Critiquing Codependence Theory and Reimaging Psychotherapy: A Process -- Relational Exploration
by Mary Elizabeth Moore
Mary Elizabeth Moore is Professor of Christian Education and Theology at the School Theology at Claremont, 1325 N. College Avenue, Claremont, CA 91711. She is the author of Education for Continuity and Change: A Traditional Model and is currently working on a book of dialogue between process theology and educational methodologies to be entitled View from the Bridge: A Traditional Model and is currently working on a book of dialogue between process theology and educational methodologies to be entitled View from the Bridge: Theology and Educational Method.The following article appeared in Process Studies, pp. 103-123, Vol. 29, Number 1, Spring-Summer, 2000. Process Studies is published quarterly by the Center for Process Studies, 1325 N. College Ave., Claremont, CA 91711. Used by permission. This material was prepared for Religion Online by Ted and Winnie Brock.
The reconstruction of psychotherapy is a great challenge, especially in the face of postmodern impulses to deconstruct concepts and theories that have been taken for granted for many decades.1 Of course, psychologists and therapists continually address this challenge, but human needs for healing continue, even while people raise foundational questions. With simultaneous pressures to reform thought patterns and practice healing, therapists may find process-relational approaches to postmodernism of particular value. This constructive postmodern path is not safe and easy, but it does respect sharp deconstructive moves in philosophy, while valuing the need to continue functioning in a world of pain.
At its best, postmodern thought raises questions with established patterns of thinking in the modern world, questioning the assumption that reason is more important to human well being than imagination and emotion, and the assumption that scientific theories are literal descriptions of reality rather than social constructions. At its best, postmodern thought stirs more than critique; it also stirs imagination regarding new ways of thinking and acting in the world. Both the critiques and reconstructions are important for psychotherapy.
The purpose of this essay is, thus, to engage in critique and reconstruction. The critique focuses on codependence theory, a theoretical resource for psychotherapy which is itself a reaction against many modern assumptions about human beings. The reconstruction is an act of imagination that points to, but does not fully delineate, an alternative approach to psychotherapy. The critique carries on the postmodern impulse to question, even to question emerging views that have considerable heuristic value. The reconstruction stirs imagination regarding alternatives. Although the reconstruction in this essay is only a sketch, I hope it will contribute to an ongoing conversation and a larger work of mutual reconstruction.
I. Questioning Codependence Theory
When I first encountered codependence theory, I was impressed with the heuristic value, especially the idea that some people (particularly women) are inclined to relate with others in codependent ways. Codependence is a style of relating in which oneís identity and sense of worth are defined by others and one has difficulty in distinguishing between oneís own needs and feelings and those of others (sometimes called boundary confusion). Codependent persons often take care of others, or serve them as fully as possible, in order to foster the othersí continuing dependence and, thus, to enhance their own sense of being needed.
Examples abound in literature, as well as the counseling room. Consider Paula Spencer in Roddy Doyleís The Woman Who Walked into Doors, Paula remained with an abusive husband for seventeen years in what she described as "one beating [. . .] that went on forever." She described her life as a cycle: "Getting hit, waiting to get hit, recovering; forgetting. Starting all over again" (206). She also blamed herself again and again, despite her own better judgment. She said:
I keep blaming myself. After all the years and the broken bones and teeth and torture I still keep on blaming myself. I canít help it. What if? What if? He wouldnít have hit me if I hadnít [. . .]. He hit me, he hit his children, he hit other people, he killed a woman -- and I keep blaming myself. (170)
Such a situation represents codependence at its worst; the destructiveness -- psychological and physical -- takes over the lives of a whole family and then spreads to others.
Because codependence is commonly found among people who are closely related to alcoholics, early developments in the diagnosis and treatment were shaped by reflections on alcoholism. Twelve-step programs were developed for codependents, and popular books were written and bought widely through chain bookstores. Now the language of codependence has become a household word in many communities, more extensive theoretical work has been done, and psychotherapists are using the diagnosis of codependence widely with clients. What better time than now to step back and ask the question of whether codependence theory has heuristic value, or whether it falls too easily into reductionism in the service of diagnosis and psychotherapy.
I will approach this question with the assumption that readers have at least some acquaintance with discussions on codependence through psychological journals, popular literature, or the practice of psychotherapy. Some critical reflections have already been made on the codependence movement,2 but the particular aim here is to raise questions from the perspective of process-relational thought -- an organic philosophy and theology of nature -- and from the concerns of feminist analysis -- a critical appraisal of gendered reality. Both process-relational thought and feminist analysis are based on philosophical assumptions that all of life is interrelated; thus, they offer fresh ways to reflect on phenomena labeled as codependence and critical tools for postmodern analysis and reconstruction.
A. Why Question a Good Theory?
I cannot question codependence theory without a personal prologue to keep me honest. I see more than a few codependent traits in myself, and viewed from the outside, I probably appear to some people as a classic case. For this reason, any critical analysis that I do needs to be subjected to suspicion that my own psychological motivations may be denial, repression, or some equally powerful defense mechanism. Not only am I personally culpable, but I also live within institutions (family, higher education, and the church) that are particularly susceptible to codependent relationships. Again, this may arouse suspicion of the potential biases in the following critical analysis.
