Re-thinking Co-dependence

"Co-dependence" is a word that is tossed about frequently in the recovery community, as well as in arenas focused on developing and maintaining healthy relationships. A loaded and largely pejorative concept, co-dependence is characterized by poor boundaries, enabling behaviors and feeling (misplaced) responsibility for others' feelings, decisions snd lives. While people of nearly any age, or gender, can be labelled as co-dependent, it is a tag that, historically, has been slapped largely on women. Cultural review suggests that the initial focus on substance abuse recovery for male alcoholics via the 12-step program of Alcoholics Anonymous generated the idea of supporting and educating the wives of these men, with the hopes that informed, knowledgeable wives would provide essential support to alcoholics in recovery. Even today, most AA meetings are male-dominated, although over the years, we've seen a boom in groups created specifically for women, adolescents, people of color and lesbian, gay, bisexual and transgender folks. The initial purpose of including spouses in the 12-step programs was to provide them with much needed support, but also a forum for them to explore their roles in the dynamics that facilitated their partners' drinking snd changes they could make to support their husbands' quest for sobriety. Along the way, though, the concept of co-dependency has grown to a scope and reach I'd suspect was never part of the plan when Dr. Bob and Bill W. first welcomed a group of drunks to the initial AA meetings. It seems to be applied so broadly that the seriousness of the unhealthy behavior, thoughts and choices made by true co-dependent people, not to mention the often grueling recovery co-dependent folks have to undertake to free themselves from this soul damaging condition, is watered down and misinterpreted. Additionally, using the term to label unhelpful, ill-guided or ineffective ways of relating casts a negative light on people who don't really fit the parameters of true co-dependency.
The reality is that co-dependency, like most patterns of behavior, is complex, individual and generated by a variety of different origins. Lumping all caretaking behaviors, or any fluid boundaries, under the label is harmful and confusing. Many of the behaviors and attitudes called "co-dependent" are actually well-learned lessons that folks absorb from their environments. Young girls, studies show, are still more encouraged to share, let others "go first" and compromise their own wishes for the good of the group, than young boys are. To burden women with the label of co-dependency when they are simply enacting generations' worth of messages about what makes a "good woman" seems unfair, at best, and destructive, at worst. Feminist theorists have long argued for a view of human psychology that better encompasses female experience, learning and voice. We can help our clients grow and change without blaming them for being good learners. Perhaps the genesis of co-dependent behaviors is less compelling than the benefits of changing them: healthier relationships, boundaries that are firm but flexible; self-responsibility and self-love; expectations of equal treatment with others. But until we change what we teach about gender roles, self-sacrifice and nurturing -- and who we expect to do the nurturing -- the phenomenon of co-dependency, and the path to recovery, will likely continue to be struggles for clients in our therapy rooms.

"Would You Rather Be Right--Or Happy?"

Am I the only one who would answer, "I'd rather be BOTH!" I'm pretty sure I'm in vast company. I've heard therapists, self-help books and TV talking heads suggest that, in relationships, we can choose to stick to our guns on a point of contention with our partner, or we can choose to accede to our partner's wishes and views and "be happy." But in my practice and in real life, I've found that many people find this choice excruciating. It's not the simple no-brainer it appears to be initially. People often feel intensely tied and loyal to their needs, viewpoints and desires; asking them to choose between strongly held positions and their longing for happiness can feel like a lose-lose proposition. I struggle with framing the choice as an "either-or": "If you choose to be right, you can't be happy. And vice versa." In actuality, what we are hoping for is our clients to see that winning an argument or proving their point can't preclude the satisfaction ("happiness") of knowing they are caring for the needs of the relationship FIRST, before their individual needs. I try to help clients understand that meeting the relationship's needs is DIFFERENT from "giving in." In this case, Jane isn't letting Joe "get his way." By focusing on what's best for the relationship, clients are taking their eyes off of what each partner WANTS--it's what the partnership NEEDS that matters. Sometimes, that's the same as what one partner wants. But often, the relationship is like a separate entity all together. I envision, and educate clients, that the marriage is the "third client" in the room: what it needs to thrive and grow must be addressed, or it will wither away. People caught in conflict, bent on winning the latest match in their relationship's Grand Slam tournament of arguments, can sometimes buy into doing the right thing for the benefit of the partnership. We don't think twice about making effective decisions about our children, even when we are angry at our spouse. We can look at relationship challenges the same way. After all, when the partnership wins, BOTH sides win, too. And really, is the fight about stopping for directions really about directions, anyway? Most conflicts are generated by deeper symbols and values than what two people are quibbling about on the surface. If we approach our conflicts with an eye on a resolution that aids the relationship, we may find ourselves getting to a place of peace with our partners more quickly and with fewer lasting wounds. That is, except for when my wife asks me, for the thousandth time, WHERE she put her car keys. If I could just get her to put her keys in the little dish on the counter, like I've told her...

