Develop a healthy sense of self to overcome codependency

Do you struggle with your boundaries and usually give too much to your partner without receiving back the love and respect you expect?  Are you involved with an avoidant personality type and frustrated with the level of communication in the relationship. Do you see yourself as dedicated to the welfare of others? If these questions make you answer yes, then perhaps you might benefit from reading on.

Codependency is rooted in addiction. It is about over-functioning in someone else’s life but under-functioning in your own.To have a working understanding of codependency is to see a co-dependent as someone who cannot function from their innate self and whose thinking and behaviour is instead organised around another person, or even a process, or substance.

The term is located within a systemic framework. Codependency was originally a term used to describe a particular relationship dynamic where one partner had a substance abuse problem and the other didn’t. The individual who didn’t have the substance abuse issue became caught up in a cycle of excusing, tolerating, defending and even enabling the addiction of the other. In Alcoholics Anonymous (AA) the problem became known as an issue not solely with the addict, but also the family and friends who constitute a social network for the alcoholic. Al-Anon (the sister fellowship of AA) was formed in 1951, and holds the view that alcoholism is a family illness. Al-Anon is one of the earliest recognitions of codependency.

The term codependency is not universally accepted in the therapy world. For some clinicians codependence is over-diagnosed. For them, people could be helped with shorter-term treatments instead of potentially becoming dependent on long-term self-help programmes or therapy. Such treatment, they argue, can be theoretically misplaced as the direction of the treatment can follow the disease model of addiction. For others it is a healthy personality trait, albeit just taken to excess. The key in determining whether you have a problem yourself is to assess the extent of the under-functioning in your own life as a result of caring for another. Does your own life suffer as a consequence of your concentration on the needs of another.

Clients don’t often attend counselling and psychotherapy for codependency, or other addictions for that matter, but might present with problems associated with anxiety in their lives, for example, or relationship issues more generally. Once in the process of attending therapy sessions,however, they can become more conscious of their underlying codependency issues.

In order to understand codependency it is useful to gain insight into what kind of attachment style you operate from in relationships. We develop a style of attaching that affects our behaviour in close relationships throughout our adult life. One of our prime drives, after all, is to affiliate, just like our drive for survival.  Our attachment style is largely dependent upon our mother’s behaviour, in addition to later experiences in childhood and other environmental and social factors.  For more information on this see my article on attachment styles and recovery from codependency.

Recovery from codependency, like all addictions, involves the development of a healthy self and allowing for an expansion of consciousness.  Healthy relationships are when each person can remain themselves and when the dynamic allows for change and flow. If you are in a codependent relationship a recovery path could be to detach with love, face illusions about your life and your relationship, set healthy boundaries and develop your spirituality.This can help build a healthy sense of self going forward when you learn to take care of your own needs and ultimately learn to be happy with your own company.

See also

Any book by John Bowlby
Attachment in Adulthood: Structure, Dynamics, and Change –  Mario Mikulincer & Phillip R. Shaver
Adult attachment – J Feeney & P Noller
Handbook of adult attachment – J Cassidy & R Shaver
My life as a border collie – Nancy L. Johnston
Codependency no more – Melody Beattie
CoDA UK – 12 step fellowship and a checklist for codependence

 

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Dealing with your fear of abandonment in relationships

fear of abandonmentWe do not arrive in adulthood with a perfectly formed state of emotional well-being. Often, we carry around baggage to varying degrees of weight from our past, whether that is from our childhood, early experiences at work or from our family dynamics. Past events can impact on how we interact in the present and can influence the quality of our relationships. If we experienced some form of trauma or suffered a developmental rupture in our formative years the danger is that we may have a wound to heal. Applying a sticky plaster on a wound can sometimes be of benefit but often the wound may need greater care and attention to lighten the loud.

Parental discord and divorce can be confusing for a child and to their sense of safety and security, as they can assume it is something they have done wrong. When such adversity occurs there may have been some damage to the child’s ‘secure base’ and the emotional fall-out could be the development of a fear of abandonment. Such events can contribute to an attachment style in relationships.

The work in therapy can be about bringing awareness to your way of operating in the world and why you act the way you do. Healing your wounds can transform your relationships. See my latest article on fear of abandonment in relationships for more information.