Despite these risks of distortion, the questioning of codependence theory seems worthwhile for several reasons. First, it is so widely used in popular interchange and in sophisticated psychotherapy that it merits critical analysis. The fact that church communities and pastoral counselors have been among the leaders who have appreciated the heuristic value of the theory and the healing value of the diagnosis and treatment suggests that theological analysis would be valuable to any critical reflection. Further, the theories of codependence have not thus far been developed with much careful discussion of the relationship to altruism or with extensive comparisons between healthy interdependence and unhealthy codependence. Whether it is the theory itself that is flawed or its psychotherapeutic implementation, the treatment of codependence can lead persons to reject relationships altogether. It can also lead people to fear interdependence in any form, and to interact with other persons and institutions in passive aggressive ways, seeking to withdraw from personal and institutional involvement while indirectly undermining corporate life.
B. Codependence and Theological Questions
This oversimplified analysis already begs some theological questions, first in relation to women, and then, in relation to the nature of God and the universe. Since women are more often diagnosed as codependent than men, stereotypical or reductionist tendencies may be inherent in the diagnosis; these are potentially destructive for women. For example, what happens if the qualities of sensitivity to others and self-giving are defined entirely in the negative; especially, how do these negative valuations affect women whose socialization has often nurtured these very qualities? Certainly the dangers and damage of such socialization are obvious, and the evidence is convincing that these qualities often contribute to womenís self-abuse and abuse by others. On the other hand, what are the potential dangers of defining highly relational women and common relational characteristics of women in largely negative terms? Is the danger akin to the diagnoses of hysteria among women in the late nineteenth and early twentieth centuries? Is the danger that women will not be taken seriously in their fullness but be reduced to a simplistic psychological definition?
In addition to the potential dangers to womenís existence, what assumptions does codependence theory carry about the nature of God and the universe? The theory implicitly challenges any theology that views God or Jesus chiefly in terms of sacrifice -- theologies in which the redemptive work of God is described primarily as Godís sacrificing Jesus or as Jesusí sacrificing himself.3 The theory explicitly challenges any theology that fosters codependence as a value, especially a theology that fosters martyrdom or forms of self-giving that contribute to self-destruction, self-abnegation, or dependence on others for a sense of value. These are significant concerns emerging from codependence theory, but they are often stated without extensive theological or social analysis, thus leaving many open questions regarding the nuances of diverse theological perspectives and the varied experiences of peoples in diverse racial-ethnic communities, socio-economic classes, and regions of the world.
Codependence theory implicitly suggests an individualistic worldview as well, especially if the only options for communal worldviews are described in codependent terms. The consequences of such a non-communal worldview can be philosophical and psychological: a retreat into individualistic or atomistic views of the universe, a high valuing of individual human existence over social existence, a subtle rejection of people who hold more communal understandings of the world, an encouragement of people to seek their own identity by rejecting the influence of others, and a negation of the human ability to experience or act on healthy impulses to give of self and to care for others.
Perhaps, these are all reasons to question a good theory, but they are not necessarily reasons to reject the theory. The purpose of the remainder of this essay is to probe these questions and to seek alternative views of relationships and alternative approaches or resources for psychotherapy.
II. Codependence Theory: Life-Giving or Death-Dealing for Women?
On first blush, codependence theory seems to promise life to women, indeed to any individual or institution that gets caught in the codependent syndrome, described by Anne Wilson Schaef and Diane Fassel as "a constellation of behaviors that emerge in relation to the addictive system and dysfunctional family patterns" (73). Codependent and addictive behavior, while bearing some common features, are actually syndromes that are mutually reinforcing. The qualities of codependence include taking care of others, giving of oneself to the point of exhaustion or depression, suffering and complaining while denying help, living in close relation with addicts and/or other codependents, and discerning and responding to the cues of others ("external referencing and impression management") (74-76).
Of particular interest for the focus of this essay is the way theology and the psychotherapeutic profession play into the dynamics of codependence. According to Schaef and Fassel, "the societyís concept of the Ďgood Christian martyrí is the perfect co-dependent" (74). This means that the culture often values the behavior of the codependent positively, while giving a negative valuation to alcohol and drug addiction; in fact, they add, "helping professionals have themselves become the practice of the disease of co-dependence" (75). In other words, the official codependents in our society are often psychotherapists, priests, rabbis, and other practitioners of healing.
Religious communities often perpetuate the hand-in-glove relationship of codependent and addictive persons by encouraging the helping relationship as a religious ideal -- the relationship of one helper or helping institution with others in need. Again, Schaef and Fassel speak to this dilemma, saying, "to the extent that religious systems are caught in the same processes as the addict, they themselves support our remaining in the addictive system" (67). They describe the processes of an addictive system as denial, confusion, self-centeredness, dishonesty, perfectionism, seeking after sufficiency in a scarcity model of the world, seeking to control, frozen feelings, and ethical and spiritual deterioration (62-67).4
Though the theory-building on codependence began with the study of individuals in addictive family systems, the study has in recent years taken account of codependence as a phenomenon in institutions and organizations. Schaef and Fassel identify four forms of addiction in organizations: organizations in which a key person is an addict, organizations in which persons take their addictive or codependent disease into the organization and replicate the dysfunctional system, organizations which themselves become the addictive substance, and organizations that are themselves addicts (77-176).
