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Treating Codependency: Learning to Be True to Yourself

By Leslie Davis

"I’m here to take care of me, not to fix you.”

If you are a patient at the Sierra Tucson alcohol and drug treatment center, you may be walking around the facility with a badge that has these words.

Many patients who enter our treatment center struggle with codependency issues, and all programs at Sierra Tucson address codependency as part of treatment.

“We are a dual diagnostic facility and we’re increasingly seeing patients who recognize codependency as a core issue, both before and during treatment,” said Phillip S. Mitchell, M.A., MFT, MAC, a Unit Therapist with more than 16 years of service at Sierra Tucson. “It’s very prevalent and very damaging.”

Traits of Codependency

Many people mistakenly think that codependency is limited to the enabling of the addicted person by a spouse or other family member. But that is just one piece of a bigger puzzle, Mitchell said.

“Codependency includes many behaviors based on compulsively deferring to others to direct what a person will do or say, or not do or not say — as opposed to checking in with one’s own feelings to determine what’s appropriate in their words or action,” he explained.

These behaviors can include the following:

• When your positive feelings about your self-esteem come from receiving approval from and feeling accepted by others
• Placing too much attention on pleasing others
• Trying to manipulate others
• Self-esteem that comes from trying to solve another person’s problems
• Paying more attention to how others feel instead of how you feel
• Fear of rejection (this is the core fear that drives codependent behavior)
• Setting aside your own beliefs to feel connected with another person
• Valuing the opinions of others more than your own
• Choosing your clothing and personal appearance to gain approval from another person, instead of choosing in accordance with your own preferences
• Lacking healthy personal boundaries

All of these behaviors place someone other than yourself first and indicate that you are not necessarily comfortable in your own skin.

“People may get the message that they are defective, ‘less than,’ or unworthy,” Mitchell said. “From that comes the belief that they should conform to what other people think.”

A Common Occurrence

Codependency issues aren’t just relegated to people entering a drug and alcohol treatment center. A key figure in Family Systems theory, Virginia Satir, studied more than 10,000 families and discovered that 96 percent of them exhibited codependent thoughts or behaviors. Common codependent roles include the following: controller, fixer, caretaker, mediator, enabler, rescuer, martyr, and victim.

“There is a basic fear that drives codependent behaviors,” Mitchell said. “It’s commonly a fear of rejection or non-acceptance.”

Mitchell says that people have to love themselves before being able to effectively offer and share love with others. He likened it to an airplane emergency — knowing to put the oxygen mask on yourself first, before being able to help a loved one. Only when you learn to take care of yourself can you truly help others.

“The more you learn to accept who you are, the less likely you rely on others’ opinions of you,” Mitchell said.

Codependency and Addiction

It is common for people with substance abuse or other behavioral addictions to also have codependency issues. People who conform to codependent roles eventually create a void within themselves that they tend to want to fill with drugs or an addictive behavior. Such a void may also lead to depression, which may further stimulate addictive tendencies.

Many early issues of codependency stem from “peer pressure” as a teenager, a dysfunctional family background, or traumatic or abusive experiences. With peer pressure, teens often get the message that, to be accepted by their peers, they need to change their behaviors to fit in. That may include abusing addictive substances in order to have a sense of belonging.

A dysfunctional family dynamic or a traumatic or abusive experience is also likely to foster codependency. These experiences often lead to substance abuse as a way to allow survivors to fill a void, escape reality, or numb feelings which they were erroneously taught to fear.

Recovering from Codependency

Treating codependency issues requires patients to first identify their particular style or styles of codependency. While working with a therapist, patients will often trace back to their childhood to understand where their codependency issues came from and to identify mistaken beliefs about themselves that continue to foster such patterns.

“If a person doesn’t examine their own styles of codependency as part of recovery, recovery is less likely to succeed,” Mitchell said.

Patients who enter residential treatment are often aware of their codependent tendencies and become more able to see them and let them go through the treatment process. Sierra Tucson’s treatment programs can help people learn to overcome their codependency issues and establish healthy behaviors and communication skills. This allows them to set healthy boundaries, express clean confrontations, know how and when to share appreciations, be accountable, and express love.

“When you can learn to honor and embrace your emotions and listen to the message that each emotion carries, you can begin to reverse codependency,” Mitchell said.

Individual, family, and group psychotherapy can help patients become more aware of their codependency issues, address any co-occurring disorders, and understand how they all connect, Mitchell said.

“This is key to achieving lasting recovery,” he said. “With such inner work, patients can learn other behavioral options from which to choose instead of being locked into old, familiar patterns of codependency.”