 

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Can Attachment Theory form part of an integrative model of psychotherapy

John BowlbyJonathan Bowlby (pictured, left) has been described by Storr as “one of the three or four most important psychiatrists of the twentieth century.”  For the purposes of this post, I intend to focus on his work on Attachment Theory. Bowlby was troubled by the dogmatism and cultism of the psychoanalytic world and argued strongly for open scientific debate and inquiry.  He felt that psychoanalysis neglected the role of real environmental trauma in the genesis of neurosis and emphasised instead the part played by infantile fantasy.

Bowlby’s papers that launched the theory (later developed by others including Mary Ainsworth) made a simple but, in the context of prevailing Kleinian orthodoxy in psychoanalytic thinking, revolutionary point. First, there was a primary attachment bond between mother and child, which did not depend on “oral drive” or reward by feeding and whose evolutionary function was protection from predation. At the time this point was incendiary in the psychoanalytic community but actually it could be viewed as no more than an extension of ideas already in the object relations school (Balint’s “primary clinging”, Winnicott’s concept of an “environment mother” as well as “object mother”, and Fairbairn’s views that drives are “signposts of the object” rather than vice versa).  Second, the idea that separated or bereaved infants and small children could experience grief and mourning no less intensely than could adults, was rejected by the psychoanalytic community wedded to the idea that mental pain had its origins in the internal, rather than the external, world. Third, Bowlby’s ideas on separation anxiety were closely related to Freud’s mature view of anxiety, which he saw as an affective response to threat (castration) but also as the threat of separation from a loved one (Freud 1926).

In contrast to the Freudian theories of his training, which centred on drive theory and incomplete sexual development as being responsible for neurosis, Bowlby developed his own theories on attachment, separation and loss and the effect of maternal deprivation on children.

 therapy should concentrate not so much on conflict as on deficiency

Attachment Theory met with strong resistance in the psychoanalytical world because it was viewed as an interpersonal, rather than an intrapersonal, theory. It implied an essentially harmonious, rather than conflictual, model of mother-infant interaction, unless the interaction is disturbed by external difficulty. The implication of this is that therapy should concentrate not so much on conflict as on deficiency. Also, the role of sexuality in infant life is downplayed as pleasure is related to proximity, play and nurturance rather than orgasmic discharge. The key issue in infantile experience becomes not so much power (power of the phallus, the breast, the logos) but space. Attachment theory has been described by Holmes as essentially “a spatial theory: when I am close to my loved one I feel good, when I am far away I am anxious, sad or lonely”

There are four styles of attachment that have been identified in adults: secure, anxious-preoccupied, dismissive-avoidant and fearful-avoidant. These roughly correspond to infant classifications: secure, insecure-ambivalent, insecure-avoidant and disorganized/disoriented.

Internal working models can be very evident in the therapeutic relationship.  Clients may become fearful of abandonment when told that the therapist is taking leave. Averil Earnshaw notes that family time is the time that rules our internal world (Earnshaw, 1995 Time will tell). She was specifically referring to the effect of critical dates in transgenerational links with family background. In history taking, an investigation of any potential critical date phenomena can illuminate areas of family malfunction/perversity/trauma and conflict.   The therapist may experience some counter transference, reminiscent of Winnicott’s article on “Hate in the Counter Transference” (1947). However, it is important that therapists don’t allow these feelings to impact in the rule of neutrality. These feelings should be explored in group supervision in order to stay focused on client material.

missing the heart of the psychoanalytic project

It can be argued that Attachment Theory and attachment-based psychotherapy is not simply another therapeutic approach, it is a core concept that is at the heart of many therapeutic relationships. However, Bowlby has been accused of neglecting the inner world and, therefore, missing the heart of the psychoanalytic project. Indeed, the psychoanalytic reader will find little in his trilogy about free association, dreams, fantasies, the Oedipus Complex or other staple psychoanalytic fare.

Bowlby believed in monotropy but it can be argued that children can develop multiple attachments. Children can have a number of attachment figures. As well as attaching to mothers, children can, for example,  bond with fathers, grandparents and paid staff e.g. nannies, babysitters or child minders.

Furthermore, Bowlby believed that there was a critical period for forming attachments but it could be argued that this is too extreme. It can be argued, for example, that there may be a sensitive period for attachment rather than a critical period. This means that the first 3 years may be the best time to form an attachment but it doesn’t follow that it’s the only time.  Children can form healthy attachments with others after the age of 3 as this can be seen by the positive impact of adoptive parents on a child’s life.

Bowlby believed that the effects of deprivation were irreversible but it can be argued that they can be reversed. For example, there is a famous case of two Czech twins who spent early years of their lives locked in a basement after their mother had died. They were cruelly treated by their father and stepmother to the point of suffering deprivation. However, when they were taken into care. they gradually got over their abuse and neglect. They formed strong bonds with the family who fostered them and both twins went on to have successful marriages.

