There is a long overdue, emerging understanding of trauma. Prompted most recently by our returning veterans, trauma is beginning to be discussed—not just in therapist’s offices and at conferences, but in the news and over dinner—as our country gradually begins to understand the pervasiveness of trauma, its nuances, and our responses to it.
But one group has been focused on trauma for years now, those who identify themselves as having codependency. Yes, this is a group that we thought we knew so very well. But when we look beyond their words, when we decode their experiences, when we look at them from a more developmental and mental health perspective, we see the obvious: the trauma connection.
The effects of trauma as a driver of codependency have been widely explored in books, conferences, psychotherapy and mutual support groups. In fact, one could argue that trauma is the main element discussed in Al-Anon, Alateen, ACOA (Adult Children of Alcoholics), and even AA and NA meetings, although it is rarely given that label.
Trauma: The Missing Link in Understanding Codependency
But this is beginning to change. The shift to identifying and focusing on trauma as part of treatment is filling in many of the gaps for those in recovery. One patient told me recently that she identified herself for years as being codependent because she is the adult child of an alcoholic. This identity helped give shape to her feelings and to her challenges and gave her a label for identifying what was going on within her, helping to contain it. But she now realizes that seeing herself as only an ACOA didn’t really address her feelings, her mood swings and her insane jealousy.
“Considering myself as an ACOA helped me perhaps understand why I was feeling as I did, in a general way. It was certainly helpful. Liberating even. I no longer walked around feeling crazy, or just blaming myself. But thinking of myself as an ACOA didn’t help me with what I now understand to be my trauma triggers. Being an ACOA didn’t really help me know what to do to stem my negative feelings—especially my jealousy—which dominates my life. Now I realize that what was under the umbrella was trauma—lots of it! Naming it has given me power to begin to deal with it.”
Trauma with Both a Big T and Little t
The shift to identifying trauma as a key issue for those with codependency has been gradual. Part of the reason for this is our understanding of just what trauma is has been changing. Up until fairly recently, trauma as a diagnosis was limited to what I now call trauma with a big T. This is the trauma that is identified as acute stress disorder or post-traumatic stress disorder (PTSD). These types of trauma are defined by the duration of the symptoms—under thirty days represents acute stress disorder, and over thirty days indicates PTSD. The symptoms associated with these types of trauma include recurrent, intrusive thoughts of the traumatic event; nightmares; flashbacks; and associated problems in key relationships, marriage and work (APA, 1994).
The problem with the previous definitions is that they do not capture all types of trauma. Besides those just described, there is also trauma with a little t. Trauma with a little t can result from being bullied, knowing a friend is suicidal or is cutting themselves, having a parent or spouse lose a job and a home, living with a returning vet who has diagnosed PTSD or having been abused as a child or adolescent by a caregiver. And here the traumatic responses may be very different—more nuanced and varied, and unlike the symptoms of PTSD. These traumatic responses may include problems in regulating mood, going from one feeling state to another without an apparent outside stimulus; having symptoms of physical illness without an apparent cause; putting oneself in high-risk situations; and/or having difficulty protecting oneself.
For children who have a history of abuse, most often by a caregiver and/or by an older sibling, traumatic responses can be inattention, poor school performance, depression, self-injury, poor hygiene, behavioral problems and distrust of adults. In short, their presentation can look a whole lot like many other diagnoses, such as attention deficit hyperactivity disorder (ADHD), conduct disorder, depression and the ever popular bipolar disorder. Those concerned about how best to describe the impact of this type of trauma on children, speak of complex trauma (van der Kolk, 2003). And when these children grow up to become adults and reexperience trauma through military deployment, being sexually assaulted or witnessing a violent event, they may develop more classic symptoms of PTSD—what some researchers call complex post-traumatic stress disorder (C-PTSD) to capture the patient’s earlier trauma history (Hermann, 1999; van der Kolk, 2003).
In addition, there are other forms of trauma with a little t. One is secondary trauma—the overwhelming feelings that helpers of all types are at risk of feeling. This is what counselors, teachers, first responders, volunteers and good Samaritans at times feel when they absorb the trauma of those they are assisting. And when this form of trauma sinks in and begins actively and negatively to affect the helper we speak about it as compassion fatigue.
Wyatt, an emergency room nurse and a local EMT, prided himself on keeping a cool head. This is why he was so very surprised at his reaction following the tornadoes in Alabama. “Even though they didn’t get as much press as the others, the devastation was overwhelming. I couldn’t wrap my mind around it. I felt as though I was in a fog. And the worst part was that it continued when I returned home. I had a hard time getting to work on time, never an issue before. It was like I got worn-out by seeing the suffering there.”
And there is historical or intergenerational trauma, where trauma is transmitted within the family or the culture even if it is not experienced firsthand. We see this in the children of children of alcoholics who are reared on family stories of beatings and deprivation, even if this does not exist within the nuclear family in which the child is raised.
