Dr. Rob Weiss joins us to discuss how clients can move beyond codependence to prodependence. See the full video and transcription below:
Inspiration Series: Prodependence: Moving Beyond Codependence
Voice-over: The broadcast is now starting. All attendees are in listen-only mode.
Keith Arnold: Hello! Welcome everybody my name is Keith Arnold. I’m with the Gateway Foundation. I’m Chief Marketing Officer. We’re so glad you joined us today and thank you for spending part of the afternoon with us. We have this Inspiration Series that we developed and really we wanted to develop this program to give people thought leaders in the industry that they may not have access to. So that’s why we developed the Inspiration Series. Rob Weiss, today, is our first speaker of the four that we have and then we’ll continue it again.
Before we get started, I just wanted to say a couple things. First of all, for those of you joining us today, I want to say thank you on behalf of Gateway. The work that you’re doing, helping people right now with addictions and behavioral health disorders is amazing. You know we hear so much about heroes and we see it on the TV, we read about it in papers, you know, the hospital workers, the first responders, but I gotta say the clinicians that we have a Gateway, the clinicians that you are, working with patients every single day, whether it’s telephonically, whether it’s virtually, whether it’s in person. You know we know that over a hundred and thirty people die a day of overdose and Covid is doing everything they can to separate people, and we know separation leads to addiction or helps make it worse. People are isolating and people like you who are listening to this broadcast, who are helping professionals, are amazing and so needed during this time. So thank you for the work that you’re doing, thank you for attending this lecture and I’m gonna go over a couple housekeeping items before we get going today.
This is our first webinar so we are, we’re going to do it together. So we have these controls that you will see here. You can expand them or shrink them. We have time for questions at the end with Rob and if you want to type in a question for him to answer, please use that. We have a chat bar as well if there are messages that we need to see, or comments, by all means, use the chat function but questions will be reserved for Rob as we go forward. Some of you, perhaps, are interested in CEs and this segment, this presentation will be for 1.5 CES and following the presentation, we’re gonna send you a, are you all seeing this? Okay. Sorry about that, I had a thing I miss my screen. So CEs, very very important so we will send you an evaluation after this presentation is over. Please fill out that evaluation, send it in to us and we’re gonna send you a certificate.
Alright so without further ado, I do want to mention our sponsors – the Higher Thought Institute. Paul Orman is the CEO of the Higher Thought Institute. Thank You to the Higher Thought Institute for providing the CEs, many of the CEs that we are delivering today are because of the Higher Thought Institute. Some of you may remember the Summits for Clinical Excellence, probably the best conferences in the country. Paul Orman, was the founder of the Summits for Clinical Excellence sold them to Vendome a couple years ago and is now back better than ever producing conferences. He had one in Philadelphia last year and one in Chicago this year in April that was postponed because of Covid so we’re so glad to Higher Thought Institute, they will be doing webinars as well.
Our sister company Beacon House which is an amazing small, intimate program, beautiful Monterrey, 22-bed facility, inpatient alcohol drug co-occurring and one of our presenters later on TJ Woodward is a consultant with them that you’re gonna hear from on conscious recovery. So so proud to be affiliated with Beacon House, an amazing organization. They are open for business, they are treating patients and they have virtual outpatient as well.
Obviously Gateway Foundation, a 50-plus year organization serving the Illinois market and Delaware as well. We have 14 sites around Illinois and we are growing. We have evidence-based programming with nine core evidence-based practices. We serve people men and women, adolescents, we have specialty programming. We help people from detox and withdrawal all the way to outpatient, some sober living, obviously residential, POP, PHP, and OP. We do have virtual programming as well so we are open for business, we are seeing patients day in and day out. A big shout out to our staff who is out there working and helping those patients. So appreciate you.
Obviously Seeking Integrity. This new venture Rob Weiss, Dr. Rob Weiss has started really to focus on intimacy disorders. He is the, the leader in our field about intimacy disorders, sex addiction, pornography addiction, has written 10 books, an amazing man with with an incredible company that does consulting, that does webinars, that does workshops and in-person workshops, providing treatment for people suffering from intimacy disorders and sex addiction.
And that brings me to Rob. So very quickly, very quickly, Rob and I got to work together for a number of years, over seven years at Elements Behavioral Health. He started with SRI Sexual Recovery Institute in California and grew that, and then he was able to bring to the rest of the Elements programs incredible intimacy disorders, in various of our programs when I was at Elements. He has written 10 books. He is a leader, thought leader in sexual addiction compulsivity, gay men and sex, internet pornography and now prodependency and he is an incredible passionate man. The thing that I respect most about Rob besides him constantly growing and educating himself, is his commitment and passion to help the person struggling. In the end it’s about that person that he needs to help, to reach out to, so I’m sure you’re gonna enjoy today’s presentation on prodependency. He’s an amazing man and a good friend so without further ado, Rob, are you there?
Dr. Rob Weiss: I am here. Can you hear me?
Keith: I can. I am going to send the controls over to you
Rob: As any therapist does, I love control. Thank You, Keith.
Keith: You are welcome and action! Do you hear…
Rob: So listen, you see me?
Rob: Do you see this? Does everything look good Keith?
Keith: Yes everything looks good, everything, let’s uh, no put your, hold on I see my screen. Let’s try that again. Verify change, sorry hold on, here we go, yes right, there!
Rob: Alright give me a sec…how’s that? Can you see me and the screen now?
Keith: Yes! I’m gonna, I’m gonna say goodbye to everybody. I’ll come back at the end. Thank you very much, Rob, we’re giving you an applause for joining us.
Rob: Thank you. I think, you know, there’s lots of time for a therapist to volunteer a little bit of time online and I know for me, just to say it to all of you, hello and thanks for being here and I’ve spent the last three years volunteering on various sites online so I really enjoy this experience and feel comfortable in the experience and if I can help any of you feel more comfortable with it you know just let me know I’m not hard to find.
This talk and this conversation is really a philosophical and a thoughtful one related to the field of addiction. I have been in recovery as an addict since 1985 so I’ve been in the 12-step rooms of recovery for 35 years and I just realized that 25 years ago I got a license in the state of California to practice psychotherapy as a social worker. So I am 35 years in recovery in 25 years in the field of addiction treatment and that is primarily what I’ve done. So I have to say that I was around when codependency came along, I’m young enough to remember it. I remember it coming along when I was not a professional. I have seen it be played out over the last 35 years in clinical work and I just I can’t buy it. I have never really been able to wrap my head around codependency and so what I decided to do was as a PhD exercise, I had to do something, and so I studied the field of codependency and I read every book and every article and I as much research as I could and I came up with a lot of conclusions that I think really validate my beliefs that codependency is, in essence, a pop-culture notion and doesn’t really have a place in mental health literature. In fact, it isn’t in mental health literature just to put it plainly, so it never has been.
So what I want to do whatever your feelings about codependency, I want you to have an open mind. I want you to think about what I have to say and I want you to…I won’t tell you the population I’m talking about before we start. I’m not speaking to you, a therapist. If you’ve been in the field for 35 years and you’ve been working the addictions and you’ve come to peace with how you want to work with partners and families and I’m not really speaking to the person whose worked codependency, it’s really been helpful for them and I’m asking to change their mind. What I’m speaking to, the person I’m interested in is the new clinician who doesn’t really understand whether they’re a KDAC or a coach or a licensed therapist, how to best manage the treatment of families affected by addiction and loved ones and I decided and looked at the fact that we might need a new model, other than codependency. And so I’m specifically interested in the first six months of recovery – what really happens to the partners and the families and how are they treated by us, by the institutions, by therapists, by really all of us and how we’ve been trained related to early work. When you’ve got an addict newly sober or you know first six months, first year, how do we address and support families?