Whilst a lot of research on Attachment Theory has focused on infants, Bowlby considered attachment to be a life-span construct. The challenge for Attachment Theorists was to demonstrate the need for measures of attachment beyond infancy. Main helped in this with the development of the Adult Attachment Interview (AAI) which is commonly used in psychotherapy nowadays.

So, can Attachment Theory form part of an integrative model of psychotherapy? A major part of assessing a new client is to take a thorough early history and seek to build a picture about early bonds. An initial assessment would not be complete without finding out about the client’s relationship with each parent and family member during childhood and significant childhood events. The manner in which a person forms (or fails to form) a therapeutic alliance and the nature of transference, resistance, and dependency within therapy can be viewed as reflecting attachment history (i.e. pattern).

Indeed, Transpersonalists would take heed of what Bowlby had to say. In Wilber’s Spectrum of Consciousness it is necessary to embrace psychodynamic tools and techniques in order to deal with pre-personal client material. Further, Robert Sardello maintains there is a great risk in embracing the spirit before sufficient time is spent on dealing with the personal baggage of one’s material life. (Love and the World: A Guide to Conscious Soul Practice (Google eBook).

See also

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What is the transpersonal approach to early life theory of psychological development?

 

I am currently undertaking research to evaluate the relevance of early life and psychodynamic ideas of unconscious communication e.g. transference and counter transference to transpersonal integrative psychotherapy.  I am reminded how ground breaking the ideas of Freud was, how distasteful the language and ideas of Melanie Klein can be and how attachment theory is so male centered in thinking.   But I am also reminded how difficult the transpersonal approach can be for some people.

A transpersonal perspective on the psyche (Wilber 1978) is that we come from spirit, our true nature is divine and our essence is of a split-off fragment of an all-encompassing consciousness. The word ‘spirit’ is derived from spiritus which implies wind or breath. The alchemical journey is to reveal our true nature, before we were born.

Sa’adi says “Every being is created for a purpose and the light of that purpose is already kindled in his soul” (Khan, 1978 p 182)

However, sometimes I get the feeling that people, outside transpersonal circles, begin to question my scrupples when I start making reference to our essence, or dare I mention it, our soul qualities. For them we come from matter and they aggressively discount the notion of the soul. Religious connotations aside at this Easter time, it is quite a leap for some people to consider the notion of soul qualities, even more alarming would be issues pertaining to transmigration of the soul. The truth, though, is that I am at best agnostic myself most of the time as I struggle with life’s injustices and with the notion that there is a soul let allow a journey of the soul.  For me, the ultimate creative attitude in life, especially whilst learning,  is to try to remain open minded as I deal with such struggles.

As integrative psychotherapists we are not merely practitioners of new age ideas bent on tuning in to the elements and seeking mercurial fixes for the client.  Yes, we can avail of the elements when seeking to see the person in the round but we will never hesitate to work with transference and counter transference and seek to identify the unconscious material in the therapeutic relationship. I believe that as integrative therapists we are carrying a basic toolkit of theory and methods out of which we can produce an approach that is appropriate to the client.  In this I like what Erikson (Erikson 1987) said about a new psychology emerging every time we close the door and sit down with a new client. That is truly to remain open minded.

 

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Attachment theory and John Bowlby

John Bowlby (26 February 1907 – 2 September 1990) was a notable British psychologist, psychiatrist and psychoanalyst. He became a psychoanalyst in 1937 and  during the War he served in the Royal Army Medical Corps. With his wife (Ursula Longstaff) he had 4 children. Following the War Bowlby became Director of the Tavistock Clinic in London and in 1950 he became a mental health consultant to the World Health Organization.

What is Attachment behaviour?  Attachment behaviour is any behaviour designed to get children into a close, protective relationship with their attachment figures whenever they experience anxiety. The child’s instinctual attachment behaviour repertoire includes crying, clinging, sucking, following and smiling.

There are three stages in attachment formation:
1. Protest: healthy anger and or tears
2. Despair: hopelessness
3. Detachment: process of cutting off

There are different types of attachment:
1. Signaling behaviour:
2. Averse behaviours:
3. Active behaviours

The benefits of attachment:
1. Protection from danger
2. Supply of food
3. Need for social interaction: babies are learning all the time how to operate in groups as part of the survival instinct.