This shift to a social psychological analysis of community life marks a broadening of codependence theory; it also accounts for an interaction between individual and social pathology. On the other hand, it perpetuates a tendency to interpret communal life through categories of individual psychology and through diagnostic categories of psychopathology. Can such diagnosis of addictive systems provide adequate understanding of any social community? Are the origins of cultural, ethnic, and gender patterns reducible to the dynamics of the individual psyche, or can they be better explained in terms of a complex interplay of individual, social, economic, and historical forces? These questions cannot be fully addressed in a single essay; the questions can be approached, however, by evaluating the adequacy of codependence theory through gender analysis.
A. Women and Codependence
Thus far, the discussion of women has been by implication, but reflect for a moment on a few realities: the majority of persons in the United States diagnosed with depression are women;5 the majority involved in religious communities and helping organizations are women; and women are more often associated with the ideals of self-giving than men. We should not, then, be surprised if psychotherapists frequently use the language of codependence in helping women name their hurts and illness; nor should we be surprised that many books recommended to codependent and addictive clients in the healing process are focused largely on women.6
A distinction should be made between the more popular and the more empirically based codependence theory; yet, in both, women have been the subject of research and theory more than men. The basic reason for this is a laudable effort to redress a neglect of women in earlier theories. Anne Wilson Schaef for example, has been a popularizer, and many women and men have met codependence theory and found psychotherapeutic guidance via her works. Schaef was aware of gendered realities before she began using the language of codependence. She began with an insight that existing theories of psychotherapy were not very responsive to women, and in 1981, she saw this problem in her own twelve-year old practice of psychotherapy:
As more and more women came to see me, it became clear to me that I did not know what to do with them. [ . .] As I reviewed my training, I began to realize that what I had been taught was useful in working with men but at best useless and at worst harmful in working with women. (Womenís, Foreword)
In approaching this problem, Schaef describes the limits of both intrapsychic and interpersonal approaches to therapy and puts forth the idea in Women Reality that an analysis of the "ĎWhite Male System" is necessary if psychotherapists are to understand the dilemmas of women in society (1-4). The problem infuses the general society, the counseling room, and the most influential theories of psychotherapy
Schaef refers particularly to Sigmund Freud and Erik Erikson, whom she describes as "very astute observers," but not very good interpreters of women "because they could only interpret from their own, White Male System bias" (Womenís 33; cf. Homey 54).7 She gives one example in Freudís assertion that women envy men -- an astute observation in itself, but one distorted by Freudís idea that womenís envy centers on the male penis. She says:
I have met very few women who really wish they had a penis. [. . .] There is something men have that we would very much like to have though: the birthright of innate superiority, the power and influence one inherits by being born male. (Womenís 33; cf. Horney 54-55, 223)8
Schaef proceeds to explain some of the ways in which the White Male System defines all aspects of womenís reality as inferior and does not even leave room for women to express their rage without the label of "inappropriate" (Womenís 85-88).9
Further complicating this picture for women and ethnic minority persons, Christian theology has been used to reinforce the patterns: "Without a doubt, the church has perpetuated the concept that the suffering servant is the holiest person of all. Women and minorities have been encouraged to be suffering servants, thereby achieving absolution" (Womenís 167).
Attending to Schaefís view opens the issues, but it is also a distortion, for she is a popularizer. By her own testimony, she is writing as a synthesizer looking at the big picture, and she is concerned that her work not be used as a "weapon against women"; she worries that therapists will use her work to tell women "what they should be feeling, thinking, and working on" (Womenís Foreword). Selecting Schaefís work is intentional, however, because the sales of her books represent some of the best evidence of the heuristic value of codependence theory
Schaef is not the only psychotherapist who has attended to women and codependence. In fact, much of the research on codependence has focused on women as primary subjects. This is apparent in the numerous studies of wives of alcoholics as well as in reviews of the literature on codependence (Farris 113-32).10 What is also evident in this research is that definitive conclusions are not possible in regard to the health of women married to addicts because different personality dynamics and different degrees of personality disturbance are found (Farris 115-26).11 The evidence does not support an easy conclusion that women married to addicts have more personality disturbances than others in the population. This leads back to the question of whether the theory of codependence and the popular conclusions regarding the relation between codependence and women are overly simple: is the theory heuristic or reductionistic?
B. Women and Theological Traditions
The encouragement of codependence in women is deep within the traditions of Christianity, so this psychological diagnosis is not surprising in cultures influenced by Christianity. Since the problem can also be found in other religious traditions, this analysis of Christian tradition is done in hopes that future analyses will be made within other traditions as well. A twofold problem exists for women in Christian theology -- namely; the assumption that women are inferior to men and the ethical norm for women to be subject to men. These theological assertions are drawn from many corners of the biblical and church traditions, but one theologian who has had major influence on Christian theology exemplifies the problem in his explicit treatment of the subject -- Thomas Aquinas.
