Rethinking men and codependency

Over the past two years we have been training and speaking with addiction professionals around the country in an effort to rethink how the addiction field can provide effective treatment services for men. Our work, with a strong emphasis on how men navigate relationships, already had us thinking about the idea of male codependency. When we were invited to speak last April at a conference sponsored by the Indiana Association of Addiction Professionals on the issue of male codependency, it required us to flesh out a framework for our emergent ideas.

In this article we offer a brief description of this concept, with the primary interest of generating dialogue and inquiry into how addiction professionals might think differently about men and codependency. We propose the following for consideration:

·        The traditional notion of codependency pathologizes behavior that is intrinsically human and even healthy at times.

·        Codependency can be viewed as existing on a continuum of relational behavior.

·        Men engage in codependent behavior as frequently as women do.

·        Codependency manifests differently according to gender and is a product of gender-based socialization.

·        The masculine expression of codependency may include dominating and violent behavior, which is a compensation for shame and lack of relational skills.

Men and relationships

Core to our message is the notion that supportive and healthy relationships are critical to long-term recovery. Further, we believe that while most men have little difficulty getting into relationships, they often are not equipped with the requisite skills for maintaining relationships.

These skills are rarely taught and modeled by fathers, brothers, coaches, teachers, or other adult males. In fact, boys are generally encouraged to devalue and scorn many of the skills that we identify as central to the process of developing intimate relationships. This results in many boys and men acting as though connection and intimacy are not important to them.

Some might therefore conclude that relationships are not important to men, or that men are somehow inherently incapable of engaging in relationships to the same degree as women. We could not disagree more. While the manner in which men engage in and talk about their relationships is often different from the way women manage relationships, it is no less important or valuable.

Relational cultural theory

Until the 1970s, the predominant model for developmental psychology focused on the process of separation, individuation and autonomy. In 1978, Jean Baker-Miller, MD, along with psychologists Judith Jordan, Irene Striver and Janet Surrey, posited that developmental psychology and clinical practice were not paradigms that worked well for women based on their experiences.¹ They suggested that all growth for women occurs through the development of relationships with others.

Relational cultural theory (RCT) primarily focused on women and women’s experience; to date there has been little written on RCT and men. Stephen Bergman, MD, a Harvard-trained psychiatrist and Janet Surrey’s spouse, wrote a seminal article on men and RCT entitled “Men’s psychological development: A relational perspective.” Bergman acknowledges that men are raised to want independence and individuation, but he says there also is a significant cost: “As with women, the sources of men’s misery are in disconnections, violations and dominances, and in participation in relationships that are not mutually empowering.”²

Men are raised to separate and be separate, irrespective of the harm caused to themselves and others. Control and power are two of the skills that boys are taught in their journey to manhood. The idea that this psychosocial theory could be applied to men in addiction treatment by taking into consideration the developmental differences inherent in men’s psychological growth is relatively new.^3,4

Independence-interdependence-codependence

The term “codependency” was initially used in describing the cluster of maladaptive behaviors that family members, partners, children and other concerned persons develop in response to the addicted person. It subsequently became a way of defining individuals who became enmeshed in a relationship to the extent that their self-worth and emotional stability were entirely contingent on the behavior of another.

Codependency implied that deriving positive feelings about oneself through a relationship was not entirely healthy. It implied that as adults, we should be able to discover and maintain self-worth as autonomous and independent creatures, not needing others’ approval. Finally, it became an identity (a pathological identity) rather than describing a tendency toward certain behavioral patterns.

In addition, most of the literature on codependency was written by women and for women. Apparently, it was thought that men were far less susceptible to sacrificing their identity and autonomy in relationships. As proponents of strength-based treatment models, we saw the traditional framework for thinking about codependency as highly problematic. And as adherents of RCT, we believe that men are just as likely to experience codependency as part of a relational continuum.