So let’s start our talk. Let me just say quickly that this talk is based on a book that I wrote and it was published in 2018 called Prodependence: Moving Beyond Codependency and it’s sold really well but not as well as I had hoped and the reason I realized is – because people think that this is a book about codependency or moving beyond your codependency. That’s not what I’m writing about. I’m writing about moving on the whole, moving beyond the whole concept of codependency, is what this talk is really about and you can find the book anywhere and I’m very grateful to say that Rutledge, who was our academic publisher, has asked me to write a clinical guide which will go into the schools so I feel like this is a very meaningful concept that I’m very glad to bring to you today.
Now I’m going to start with a couple of caregiving scenarios and I want you to, I’m gonna play this roll out as if this were me and I’m gonna give you two of them and I want you to just compare them for your thinking.
My wife, let’s say of 15 years has been diagnosed with cancer and she’s really resistant to cancer treatment, she hates the chemo, she doesn’t want to go back. We have three kids under the age of 14 at home and the outcome of her cancer is uncertain. Now in response to this deep crisis in our family, I go out of my way as her husband to assist her and care for my family I push aside my own needs and my desires in the process. I start working two jobs I stop myself care I quit all my recreational activities. I might gain weight, I might start working two jobs to cover for her. I stopped exercising, I lose sleep and I worry about my family all the time. During the course of her cancer, I have to say, I found myself feeling sick overwhelmed hypervigilant and in many ways kind of afraid much of the time. I don’t know if she’s going to get well or not. Mow how do my friends, my family, my therapist and my employer react to this scenario? Don’t you think that, how would they advise and support me you know would they, I think that in the scenario people would bring me rolls and tell me I’m a hero and they love me and they’re so sorry I’m going through this and could they spend a night in my house so I could get out and they could look after the family so I can have time for myself? I think those are the kinds of things that would happen if this was a scenario in my life, and I think that most people would consider me and my family, in fact, to have been a victim of cancer you know? When I met my wife 15 years ago I didn’t expect her to end up with this kind of cancer and when we had our kids, we didn’t expect this to happen, there were no real signs but this is where we are. The whole family is in a crisis.
Now I’m going to change the scenario and I’m going to change it to addiction. My wife of 15 years has become addicted to opiates and she’s resistant to treatment, in fact, she already went through once and she’s right back with the drugs and the alcohol and I can’t get her to even talk to a therapist. We have three kids at home under the age of 14 and the outcome of her getting sober is really uncertain. Bow in response to this crisis, I’d go out of my way to assist her and I care for my family, pushing aside my own needs and my own desires in the process. I start working two jobs. I stop self-care. I quit my recreational activities. I gain weight, I stop exercise, I lose sleep and I am worried all of the time. After a while I’ve started to feel sick and overwhelmed and hyper-vigilant and reactive and afraid I don’t know what the outcome of my family is going to be. How do you think my friends, my family members, my therapist, and my employer might react to this situation? How do you think they would advise and support me and would it be different? Would they, as I do, by the way, consider me and my family too have been in essence can be victimized by alcoholism or opiates, opiate addiction, because my wife and I, you see when we got together 15 years ago we had a whole bunch of fun but there wasn’t really active addiction in our lives, when we had kids there really wasn’t an active addiction problem but when she broke that arm and leg and she got on opiates and ever since it’s been a nightmare. So we weren’t expecting all of this.
I would say to you that probably this family is just as victimized by cancer, I’m sorry by addiction, as the family prior is victimized by cancer and yet we don’t look at it in the same way in our world and specifically in the addiction world and I wonder why? Like what is the difference between someone who is medically ill and their families of crisis and someone is mentally ill or addicted, which is a form of mental illness and they’re in a crisis? Well, I think we’ve always stigmatized addiction, right? I mean the addiction thought leaders are stigmatized so of course anyone in association close proximity to an addict would be stigmatized too because if we think oh well if they just if the addict would just get it together and just stop and you know if you think that way or even in an AA perspective like well they just can’t get sober, they’re not trying hard enough, well then what do we think about the spouse? That they’re losers, that they should be…that they’re enabling, that they should know better – all of these kinds of judgments, in my opinion, that we have about family members and spouses.
Now medical caregivers, they are stigmatized too but more with pity, you know? If I’m looking after my wife with cancer, they say oh poor dear. If I look over after someone with addiction they look at me like hmm maybe he needs to do this differently. That makes no sense to me.
Now I do understand that caregiving and traditional female gender roles like mother and nurse and social worker and teacher, we are already underpaid, undervalued and stigmatized. So someone in a caregiving position to anybody is always going to be one down. Mental health caregivers will they have stigma by association too but I will tell you that the word codependency and none of those concepts are used in mental health today and I’ll simply say to you, that you know if you tell a family, and this is very codependency focused, if you tell a family that’s got a bipolar, broken person that they need to back off and let that person figure it out for themselves and they do distance themselves and let the person really figure out how hard life is and they need that, will motivate them to get on their meds and anything else is enabling them. Well, that’s how we get homelessness…homelessness and the mental health community understands that it isn’t all of the treatment and recovery is not at all about distancing and separation, that we need family support more than any support, to help the troubled person heal and I don’t think it’s any different in the addictions.
Now we also have a documented history in the addiction field of reacting to, blaming, shaming, hurting and blaming and shaming, hurting, angry and confused people who are deeply fearful that they’re gonna lose their daughter or their husband or their wife to addiction and yet we turn to them and we label them. Now shaming female caregivers in the addictions is nothing new and I took a quote from William White and Dr. White is sort of the historian of the addiction field. When I worked on my PhD, I was looking at how partners were treated and caregivers in, in like the 40s and 50s in AA and NA and all or AA there was no NA and what he said was, he said the general view of the alcoholic wife depicted in early AA and psychotherapy literature which is like the 30s, 40s and 50s was that of a woman who was neurotic, sexually repressed, dependent, man-hating, domineering, mothering, guilty and masochistic and/or hostile and nagging. The typical therapist’s view of the wife of an alcoholic at that time generally was one of “I would drink too if I were married to her.”
In my belief system, codependency is just a much more sophisticated version of blaming and labeling and shaming innocent caregivers who’ve done nothing more than try to rescue the person they love, which, by the way, any of us would do if the person we love was failing for whatever reason. And this whole process sets my hair on fire and if you’re looking closely I don’t have any hair. Now, over the past 35 years, we have seen in the addictions, multiple new treatment models developed for addicts. We have somatic therapies and Buddhist therapies and non-12-step and you know all kinds of stuff and and and all kinds of things. I could name a dozen. But when it comes to the formal research-based models of treatment for families of addicts or loved ones of addicts, for spouses of addicts, we have only one model and we’ve only had one model for 35 years. But how accurate is that model? How proven is that model? How realistic in day-to-day life in 2020, is a model that was made in 1982?
The trauma-sourced, trauma-based codependency model even when you stretch it, you restructure it, and Lord knows we have, and I’ll explain that in a minute, even though you advance that you stretch it to meet changing views of the addictions, it’s still codependency. It’s still a model that is based in trauma. Early childhood trauma reactivity is the essence of codependency and we have no new fully articulated research-based models for the treatment of spouses and family of loved ones. It’s like the whole addiction community went to sleep in 1985 and said we’ll just keep this forever and never look at and never change it. Although I certainly hear people being unhappy with codependency.
So this is how all this happened and in my research, I got to look at how did codependency happen – was it a clinical issue, was it a public issue, was it a pop issue, was it mental health? How did this happen? And I really got to study it and so I’m going to talk to you about some of that and some of this history with familiar with you, to you and some of it won’t.
