The five core issues of co-dependence

By Jeff van Reenen (MSc MFDAP NCAC Accredited), Addiction Treatment Programme Manager at Priory Hospital Chelmsford

Co-dependence, or developmental immaturity, is a disorder caused by childhood relational trauma, where healthy attachment to the primary or secondary caregiver is impaired and, in some cases, either severed, or at minimum, harmed significantly.

Relational trauma results where there may have been circumstances of child maltreatment, sexual abuse, sexual harassment, rape, psychological and emotional abuse, bullying, domestic violence, narcissistic abuse, abandonment, rejection, complex grief, traumatic loss and other forms of attachment, betrayal or disruption.

Thus, those who identify as having experienced less than nurturing or abusive family systems in childhood can be susceptible to developing adult behaviour patterns that lead to co-dependency. The co-dependency patterns can translate into addictions, mood disorders, physical illness and relationship struggles.

The five core symptoms of co-dependence

The chain of symptoms that characterise co-dependence are known as the ‘core’ or ‘primary’ symptoms and they describe how co-dependents are unable to be in a healthy relationship with themselves and others.

The core symptoms of co-dependence include experiencing difficulties with:

• Self-esteem and self-love
• Setting functional boundaries with other people and protecting oneself
• Owning one’s own reality and identifying who one is
• Addressing one’s adult needs and wants, manifesting into self-care difficulties
• Being moderate or contained

In dealing with each of the core issues, the dysfunctional adult (or co-dependent) tends to act in the extreme.

If we look at the self-esteem, identity, and needs and wants issues, for example, people may present in the following ways:

• There is thinking that fluctuates between being ‘worthless’ or ‘better than’, or feeling too vulnerable or invulnerable
• Feelings of being so bad to the point of detestation or, through delusion of perfectionism, think that they are irreproachably good
• Some would feel too dependent, wanting others to take care of them but others could present as anti-dependent, or ‘needless’ and ‘wantless’ – refusing to accept help or admit that they had any needs at all
• Some of those with co-dependence issues may also act childishly and immaturely whilst others may seem overly mature, rigid and controlling

Impact on the child

As children, we can be relationally traumatised by enmeshment, neglect or abandonment.

Enmeshment is the inappropriate closeness of family members. In an enmeshed and over-involved relationship, individuals get lost in the relationship. There is a lack of clear boundaries, thus each individual has difficulty developing a clear sense of self. Examples of phrases that demonstrate enmeshment are, “you’re my everything”, “without you, my life would not be worth living” or “you complete me”.

Neglect happens when a child’s basic dependency needs were not met. Dependency needs are our basic needs for food, clothing, shelter, safety and medical attention. Either the parent did not know how to meet these needs or the parent did not meet these needs well enough. Neglect in childhood may lead to depression, anxiety, eating disorders, anger issues, or alcohol and drug abuse in adulthood.

Abandonment happens when the loss of one or both parents occurs physically or emotionally. If the parent was not present in the child’s life or the parent withheld affection or nurturing, the child was abandoned. Abandonment in childhood can result in adulthood difficulties with expressing and managing emotions, trust issues or a having a need to be in control.

Impact on the adult

So what does all of this mean for the person who suffers from co-dependence?  The core issues will present as secondary symptoms for the dysfunctional adult, making life unmanageable through problems with:

• Control issues (too controlling or no control in relationships)
• Resentment and/or anger
• Intimacy and problems having authentic and meaningful relationships
• Avoiding their own reality through addiction as well as mental illness (depression and anxiety) or physical illness (the patient who is constantly ill or has physical symptoms of illness)

Treatment that addresses the core issues

Priory Hospital Chelmsford is launching a new one-day workshop programme, ‘Grow yourself up’. The programme has been specifically designed for people who have experienced less than nurturing parental relationships in childhood, and will help participants to explore these childhood origins and the core issues of their adult dysfunctional behaviours.

Additionally, the addiction treatment programme at Priory Hospital Chelmsford, addresses co-dependency and developmental immaturity issues, working with the patient with their addiction and mental health problems. The programme and the therapists work to support the patient by helping them to build solid foundations to begin to recognise and deal with their problematic core issues and thus the unmanageability of life.

This results in the patient being able to recognise and to start dealing with their mental health and their addiction issues, ultimately resulting in building happier and more intimate relationships with themselves, and consequently others in their lives.