Codependence – the pathological form of relationship which is characterized by a deep preoccupation and a comprehensive involvement into life of other person, most often dependent on alcohol, drugs, gamblings. It is shown by emotional and behavioural deviations, violations of social adaptation. Sozavisimy people have the underestimated self-assessment, are inclined to self-accusation, self-abasement. Suppression of anger, requirements leads to a depression, uncontrollable tantrums, aggression. Diagnostics of codependence is carried out by method of poll, psychological testing. For treatment technicians of psychotherapy, participation in support groups are used.
The term "codependence" is meant by "joint dependence". For the first time it was used in medicine and psychology in the late seventies when the reasons of high level of a recurrence at patients with chemical dependence began to be investigated. Alcoholics and addicts, coming back after therapy and rehabilitation to a family, renewed addictions. Studying of relationship between close relatives and the patient revealed a codependence phenomenon as steady system of the installations, incentives and reactions supporting the use of drugs and alcohol. Among close relatives of addiktivny patients prevalence makes up to 80-98%. Sozavisimymi becomes more often than the woman.
Factors of development of sozavisimy behavior have social and psychological character. The main condition of its formation presence of the close relative, the friend loved with a pathological addiction – drug addiction, alcoholism, a game addiction, workaholism, morbid depression, dependence on sex or food is considered. Factors of the increased risk are:
- Close relations with dependent. Violation develops at wives and mothers. Fathers, sisters, brothers, beloved, children are less subject to codependence.
- Dependence experience. Frustration is formed at the persons having a chemical addiction in the past. Also those who are in borderline between norm and pathological dependence treat risk group.
- Negative conditions of education. Codependence often arises at the people who grew up in emotionally repressive families. Their parents and close relatives were subject to fears, rage, had dependence, a mental disorder, showed violence or used it as an educational measure in relation to the child.
Pathogenetic basis of codependence are unproductive ways of adaptation to the relations with pathologically changed personality. Initially "savior" has some uncertainty in himself, suffers from the underestimated self-assessment and fear of loneliness, needs approval. Through care of more vulnerable, dependent person own shortcomings are compensated. The social mechanism supporting codependence is cultivation of sacrifice, devotion, disinterested aid to the neighbor. Elements of such behavior take root at school, the religious organizations, mass media.
The role of the woman is often interpreted through service to the husband and a family, boundless devotion and attachment. At the same time the productive ways of behavior based on strength of the personality are ignored. The more the sozavisimy person is involved in a role of the savior, the his emotional, behavioural and personal deformations become deeper. Gradually they objektivizirutsya – lose touch with the specific person, are implemented in all spheres of life. On the other hand, the expressiveness of codependence of "savior" becomes more considerable, the lack of initiative of "victim" progresses more – need to show independence and will power, to fight against an addiction is lost.
At sozavisimy people destructive ideas of relationship, emotional and behavioural frustration come to light. At the mental level sample beliefs and installations dominate: relatives need to be helped, it is impossible to leave the friend in trouble, the word can cure, the true love will endure everything. They do not correspond to reality – do not consider the pathological mechanisms which are a basis alcoholic, narcotic and other dependences. There is a substitution of the effective help by excessive sympathy, pity, care, daily leaving – the relation which is convenient to the patient (dependent) and interferes with his recovery.
Sozavisimy denial of pathological attachment, underestimation of problems is peculiar. Often moves behavior fear of loneliness, condemnation of people around, fear for the patient's life, lack of own reference points to lives. Therefore such people are all the time nearby, accompany on walks, campaigns to the doctor, choose clothes, cook food – will organize life according to needs of the partner, neglecting own comfort and desires. At the sozavisimy person social responsibility is reduced, all problems are explained by a disease of an addikt. The relations are implemented from "parent" and "child" positions: one shows love, care, forgiveness, another affords "whims" – alcohol, drugs, inaction, violence, insults. Sozavisimye interpret the behavior positively as ability to love the person with all his shortcomings and weaknesses. Such relations can last for years, without making participants happy.
Long codependence is followed by accumulation of negative emotions which are rejected as unacceptable. The irritation, anger, disappointment, depression and fear are suppressed. The growing tension as a result is shown by uncontrollable flashes auto-and the heteroaggression masked by a depression. Sozavisimye are in group of high risk on suicide behavior, often are socially deadapted as all the time and forces spend for care of the patient. For dependent a complication is strengthening of a pathological habit, high probability of a recurrence after a course of treatment.
The codependence problem usually is found in the course of treatment, rehabilitation of people with alcoholism and drug addiction. The intra family relations are investigated by psychiatrists, psychologists, psychotherapists. The main method is kliniko-anamnesticheskiya, psychological examination is in addition conducted. Complex diagnostics includes:
- Conversation. The doctor collects anamnestichesky data: family composition, nature of dependence, duration, participation of relatives in rehabilitation of the patient. Characteristic of answers of the patient: denial of codependence, switching of attention from own problems to a state and health of the dependent member, attempt to cause pity and sympathy in the expert (to involve in the sozavisimy relations).
- Questionnaires. For an objective research the standardized techniques directed to identification of codependence and the accompanying states – depressions, uneasiness, aggression are used. A set of tests is selected the psychologist individually, can include a questionnaire "Check of personal qualities on codependence" of B. Uaynkhold, D. Uaynkhold, a scale of a depression of T. Beck, a questionnaire of uneasiness of Spilbergera-Khanin.
- Projective techniques. For diagnostics of unconscious emotional components of the identity of sozavisimy patients pictural tests and tests of interpretation of situations are applied. Results allow to obtain more reliable information about existence of fear, alarm, the destructive relations.
Treatment of codependence
Elimination of codependence is carried out by psychotherapy methods, is directed to restoration and reconstruction of the personality. The main objectives are increase in level of emotional sensitivity, formation and strengthening of ideas of borders I, increase in a self-assessment. The psychotherapeutic help is implemented in several formats:
- Individual sessions. Work with destructive installations, the distorted self-perception, fears is carried out. Patients are trained openly to express negative emotions, to reduce the level of alarm and tension, to care for itself. Methods of cognitive and behavioural psychotherapy, auto-trainings are used.
- Family consultation. The family members who do not have codependence are told about the mechanisms which are the cornerstone of such relations. The psychotherapist makes recommendations of ways of support of the dependent and sozavisimy family member, the organization of their interaction. Temporary separation, redistribution of household chores can be sometimes necessary.
- Group meetings. On trainings various ways of productive interaction are implemented. Patients begin to feel and understand own importance, acceptance by other people. There is a sense of security, supports, the belief in own forces increases. The image of the I as socially adapted, successful, possessing personal power person is formed.
Forecast and prevention
Efficiency of treatment in many respects is defined by timeliness of its beginning. Codependence gives in to therapy better at early stages when the patient has more sokhranna resources for restoration – will power, confidence, understanding of value of own personality. The main preventive measure is the correct education of the child – formation of an adequate self-assessment, belief in the forces, ability to openly show emotions, to speak about desires and requirements. If in a family the patient with an addiction appears, it is necessary to consult with the doctor about rules of assistance. In such situations to the forefront there have to be strong-willed qualities, readiness to resist to a pathological inclination, but not sympathy and pity.