The View from Home

Vacation's over. Luggage is unpacked. Sand is shaken out of sandals and beach towels. Shoulders are peeling and swimsuits are stuffed back into drawers. Other than kitschy souvenirs, tan lines and fuzzy cell phonier photos, what do we bring back with us into our regular lives of work, home and family life? I'd like to think I can keep the sense of peace and calm I had on our trip, and sustain it as I juggle seeing clients, shuttle my child to endless summer activities and find time to pay the bills and change the sheets that are still on the bed from BEFORE we left. Why is that such a staggering task? Just days ago, I was enjoying a poolside cocktail, oblivious to the demands of voicemail and the deadlines of paperwork. I was watching the wind shake the fronds of the palm trees and hanging my son's bathing suit over the hotel balcony railing to dry in 95-degree heat. clearly, we vacation to get away from our everyday lives and to refuel ourselves to be able to face the challenges of our stressful lives. How do we keep the "glow" of our downtime from fading? I haven't discovered any easy answers, nor have I been successful in keeping the pressures of life from crowding out my bliss within days of returning home. Sometimes it helps to spend a few minutes scrolling through those lopsided phone photos. Or to use the time between appointments to close my eyes and remember the sensation of zipping down the water slide, my son whooping and hollering behind me. I pick up the seashell and study it's ridges and dips, catching the faint whiff of sea water trapped in it's whorls, and I let the sense of ease wash over me, like the waves washed over my feet as I huddled in the sand just days ago. There's no way to keep the vacation energy flowing as easily in "real life" as it does when we're off in the tropics. But using our sensory memories, reviewing photos and shared memories with those we vacationed with, and taking time out daily to slow down our bodies with focused breathing, stretches and sitting quietly can keep us moving forward, at least until the next chance we get to unplug and head out of town.

It Smells Like Teen Spirit

As the end of the school year approaches, I'm struck again by the transitions and milestones that constantly dot the landscape of parenting. Whether it's signing your child up for a "real" baseball team after he's conquered the challenge of tee ball, anticipating your teen's first prom (and all the accompanying risks, drama and excitement that comes with it) or trying to whittle down the guest list for your graduate's party, the changes and challenges in our children's lives, and our own, seem never ending. The cliche that "They grow up so fast!" rings with a truth every parent can relate to. I can remember with clarity the entire outfit my son wore to his first day of preschool (complete with the camouflage backpack that was larger than he was), and now we are headed out to buy his eighth grade graduation suit. Like most parents, I look back with some regret for not capturing every milestone on film or appreciating every grimy grasp of a little hand around mine. But I have to admit, the teen years are by far my favorite (so far!) I can hear the groans and imagine the eye rolls of many parents who have weathered the angst-filled and admittedly dangerous teen years and come out the other side with ulcers, thinning hair and even sometimes legal bills. Those parents would warn me that I ain't seen nothing yet from my only near-14-year-old. And I would agree. The broken curfews, hidden beer cans and muttered F-bombs that await me will undoubtedly try my patience, frighten me in the early morning hours, and have me catastrophizing about breaking my little jailbird out of the Big House. But I have to admit that I am looking forward to the teen dramas with more than a little anticipation. Maybe it's my experience providing therapy for the last 20 years. Or maybe it's the memories of my own risk-taking adolescence that lures me into believing my little angel couldn't POSSIBLY be as bad of a kid as I was. (I'm dooming myself to eating my own words, aren't I?) But these years when my child has grown into his personality, when he has learned to use his voice and stretch into his personhood a bit more, have been a source of delight and wonder for me. The infant and toddler years were so challenging and fear-filled: for me, there was nothing more anxiety-producing than hearing my baby wail and not knowing for sure how he needed me or whether I was meeting his need in a way that did more than just quiet his crying. Apparently, I function much better in a relationship where I receive comprehensible feedback, when I can ask and get answers to questions about what my child needs and desires, and direction on how to best meet those requests. I was frantic and frightened by my catastrophic forebodings that I would "miss" some crucial sign from my small child, thereby causing mortal physical or psychological harm from which neither he nor I would ever truly recover. I know I am fooling myself now in thinking I have more clues about what my son needs--or doesn't need-- from me. Although a rather chatty kid, I'm aware that there is much in the mind and life of a teenage boy that I will never be privy to. But at least now I can ASK-- and if the only response I receive is a grunt or an eye roll, I can soothe myself with the reassurance that I've kept up my side of the parent/child bargain. I'm still mystified by my friends who long for those baby years, and who jump at any opportunity to nuzzle any infant in close proximity. Equally baffling to me are those folks who get more joy from the 35th reading of "Good Night Moon" to a willful two-year-old than from a long(solo) soak in a tub. Nope, I'll take those moments with my teenage son over almost any other outlet for my energy-- even if those moments involve smelly gym clothes, drooping jeans and a ravaged refrigerator. What about you? Was there a favorite time for you with your kids? Were you surprised at the ways you managed the different phases and tasks in their childhood? I'd love to hear your stories!

Anxiety: Normal Worry or Serious Symptom?