We believe that there are three relational postures that exist along a continuum: independence, interdependence and codependence. We do not believe that any of these are inherently positive or negative, but rather represent points along the continuum of relational behavior—we are all constantly moving among these points. At various times and within various contexts, we may be well served by being more or less self-sufficient. It is tempting to look at interdependence—when individuals seek to relate to one another through a system of mutuality and compromise—as the ideal form of relationships, yet it is unlikely that most relationships can remain in that space for an indefinite period. In other words, because relationships are inherently dynamic, none of these stages are final points.

We may, in fact, define relational “health” as an ability to adapt as necessary depending on the context of the relationship and what is called for from the individual in that moment. Therefore, another way of looking at codependency is the act of sacrificing our needs and wants for the welfare of another. Parents do this all the time. It also might be appropriate within intimate partnerships at times when one partner’s needs are extreme.

Thus, we suggest that there is a healthy form of codependency that is different from interdependence. It becomes problematic when this chronically characterizes a particular relationship or becomes the primary posture in all relationships. It is also destructive when it manifests as control, manipulation, or violence.

Male relational dread

Bergman also introduced the concept of “male relational dread.” Because men are taught to prize independence and are not taught the skills to develop interdependence, relationships become inherently threatening. As a man moves toward more intimacy and commitment in a relationship, he literally may experience dread as he faces the perceived loss of independence and is required to utilize skills that he does not possess (and that have been systematically rejected as unmanly).

Primary among these skills are fluency in the language of feelings, an ability to be vulnerable, a willingness to ask for and offer support, extending and honoring trust, compassion, and empathy. Very few, if any, of these requisite behaviors for healthy and intimate relationships are consistent with the “rules of being of a man” that boys are taught from a very early age. If we accept the notion that all human growth occurs through connection with others, then growing up male is a process that is inherently conflicted and perhaps even traumatic for many boys and young men.

When boys do not follow the expected rules and instead exhibit some of the qualities identified above as being necessary for intimate relationships, they are likely to suffer ridicule, shaming, alienation and even physical violence. Boys thus grow into men who lack the experience of learning and practicing relationship skills. And as men, they view intimacy and connection with fear and hostility. This is not because they do not desire intimacy and connection, but because they have little familiarity with them. In other words, men lack what we refer to as “relational competency.”

Relational competency

Using RCT as a foundational principle inevitably leads to a strength-based approach, with a focus on skills, resources and natural supports. We have identified nine core skills we believe are essential to supporting men in creating and maintaining healthy relationships:

·        Communication.

·        Conflict resolution.

·        Setting healthy boundaries.

·        Identifying personal needs.

·        Self-care.

·        Emotional expression and regulation.

·        Intimacy with both men and women.

·        Willingness to ask for, accept and offer help.

·        A healthy concept of one’s sexuality.

It is evident that these core skills are not part of the “rules” that guide how boys become men. We therefore suggest that it is imperative for clinicians to ensure that we are addressing these topics and helping men build these skills while they are in treatment. In fact, we suggest that developing these skills should be one of the primary goals of addiction treatment.

Male relational dread and codependency

As we began thinking about how male codependency might be reframed, we considered relational dread and the external and internal communication strategies that men tend to use in relationships. When we look only at men’s external behaviors we are not likely to view their behavior as interdependent or codependent. In fact, it is these behaviors that led Bergman to label men as “agents of disconnection” because the behaviors are much more about interrupting or ending relationships. Working with men will inevitably demonstrate that most of these external behaviors are compensation for distressing internal experiences that they are frequently unaware of, have difficulty communicating, or are unable to resolve.

Feelings of deep shame about one’s “neediness” and “lack of manly virtues” become central to the internal experience of many boys and men. They may feel pride in their independence and self-sufficiency, but they also feel lonely and isolated, as well as emotionally and spiritually empty. There may develop a stark dissonance in how they present to others and how they feel inside. Such a dichotomy might look like this:

External

Arrogant

Rageful

Detached

Manipulative

Controlling/Paternalistic

Internal

Ashamed/Powerless

Vulnerable

Inadequate

Fearful

Insecure/Need