In speaking of the creation of humans in the image of God, Aquinas makes a case that men are created in the image of God in a way distinct from women. He presents a two part case, beginning first with the argument that the intellectual nature of the image of God is "found both in man and in woman," appealing to Augustineís argument that this expression is necessary "lest it should be thought that both sexes were united in one individual" (472). Here we see an instance of protecting the distinction between male and female. To this Aquinas adds a second argument:
But in a secondary sense the image of God is found in man, and not in woman: for man is the beginning and end of woman; as God is the beginning and end of every creature. So when the Apostle had said that man is the image and glory of God, but woman is the glory of man, he adds his reason for saying this: For man is not of woman, but woman of man; and man was not created for woman, but woman for man [emphasis in original]. (472)12
In this second argument, Aquinas moves beyond the distinction between male and female and expresses the primacy of male over female, a primacy rooted in Godís creation and witnessed in the Bible.
The fundamental theological problem for women in Christian tradition is this argument for the inferiority of women to men. A second problem is the ethical argument for women to be subject to men. Again, Aquinas makes this argument, appealing to Genesis and embellishing the argument with assertions that women are inferior to men. The primary role of women in relation to men is in the work of generation; thus Aquinas argues:
It was necessary for woman to be made as the Scripture says, as a helper to man; nor, indeed, as a helpmate in other works, as some say, since man can be more efficiently helped by another man in other works; but as a helper in the work of generation [emphasis in original]. (466)
Building on this basic theme, Aquinas makes an explicit case for the subjection of women to men, not the kind of subjection emerging from sin in which the subject is used for the benefit of the superior, but the kind of subjection that existed even before the entry of sin into the world in which people are subjects for their own benefit. Of this second kind of subjection, Aquinas says:
There is another kind of subjection, which is called economic or civil, whereby the superior makes use of his subjects for their own benefit and good; and this kind of subjection existed even before sin. For good order would have been wanting in the human family if some were not governed by others wiser than themselves. So by such a kind of subjection woman is naturally subject to man, because in man the discretion of reason predominates. (466-67)
We see here a picture of women as inferior, less able to reason, and more needy than men.
The question before us now is whether the theories of codependence promise to free women from such characterizations -- from their sense of inferiority and from their traditional assignment to subjection and helping roles. On the other hand, will these theories subject women to even more characterization? The particular danger is a diagnosis that names the helping roles (into which women have often been well socialized) as illness or codependence? These questions fuel the remainder of this essay, particularly the search for a larger theory
III. Beyond Codependence: Toward a Larger View of Life
The central question is whether codependence theory gives life or death to people who are subject to this diagnosis. Of course, the answer largely lies in how the theory is used, but the focus here is on the theory itself. Focusing first on women, who have been most often diagnosed as codependent, the theory implicitly denies the inferiority of women or anyone else; the theory also denies womenís obligation to be subject to others. Subjection is necessary neither for oneís own good nor for othersí. On the other hand, the theory also carries an implicit denial of the traditional virtue of giving that is associated with women, even a denial of generosity as a positive impulse. Does such a theory promise fuller life or death?
Answers exist within codependence theory itself for the question I am raising here. For example, Anne Wilson Schaef makes the distinction between relationships and pseudo-relationships; the former support life and the latter destroy it. Schaef herself raises questions with codependence theory, recognizing that the label "co-" can be an avoidance: "Most people would rather be a Ďco-í than an addict" (Escape 6). She recognizes that the labels of co-dependence and co-sex addicts are easier to accept than other addictive labels; therefore, claiming these diagnoses may be a way to avoid seeing oneís own addiction. Shaef shows how these codependent roles are addictive in themselves, drawing people into pseudo-relationships and, thus, into an escape from real intimacy (Escape 6, 106-11). Taking Schaefís view, codependence itself is death-dealing to relationships in much the same way that addictions are.
In developing this theme, Schaef describes her own move beyond the "caretaker, controller issues" and the idea "that co-dependence is a relationship disease"; she concludes instead "that co-dependence underlies every addiction" (Escape 106). In making this move, she describes various addictions that flow from the co-dependence, namely, "ingestive addictions, process addictions, certain neuroses, certain psychoses, character disorders, and non-liberated men and women" (Escape 107). Though she asserts that codependence and the underlying addictive process are not exactly the same, she admits to being unsure about what the difference is. The implication of this thinking is that codependence is nor only a disease, but it is foundational to many other diseases, thus intensifying and expanding the seriousness of codependence as a clinical category.
When viewed from the perspective of psychoanalytic theory, this idea could be seen as an expansion of the traditionally understood defense mechanisms of projection, rationalization, reaction-formation, dissociation, regression, repression, identification, introjection, and compensation. These defense mechanisms (or some of them) are seen in codependence theory as the central causal problem rather than the symptom of a deeper problem. From Sigmund Freudís perspective, the opposite is the case; defense mechanisms are seen as means for dealing with anxiety which is aroused by deeper sexual and aggressive drives. These deeper drives are the real causal forces in human personality, according to Freud.
What does a process-relational view contribute to this discussion? It would certainly affirm the Freudian and post-Freudian assumption that the underlying causal force in human life is energy, or deep drives. A process-relational view is distinct from psychoanalytic theory however; the underlying force is not seen as sexual energy or the will to power, but rather, as the will to life. Building on this basic notion, we can describe the powerful energies within human life as energies directed toward preserving and enhancing life. If this is the case, then defense mechanisms might be seen as efforts of that internal energy to protect what life a person is able to experience and to create opportunities for new life to grow.13
In such a view, defense mechanisms function not merely to protect persons from anxiety (external or internalized threat), but also to open persons to new life. From the perspective of process-relational thought, defense mechanisms might be seen as cries for help, or doorways that potentially open possibilities for people to respond more fully to the influence of Godís initial aim and to the more life-giving influences of their past.14 The concept of concrescence is critical because every moment offers the real possibility for fuller life to emerge.