As the world begins to make sense of the tragedy of the bombing in Boston last week--and the equally harrowing pursuit and capture of one of the alleged perpetrators--we might expect that our anxiety levels and feelings of being unsafe in our surroundings would start to ebb as the days go on. But for some people, that relief won't come quite so easily. They may find they are still hypervigilant, still metaphorically (or actually!) looking over their shoulders for the next disaster to approach. They may still suffer insomnia, eating and sleeping disruptions, and obsessive thinking that is hard to rein in. They may avoid all news reports of the bombing or be consumed by the need to know every detail of the investigation, the rationale of the criminals behind the act. And the individuals cotinuing to suffer with these kinds of distress are not simply post-traumatic stress disorder survivors who are being retriggered by reports of violence. Even people who've never before reported experiencing anxiety symptoms or trauma history are being challenged by worry, fear, obsessions about their safety and concerns abOut the future. Perhaps it's the media saturation we now live with, or a heightened knowledge about safety issues and concerns, but whatever the genesis, we need to be able to recognize when anxiety is growing beyond our control and know how to seek help. If you experience three or more of the following symptoms for more than a few weeks, consider contacting your physician for a referral for counseling:

1. Restlessness, irritability or agitation
2. Inability to control your worrying
3. Fatigue
4. Difficulty concentrating
5. Muscle tension
6. Sleep or eating disruption
7. Worrying about several different topics/life areas

Counseling can assess whether therapy alone can help to alleviate your symptoms, or whether an assessment to evaluate for medication is called for. Data supports that cognitive behavioral therapy (CBT) is highly effective in helping people manage their anxiety. The world is likely to continue to run at a rapid pace, and we are probably not going to be able to avoid exposure to tragedies and struggles. But empowering ourselves to pursue help when we need it can be the first important step in feeling more in control, and safer, in our own lives.

Faith Over Fear

As I watch the coverage of the tragedy that has occured at the Boston Marathon, I find my faith in the benevolence of the Universe shaken and doubting. I regularly teach my clients about the power of positive thinking, of having faith in the face of fearful circumstances. I encourage clients to believe that the world is a safe place overall, and that people are, more often than not, wired for good. I usually struggle with the idea of evil: perhaps idealistic and naive, but my sheltered, suburban life has allowed me to believe that evil is an "idea", a concept more than a reality. And then these tragedies happen. Is evil real? Are we at it's mercy, whenever it desires to strike? Is our belief in a loving, protective Higher Power a fallacy? Or are these tragedies reminders that faith is easy to have when we feel safest, but it is exactly when we face our most fearful times, when we are riddled with doubt and questioning, that we most need to rely on our faith. I wish i could say I am able to take strength from my faith, that I can lean back into the arms of Universal Love and trust that peace will reign in the end. But I'm unsure, at best, of how I feel and what I believe. I'm hoping to learn from all of you how you have faced tragedy and learned again to trust, to believe, and to hope.

Positive transitions = Vulnerability

When we think about the developmental milestones that mark our lives--weddings, births, graduations, first jobs--we often think about the positive feelings, achievements and sense of empowerment we expect to accompany these tasks. But just as often, people experience an equal amount of vulnerability and emotional risks. I've had clients who are nearing the end of their college careers, and find themselves struggling with anxiety, fear, and depressive symptoms they believed were long in the past. Clients who change jobs to positions with more status, power or pay are confused by the sense of doubt and stress that accompany this change. And most of us know of the perils of post-partum depression, when new mothers may struggle with sadness, anxiety and a fear of not being up to the tasks of parenting. However, while new mothers are in the midst of tumultuous hormone changes that affect their mood and sense of efficacy, I've worked with men who experience similar challenges when they add children to their lives. The myths associated with these celebrated events are part of the problem. We feel ashamed, "broken" or wrong for having negative feelings alongside a joyous event. We feel confused and doubtful about our ability to navigate even positive life events with ease. Sometimes, we feel cheated by sadness, grief, anxiety or anger that prevents us from being present to joy. But all change brings stress, because it's a shifting of the status quo to a state that is a bit unknown. And even positive stress (eustress) taxes our emotional, mental and physical capacities. We would do better to expect a range of emotions to accompany exciting life changes, rather than assuming we will only feel happy, joyous or grateful. Being gentle and compassionate with ourselves during times of transition helps to lessen the strain and ensures we notice and attend to our feelings. When change is looming, we need to increase our self-care: get plenty of rest, healthy food and exercise, and stay hydrated. We might benefit from taking extraneous responsibilities off our plates. The next PTA meeting, Pinewood Derby or church rummage sale may have to run, this one tine, without us. And when we experience unpleasant emotions side by side with positive life events, we can try our best to be tender with those feelings, for they are there to teach us something. Perhaps the fear about a new job is a reflection of our perfectionistic streak as much as it is a fear of failure. That anxiety can clue us in to be conscious of our self-expectations, and to accept that, in some cases, doing "good enough" is better or healthier than doing "perfect" work. Sadness at leaving a beloved college campus and dear friends reflects the depth and meaning we've built into those relationships. Failing to acknowledge our full range of feelings can create unconscious self-sabotaging or worsening of symptoms. We respect ourselves most when we don't expect positive life milestones to come without some less-than-positive feelings. It's by embracing all our emotions that we reap the richness of all life offers us.