Hello everyone and welcome back. In our last section we talked about family systems models. In this section we begin talking about a concept called co-dependency which relates to family systems. So let's begin by going to slide two.

As we can see here in slide two, basically what co-dependency relates to is impairment of nonalcoholic members. It has three major components; codependency, what we call children of alcoholics, and adult children of alcoholics. All of the concepts are clinically derived and they have very limited empirical support. The ambiguity between the terms and concepts has led to lots of confusion.

The concept of codependency, as we see in slide three, basically originated with chemical addictions counselors who were focusing on the spouses of alcoholics. They initially used the term "enabler" to describe the spouse who tended to support the alcoholic. The next term that came about was the term "co-alcoholic" because it implied the spouse was suffering with the spouse who was using the compounds. Ultimately, in the late 1970's the term was replaced by the term "codependent".

So, what is codependency? Codependency, as we see in slide four, is useful for explaining the behavior observed in the spouses of alcoholics. Individuals with codependency basically seen to be part of the problem. Their enabling, that is, their supporting the use of the substance by the alcoholic continues to allow the alcoholic to use. Codependency also created a framework for spouses regarding their own recovery.

What is the definition of codependency? Well, as we see in slide five, it is any person living in a committed relationship with a user. The person can be a spouse, parent, child, grandparent, or other person. Basically, it is an individual engaged in the disease process in their own right.

Where do these behaviors originate? As we see in slide six, they are thought to emerge from an abuse experienced in the person's family of origin. That is, there is some kind of theoretical relationship between shame and codependency. The problem as we can see here is that the definition defies precision. Most of the authors define it in relation to their own attitudes towards the addiction process.

There is a wide variety of other definitions as well and these are shown in slide seven. Black basically contends that codependency refers to anyone whose behavior is characterized by the numbing of feelings, denial, low self-worth and compulsive behavior. The point is there are other definitions out there.

Cermack provides a variety of types of codependency and these are listed in slide eight. He contends that these definitions include martyr, prosecutor, coconspirator, and on, and on, and on.

So what about these individuals that have codependency? What do they do? What are they like? As we can see in slide nine, they lose the ability to distinguish between the needs of others and themselves. As a result, they do not develop a firm sense of self according to a variety of psychological models. In adulthood, these individuals have problems managing stress, problems engaging in mature relationships, and they are also at increased risk for alcoholism. This then repeats as they have their own children and often times these individuals are called "Adult Children".

There are two types of contrasting models. The first by Kitchens, on slide ten, basically has an addict centered model and it comes from the Chemical Dependency field. Here, the codependent reacts to the addicted person who is the center of the attention. The addiction can be a drug, religiosity, or work. Consequently, everyone reacts to the addicted person.

The Faulty Family Model as we see in slide eleven comes from the Mental Health field. Basically, here the family is used as the core problem. Everyone is dysfunctional including the user. They have problems coping with each other and have similar problems as shame-based families.

There is also a new term that is coming out and these are called Children of Alcoholics or COA's. These are related parts of codependency models but instead it involves kids. As we can see here, forty-three percent of all families have one or more parents abusing substances. In these families there is a lack of expression, lack of communication, etc. And there is a term that Black basically contends is "you do not talk, do not trust, and do not feel" and that is the way and individual should be when you are in a family.

Families also have a wide variety of problems that contribute to impairment. As we can see in slide thirteen conflict, stress, violence, and child maltreatment are very common especially with individuals that are using methamphetamine and other types of drugs.

As a consequence of all of this, as seen in slide fourteen, these children have an elevated risk for substance abuse. They are also more vulnerable for a wide variety of impairments including psychological problems, child abuse, lower academic achievement, and on and on and on.

Of these children as we see in slide fifteen, some become very resilient to the problems going on in the family. That is, they can resist the problems and they ultimately grow up to be well functioning adults. How this occurs is very interesting. Some individuals contend that they view the problems as a challenge and they then work through these challenges. The second group with the problems goes and gets themselves therapy, identify themselves as damaged and with therapy become resistant to the problem.

Generally, as we can see in slide sixteen, children of substance abusers may need therapy or some kind of intervention. Professionals then need to be aware of the problems that go along with them. Their care may include clinical care, prevention, or even long term treatment.

Now, finally, a lot of these problems say the family systems models and COA’s may continue on into adulthood. These are what we call Adult Children of Alcoholics or ACOA's. They are characterized by a wide variety of things such as mistrust of intimacy; affect disorders, internalized sense of shame, and on and on and on. Again, the problem, as we talked about with the children of alcoholics and other issues with family systems models is that there is a minimal amount of research and a lot of it lacks specificity. That does not mean the problem exists it just means that we need to look at it in more depth.

So in conclusion as we see in slide eighteen, there are lots of problems related to codependency, children, and even with adult children of alcoholics. But the concepts still have problems with validity and many parts of it even lack empirical support. We can still use the concepts however we also just need to understand what the limitations are.

Well that concludes this section in relation to family. In our next section we are going to begin talking about treatments of substance abuse. So until then we hope you have yourself a great day and we look forward to talking with you soon.

Back