Appealing to the same form of argument, the will to relationship could be seen as a will to life-giving relationship. This is sometimes distorted into death-dealing relationship. If postmodern thought pushes toward a relational view of the universe, then postmodern thinking poses a worldview (or a variety of worldviews) in which relationships are not optional; they are part of reality. For Schaef to distinguish between relationships and pseudo-relationships may be an appropriate plea for distinguishing healthy from destructive relationships, but one cannot assume that any relationship is not real. Relationships are real, and they are pervasive.
Defense mechanisms might be understood, then, as the meager efforts that people make within present relationships to protect what life-giving elements do exist. Perhaps, people are simply protecting the positive value that they experience in these relationships, hoping to open the way for more just and loving relationships in the future. In such a view, defense mechanisms are not idealized as ends in themselves, but they are valued for what they reveal of human yearning and what they can potentially contribute to human thriving. Problems arise, of course, when defense mechanisms are perpetuated long past their usefulness, living on as part of an unfinished and unintegrated past. But what would happen therapeutically if people were encouraged to discover (or rediscover) their impulses to protect life and then draw upon those impulses as a force for healing?
Lest this be judged as hopelessly optimistic, consider how limiting is the cause-and-effect thinking of codependence theory in which one pattern of behavior (addiction) explains another (codependence). Even psychoanalytic theory, with all its fascinating complexity, is grounded in cause-and-effect explanations of human behavior. One unique contribution of process-relational thought to the postmodern movement more generally is the recovery of mystery, denying none of these dynamics of cause and effect, but affirming the reality of novelty Godís initial aim is contributed to every becoming occasion, and every occasion receives the entire inheritance of the past, which itself may enter into the subjective aim of a becoming occasion in a novel way (not always the predictable ways that are explained by cause-and-effect theories). The possibilities of novel response are limitless, certainly moving beyond simple causal explanations. Further, the possibilities for healing expand far beyond existing diagnostic categories, even the most complex and adequate of those categories.
With these ideas in mind, one can see the actions of codependence as actions toward life, actions toward living fully and living in full relationships. Rather than focus on codependence as a diagnostic category, the focus can be shifted to codependence as an effort toward life. This is not to deny the destructive potential of codependent behavior, but to shift the figure and ground, placing the dynamic effort toward life in the foreground and looking to that dynamic as a positive force upon which to build.
We are talking here of reversal thinking. For example, the codependent spouse of an alcoholic may be seeking to find and enhance the glimmers of life that exist within his or her limited marriage relationship. That personís positive search for life, however limited, might be more promising ground for healing than the distortions themselves. Analyzing relationships in this way, psychotherapists can encourage people to build on positive impulses rather than to focus on destructive self-labeling or hasty withdrawal from questionable relationships.
Although ending relationships is sometimes best, it is also a limited choice, due to communal, family, vocational and psychological complexities; it can even be a misleading choice, as when people disregard the persisting influences of relationships, even after distancing is accomplished. This does not mean that people should be encouraged to remain in relationships at all costs or continue in the same destructive patterns. Instead, they need to be encouraged to recognize in those patterns a yearning for life that can provide the energy for more promising, life-giving choices. Those choices might well include a distancing from certain relationships or a radical shift in the mode of relating, but the impulse to change will be built on the seeds of life that are already present rather than on self-condemnation.
Other examples can be given for this kind of reversal thinking. The overachiever may be one whose opportunities have been limited or who has been discouraged from full participation in life; the effort to achieve may be the personís effort to live to the fullness of her or his abilities. Similarly, a person who is highly dependent on relationships may be someone who has been limited in relationships in the past and discouraged from fullness of relational being. The personís effort to seek and build upon relationships may be promising ground not only for diagnosing pathology but, more importantly, for discerning the desire and capacity for life-giving relationships.
When applied to communities of people, as to women, the move of codependence may be seen as an effort toward countering years, even centuries, of demeaning socialization. The tendency for codependence to become stronger in women is surely no accident, given the repeated messages of inferiority and experiences of subjection that women have encountered. The very exercise of codependent behavior among women may be an effort to claim life; from this, more adequate efforts can later grow. When women acknowledge and celebrate their efforts to claim life, they will be empowered to move beyond self-destructive cycles and toward fuller life.
IV Beyond Codependence: Toward a Larger View of Relationships
The discussion thus far points to the conclusion that codependence has had enormous heuristic value in naming the experience of many people, especially many women. The value, however, has been in giving voice to a phenomenon on the surface of experience, but not In unearthing the depths of that experience. The reflections on life instincts in the previous section point to the possibility of a larger view of life, and now we will seek a larger view of relationships. Here is where process-relational thinking may be particularly valuable; philosophers and theologians describe a relational universe in which the dynamic of codependence is only a minuscule part of human relatedness with the world. If codependence theory is overstretched, the practice of codependent diagnosis and counseling may indeed be reductionistic. If codependent interactions are not recognized as singular strands in a larger relational web, the fullness of psychological explanation, and the fullness of life, may be thwarted.
