Codependency: patterns of attachment | Addiction Professional Magazine Skip to content Skip to navigation

Codependency: patterns of attachment

October 10, 2012
by Shannon Brys, Associate Editor
| Reprints

To many professionals in the treatment field and their clients, the term “codependency” can be confusing and unclear.  Some clients even find the term offensive and/or say that it is a poor fit to describe them, according to Ann W. Smith MS, LPC, LMFT, NCC.

Smith is the Executive Director of Breakthrough at Caron, which is a 5 ½ day residential personal growth workshop designed for those who are struggling with relationship patterns developed from early attachment injuries in core relationships. The program helps adults shift destructive life patterns, improve relationships and strengthen self esteem.

She explains the evolution of codependency starting in 1980 when the addiction field began to show interest in involving the family in addiction treatment.  Soon after that time, Caron introduced a residential family program.

She discusses the labels that were used before the term “codependency” came about.  One of these labels was “co-alcoholic” and she says that this one didn’t stick because the term chemical dependency replaced alcoholism.  Another label that was used early on was “chief enabler or ‘collateral,’” which were used for the spouse of an addict when their spouse was in treatment.

As time went on, committees met and the terms “Adult Children of Alcoholics (ACOA)” and “codependency” began to emerge across the country around 1981.  At the 1989 National Conference on Codependency, a commit of experts in the codependency field, including Smith and Sharon Wegscheider-Cruse, came together to establish this definition:

“Codependency is a pattern of painful dependence on compulsive behavior and on approval seeking, in an attempt to gain safety, identity and self worth.  Recovery is possible.”

Although Smith was on the committee that developed this definition, she still felt that it was too general and that it couldn’t be applied to specific people.  She explains the following definition of codependency that she created:

“Codependency is a condition or state of being, that results from adapting to dysfunction (possibly addiction) in a significant other.  Codependency is a learned response to stress which, over a person’s lifetime, can lead to the development of the following characteristics:

·       External Focus

·       Repressed Feelings

·       Comfort with Crisis

·       Boundary Conflicts

·       Isolation

·       Stress related illness

·       Compulsive Behavior”


She explains that with the mixture of definitions that exist on codependency and the early perceptions of it, it was very confusing.  She says that early perceptions, because it was implied by the field that another person was the source, made codependents look like victims of the situation.   She shows her dislike for the world “enabler” in this situation saying that it is a “nasty word” because of the misconception that “if you were a better family member, they wouldn’t be an addict or this situation wouldn’t have happened.”

Looking at codependency therapy, “family involvement is key,” according to Smith.  She says that “the addiction was not caused by the family, but it thrives in a painful system.”  She then goes on to explain the Attachment Theory Perspective, saying, “Every human being adapts to some degree in an effort to sustain emotional attachment.” 

She notes that “anxiety increases when we don’t have a secure and consistent connection as children” and goes on to explain three factors that determine how a person adapts and tries to maintain that connection:

·       Temperament

·       Birth order and siblings’ choices

·       Degree of stress or trauma


If a first born child is born exhibiting traits of compassion or a “Leader Gene,” that child will most likely demonstrate a natural fear response to move toward painful situations to try to help.  Smith says this side of the spectrum is called “Anxious Attachment Style.” 

On the other side of the spectrum, children that are born second, third or fourth and exhibit traits of an extravert or independent spirit, may tend to leave the situation when anxiety increases.  A child in this same birth order category that shows traits of an introvert may withdraw into themselves when anxiety increases.  Either one of these is known as the “Avoidant Attachment Style” as they pull away from conflict.

Smith also touches on insecure attachment and says that these patterns often emerge without conscious awareness. “They are stuck in patterns that they have no awareness of and they end up not knowing themselves at all,” she explains. 

Attachment injury, she says, occurs when a person feels abandoned or betrayed at key moments where comfort and connection are important.  Some examples of key moments might be during an illness or injury, a time of loss, childbirth, affairs, a time of vulnerability, etc. 

“Since shame and fear are a significant part of the pain our clients present, we need to be ever aware of the impact of our words,” Smith says.  She explains that using sensitive and affirming language, therapists can normalize the experiences and choices of clients. 

“The language of attachment is relatable and understandable, easing pain and fostering trust in the therapeutic process and within clients themselves,” she continues.