These four books defined and dominated the field of, and the concept of, codependency in the 1980’s. They laid out the underlying concepts of that, I call it a drama model, it’s a trauma model sorry about that, and the theory about it remains unchanged by definition since publication and here are the books. We have Claudia Black’s It Will Never Happen to Me in 1982, Women Who Loved Too Much Robyn Norwood in 1985, Codependent No More Melody Beattie in 1986 and Diagnosing and Treating Codependency or Codependence in 1986. A couple of things, the reason I put Tim Cermak’s book Diagnosing and Treating Codependence is because he was an MD and he was involved with the APA and his job in this whole codependency movement he took it on himself, was to make sure the codependency made it into the DSM. He put out a research project after research, he wrote this book, he did all this work but to date, let me just remind you that codependency has never been in the DSM, has never been in the ICD, it has never ever been a mental health diagnosis and all of you know that you cannot bill someone under codependency because as far as the insurance companies are concerned it doesn’t exist and as far as mental health is concerned, codependency doesn’t exist. It’s only in the addiction world, where we wrap ourselves around, and in the pop culture world, where we wrap ourselves around this concept as if it were immutable, had to be there forever.
I do want to say also something about Claudia Black’s book. I think Claudia actually had the right idea and I always give her kudos for this because when she was writing before really Melody Beattie came along, Claudia Black was talking about this concept called co-addiction and she said partners are co-addicted and what she meant by that I agree with which is there’s a huge crisis in the family and the crisis is around alcoholism or drug addiction and that partner or that parent or that loved one becomes obsessed with the person’s drinking or using or really obsessed with the problem and I agree with that. I think when there is a crisis around addiction, that people who love the addict become obsessed with their problem but I don’t think there’s anything wrong with that. In think…in fact I think that’s what any of us would do if someone in our family was failing.
Let me give you a little story. I was doing this talk in Boston about a year ago and I had a guy, I noticed him in the audience, he was a social worker. I found out later he had this huge backpack on his back, this big purple backpack, and I got…I saw it. It was like he didn’t have a place for it in the audience and when I was signing books after, he came up to me and he said I get it. I’m like what do you mean and he said well you see this backpack here and I said yeah you can’t miss it it’s huge he said well it’s full of books on cancer. He said cuz three weeks ago my dad told me that he had cancer and so far I have bought every book, read every article, gone to every…I want to learn how to help him and he said when I listen to your talk, I realized that’s why the spouses, the parents read every book, go to every, do detective work, go to every out resource they can, to learn about addiction because they feel out of control, they want to try to help their partners and they don’t know how. And everything they’ve done to try to help hasn’t worked, so they keep looking and I don’t think that’s craziness or codependency or anything to be labeled. I think that someone who loves their partner and wants them to get better and they will do anything, put down their own life, to make that person better and what is wrong with that? If you love me and I love you and you are failing, I got to tell you I’ve been married 20 years, I will put down my life as it is to take care of my husband, no question and I don’t think there’s anything about that but love. So when people start accusing others of acting out or doing unhealthy things in relationship to love, I’m not sure you can do anything negative in relationship to love, even if the action you take is not useful, does that mean it really came out of your early childhood trauma, trauma and enabling repetition? Or does it simply mean that you love the person and you’re trying to help them get better and you don’t know how?
The problem I have with Melody Beattie and all the books that came after, is that Beattie said no no no you don’t get it. First of all, she took out the word addiction so we got codependency. Now that nasty word addiction makes nobody comfortable so Claudia was right to use it but when Melody Beattie said codependency, then anyone who was dependent on anyone or overly dependent was considered to be troubled and sick. And I remember the 80s. It was part of pop culture, you were a co, I was a co, we’re all co’s you know. I planned that vacation, oh you’re such a co. It became this huge pop culture phenomenon about codependency all over the world but that doesn’t mean that it is clinically sound not in the way we look at it. Just because a lot of people think is interesting and believe it and in my opinion just because a lot of people are willing to attack themselves for the love they’ve given to a broken person, doesn’t make it right, especially in our field.
Now if you look at a little bit of what happened back then. Codependent No More sold 11 million copies. That’s a lot for a self-help book, trust me and I’ve written 10. And it was translated into 16 languages. It became the stunning self-revelation book without question of the 1980s. But who was this book for and who read it? Was it for men and women? No and I can promise you this because 95% of self-help books today and in the 1980s were read by women. So 95 percent of the people who read Codependent No More were women and they were looking at through a woman’s perspective and not only a woman’s perspective but a woman’s perspective in the 1980s, at a time I don’t think women wanted to be too dependent on men, I think they wanted to kind of push their way through that glass ceiling. So women bought 95 percent of Codependent No More and all self-help books titles at the time and they continue to do so today.
As of 1990, there were 102 books. I want you to think about that – four years after Codependent No More, there were four hundred and two books on the market without with some form of the word codependency in the title. Let me tell you why and this was a mistake that Melody Beattie made, she didn’t trademark the word codependency which meant that anybody who had an idea about what she wrote, whether I agree with it or not, anybody could take and write about and they did, because everyone saw how popular the concept was. So everybody wrote a book about it. Which one is the right one? As of 2018 when I did my dissertation, in English only – I didn’t count foreign languages, there were over 340 books with some form of the word codependency in the title. And I ask you, which is the right one? Which am I supposed to follow? I’m a first-year addiction student who’s learning about working with addicts in the hospital. How do I learn about working with their partners, their parents and their spouses and are you gonna dip me as a student into codependency? I don’t think that’s a great idea. Neither, and I really want to be clear about this, because most personal, I treat sex addiction, it has never been in the DSM but after but clearly it was such a profound problem all over the world, that 30 years after Pat Karnes talked about it, it is a diagnosis called a compulsive sexual behavior disorder in the ICD 11, and trust me, it’ll be in the 5R because now compulsive sexual behavior is accepted as a problem but caring for other people to the point where you lose sight of reality, I think that’s what happens whenever you love somebody and they fail long enough.
Neither codependent nor codependency have ever been a DSM or ICD based criteria diagnosis. We have no formal criteria and mental health to say you have this issue or you don’t and despite all the pressure from pop culture and the books in the 1980s and 90s, the research never clinically validated these hypothetical beliefs thus the diagnosis does not stand, it never existed, it just didn’t. Now here’s why, and I really want you to get that get this, okay?, from a mental health and troubled person perspective, someone who really needs our help. Pathological dependency has always been in the DSM and the ICD as dependent personality disorder. Dependent personality disorder means that you are so dependent on me, that you are not functional unless I’m around. You’ll stay in bed, you won’t eat, you’ll be suicidal. That’s dependent personality disorder. We already had a diagnosis for people who were overly dependent to the point that their functioning was failing and that is why, since we had an existing diet designation for people who were profoundly dependent to work through the relationship over a dependency, there never seemed like a reason to put codependency in here because codependent, codependent people are functional – they’re not in hospitals for the most part, they’re not in mental ill…and mental…you know they’re not in mental illness population – they are people at a crisis who are really struggling but does that mean they are inherently broken in and of themselves? And that is what codependency says. If you marry an addict, if you live with an addict, if you love a mentally ill person, there must be something wrong with you and I don’t buy that.
Now I seriously want to ask you guys because I’ve been around for a while, what has not been said. These are the, this is what, this is now, okay, Codependency Loves Me Loves Me Not in 2014, Codependency for Dummies in February 2015, The End of Codependency June 2016, Conquering Codependency August 2016, Codependency Recovery Guide May 2018. Those are books number 338, 339, 340 and 341 on codependency. Which one folks? Could it be that we keep writing about this over and over again because it’s never quite worked and maybe we haven’t figured it out because it isn’t a viable diagnosis? That’s what I believe, and this sets my hair on fire and I don’t have any hair.
Let’s talk about codependency as we know it from the past and as I said, you can stretch it, you can change it, you can make it a have a pretty cover on book number 350, but it is still codependency. Basic theories don’t change over time when, because you write in a book about that theory. Codependency is a trauma, an early childhood trauma-based theory of human relationship dependency which by definition states that those who partner with an addict or a mentally ill person have to do so, because they need to re-engage their trauma and act it out in their adult life. And here’s the basics of codependency. Codependent people will unconsciously attach to broken people whose own needs will eventually exceed their own, overwhelm them and therefore they’re repeating their trauma. These caregivers by definition are seen to be acting out their own early trauma-based low self-esteem desperate fear of, fear of abandonment and need for approval with their addicted partner. Snd I want you to hear how this looks, thus they’re focused caregiving for a troubled person they love under codependency is perceived as a trauma-related character flaw. If you love yourself more, you wouldn’t be giving so much to that other person. I don’t think so.