As I write this, I think of persons diagnosed as codependent who withdraw from existing relationships and reflect on all their former giving as codependent and sick. Closing themselves off from their former acts of giving, they also close themselves off from larger needs in the world, thus enclosing themselves in a narrow world where they see only themselves. Is the thrust of such a move to support life or to deny it?
Perhaps such withdrawal is a necessary first step, but what is lost if diagnosis and therapy stop at this point? Perhaps codependent behavior itself is an effort that people make to move into a larger world where they can participate in the support of life. If this is the case, withdrawal from codependent behavior may be best effected if persons are encouraged to give themselves more fully to the cherishing of life -- theirs and others as well. When, as is the more customary practice, codependent persons are encouraged to cherish themselves and to withdraw from the caring of others, the pattern of dichotomizing self and others, individuality and relationship, codependence and independence is perpetuated.
What are the alternatives, and in what views of God and the world might such alternatives be grounded? Gordon Jackson answers this question with a vision of pastoral care and counseling drawn from process-relational metaphysics. He describes pastoral ministry and the healing process as creating something of beauty. In this view, people are invited actively into the creative process of life -- to appreciate, enjoy, and contribute to beauty in the world. Jacksonís view has much in common with the one presented here, which is built upon honoring the Spirit of Life, self-giving, and interdependence.
A. God as Spirit of Life
Perhaps the present alternatives of codependence and independence owe more than we realize to the dominant views of God as the Supreme Helper of the world or as the Wholly Other. Perhaps the dichotomizing of codependence and independence owe much to the dichotomizing of Godís acts into intimate care-taking and almighty judgment.15 Even the difficulty of reconciling a fully good God with a fully powerful God is an indication of the dualistic categories.
This entire complex of questions is one in which process theologians have often traveled, posing the idea that God is fully good, but not all-powerful. Hence in the process view, God is the Source and Sustainer of Life, who participates fully in every moment of life, luring every being to more fullness. At the same time, Godís power is persuasive rather than coercive; Godís power is the greatest power and the unsurpassable power, but not the only power in the universe. Thus, God interacts with the world but does not control the world. Godís life is interdependent with the life of the world. God feels the pain and joy of the world and God contributes an initial aim to every emerging occasion, but God does not and cannot determine the outcome.
In this process-relational, panentheistic view of God, God is understood to be in every being and beyond every being. God is neither defined by the reality of the world, nor independent of that reality God indwells every moment of experience, but these moments always transcend God (having received into themselves other forces of the universe, including evil forces), and God always transcends the experiences, always being more than is concretely actualized in the world.
This view offers a vision for human relationships that moves beyond the dichotomous choice between independence and codependence. Insofar as human beings are created in the image of God, people are themselves born into such a network of relationships in which each person and each community is unique, transcending every other person and community in that uniqueness. At the same time, people are born related to one another, to God, to the whole universe; thus, our actions affect the life of the world and the life of God. We cannot exist in isolation from God and the universe.
B. Self-Giving: A Human Value
Where does this discussion lead in regard to the value of self-giving, a value that falls all too easily into the distortions of codependence? Perhaps one clue lies in the work of God -- a work of self-giving without end -- a work, however, in which Godís self-giving is not an end in itself but always a movement toward Godís future of shalom.
Drawing from Jewish and Christian traditions, biblical texts describe Godís work as directed toward life -- toward justice and the wholeness of creation. That raises questions for Christian theology about why Jesus died, and what model of human life is offered to us by Jesusí journey to the cross. This question was raised in the pastoral counseling movement long ago by Helen Flanders Dunbar, who drew connections between the Christian belief in a suffering God and Christian value patterns of self-depreciation and masochism. As paraphrased by Jeanne Moessner and Maxine Glaz, "The way of the cross may lead to the mental hospital" (40-41).
Theologically, this view of Godís suffering might be refrained in a process-relational view, emphasizing Godís feeling with and for the world. Godís suffering is not masochistic, but is instead the natural consequence of being related with every moment in the life of the world. Similarly, Jesusí death was the natural consequence of radical living and loving -- the consequence of Jesusí identifying with the outcast, proclaiming Godís justice and righteousness, and giving his life fully to living. By such an argument, Jesus is seen as self-giving, but not self-destroying. He simply met and accepted the consequences of radical living. In this view, incarnation is a theological contribution to codependence theory -- a rejection of self-giving that is aimed at self-destruction or filling an inner void and an affirmation of self-giving that is aimed at supporting life.16 This view suggests that the value of self-giving would be measured not so much by how much the giver suffers, but by the degree to which the giving contributes (or is intended to contribute) to justice and love and fullness of life.
This leads me to reject Anne Wilson Schaefís ethical conclusions. As Bonnie Miller-McLemore says: "Schaef advocates an individualistic, situational ethic that is insufficient for the problems of late-second-wave [feminist] women and at odds with Christian ethics." Miller-McLemore further critiques Schaef on her assumption that "as each woman realizes her own individual good, she will have a congenial social balance of needs met and desires gratified" (72)17 What is needed instead, according to Miller-McLemore, is an ethic of reciprocity in which self-concern and concern for others are held together (77-79).
Because the term reciprocity evokes connotations of equal trade, I choose to speak instead of an ethic of mutuality -- an ethic in which both giving and receiving are valued, both self-concern and other-concern, both care-giving and justice-making. An ethic of mutuality calls not only for action between two persons or two social groups, but also, collective action toward the larger world.
