl and you take it as that I'm scowling at you and you take it to mean that you did something wrong. When in reality, they may have been lost in their own thoughts, not even have seen you. The look on their face had nothing to do with you. And, you know, the person with codependency or who personalizes things takes it personally and goes, oh, what did I do? It's not about you. And all or none, words like every time, always, never. Encourage your patients to and encourage yourself because I think everybody does this sometimes. Encourage yourself to identify exceptions. It's always rainy when I have a good hair day. Well, that's probably not true. You always disappoint me. That's probably not true. There are probably some exceptions. Maybe they're few and far between but there are probably some exceptions. So encourage people to get rid of this dichotomous thinking. Both types of people have difficulty identifying what they're feeling because they're overwhelmed by their feelings. What they're feeling, sometimes they grew up and they were taught not to pay attention to those feelings. So they can't even tell you how they're feeling anyway. Other times they can identify how they're feeling but it's so overwhelming. They just need to shut that down and numb it out and drink, eat, do something semi-self-destructive. We wanna help people start to identify how they react to dysphoric emotions and help them identify healthy ways to deal with it. Also helping them realize that they don't have to act on every feeling. You can feel guilty and you can let it go. You can feel angry and you can let it go. You know, a lot of times that fight or flight, that primitive fight or flight mechanism kicks in and we either get angry or anxious and it's over something that is not consequential. It's over something that we don't need to get angry or anxious about. So we need to learn how to just feel it, identify what caused us to have that trigger and then decide when it's worth our energy to do something but most of the time decide when it's not worth our energy and we can let it go. Attics and codependence lack empathy for the feelings and needs of others and you may be going, wait, wait, wait, wait. I thought you just said that codependence were attending to the significant others every need. Sort of. In reality, the codependent is struggling to survive and they are providing what they think the other person needs but they're not able to really understand why the other person is not reacting the way they're supposed to. My fallback is always, let's get into their head for a second. Why is it that doing what you want them to do may be not so rewarding and doing this may be more rewarding. Let's do a decisional balance exercise as if you are that significant other and figure out why they're still doing this stuff. Both types of people mask pain through anger, humor or isolation. So they'll either try to dominate or throw a hissy fit so people won't mess with them. They'll make a joke out of it so everybody laughs it off or they'll just withdraw. None of these is really the healthiest way of addressing when something hurts them. Understanding what's causing the pain and figuring out how to fix it, part of recovery. It's also part of life because people, even people without DSM diagnoses and they exist, believe it or not. Not everybody can go through life without experiencing pain. People die. You have losses. You make mistakes. Things don't work out your way. People experience pain and disappointment. Learning how to identify the cause of that and deal with it in a healthy way is part of happy, healthy living as well as recovery. And both addicts and codependents tend to have a lot of aggression and resentment and negativity. That overgeneralization. They start to look at the world as a glass half empty. They always look for the bottom to fall out. They expect people to let them down. And when you expect these things, that's what you see. So helping people make a cognitive shift and try to identify some of the good stuff is a huge step in the recovery process for all of our clients. Addicts and codependents have difficulty making decisions. Why? Because they rely on somebody else to tell them. They don't know how they feel. They don't know what they think. They don't know what they want. They are going to feel, think or want, whatever you want them to feel, think or want. Think of a chameleon. So it's hard to make decisions. If you say, Jane, what movie do you wanna go to? I don't know what movie do you wanna go to? Because I want you to be happy. And if you're happy, then I'm happy. Mantra of the codependent. Addicts and codependents judge what they think, say, or do harshly and is never good enough. So I encourage my patients, regardless of their diagnosis, to take this negative stuff that they tell themselves, like I'm stupid, I'm useless, I'm worthless. And I say, would you say that to your kid? And if you wouldn't say it to your kid, what would you say instead? And that's what you need to tell yourself. They value others' approval of their thinking, feelings, and behavior over their own. So again, it's not what I think or feel that matters. It's what you think or feel, because I want everybody to be happy. I'm gonna have to smooth everything over. Some of this comes or can come from growing up in a household with addictions where the person learned that they would be rejected or there would be punishment if they didn't conform to what the person with the addiction wanted. They seek recognition and praise to overcome feeling less than. They go out and seek praise. They seek recognition from the significant other as well as from other people. The significant other needs to say, I can't live without you. Thank you so much, you're amazing. But the other people need to also lavish attention and go, wow, you are such a strong person putting up with that or you are so courageous for doing this, that, and the other. And if the person with codependency doesn't get that, then they start getting anxious because they're not able to tell themself, you know, I'm a strong-willed person and I have put up with a lot of crap. Thank you very much. People with codependency and addictions have difficulty admitting a mistake because they overgeneralize and they take everything personally. So if I make a mistake, that means I am a mistake. Think about that for a second. If I make a mistake, I am a mistake because everything is about me and everything is overgeneralized. Therefore, they may appear, they may lie in order to appear being right or to look good because I can't let you know I made a mistake because then you might reject me and if you reject me, I have no idea what I'm gonna do. Helping people get past that. Are unable to identify or ask for what they want and need because they don't know. They haven't paid attention to their own wants and needs in so long, they have no clue. That's just a foreign concept. So start low and go slow. Don't expect people to be able to journal and have all kinds of feeling words in there. Start out with your basic feeling words. Happy, mad, sad, glad, and afraid. Have them identify, have clients identify one thing that made them feel each feeling in the past week so they can get used to starting to identify feelings. Then you can work into shades of those, enrage, resentful, guilty, those sorts of things. And both groups of people or people with addictions have trouble setting healthy boundaries and priorities because if it's all about making you happy, then I can't plan anything because I need to be able to turn on a dime and do what you need to do in order to prevent you from leaving me. People with healthy boundaries and priorities say, this is what I need to get done today. This is what I need to do. And in an