The word itself, as I said codependency earlier, evolved from an earlier phrase that Claudia Black coined in 1979 called co-addiction. By removing the word addiction from the concept of unhealthy dependency, then the concept became accessible to everybody and now anybody could be a co. As I said in the 80s we all were a little bit co.
Now, what do I think is wrong with the codependency model? Why am I fighting this struggle so strongly when everybody seems to just be in love with this model we’ve had for 35 years? Well, I’m not. And here’s why. It’s analytic, it looks at early complex childhood trauma, it’s exploratory. So the analytic and exploratory nature of how we assess and treat people we believe are codependent, what is required that we ask them and what we show them under that model in my belief system, it, I believe it, alienates them. I believe it doesn’t resonate with them, it doesn’t feel like what they’ve been doing, it exacerbates in fact their fears that somehow they are responsible for the addict’s problem, which they, and their feelings are very human and non-pathological because we always think when there’s a crisis, did some part of it belong to me. I mean that’s what grief is you know. When my grandmother died I thought oh I wish I’d had that conversation, maybe there’s something I could have done. Of course when a sick, when someone we love becomes ill, we start to question ourselves. Is that necessarily healthy? I don’t think so, but it’s just a naturally occurring process. I’m not sure that we have to hold loving parents or spouses who’ve done everything they could right or wrong out of love to try to help this person, I don’t think we should label them as broken or explore their brokenness, especially in the beginning.
In my experience, this tends to anger loved ones by leaving them wondering why so much attention is being placed on their dysfunction when they have been the hyper-functional ones all along. They are the ones about three jobs, have tried to keep the family together. I don’t believe from a very basic Social Work concept of being where the client is, I don’t think when you’re a woman who’s just come into the hospital because your husband just finally got in for sobriety and you’re going to your first family group, I know that what you want to hear is great job, you’ve got them here, they’re alive, good for you, as opposed to now, we need to break down your childhood and see how you’re part of the problem. I have seen clients say #$@% you and walk out of treatment because they did not want to be blamed for the problem. They did not see how they were part of the problem and then we, therapist,s turn around and say oh that poor dear she just doesn’t get it, because she doesn’t fit into our model? When did we ever do treatment where we blamed, blamed clients because they couldn’t fit into our model? Isn’t our job to understand where they are and what’s going on with them in the middle of this crisis rather than fitting them into some belief system that we absolutely are certain will help them and I’m not sure really does? Because not being about the client not being where the client is, leaves clients feeling more judged than understood.
The codependencies model or it’s early focus on quickly engaging such struggling people who’ve been in a crisis for a long time with their loving family, it, or whatever kind of family they’ve had, their winter graces, in these people in the very early stages of their own healing to do a deep dive into their past, their part, their history and their problem, is counterintuitive to keeping them actively engaged in treatment. Codependency requires a clinical framework that views desperate, loving spouses and parents of addicts, who I believe are likely just doing their best, it views them as enabling and difficult people whose own problems are getting in the way of healing a loved one and therefore we have to solve the partner and parents’ problems, in order to make sure that the addict stays sober. I don’t think so. Because I’m not sure the partner is the problem in any wa,y except maybe they don’t know how to live with a broken person. I’m sorry, did you go to high school or college unless you’re a therapy student and learn how to live with an addict? I don’t think you did. So why would we, why would we expect that a spouse or a partner or a parent is going to know how to do it right?
Codependency assumes, and this is a real 80s concept, that the client who is told they’re codependent will have many many therapy sessions, individual and then they’re going to go to a codependency group and maybe some workshops and they’re gonna have lots of time to consider and journal and reflect and learn about themselves because that’s what we did in the 1980s. But most people today do not have the time, the interest, the focus or the affordability to go into deep meaningful long-term therapy. What would be wrong with the concept of the family just going back to the way it was before the addiction took hold? What if as we know, we know that partner and that parent is not who they were three years ago when they come to us they’re nagging, they’re complaining, they’re exhausted, they’re overwhelmed because of the crisis they’ve been through with this person who will not get sober and they have tried their darndest to get this person sober or at least make it better but unfortunately they’re not trained in addiction treatment, so they just did the best they can.
And I want to bring up one of my favorite stories for you because this is a completely different view than codependency. So I worked with a wife who, of an alcoholic, pretty serious alcoholic, who had three kids at home and she said to me the following. She came into my office because he had started drinking during the day and he was gonna get DUIs and get you know he’s gonna pick the kids up drunk at school and he was gonna lose his job. And this is what she told me. She said you know I thought I’d figure it out how to deal with the drinking, you see the problem was is that my husband was drinking, I don’t care what he does at night, he can pass out but in the daytime, I don’t want him driving drunk with my kids. I need him to earn that living and I don’t want him getting arrested so I made an agreement with him three years ago or two years ago I quit a bottle of vodka on the table one day when he got home from work cold and I said if you can come home from work and be sober all the way to four o’clock, here’s this bottle waiting for you every day.
Now in the codependency field, that would be horrifying. This woman is bringing home bottles to her addict. What could be more enabling and mesh than that? And I don’t even understand that because I look at her and I say wow how clever were you, you managed to get two more years out of that man who was drinking despite your inability to get him sober. For two more years, you got the rent paid, he didn’t drive drunk and the kids were picked up but now he’s drinking during the day so your solution, as good as it was, didn’t really help get to getting him sober, but you know what that’s okay because now you have me the addiction counselor or the therapist and you and I together are going to help you do what you were unable to do yourself although you really tried. We’re going to get this person sober. I think when you meet people with that kind of message, even if their actions were not what you would have wanted during the addiction phase, I think they will embrace us, in fact I know this because I received the research going on. The work goes much faster with people we don’t label and blame for the love they give, gave to the person they care about or the family they adore no matter how poorly they gave that work. We intent, we in prodependence believe that it was only given with love and the desire to restore their family to help.
So now, one more thing, do partners and family members of addicts act out trauma when someone is failing that they love through addiction? Absolutely. I will absolutely see anybody in a crisis little – kids, adults – regress when they’re under a severe crisis. Kids who are eight go back to wetting the bed. Adults who were done with compulsions will go back to using and drinking. So I understand that stress exacerbates mental health issues so I don’t understand why we would blame the partners and the spouses for who they are when they show up in our offices which is often overweight and nagging and a mess. What I’m interested in is how do they get there and maybe three year, maybe as partners and parents often tell me, I become the person I never wanted to be. Have you ever heard that? And now I’m nagging, I gain weight, I’m not friendly, I love her but I’m yelling at her. That has to do with the crisis and trying to live through a crisis and it may have to do with regressing into trauma-based on living in a crisis but during the course of a crisis and immediately after, by friends, and the and the crisis is the active alcoholic, the active user, until that person gets sober, the crisis is not over. Why would I do analytic exploratory trauma work on someone’s past when they’re in the middle of a crisis and barely getting through the day with the person they love who’s drinking? I wouldn’t. Why would you?
Now there is, there are a lot of reasons I could, if you read the book it’s in Prodependence, wow how we got here but I’ll say a few things about it and I’m not going to go deeply into it. Systems Theory in part got us here because Systems Theory looked at oh well it isn’t just the addict who’s a part of this addictive system, it’s everyone in the family. And John Bradshaw gave us names for all those people – scapegoat and clown and all those names – and it may well be true that they act those things out. But I don’t believe they’re acting it out because they are inherently broken. I believe they’re acting out all those parts and roles systemically because they are responding to a meaningful crisis in the family. And they’re not encouraging and they’re not enabling it, they would give anything for it to stop, they just don’t know how to stop it. So instead of unfortunately seeing these people as victims of a crisis, we see them as having decided to be a part of this family because they already have problems and then they, then they joined this family because they wanted a place with a clothes problems out I just, that’s confusing.