Psychotherapy that supports an ethic of mutuality assigns value to self-giving whenever that giving sustains life in oneself and others. Such counseling contributes to peoplesí ability to empathize with others and to be attuned with oneself. Such counseling inspires persons to give of themselves for the sake of life, and it equips people to make difficult decisions in order to support justice and well being for all life, the life of self interpersonal relationships, social structures and the entire eco-system. It does not demand independence from relationships, but rather living in relationships in the most life-giving ways possible.
C. Beyond Codependence to Interdependence
In conclusion, the heuristic value of codependence theory for psychotherapy is clear. The theory elaborates on a common problem in human relationships in which life is narrowed and destroyed, and relationships are limited or used to destroy the Spirit of Life. The critique developed here also carries force, however, and reductionistic aspects of codependence theory become increasingly clear. Most important, codependence theory limits the discussion of relationships to certain sick patterns in human interactions. This focus neglects the limits of cause-and-effect descriptions of human behavior, as well as the depths of psychic pain which are only partially revealed in codependent patterns. It also neglects the profound will of human beings to live fully -- an instinct that motivates much human interaction and sometimes pushes toward healing even in the midst of sick patterns of relationship.
Further, codependence theory fails to recognize the distinction between codependence, in which one person or social group is defined by the other, and interdependence, in which persons and communities live in mutual relation with one another and with God. Interdependent relationships, if they are to sustain life rather than destroy it, require an ethic of mutuality -- an ethic that calls each human being to be responsive to the Spirit of Life in oneself and others, and calls all beings together into solidarity on behalf of the planet.
V. A Picture of Process-Relational Psychotherapy
A postmodern effort to imagine the future of psychotherapy is inevitably vague, due in part to the nature of postmoderism, which is clearly a movement beyond modernity, but not a fully or concretely formed system. Postmodern thought is most obviously and actively a critique of modernity and a smaller current within the postmodern movement is the constructive postmodern impulse to seek alternative worldviews and patterns of action -- an impulse marked by the active participation of many process-relational thinkers.
This essay is grounded in an assumption that the critical and constructive impulses of postmodernism cannot be glibly dichotomized. Critical work opens space for new constructions, and new constructions require the same critical eye as the old.18 In fact, the reconstructions may simply replicate modernist assumptions regarding the superior value of reason, and they may remain trapped in modern dichotomous thinking about sickness and health, dependence and independence, and women and men.
Having pronounced these warnings, the greater danger seems to lie in the failure to ground the ideas of this essay in proposals for practice, committing another modernist fallacy of divorcing ideas from their concrete manifestations. The work of practical philosophy or practical theology is one that begins and ends in practice. Certainly, the hope for real transformation in psycho-therapy pushes me to close this essay by circling back to psychotherapeutic practice. For now, the practical proposals are in the form of imaginings, awaiting further action and conversation with others. The proposals, thus, are listed as invitations for experimentation and reflection.
I. Process-relational psychotherapy would seek to enhance the will to lift and the will to lift-giving relationship, both for individuals and communities. In such therapy, people would be encouraged to identify what in their actions or the actions of their community already represents their quest for fuller life. They would be encouraged to reflect on their most positive actions, but also on those actions that are destructive, seeking to discern the impulses toward life within those very acts. Further, people would be encouraged to name those experiences that best nourish their lives and relationships and, then, to seek ways to build such experiences more fully into their daily comings and goings. The nourishing experiences may he political activity, gardening, spending time with friends and family participating in active sports, exploring the natural world, exercising, or listening to music.
Although the focus of such therapy would often be on individuals and families, the work of psychotherapy would also be focused more directly on the life of larger social bodies. Psychotherapy would concern itself with the wellbeing of communities and, therefore, would encourage and support actions that nourish communal life and relationships -- communal rituals, common meals, and communal play. The forms of process-relational psychotherapy would be many, but one of the primary disciplines of healing would be to identify and engage in actions that support the wellbeing of communities and individuals, and to do so within the context of the larger environment.
2. Process-relational psychotherapy would seek to enhance the relationships that people have with the Spirit of Life, which many will call God and others will name in other ways or not name at all. The practice of prayer, contemplation and meditation would, then, be quite appropriate to psychotherapy. Such a recommendation seems more obvious for those who are pastoral or religious counselors than for those who are "secular" therapists. Certainly pastoral and religious counselors would have a unique contribution to make here, but some practices of meditation are not bound within a particular religious tradition, and some are shared by many traditions. The proposal is that psychotherapists seek ways to engage people in prayer, contemplation or meditation, and to do so in ways that are appropriate to the therapists and clients within their particular contexts. Some of this may take place in therapy sessions, particularly if religious frameworks and language are shared by therapists and clients. Some therapists may simply encourage clients to participate in their own religious communities.
3. Process-relational psychotherapy would encourage people to be involved in self-giving, focusing particularly on forms of giving that they judge to be most valuable to themselves and others, and forms of giving that are the least tainted by their past experience with self-abnegation. The possibilities of self-giving are limitless: giving through social protest (often protesting the very oppressions that have most affected them and their people); giving through helping others (individually and collectively); giving through service to the earth (caring for the air and land, recycling, participating in the political process to protect the eco-system); giving through developing oneís distinctive strengths and the quality of oneís own life, both for oneself and for others.
