Book Review

Co-dependence Misunderstood – Mistreated 

by Anne Wilson Schaef, PhD., pub. 1986

Dr. Schaef summarizes a variety of mental health conditions and chemical dependence as all coming from the same undiagnosed disease, that of the ‘disease’ called the Addictive Process. Included are the areas of Chemical Dependency, Mental Health, the Women’s Movement, Family Therapy, and all the subcategories included in each. She attempts to categorize all of these as arising from the same dysfunctional behaviors as a result of her research involving years of collecting data in her own practice, that of many colleagues and contemporaries. “Each field helps to clarify and inform the other” (p. 16).

Her conclusion is that they are all treatable, with a much higher level of success when approached with a 12 step program originally designed for chemical dependents rather than traditional counseling.  From her research, she noticed a commonality in the way addicts and those who live with them (spouse, parents, children, etc.) interact in relationships.  Women and men who are ‘unliberated’ or in a ‘traditional’ marriage display the same characteristics as well.

The most common symptoms include:

-          Dishonesty (denial, projection, delusion, gullibility)

-          Unhealthy expression of Feelings (repression, out of touch, distortion)

-          Control

-          Confusion

-          Thinking Disorders

-          Perfectionism

-          External Referenting – other directed (low self-worth, impression management, shame-based)

-          Dependency Issues (lack of boundaries)

-          Fear

-          Rigidity

-          Judgmentalism

-          Depression

-          Inferiority/Grandiosity

-          Self-Centeredness

-          Loss of Personal Morality

-          Stasis

-          Negativism

Dr. Schaef puts the blame for her view that the majority of our American society suffers from this disease at the feet of the family structure, the education system, and the church.  She states that each of these institutions contributes to this disease explaining briefly how they do this.

She also offers hope and strategies for the co-dependent to overcome and heal from their malady.  Using examples from her own life and those of personal acquaintances, she describes in some detail how the symptoms play out in daily life and how to recognize when the co-dependent is falling back into an unhealthy pattern. To successfully combat this ‘disease’, she suggests an entire systems shift in the mental health field, social work, and with all those who offer therapy for emotional and mental issues. 

This shift involves recognizing that most offering help in these fields suffer from codependence themselves, the majority going undiagnosed and untreated, though still offering ‘treatment’ to others in need.  Training in the past has taught practices that exacerbated the problems by teaching therapists to be in control of the patient’s recovery, to focus on smaller issues and ignoring the whole, to work only on the cognitive level, and ignoring the spiritual aspect of our being. She offers what she calls the ‘living process therapy’ and has been training people for years now to begin a societal shift.

I agree with Dr. Schaef’s basic idea that the same issues trigger unhealthy behaviors and relationships whether it’s a case of chemical dependency or mental health issues. The more I think about her idea that society feeds the disease through the family, schools, and religion, I can see in my own experience and that of people all around me the truth of what she says.  Her idea of rapid, successful recovery by using a combination of the 12 step program and her therapy is very appealing.  I discovered her website, Living in Process, that carries her initial research to the present.

I’m so grateful that there are more and more resources available addressing codependency – books mostly, Codependent’s Anonymous groups and a few therapists who specialize in it. Not too many years ago, according to this author, few truly understood it or even recognized it for what it was. The only degrees offered to help focused on strategies that actually fed dependency with many in the field being themselves codependent.

I found her conclusions causing me to think about my own co-dependent issues and the treatment I’ve gotten to date. The therapist I’ve seen was trained traditionally, though she has expanded her knowledge to include the spiritual and did offer me a starting point.  I was given strategies and medication to start me off – for that I’m grateful.  I’m grateful, too, for people like Dr. Schaef who have offered so much more. I feel confident and hopeful.