Social work with codependency Addiction plays an important role in the life of the addicted individual, as well as in other family members. However, the needs of family members in living with addicts are usually relegated. With the onset of addiction treatment, family members should also begin to address the healing process of codependency. A family with an addicted member goes through various complications, such as dysfunctional family relationships, divorce, violence committed under the influence of alcohol and drugs, neglect of education, and others. Work with loved ones is mostly informative about treatment options and about addiction as a disease. Social counseling and psychotherapy with family members should also focus on coming to terms with the existing problem, gaining insight and releasing tension. In the recovery process, family members focus more on the addict than on themselves. It is therefore important in social work to counsel codependents to focus on self-care. It is ideal if a codependent client combines individual counseling with group therapy, where people with the same problem come together (Hornáčková, 2007).

In the Open Heart Outpatient Crisis Center, we provide social counseling, psychotherapy and group sessions for partners, parents, relatives of addicts, as well as counseling for Adult Children of Alcoholics (DDA).

Codependency

Beattievová (2006) in her publication "Codependency" characterizes it as a partnership in dependence. At the same time, he cites Robert Subba's definition, where codependency is characterized as "an emotional, psychological and behavioral state in a person arising as a result of long-term exposure to and adherence to restrictive rules that prevent honest expression of feelings and also direct discussion of personal and interpersonal problems" (In Beattievová, 2006, p. 42). Codependency could also be characterized as destructive behavior that reduces the ability to experience loving relationships.

A codependent partner focuses mainly on meeting the needs of others while neglecting their own needs. This symptom is common in families with an addicted member. Women are more commonly referred to as codependent (Nešpor, 2007).

Okruhlica (1998) also understands codependency as bias and involvement in the problem of relatives in relation to the addict, which leads to a change in behavior and mental state. In this state, there is often an inability to rationally solve situations related to a dependent family member. As a rule, codependency leads to damage to the mental health of the codependent. In addition to constantly considering the causes of addiction, co-addicts blame themselves for mistakes in caring for an addicted family member. It often leads to mood disorders, depression, crying and various fears. In co-dependency, the addict's parents often avoid communication and spending time together. A characteristic feature is that a coalition of one of the parents is formed.

Codependency from a historical point of view appears for the first time in the therapeutic field at the end of the seventies. The label itself began to be used in several treatment centers in Minnesota at the same time. Originally, the word referred to a person whose life was affected by living with a chemically dependent person. A person living with an addict has created unhealthy ways of coping with life. In many researches dealing with people living with addicts, physical, mental, emotional states similar to alcoholism appear. After the creation of Alcoholics Anonymous organizations (1935), in 1970 Al-Anon support groups formed from the wives of alcoholics began to emerge. The goal of the groups is to understand and manage situations related to their partners' drinking. The group support program for wives/husbands (Al-Anon) is based on the twelve step program of Alcoholics Anonymous. In the past, codependency was linked to alcoholism, later other problems such as overeating, gambling and other addictions were identified in this group. If we were to characterize codependency more precisely, we start from the fact that codependent people have submitted their entire lives to living with an addicted family member. A typical sign of codependent families is the forbidden discussion of problems, the prohibition of open expressions of emotions, insincere communication (Beatievová, 2006).

Beattievová (2006, p. 47) defines a codependent person as "who allows himself to be influenced by the behavior of another person and feels the urge to control his behavior." A codependent individual can be a child, adult, partner, spouse, sibling, grandparent or friend. The essence of codependent behavior is an urgent need to help and control. First of all, it is low self-esteem and self-confidence associated with a feeling of guilt. Due to the need to help others, the individual forgets his own needs. Codependent behavior is a self-destructive form of behavior that becomes a habit. Habits are repeated without thinking, which can lead clients into destructive relationships that are dysfunctional and bring exhaustion and restlessness.

According to Beattieva (2006), the most common characteristics of codependency include the following: concern for others, low self-esteem, suppression, obsessive behavior, control and blame, denial of existing problems, possibilities of addiction, poor communication, weak boundaries, lack of trust, anger. Codependents are unable to accept praise and positive feedback on their person. They also feel a strong fear of rejection and tend to blame themselves for everything;

Adult children of alcoholics (DDA)

Describing the DDA syndrome does not only concern the issue of children living in alcoholic families. It also touches on the issue of other addictive substances, gambling, overeating and others. Also of families, which we can conclude are dysfunctional families. Adult children of alcoholics do not learn during adolescence what children their age learn during adolescence (Woititz, 1998).