Now Early Trauma Theory, and let’s remember this, we didn’t get trauma work until the 80s. There was no trauma centers, no reporting services for children who were being abused, there was none of that until the 1980s. So in the 1980s we were really looking at trauma and we were really looking at its effect on early life. PTSD only was named in the late 1970s and in the early 80s, you know people like Bessel van der Koken, John Greer, and Christine Courtois, they were noticing that there were people who acted out in very similar ways to the people who’d gone to Vietnam who had trauma but they’d never gone to Vietnam and we started getting the idea that early complex or life trauma could profoundly affect adult life and that’s trauma theory in many ways. I’m just not sure it applies. Just because it was hot when everybody was talking about it, we were beating each other pataka bats in the 1980s to get our anger out, I’m just not sure that that theory applies to what happens when someone you love falls apart and you don’t know how to make it better and you’re doing everything you can to make it better and you do regress into a little bit of your trauma and your panic. I don’t see what that has to do with your issues.
Now Humanistic Therapy, Psychotherapy, which came along in the 1960s you know that moved us out of an Esalen, by the way California, this is California West Coast therapies, if you don’t know it it’s humanistic psychotherapy that through which came almost everything you guys are excited about today, which is you know EMDR not EMDR but somatic therapies, body therapies, mindfulness – it all came from Esalen in the 1960s, along with a lot of drugs I’m sure. But there was a focus in started in the 1980s, that moved away from what’s wrong with this person to looking at what’s right with this person and we got this whole movement in the late 80s. I know I went to lots of seminars – LifeSpring est., Insight. That is when the Me Generation was really all about me. In other words, how can I achieve the most I can and be the most successful I can be. When I think of this time in our history, I think of Bill Clinton, someone who’s so gifted, so smart, so intellectually powerful, he can use all those gifts but emotionally not so much. And you know when I think about our focus of the 1980s about personal achievement and personal success, I think it was missing something and we’re gonna talk more about that in a second.
But prodependency came up, sorry codependency, came out of the 1980s theory of looking profoundly at early trauma and I do want you to know, and this is not telling tales out of school, that every one of those books – Claudia Black’s books, Melody’s books – Melody Beattie’s books – all of those women talked about in their books that they had traumatic, abusive fathers and all of those women married alcoholic or abusive husbands but just because those were the experiences of the women who wrote those books, does not mean that it is the universal experience for all of us. I want to ask you honestly, do you think anyone ever married an addict or an alcoholic or someone who was later to become an addict or an alcoholic, who didn’t have a trauma history? Could it even be possible that a healthy person might marry someone like that? I think so.
The biggest contender for what pushed codependency into becoming the hot white light it became in the 80s and 90s and still to some degree, was the women’s movement. You have to understand in nineteen, late 1970s, the Equal Rights Amendment failed. Women were not going to have equal rights in the workplace, were not going to have equal pay – we don’t have it today. But codependency was the right message to women in the 1980s – “go individuate and self actualize, don’t depend on men, don’t depend on anybody, push through that glass ceiling, you can do it yourself girl.” That was the message.
Now, do you think that was a message for men in the 1980s? Let’s take a look at what it actually sounded like. Here’s Melody Beattie in 1986 out of Codependent No More. She says, “Stop centering and focusing on other people. Settle down and in ourselves. Stop seeking so much approval and validation from others. We don’t need the approval from everyone and anyone, we just need our own approval. We all…try that again. We just need our own approval. We all have the same sources for happiness and making choices inside of ourselves that others do, so find and develop your own internal supply of peace, well-being and self-esteem.” Good idea but then, “Relationships help, but they cannot be our source.” I don’t really buy that because we’re no longer seeing self-actualization as the primary focus of mental health treatment any longer. We’re no longer living in a world that is the Me Too 80s, 90s generation. We’re living in a period where attachment and connection is what matters. I’m not – I’m not only as good as my career, at my job and the money I can make, I am also equally good if I am in a relationship and loving my family and community so let’s – this message doesn’t carry through to me to today.
Now, this was not, I promise you, a message for men in the 1980s because we were watching Top Gun, we were already king of the hill, we weren’t worried about depending on anyone but this was a siren song, codependency, to women of that period. They were walking into that workplace with no rights and they could not care what a man thought of them, they had a fight through. If you want to think about what women were thinking about in nineteen, in the nine, early 1980s, look at 9 to 5, you know Lily Tomlin, Jane Fonda and and Lily Tomlin, Jane Fonda and Dolly Parton and here are three women who are specifically serving as secretaries or assistants and they see how much better the business could be run and there they are running around pushing away Dabney Coleman who was their boss to try to get this idiot out of the way so these women could get things to go right. That was what women were doing in the early 1980s, shoving men aside to try to get ahead.
Now what’s changed is 82 is attachment. Our focus on healing and mental health and addiction since the 1980s has turned from self-actualization as a measure of my health and success to my health being viewed in terms of the strength of my attachments, my relationships, my pair bonds, my family, my parent community roles. Today I am as strong as my connections. Listen to Brené, listen to Stan Tatkin, you know listen to us. I mean this is all the stuff we’re talking about now. Today I don’t have to become the best me that I can be, I don’t, which by the way leans toward narcissism and individualism but rather in mental health and addiction I think today my goal is to be and became, to grow and maintain and become, the best family member of, the best part of my workplace and the best community member that I can be. The Me Generation really has moved on. I think it’s time to move on our treatment models.
Now in codependency, treatment looks pretty simple. Treatment for loved ones of addicts who are codependent by definition because they’re in relation to an active addict, require us to help such people by, oops sorry, requires to help them by, helping them understand their own trauma history right from the beginning, how it relates to why they chose this person, how they chose this person, why they stayed with this person and why they’re acting in the ways they are because it is all perceived as being internal and their challenge. There isn’t really much said in codependency literature about someone responding to the crisis of their family falling apart and they’re not being able to fix it no matter what.
Partners or parents are supposed to understand and note the unproductive ways in which their history has been playing out into their current relationships and thus inadvertently helping them to enable the addiction. Partners and parents have to acknowledge the ways that they are acting out themselves and they’re acting out their own resolve, unresolved issues are worse today and thus they’re making everything worse with their incessant caregiving, enabling and mashing, manipulating, threatening, nagging, etc. They are seen as one of the sources of the problem and I want to tell you something, all of you who are listening, I don’t have any idea how many are in this room, but I want you all to hear this and know it. There is nothing that anyone can make can do to make an alcoholic drink, nothing! I can be the worst alcoholic in the world and really have worked hard to get sober and you yell at me and you fight with me because you’re angry at me as my spouse and I say well screw her, I’m gonna go drink. That’s on me. That has nothing to do with you. I could go play tennis, I could go for a walk, I could go socially distance. There are a lot of things I can do other than @#$% you, I’m gonna go drink. That is the decision of the alcoholic and it needs to remain in the hands of the addict. It never needs to be put in the hands of the spouse. I have seen too many addicts in last 20 years say things like, well I would get sober if my wife was and it wasn’t so nagging and complaining and wasn’t so codependent, who could ever get sober in that circumstance and people listen to that and believe it’s true. Thus, partners and parents need to detach under codependency, set boundaries, focus on themselves and establish clear distance from the addict.
Now some of you may say to me, especially those of you who’ve been in the field for a long time, well but Dr. Rob nobody does codependency treatment like that anymore, which is not true. Most hospitals and treatment centers, which is where I’m directing this message, do treat the codependency treatment just like we always did. But you will say if you’ve it in practice for 20 years oh I do it differently and that’s very nice I’m glad you do it differently, I hope you’re helping your clients, but which one of the 340 books on codependency is your work versed in and which version is the right one? Because this model’s never been formalized. What are we teaching our students? In what paradigm, in what research, is your new model-based? Because I’m basing this in attachment. Is the way you work within such, with such families documented clearly so we can properly educate new professionals in the way you as an older professional doing treatment? Where did you learn to do what you do? You see I think a rose is just a rose by any other name and revisions or adaptations to previously formalized treatment models cannot eliminate their original intent. To change original intent you need a new model. All of the founding codependency literature, places my own trauma history and trauma repetition at the core of my response to addiction or mental illness and therefore it asks my own trauma repetition in my history, in my past, as a partner and a parent, to be the focus of my early assessment and treatment and I think that’s wrong. Whatever you say about this model, it’s still codependency.
