Codependency is a Toxic Myth in Recovery
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Tough love can be deadly to a person in recovery.
Maia Szalavitz is a contributing NYT Opinion writer and the author, most recently, of “Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction.
Following are experts ftom an article first appearing in the New York Times | June 8, 2022, online edition.
Codependence has long been part of the dominant addiction treatment philosophy in the United States, which is based on the 12 steps of Alcoholics Anonymous. In this approach, people with addiction are taught that they have a disease and that recovery requires surrender to a “higher power,” moral inventory, making amends for wrongs done and attending meetings. (Although its influence has declined slightly, around two-thirds of addiction treatment facilities are still 12-step-focused.)
[But there] is little evidence ... that codependence actually exists. The diagnosis was rejected by psychiatry’s diagnostic manual, The Diagnostic and Statistical Manual of Mental Disorders, or D.S.M. And unfortunately, what the concept actually enables is harmful treatment. ... Codependence doesn’t make the grade as a psychiatric disorder for many reasons. For one, there’s no accepted way to measure it. Other diagnoses better integrate personality traits like being controlling and overly self-sacrificing that are sometimes ascribed to codependency.
Parents [are] being labeled sick because they refused to leave their kids homeless or have them arrested, even though both situations can worsen addiction. When someone is ill with any other disorder, relatives are not shamed for obsessively caring or rearranging their lives to help. Instead, those who abandon suffering loved ones are stigmatized. But when it comes to addiction, parents are told that their loving kindness is pathological because they somehow benefit psychologically from keeping their children addicted. Only letting them hit rock bottom will allow recovery, the thinking goes.
When one woman, Susan Ousterman, tried to comfort her son by sending him care packages in rehab, she was told by addiction counselors and others that she was “going to love him to death.” Detach and let him hit bottom, she said they insisted. Her son, Tyler Cordeiro, died of an opioid overdose in 2020 at age 24.
“The tough love narrative taught to parents was absolutely a factor in his death,” she said, describing how being rejected by his family left him hopeless and demoralized. These days, she spends her time advising other parents to think differently.
To read the full New York Times article, please click here.
Maia Szalavitz is a contributing NYT Opinion writer. \She covers addiction and public policy and is the author, most recently, of “Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction.”
Codependency Is a Toxic Myth in Addiction Recovery
This essay was first posted as a New York Times Opinion | Guest Essay published n the NYT July 8, 2022 online addition.
I’m sorry people have been criticizing this article, lifering. I think it had something very important to say and it’s a shame it’s offended some. The only criticism I can think of, for this article, is that it’s a little absolute, similar to anonymous groups in that respect actually. My understanding of lifering and all non 12 step recovery models is that they acknowledge the difference between people, that not everyone will respond favourably to any one type of treatment mode. IMO AA all too often turns people into even worse people, because it’s outdated and thus toxic by today’s standards. Like how they are literally taught and encouraged to tell people that if the steps don’t work for you, you didn’t do them well enough. It’s incredibly arrogant to assume and talk down to someone as if you know their experience better than they do. But when I tried NA, this type of attitude was standard and preached to adopt. There weren’t other options at the time, so when the 12 steps didn’t work for me, I got discouraged and fell off the wagon.
That’s not to say NA was without value, because some of their mottos did help me when I found myself alone and struggling with sobriety.
I’m just really thankful that this time around (getting back on the wagon) there are so many good critiques of the steps and alternatives that provide a supportive environment that connects us to other people who relate. The understanding of addiction had changed greatly over the last decade and it’s such a relief to see articles like this one that challenge the long standing methods people have used to treat addicts and addiction. Obviously, the old ways don’t work. Don’t believe me, just go downtown and have a conversation with a homeless person. Tough love killed millions. Most addicts just need to feel loved and safe and supported. Addiction is often a trauma response. What addicts don’t need is further judgement and criticism and disapproving stares. I am so thankful every day of my recovery this time because I am able to actually get help. Help that works. Help that listens and respects my autonomy instead of putting words in my mouth and shaming my experience. You help people like you love, with an open hand.
Thank you, PeachE, for bringing forward your perspective. I appreciate your candor and your positive outlook on your recovery journey. Best of luck to you and I hope we run into each other in a meeting some day.
Codependency is a complex concept to grasp. In early recovery, we have so many personal issues to process. No need to add an extra layer of codependency. AA does work … for some. Not me. I almost relapsed several times in early recovery, due to AA’s tough love. I got shamed at AA meetings. Blamed by sponsors and sober house managers. Alternative recovery programs help fill the need for compassion, kindness and gentleness. They provide modern and effective tools for dealing with life stresses.
Hi Julie — Thank you for sharing your personal experiences here. While I, too, have found more success in a flexible, encouraging environment, recovery journeys are deeply personal for everyone. I have friends who have been very successful relying on traditional 12-step programs to support their sobriety. I am thrilled to see health care providers and treatment professionals beginning to recognize the importance of recovery choice. I hope this growing openness will eventually extend to family and friends of people searching for substance use recovery.
I was really shocked when I saw this article in the NYT. In my view, it does not characterize well what real codependency is (which does occur in certain relationships and is very toxic) vs. a whole host of relationship behaviors that are NOT toxic nor codependency. I think it’s a complex topic in general but I found myself agreeing with nothing in the NYT article. Honestly, I’m quite sad to see it being referenced in any sort of positive light in LifeRing spaces.
Hi Lisa — Thank you for your feedback. Please accept my sincere apology for contributing to any shock you experienced when you originally read this article in the Times. It was not my intention to cause distress or sadness.
I posted this opinion piece because I believe it provides an interesting perspective into the influence stigmatizing language and generalizations can play on individuals in recovery and the ones who love us. It’s just one person’s opinion — one I thought might be worth a read. Like all things LifeRing, we can only speak from our own experiences and perspectives. Thank you for sharing yours.
This article is so full of ignorance, incorrect assumptions, and logical fallacies that it takes my breath away. I can’t believe it got published, let alone reprinted approvingly. There are many valid ways to critique AA without having to resort to misrepresentations, oversimplifications, and citation of completely anecdotal “evidence.”
Hi David — Thank you for your feedback. This is an opinion piece that shares a different perspective on the application of “tough love” as a tool for substance use recovery. LifeRing fully respects all pathways to recovery. AA is certainly one.