Woititzová (1998) reports the following observations regarding adult children of alcoholics:

  • they are not sure what behavior is normal – this is the most basic characteristic of DDA,
  • they have difficulty completing tasks – they are unable to determine a time schedule,- they lie in situations where it would be easier to tell the truth – lying has its justification in families affected by alcohol, lying is one of its basic features,
  • they judge themselves without pity - they believe that they are the cause of all problems,
  • have trouble having fun and take themselves quite seriously,
  • have problems with intimate relationships – they desire intimate relationships, which is very difficult for them considering that they have no measure of a healthy intimate relationship,
  • react disproportionately to changes that they cannot influence – which results from the fact that even as small children of alcoholics, they had no influence on anything, but took responsibility for the environment,
  • constantly seek and require praise and reassurance - the fact is that a child creates an idea of himself based on the sharing that his parents convey to him,
  • they usually feel that they are different from other people – they feel that they are different from other people, they carried this feeling throughout their childhood, which persists in them even in adulthood. adult children of alcoholics find it very difficult to believe that someone accepts them and they don't have to work hard to deserve it,
  • are extremely responsible or extremely irresponsible,
  • they tend to be extremely loyal, impulsive and allow themselves to be drawn into the course of an event, while they would consider other possible alternatives of behavior.

Social counseling for codependents

With codependency, the individual's mental health is often damaged. Many codependents don't realize that they need to work on their own personality. Many times they contact us at the outpatient crisis center precisely because of an addicted family member and are looking for a form of help that they could provide. In the clinic, in addition to counseling for addicts, we also provide counseling for co-dependents, where they receive basic information about co-dependency and the possibility of working with their attitudes.

Co-addicts consider the reasons why their child or partner reached for an addictive substance. They are accused of errors in the creation and care of the addict. Their mental state is manifested by mood disorders, depression, crying and fear. It also leads to somatic complications such as loss of appetite, stomach pain, cramps, weight loss and others. Counseling for codependents can be focused on advice and help for those who are not significantly codependent and counseling dedicated to those who are significantly codependent (Okruhlica, 1998):

  • Advice and help for those who are not significantly co-dependent – counseling is aimed at providing practical information regarding the issue of addictive substances and addiction treatment options. The main topic of information is: : - basic knowledge about addictions, : - preventing manipulation by the addict, : - principles of rules in the household if there is a dependent in it, : - how to support an addicted family member to abstinence, : - what to be prepared for in advance, : - how to handle stressful situations.
  • Counseling for those who are codependent – the goal of counseling is to compensate codependents and come to terms with the existing condition. Also, suppress temporary activities aimed at supporting the addict, because in this case they tend to be counterproductive. Counseling is aimed at codependents on how to manage themselves.

Many co-dependent clients in more difficult conditions need short-term supportive help as part of psychiatric treatment, through medication. We consider it appropriate if codependent clients go to a joint social worker or psychotherapist at the same time as a loved one. Okruhlica (1998, p. 178) recommends "often to self-help support groups, where people, mostly relatives with the same fate, meet and look for a source of instruction on how they can manage themselves on the models of others."

Andrea VASILESCU List of bibliographic references

[1] BEATTIEVOVA, M. 2006. The end of codependency. Trnava: Society of St. Vojtech, 2006. 275 p. ISBN 80-7162-631-7. [2] HORNÁČKOVÁ, Ľ. 2007. Mini didactotherapy of addictions (educational guide for addicts). Trnava: Outpatient crisis center Otvorené srdce, n.o. 2007. 20 p. [3] NEŠPOR, K. 2007. Addictive behavior and addiction. Prague: Portal, 2007. 170 p. ISBN 978-80-7367-267-6. [4] OKRUHLICA, Ľ. et al. 1998. How to practically navigate addictions. Handbook for consulting activities. Bratislava: Center for drug addiction treatment, 1998. 276 p. ISBN 80-968111-1-8. [5] WOITITZOVA J. G. 1998. Adult children of alcoholics. Prague: Columbus, 1998. 179 p. ISBN 80-85928-73-6.

VASILESCU, A. 2011 Social work with co-dependents. In MÁTEL, A. – JANECHOVÁ, L. – ROMAN, L. (eds.) 2011. Social pathology and social work intervention. Proceedings of the international scientific conference. Bratislava : VŠ ZaSP sv. Elizabeth. ISBN 978-80-8132-018-7, p. 45 - 56.