So I did three years of research. Right? I had to do a PhD and so I did a whole lot of questions on therapists and the therapist like I chose to answer these questions were professionals who had been in the field of addiction for at least 20 years. All of them said that they had supervision or consultation in addiction work and that they had taken courses in the treatment of codependency. Now I have tons of questions about them that I could show you, most of those are worked into this talk but I would just wanted to bring this one question to you because this is how all of the rest of this talk plays out. I simply said to these 68 addiction professionals, to what degree do you conceptualize the partners or spouses or parents of loved ones, the loved ones of an addict, to what degree do you conceptualize the partners and loved ones of an, of addicts as being in the midst of a personal crisis in their first 60 days in therapy? So they have an active addict or a newly recovering addict in their life and they’ve now just gone to see you in therapy is what I said to these therapists. How many of you think the person is coming to see you the parent, the caregiver, the sister, whatever it is, is in a crisis themselves? and the number I got was 91%. 91% of you therapists believe that the person who is married to or committed to or the parent of an active addict is in a major crisis, life crisis when they come to see us. Well that made my life really easy because all I did was look at crisis counseling. This is what these people need when their loved ones is in the hospital. This is what these people need when their loved one is still struggling with addiction because they’re in a crisis and until their family life has settled down, that person has gotten sober or they have left that family, they are in a crisis too and they can be in a crisis for the next year and a half until that person gets sober. My job is to help them through the crisis not ask them to question or doubt themselves.
Crisis is a state of emotional turmoil or an acute emotional reaction to a powerful stimulus or demand. Now there are three characteristics of a crisis. You tell me if this meets your understanding of a parent or a partner or a loved one of an addict, who’s actively using. One, the usual balance between thinking and emotion is disturbed. Meaning that partner is acting deeply out of their emotional self and being highly reactive or they are just really being intellectual and shut off, but either one is not really solving the problem of helping them. Their using, usual coping mechanisms have failed – going to the gym, hanging out with friends, that’s just not enough, they’re overwhelmed. And finally, there’s evidence of impairment in an individual or family member. These are the critics, sorry these are the criteria of a crisis so if these are the criteria of a crisis, I think this is where our partners and family members are when they walk in to see us in any treatment center.
Crisis intervention methods are meant to provide help to individuals during a period of extreme stress. It’s a focused kind of work and the interventions within it are by design they’re temporary, they’re active, they’re supportive and they have nothing to do with looking at the past. This is crisis counseling defined and I took this, is not, these are, none of these are my words. I took all the words that people who wrote about crisis counseling and put them together here. Basically is it in crisis counseling whether it’s an earthquake, a tsunami or your loved one is an addict and you can’t get them to get well, you have to keep it simple. When people are in a crisis, they respond best to simple procedures – here’s what you do, here’s how you handle it, simple things have the best chance of having a positive effect.
Number two, be brief and clear. Psychological first aid for people in crisis needs to remain, remain short. Offer useful, concrete direction and support. I didn’t write this. Keep it practical, as impractical suggestions can cause the person to feel more frustrated and thus more out of control. Work in the here and now. Clients in a crisis don’t have the psychological sophistication to engage in in-depth clinical evaluations or discussions of their past. Remain focused on the problems at hand. Offer hope. That is what we’re supposed to do in crisis counseling, not ask about the past, not explore their difficulties. Now listen, if somebody a year into this process when their partner’s gotten sober and life is going better, either you come to them or they come to you and say you know there were some strange things you were doing when that person was using you want to talk about that and look back now that they’re sober? Go for it and if you really want to call that codependency treatment, I don’t see it as that, but if you want to call it that, go for it! But don’t tell me that the partner or a loved one who’s coming to the hospital to try to get this person sober is codependent because I know, and certainly don’t tell them that because they’re already feeling terrible about themselves, horrible that their family couldn’t get better, embarrassed, humiliated and frustrated and they don’t need to be hearing any more bad news, especially about themselves.
When the spouse or a loved one of an active addict or mentally ill person walks into my office, I see them solely as a person in the midst of a profound life crisis which is not of their own making, one that anyone of us would have little ability to solve on our own. By definition, this partner, this parent has been victimized by repeated betrayals, lying, cheating, manipulating, all the stuff that addicts do to keep using and victimized by the person that they love, because that’s a person who’s stealing their jewelry and yet this is someone with whom they shared a deep and trusting bond. Their trust is not broken by the addiction itself that they you use and you drink, that hurts and makes me angry, but it’s the lying, it’s the manipulations, it’s the seduction, it’s what all the stuff you do to keep on using, that makes me crazy because I don’t know, you said you’re going home at 6:30 but now it’s 8:30 and now you’re telling me that you never said you’re coming home at 6:30. That’s gaslighting, that’s what an addict does to make a partner to get away with what they’re doing and have a partner not be suspicious but what does that do to the partner? That’s really hard on them to be lied over and over again manipulated. I would imagine that might be someone a little crazy!
I strongly believe that people in the midst of a profound life crisis what, need crisis counseling methods, not analytic not, exploratory evaluations, not interventions, as these experiences often feel to them blaming, intrusive, painful, counterintuitive and distracting.
I’m offering you a completely 180-degree turn on how we perceive this population. I’m asking you to take codependency and completely flip it on its ear. Rather than seeing these people as innately troubled, let’s see them as incredibly strong. Prodependence is an attachment-based theory of human dependency which states of those who partner with an active addict or a mentally ill person are no more or less than loving people who are caught up in circumstances beyond their own ability to cope. Moreover their desire to help the addict and all by bringing home bottles, all related actions toward trying to help the addict, useful or not, only demonstrate a normal and healthy attempt to remain attached to a failing loved one while simultaneously facing extraordinarily difficult circumstances.
Prodependence is a treatment lens through which I believe we can much more compassionately and view loved ones and attached caregivers of because we need to because we through this model our focus is their strengths not their past trauma. Prodependence is not a label – nobody’s prodependent. It’s not a pathology, it’s not something you describe in terms of illness. It’s a theory of relationship. It’s a theory of relationship that basically says when you’re deeply attached to a loved one for a period of time, you probably will do anything to help them into including giving up yourself and that is probably a good thing because the people who love me when I’m ill I think are heroes and the people who show up and consistently show up when I’m struggling or are people I will love forever, not people I’m going to call sick.
Prodependence does recognize that if a caregiver’s actions which are only given out of love or frustration and anger which is love, that they can run off the rails and they can become counterproductive to sobriety but then I can just work with a person to put those measures back on track. I don’t have to blame them or shame them or give them a negative label for why they brought home bottles. I can just say well that was a clever idea but it didn’t really work, why don’t you try this? and then the person feels validated for the attempt they made even though it didn’t work, rather than blame. Prodependence does not imply that any caregivers dysfunctional behaviors right arise out of their past trauma or their pathologies.
To treat loved ones of addicts or the mentally ill using prodependence, we do not need to find anything wrong with the partner or the parent or whoever the caregiver is. We simply acknowledge the trauma that they’ve been through and the inherent dysfunction and pain that comes from living with someone you love and you can’t make them better like an active addict.
Video clip: What I try to do now and I can’t tell you I do it consistently and I can’t tell you it’s easy. Is face the addicts in my life, that I want to deepen the connection with them, to say to them I love you whether you’re using or you’re not, I love you whatever state you’re in and if you need me I’ll come and sit with you because I love you and I don’t want you to be alone or to feel alone and I think the core of that message “you’re not alone, we love you” it’s to be at every level of how we respond to addicts politically and individually. For a hundred years now we’ve been singing war songs about addicts. I think all along we should have been singing love songs to be them because the opposite of addiction is not sobriety, the opposite of addiction is connection.