emergency, I can probably help out but my needs and my wants and my health have to take priority because I'm no good to you if I am completely drained and exhausted and depressed. Switching over to codependency. This is more seen in people with codependency and addictions or codependency only. People with codependency want to believe that people are incapable of self-care. If I don't do it for him, he's not gonna be able to do it. So I need to help. I need to put my two cents in. So I'm gonna try to convince other people how to think and feel because if I convince them that I'm right and that they need my help, then they can't abandon me which leads to offering unsolicited advice and direction which may or may not be accepted. A lot of times it's going to be rejected which means the person with codependency will start feeling resentful. It's like, well, fine, you don't want my help? See how you do without me. Kinda turning on a dime. You know, you're feeling a little bit of the borderline influence here. The person with codependency may lavish gifts, favors, and attention on those that they need to influence. So if providing basic needs doesn't help, then they may up their game a little bit because they're trying to avoid abandonment at all costs because loss of that person means loss of self. Codependence will often use blame and shame to control. You know, I've done all this for you and this is what you give me. Adopt an attitude of indifference, helplessness, authority, or rage to manipulate outcomes. The codependent is a very, very skilled manipulator. So it's important to understand what these outbursts or what these fluctuations in emotion mean to that person and what the benefit is to them. What's the benefit to you when you go through one of these episodes where you act completely helpless and you require the other person to take care of you? What's the benefit when you get all angry and rageful and you require the other person to submit to you? Codependence will use recovery jargon in an attempt to control the behavior of the other person. Well, I see those relapse warning signs coming out and talking about triggers and all kinds of other stuff. They'll use big words, maybe not even knowing what they mean in order to try to make the significant other think that they are more in control of the recovery. Codependence may pretend to agree with others to get what they want. That's true with addicts too. So what do we do about it? Identify benefits and drawbacks to the relationship and the benefits and drawbacks to being single. A decisional balance exercises, tip 35 from SAMHSA, you can download it or you can Google decisional balance exercises. They're real common on the internet to find worksheets. It is important to understand the benefits and drawbacks to both because you can't tip that decisional balance scale without addressing all four quadrants. Codependency, like other addictions, is used to escape, distract or avoid pain. So this person is in this relationship, the benefits of this relationship are providing the person with a sense of self-esteem. They are providing the person with a sense of security, that it's distracting the person from their own intracyclic pain. There's a whole list of reasons or rewards or benefits to this person staying in a dysfunctional relationship. So you need to figure out how to counter those with something more rewarding. Begin self-esteem work. There are just oodles and oodles of self-esteem books out there. I really like the ones from New Harbinger by McKay, but you can go online to, I think it's therapy tools, and there are free worksheets online to help people work on self-esteem. Self-esteem is all about who you think you should be compared with who you think you are and figuring out how you feel about the difference and working on the things that you feel like you don't have developed well enough yet. Until the person, the codependent, can provide self-validation, all relationships can potentially become codependent. So thinking about the past week, what are three times where you may have or your clients may have engaged in codependent behavior? What did they do? And how effective was it for them in the short-term? In the short-term, it was probably pretty effective. What about in the long-term, though, a week later, two weeks later? If you would have had this new information, what might you have done differently to help your client or help yourself handle the situation differently so it had a better longer-term outcome? And how can you start integrating some of the knowledge about codependency into your daily recovery routine and your therapy toolbox, if you will? Codependents generally get in relationships with addicts or others who need to be rescued. This need to rescue or be indispensable often stems from not feeling good enough, having low self-esteem and needing other people to tell you you're okay. Because if they don't, you fear abandonment. The person with codependency doesn't feel like they are lovable for who they are. The codependent derives his or her goodness from the success or failure of the other person and the relationship. So if the significant other relapses, the codependent takes it very personally. If the significant other is doing well in recovery, the codependent takes it very personally. And in reality, most of it has to do with the significant other, not the codependent. But that personalization, everything is about them. Recovery involves developing a sense of self-worth, addressing the issues that are causing depression and anxiety such as grief over prior lost relationships. This can lead you into a dysfunctional relationship holding on past when it should have been let go because you're afraid of losing it again. A sense of helplessness to change another person. Maybe when you were growing up in a household, the one of your parents was addicted, was in and out of jail or died from an overdose. That can have long lasting consequences. So we need to look at where this need to change or control the other person came from. And then address these underlying fears and your typical cognitive behavioral ABC worksheet does a great job of it. Addressing these fears of rejection, isolation, failure, loss of control and the unknown. It's gonna happen. So how do you deal with it? When you face something that's unknown, how do you feel? How do you de-escalate yourself? And what are things you can do to cope with it? Learn about creating a network of healthy relationships with self and others. And self is important. And yeah, it's not really a network when you're forming a relationship with yourself. But in order to form a healthy relationship with others, you have to know what you want, what you like, what you think, what you feel and how to set healthy boundaries. It's only then can you start interfacing with other people and bringing something to the table. You also need to learn how to accept multiple perspectives. And the person with codependency has difficulty getting outside of their own head. They see why people should behave a certain way because that's how they think. That's their perspective. So it's important to work with clients or work with yourself to get into the head space of the other person and go, okay, they didn't react the way I thought. Gee, I wonder why? So let me look at it from their perspective and see if I can understand it any better. This is just a cursory, a really high level overview of the whole issue of codependency. And in the coming weeks, we'll do some more podcasts and classes about codependency and working with people with codependency issues. But hopefully this will give you a sense of kind of what you're dealing with and some places that you might start either in your own recovery or working with clients.