Feminist writers can be critical of Bowlby as he referred primarily of the mother role as being female.  Bowlby was commissioned by the World Health Organization to write a report on the mental health of homeless children in Europe. In 1951, he published Maternal Care and Mental Health in which he outlined the following “the infant and young child should experience a warm, intimate, and continuous relationship with his mother (or permanent mother substitute) in which both find satisfaction and enjoyment.” The evacuation programme was subsequently seen as a mixed success given the separation between mother and child.

Bowlby used the term “Internal Working Models” to describe how young children form
mental representations within close relationships. Internal working models are based on
the child’s sense of worthiness which is dependent upon other people’s availability and
ability and willingness to provide care and protection. This will affect social competence in key areas including:
• The mental representation of the self
• The mental representation of other people
• The relationship between self and others
Internal working models therefore contain expectations and beliefs about:
• One’s own and other people’s behaviour
• The ‘lovability’, worthiness and acceptability of the self
• The emotional availability and interest of others, and their ability to provide protection.

Between 1964 and 1979, Bowlby wrote his trilogy Attachment (1969), Separation (1973), and Loss (1980) based on his own and others research.

4 types:

1. SECURE ATTACHMENT
Basic characteristics of a secure person:
• Felt secure position enabling a positive view of self, other people and close
relationships.
• Positive approach to social life. Socially competent.
• Able to deal accurately, appropriately and effectively with strong emotions including
anxiety, distress and anger.
• Inner felt security means under stress the individual can draw on a range of
personal and social resources to cope with stress.
• Can access and appraise the origin and character of their own and other people’s
feelings in such as a way to preserve their own self esteem and autonomy.
• Because they are personally insightful, emotionally literate and socially fluent they
are viewed positively by others.

2. AVOIDANT, DEFENDED AND DISMISSING PATTERNS
General characteristics include:
• Wariness and nervousness about entering close relationships – although there is a
desire for relationship, it is viewed with caution or in extreme cases,
incomprehension.
• Felt security is achieved by an over reliance on the self and an under reliance on
others.
• The preference is for the rational rather than the emotional, thought rather than
feeling, cognition rather than affect, physical competency rather than social fluency.
• Function well in jobs that require abstract, practical and cognitive tasks such as
computers, machines, figures.

3. AMBIVALENT, DEPENDENT AND PREOCCUPIED PATTERNS
General characteristics include:
• Have deep anxieties about the ‘lovability’ and value of the self. Concerns as to
whether people are genuinely interested in them or are emotionally available in
times of need. This makes them prone to separation-anxiety.
• Whenever close relationships become threatened or there is pressure to become
more independent or self-reliant they become stressed and anxious. They become
fractious, fretful and clingy if there is a feeling that availability of an attachment
figure will be lost.
• Felt security is achieved by maintaining a high level of involvement with people.
• Good in social situations, networking, being centre stage, meeting and helping.

4.DISORGANIZED, CONTROLLING AND UNRESOLVED PATTERNS
The main characteristics:
• Normally seen in behaviourally very disturbed children. They do manage to
organize some behaviour by either deactivating or hyper activating their attachment
behaviour. Disorganised as the name suggests means there is no consistent
pattern for regulating their affect, achieving proximity or gaining care and protection.
They have no way of adapting to the care-giving relationship.
• The parent rather than an external situation alarms the child. Unpredictable, scary,
violent or deeply puzzling behaviour by the caregiver leads the infant to be afraid of
or for the caregiver. The child is faced by an irresolvable paradox. The parent
frightens the child. Fear and distress activates attachment behaviour the purpose
of which is to protect and bring the child into proximity with the carer, however, the
carer is the source of the distress. If the child moves towards the carer there is
distress if it moves away there is distress. Thus anxiety and distress continue to
rise and threaten to overwhelm the infant.
• There is a profound sense of fear and helplessness, self and others appear chaotic
and incoherent.

Bowlby’s work has influenced many eminent psychologists, including his colleague Mary Ainsworth, who has also made major contributions to attachment theory. The important aspect of this work is always to check for the transference when seeing clients.

References
Holmes, J. (1997) John Bowlby and Attachment Theory. Routledge: London.
Howe, D., Brandon, M., Hinings, & Scholfield, G. (1999). Attachment Theory, Child
Maltreatment and Family Support. Palgrave: Basingstoke, Hampshire.
Karen, R. (1994). Becoming Attached. Oxford University Press: Oxford.

Lecture notes from CCPE: Angela Gruber

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