Rob: So that’s Johanna Hari talking in his TED talk and what I want to say to you about that, is when you listen to Sue Johnson, when you listen to Brené Brown, when you listen to Stan Taktin, when you listen to my work, this is what we’re all talking about and let me tell you where my little place in the field exists. I have taken these attachment-based theories and this relational work and put it into one particular environment – the addiction and mental health environment, in terms of partners and spouses. I’m interested in what’s going on with the attachment and love process when someone that you love is failing and you can’t make it better and that really for me and prodependence is a model that I consider to be bringing the way we view partners and family members into the 21st century, by making it an attachment-based model not a trauma-based model. Yes, the partners are responding to trauma but the trauma is about their attachment to the person they love and the failure of that attachment, not about what happened to them they were four. Now they may be re-enacting things that happened to them when they were but they’re not doing it just because they’re married to an addict, they’re doing it because they’re in a crisis.
Now to my peer,s to you guys, I want to say I’ve worked in residential treatment centers for 25 years, I have one of my own and I can tell you that I’ve sat in so many nursing stations and in, you know, group supervision hearing things about family members like this, the loving family member that comes to the hospital and tries to, or the treatment center, comes into your office to try to help the person that they love and we say things like, “well that mom’s just sicker than her kids she won’t let him go” as if any parent should ever be asked to let a child go. “I worry about her home, going home with her brother he’s a born rescuer.” Well if I was going home with someone I would hope were a born rescuer…oops hold on a second here…therapist saying things like I worry about her going home…oh sorry. “That wife is so focused on his drinking, she doesn’t see her part.” What if she doesn’t have a part maybe if her part was just trying to make it better and she couldn’t?
What if love and you, so here’s the whole bottom line for you guys, what if the loved ones of addicts are not difficult to treat at all and the problem has lain more and how we conceptualize them? What if our primary and sole therapy model for these people which is codependency has left these clients feeling misunderstood, marginalized, confused and more ashamed than when they started? Why leave someone who has loved and loved and loved to try to help someone, in whatever way they could to try to help someone they care about get better, why would you ever leave that person doubting themselves at all? Why would you prejudge the loved one that a loved one is codependent or in any way as drivers a dysfunctional system? Because my friends, it is a basic mental health theory that we do not apply any kind of label or diagnosis to someone who’s in a crisis because we understand that someone’s in a crisis is acting crazy, so we don’t say oh they must be borderline or they must be codependent or whatever because we don’t know who they were four years ago. We don’t know who they are when they’re and their norm. So I have learned that I don’t diagnose people in their crisis. I watch them and I listen to them and I learn about them and I certainly don’t do anything to make them question themselves. What happens if this diagnosis that we’ve given them, this label of codependent because it’s not a diagnosis and the treatment that follows up it and has followed it for 30 years could push partners and family members and parents to feeling more misunderstood and thus becoming defensive? Why not focus on the family members strengths while also being where they are from day one? I think this is a much more productive way to work with these folks. It doesn’t meet our deep need to help as therapists people dig it out and get it out there because then it’s going to make them better. No it doesn’t meet that need that we have. But by focusing on their strengths and giving them endless support, they feel better, they recover faster and their families do better. I know this. I’m researching it.
Under Prodependence, which is a book, Prodependence: Moving Beyond Codependency, a book written to try to shift us from codependency as a model for treating the addictions and the family members of addictions to a different model. Under prodependence I believe that we can refocus every single action of a painful hurting loved one through a lens of strength-based attachment, and thus we literally reframe their deficits as strengths. So here on the left are the words of codependency, here are the words of prodependence. So where you might say, “oh that woman is so enmeshed,” I would say, “my goodness she’s deeply involved with her family, God love her.” You might say, “well she’s externally focused, she’s putting all those problems on the addict,” I would say, “I think she’s quite well the situation in hand and she’s right the problem is the addict. Things were fine until they started using and drinking and things will probably fine when they stop.” So guess what the problem is the addict. Let’s stay focused on where the problem is.
Some of you will say she’s enabling, I will say she’s incredibly supportive. You’ll say she’s fearful, I say she’s deeply concerned for those she loves. You’ll say she has no healthy boundaries, I will say she is so eager to care for that person she loves she’ll do things that don’t even make any sense to her. You can say to me she will not stop fixing or he and I will say they’ll do anything they can to help somebody they love, wouldn’t you? Codependency says they’re obsessed with the addict, I say they’re obsessed with the drinking and the using, not the person. They want to heal their family. They’re obsessed with the healing of their family, wouldn’t you be? Codependency says they’re living in denial, I think that they see the problem all too clearly. They’re not staying with that person that they love because they’re codependent and re-enacting trauma, they’re staying with that person because they still love them. Just because someone turns into a mess doesn’t mean I still don’t see how I love them, how we love each other, the good that we shared and furthermore that I don’t hold the hope that if you get well, we might have that again, so I am holding on to the vision of what we shared in the pas,t the best of you, the you I know you were when you were healthy, I think that is the part of partner I would want who has visions of me in a good way moving back in that direction and therefore they are determined to take care of me. They’re not living in denial, they’re not controlling and nagging, I mean they look like they’re controlling and nagging but what’s really going on is they’re terrified, they’re afraid that things are going to get worse and by the way, they have a history of things getting worse, so they’re not, there’s a reason why they feel that way. You might call them raging and nagging, I see them as someone who’s desperately trying to produce an effect in the situation that’s not changing no matter how hard they try. You may see them as hypervigilant, I will see them as anticipating problems because they’ve already had problems and they think more are coming and I think that’s a strength to be able to anticipate problems.
Now you will say to me, we’re almost done with the talk by the way, we’ll have time for questions, you say to me as therapist well what about their trauma history and I say here’s an idea, let it wait! Don’t you think there’s plenty of trauma to go around here and now if you live with an active addict or a mentally ill person? Why not give these partners and parents and loved ones and wives and husbands the grace to come to us when or if they ever become ready to self explore and self examine? Why do we have to force it on them in the moment of their greatest crisis? Oh look at yourself. I think it’s in what we do is intrusive. I think we take the person who’s in a crisis and we asked ask them to redirect in a way that doesn’t make sense to them and makes them feel bad. We can help these people with the problem they have right now without lengthy explorations of their own painful past, unconscious things they don’t know about and make them, and surrounding, thereby surrounding them self doubt. They already feel like they’re the problem, we just make them feel more like they’re the problem and folks they are not the problem. They would have been pretty fine all along if that person just hasn’t started drinking.
Now the messages that came out of the codependency movement, I am all behind. Self-care, self-care, self-care. I do want to teach and support these partners and family members to have better self-care, better boundaries, to picking the right battles. I want them to assert healthy anger. I want to teach these people that it’s okay to love and hate someone at the same time because I think ambivalent love is something we feel toward someone who’s hurt us. I want to teach them avoid violence and verbal abuse. I want to help them identify help. I want to give them peer support. I want to give them education and insight. I want to help them process their grief about how their life is turned out. I want to restore them to healthy coping and I want to manage their fear or their entitlement and their rage and that list my friends is plenty to do with someone in the first year of recovering from living in an active crisis with an addict who’s not getting well.
Now I added this slide, I want you to think about this because how is the affected, how is the addict affected by these models? How do addicts feel about codependency? Here’s a thought for you. Think about, I don’t want to read the top, I’m going to read the stuff in the blue here to you if. I’m an addict and I think about codependency deeply it really means that anyone who chose to love me must have been very troubled themselves or otherwise they never would have loved me because I’m so broken, a healthy person never would have picked me. That is what codependency says and further, if you were healthier, my partner, my parent or whoever it is, you never would have focused on me or paired with me, because you would have seen my problems, would have left a long time ago, if you’d been healthier. I don’t think that’s true!