4. Process-relational pschotherapy would encourage people to enjoy life and enjoy relationships, seeking ways to enhance their ordinary lives and relationships so that they bring more enjoyment to all involved. This would include analyzing ordinary life to discern what is already present to be enjoyed, what is absent, and what might be transformed or initiated as a movement into enjoyment. The aim would be to enhance the quality of life and the quality of relationships, recognizing that relationships do exist, that they are often filled with brokenness and pain, and that the healing of relationships can contribute to the healing of individuals and the healing of the world.
All of the proposals imagined here are exploratory but underlying them is the hope that psychotherapy can empower people to critique and transform their world. Process-relational psychotherapy might be understood as the mutual practice of healing. People are encouraged to work together in healing their world, themselves, and the communities in which they live. The hope is to create and nurture communities of well being that will foster well being among their members and in the larger world.
1. An earlier version of this essay was published as: "Codependence Theory: Heuristic or Reductionistic?" The first version was presented in a conference on Process Thought and Psychotherapy, sponsored by the Center for Process Studies, School of Theology at Claremont, October 1992.
2. James Farris reviews the literature on codependence and critiques the approach of twelve step programs in healing, particularly in regard to the elements of twelve step programs that reinforce dualistic spirituality, based on an assumed chasm between the divine and human.
3. This issue is raised with more explicit detail in feminist and womanist writing; a connection is demonstrated between the accent on Godís sacrifice and the ethic of self-sacrifice as a human value. Further, these theorists observe that the value of self-sacrifice is often applied more vigorously to women than to men. Two important sources for these discussions are: Isabel Carter Heyward, The Redemption of God and Joanne Carlson Brown & Rebecca Parker, "For God So Loved the World."
4. Other characteristics are described elsewhere, such as crisis orientation, depression, stress, abnormal thinking processes, forgetfulness, dependency, negativism, defensiveness, projection, tunnel vision, and fear" (68). See also Schaef, When Society Becomes an Addict, 86-93.
5. Christie Cozad Neuger has described the epidemic of depression among women, as well as the major explanatory and prescriptive theories.
6. See for example Beattie, Baer, DeRosis, Dowling, Kimball.
7. In this critique, Schaef stands with women psychologists and psychoanalysts since Karen Homey, who have noted that Freud and most early post-Freudians were men, whose understanding of menís psychology was greater than their understanding of womenís. Consider Freudís Outline of Psychoanalysis and Civilization and its Discontents.
8. Karen Homey describes with more complexity than Schaef the inadequacy of a theory of female psychology based in biological difference and disregarding the force of masculine-dominated culture.
9. This is the theme of the entire book, but Schaef deals explicitly with rage on these pages.
10. See also Whalen, MacDonald, James and Goldman.
11. Farris notes that research on enablers and co-alcoholics (prior to the coining of "codependence" in the early 1970s), as well as research on codependents, leads to mixed conclusions regarding personality disturbance among these people (115-26). He concludes that research is inconclusive on the emotional health of codependents: "With regard to the rate of personality disturbance among wives of alcoholics as compared to wives of nonalcoholics, research findings are mixed. Regarding the issue of the presence of personality disturbance among wives of alcoholics sufficient to warrant generalization that wives of alcoholics are disturbed, research findings are open to both interpretations and the charge that they reflect cultural stereotypes" (124).
12. This argument is quite different from that of contemporary feminist scholars who make a case that the Genesis 1:27 passage regarding the creation of "them" in the image of God is an instance of inclusiveness in a biblical text, referring to the image of God in both men and women and, thus, the possibility that God can also be imaged as both male and female. See, for example Trible.
13. These ideas bear close resemblance to Greiderís description of "the instinct to survive and live well." ("All" 2). See also Greiderís Reckoning with Aggression. Theology, Violence and Vitality.
14. This idea is developed more extensively in the essays of David Roy and Robert Brizee.
15. Bonnie Miller-McLemore is also concerned about the classical Western views of God as ultimately separate, self-sufficient, omnipotent and beyond influence. She connects this theological issue with her psychological concern regarding the dichotomy between autonomy or self-concern and concern for others. She finds theological resources in Catherine Kellerís view of God who "activates connection" (77-80; cf. 63-85). See also Keller.
16. A similar accent can also be found in other theological perspectives, even in Jürgen Moltmann who strongly emphasizes service and the human call to assume suffering in solidarity with others who suffer. He says, "the person who wants to fill an inner emptiness through service to others will only spread this emptiness further [. . .] Only those who have become free within from self-seeking, from preoccupation with self, and from anxiety about life, can share suffering and take it upon themselves -- and free others" (30).
17. Miller-McLemore argues further that Schaef assumes the inherent goodness of human nature, but limits her assumption to women. In so doing, she ignores "the depth and complexity of human nature and its capacity for both greatness and corruption, goodness and evil" (72-73).
18. Jantzen ("Knowledge") emphasizes the point that postmodern deconstruction is intentionally vague. For Derrida, deconstruction is more of a creative inquiry than a fixed method to be grasped. It is a mode of inquiry that gives attention to subtext, convention, and margin; it is not antithetical to reconstruction, but wary of reconstruction that is done prior to major social reordering. See also Jantzen (Power).
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