Versus here’s how, what goes on for the addict under prodependence. One, oh my god despite all this horrible stuff that I have done this man or woman decided to stay with me? Maybe there’s something good about me that they don’t see because I think a healthier person would’ve left me but maybe if they’re staying maybe there’s something they see in me that might get some love in me, some good in me, that I don’t see right now but maybe they’re staying and I have the hope that I could get to that and we could be that together again. What if this person who loves me is holding on to the good in me, the thing that they believe is just waiting to recover and reappear when I get sober? To me, that’s what prodependence does. It makes my partner not sick for staying with me, but as being the person who holds on to the vision of who we have been and who we might be.
And finally I want to say to you, when did loving someone especially a trouble person become a pathology? If you love too much then please come by my house because I want you in my life as much as possible. At Thanksgiving, I want all the people who love too much because they make their best stuffing, they play the best cards, they want to stay up late at night and have fun. I love people who love too much and I want more of them in my life. I want to become someone who loves so much.
Now you can, and this is important to note, you can love inadequately. You can choose partners based more on emotion than thought. You can love where no love is earned back or offered back. You can love in ways that are unproductive to yourself and to other relationships. You can love in ways that mirror past problems in trauma. You can love the wrong people. You can love in ways that unknowingly caused more harm than good. You can! You can love people who cannot and do not love you back but don’t tell me ever that we can love too much because love just is and where we go with it and how we manage it, maybe we need some guidance and support but please don’t ever pathologize someone for the way they love someone, for the depth of love they feel someone, for someone or the actions they’ve taken to support the person they love because I think that is an extreme form of help.
And with that, I’m going to say I’ve written a bunch of books. I’ve written well, this is just a few of them, some books on sex addiction and co- and then pro dependence. I also have a treatment center, and I just want to say this, called Seeking Integrity and we are very specialized. We treat, we’re only six beds, everybody gets their own bedroom, their own bathroom and we’re very affordable and all we treat is men who have sexual issues or men who pair drug and sex issues like meth and sex and alcohol and sex, stuff like that. And please think of us if you are making referrals.
Finally I just want to thank so much Keith Arnold and all of you guys for being here. I hope this has been helpful for you. I love giving this talk. I think it opens hearts and minds and even if it doesn’t work for you, I think, well please buy the book, read the book, you’ll find more in it and I did say earlier, I’m going to say again that there is going to be a clinical guide published by Rutledge, Rutledge published Sue Johnson workbooks and some other clinical educational pieces and they want to put this, this prodependence, into the schools and for that I feel like I’ve heard a little piece in our field because if this goes in the schools we’re gonna have a kinder more loving way to treat these families and they’re gonna do better.
Hey Keith Arnold! Are you still listening? Would you like to take control?
Keith: Hello Rob! Yes, I am.
Keith: Hold on. Let’s see, I’m gonna share and then we’ll take questions.
Rob: And for the next twenty minutes Keith will moderate the questions and I’ll answer them.
Keith: Yes we have, hold on, let me share my screen. Actually I don’t even hear it at this point. So just a couple comments. One from Janet Mason. She said she’s also seen treatment programs swing the other direction. Many don’t try to help the family at all. They talk about it being a family disease but then they cut off the family completely out of treatment, creating the same effect as trying to treat the family member – lack of connection, feeling more out of control and confused. So do you want to talk a little bit about involving the family?
Rob: Well only that you know, and Keith and I have both seen this, you know we’ve seen a world of plenty where our field was flushed with money, we’ve seen it where it was empty and insurance didn’t pay anything and you know, I’ve been inside clinical programs long enough to know that if they’re not making money or surviving then family members are going to be left home because there’s not the money to treat them or we’re not prioritizing their needs. So I always think that these questions come back to how much effort, time and money are we willing to put into the meaningful care of the people we treat.
Keith: Great, awesome. Any last questions for Rob?
Rob: I will say something, Keith, while we’re just waiting for questions. I get questions about Al-Anon and CODA, like “well I always send people to the support groups, how do, what do I do now?” And this is how I would say that. I think that, I think certainly Al-Anon is a wonderful program. And Al-Anon, by the way, never implied that you were addicted to your husband or wife, it always said you were addicted to the obsession of their drinking. So Al-Anon got it right from the beginning. But here’s the thing I wouldn’t send someone who, I would not send a client to one of those groups, until they had fully internalized in the work with me or you that this is not their fault, that there’s nothing they could have done to make it better because there isn’t and once you get that in them, then they can go to meetings because there’s so much now on not in Al-Anon but in the folks around Al-Anon, who are like we got to look at your part, you got to look how you’re broken and that’s how people have to really be able to hold on to themselves in that arena before they can go there and not say well maybe what I learned is wrong and then start doubting themselves.
Keith: Excellent and Rob, given this time of isolation, social distancing, you know that goes against prodependency, reaching out, what are you seeing and how are people staying connected?
Rob: Well I mean I think we’re all having, those of us who who can make ourselves comfortable with technology, I mean I see it everywhere, I see it absolutely. First of all, I think it’s a very prodependent time because I got to get along with my husband. I got to get along with them in the morning, in the evening. I got to figure out how to make it work. You know I’m used to having six or eight hours a day where we don’t have to look at each other. Now we’re together all the time. So learning to negotiate dependency is what prodepence is all about.
You know Keith, I wrote a chapter in this book, it’s my favorite chapter. It’s called twos don’t marry sevens and what I mean by that is if you are an emotional two – you know you’ve got issues you’re addicted, you’re struggling and you look at that person there’s an eight and they’ve got their poop together, you might think you want to marry them, get involved with them, date them but the truth is you never will because every two or three I’ve ever met looks at that eight and says oh my god, they’re so boring and then if you’re an eight or a nine and you got your poop together, you don’t want to look at that person, you look at that two or three emotional addict person, you say oh my god they’re much too much work so twos don’t ever marry sevens. Twos and threes, we’re going to marry each other.
Part of the belief system behind prodependence says, and I truly within my soul believe this, that two broken people working to heal together are going to get further than individuals trying to heal by themselves. I am stronger healing my relationship with my spouse with my family than I’m ever going to be healing it by myself. and uh yeah and like that.
Keith: Awesome. Well thank you so much, Rob. Just in the few minutes we have left, I know people are concerned about CEs so I’m just gonna mention that again. Please, shortly we’ll be sending you out the evaluation. Send those back to us and we will send you your certificate. Coming up! Very excited to have Dr. Colin Ross join us on trauma and attachment on Friday, next Friday, a week from today then Beacon House’s very own TJ Woodward on creating a new narrative of recovery or for recovery, conscious recovery and then guess who’s back in force Rob Weiss, Dr. Rob Weiss with the fusion of substance use and sex addiction. So thank you!
Rob: Can I do one more thing, Keith?
Keith: Of course, you always can, yes Rob.
Rob: Something to do while you’re bored at home. I created a podcast called Sex, Love and Addiction, Sex, Love and Addiction. It’s not a vanity podcast, we’re getting close to a half a million downloads, that’s a lot. Most people get five thousand. So and Sue Johnson is on there with me and Stan Taktin is on there with me and Helen Fisher is on there and so I called upon all the gurus that Keith and I have known all these years and said would you take a little time to talk about attachment, intimacy, addiction and so if you’re interested in listening to the podcast, it’s really pretty good and I think people are getting a lot out of it and it’s called Sex Love and Addiction. Thanks for the plug!
Keith: Awesome thank you so much again! Thank you so much to our sponsors: Beacon House, Higher Thought, obviously Seeking Integrity. Dr. Rob Weiss, you’re a therapeutic rockstar and thank you to all of you who have joined us and for what you’re doing out there to help people struggling especially in this time. Stay healthy, take care of yourselves and we hope to, we hope you join us next week and for the following weeks. Thank you again so much for joining us. Gateway is open and we’re here to help.
Rob: Live long and prosper!
Keith: Thank you! Bye everyone, thank you so much!