Cassie, age 15, grew up feeling that she had the worst of both worlds—her parents being consumed by her father’s childhood trauma, and her estrangement from her grandparents. Her father would share graphic tales of his beatings as a child and of the poverty in which he was raised. All the while her mother would hold her father’s one hand, and Cassie would hold the other. “And it made me hate my grandfather so much that I wouldn’t talk to him when I was little. This was confusing to him. He was really old when I was little, and my father was always encouraging me to give him a kiss. I was so angry at him for hurting my dad. I felt that my anger was something I could do to avenge my father.”
The telling of the stories was enough to make the abuse real and a part of Cassie’s childhood. She saw how it affected her father and she felt that she had to take care of him. In this type of family the parenting roles can be reversed, with the child parenting the parent, a wonderful breeding ground for codependency.
We also see this type of trauma in ethnic and racial groups such as Native Americans and African Americans, whose oppression is part of their heritage and is present in their daily lives.
“I’m proud of my heritage. Yes, there were slaves in my family, but we persevered, became businessmen and -women, bought land. What I’m not proud of is the condition of our schools in the inner cities, the high level of young men who are incarcerated, the lack of economic opportunity. As much as things have changed, some things seem to remain the same,” says Sherril, a civil rights lawyer.
The Codependency Connection
So how does codependency fit into all of this? Codependency is the need to take care of another, often passionately, while simultaneously not caring for oneself. Codependency can be a response to trauma—and be a positive response at that. Those who have experienced trauma, usually early in life, unconsciously try to do something positive with the pain that they have experienced. They know pain, and so they find others who are in pain and care for them, giving the other what is, in fact, what they most need.
These early traumas also produce some challenging bonding. The child probably learned to bond with the caregiver on whom the child relied. Remember, the child, as a child, needs to be cared for—even if the child experiences hurt from the caregiver. So the child learns to connect with, bond with and understand the caregiver from a child’s perspective: the child sees the caregiver as someone who both cares for them and wounds them. This sets the stage for some dynamics later in life that can lead to the development of codependency.
Abigail, a teacher, made a decision to go back to work on the Indian reservation where she was born. She recalls her childhood. “I was put in foster care and taken off the rez at about age six. My parents drank too much and couldn’t take care of me. My grandmother tried to raise me, but she had many health problems.” Speaking of her experience in foster care, Abigail says, “There, they cut my hair, something that I was taught was only to be done as a sign of mourning, and they forbade me to speak my language. They also beat me. But I learned to love my foster parents. I kept telling myself that they had so many kids to take care of, that they were doing their best, even when they called me a ‘dumb injun.’ They were the only parents I really ever had.
“I was smart, went to college and was offered a position to teach in an affluent school. But I realized that I wanted to take care of my people and help reach the kids in a way that I was never helped. I wanted to be an example, live on the rez and become a foster parent myself. I know it’s a hard life, but what I’m doing is more important than who I am.”
The hallmark of those who develop codependency is that they feel compelled to take care of others or they become wed to a cause, while simultaneously not taking active care of themselves. What drives this behavior is complicated. It is a result of the hypervigilance found in many trauma survivors and in those with codependency. People who are hypervigilant experience extraordinary sensitivity to what is happening around them, including what is happening in the people around them. And their learned helplessness, their underdeveloped ability to know how to take care of themselves, results in their reliance on external cues from those around them (Oliver-Diaz & O’Gorman, 1988; O’Gorman & Oliver-Diaz, 1990; O’Gorman, 1994). This combination of hypervigilance and learned helplessness are the drivers of the development of codependency (O’Gorman & Diaz, 2012). But having codependency is not hopeless. There are programs that can help.
Healing Trauma and Codependency Through Self-Parenting
What is self-parenting? Self-parenting is a paradigm for healing that has been utilized for more than twenty years within the recovery field (Oliver-Diaz & O’Gorman, 1988; O’Gorman & Oliver-Diaz, 1990). Initially begun as a process of healing for ACOAs, it has been refined and expanded to address what we now know about trauma and codependency.
Self-parenting is a comprehensive process of empowering the client to take control of her own care through actively nurturing and developing herself. Here the client learns to self-soothe on a psychological, neurobiological and spiritual level, while identifying and owning her well-honed resilience and thus embracing all aspects of her recovery. The self-parenting process is multifaceted. It involves the use of the 12 steps of self-parenting specially adapted for codependent trauma survivors, and it is complemented by 12 healing principles, affirmations, and self-soothing techniques that include restorative and reparative experiences.
Self-parenting is becoming popular outside of the recovery field. It has recently been discovered by trauma researchers and recommended by them to help trauma survivors be the parent that they have always needed (Fogash & Copeley, 2008)—something that we have long recommended in the recovery field (Oliver-Diaz & O’Gorman, 1988).
The Self-Parenting 12 Principles of Healing
The self-parenting 12 principles of healing are offered to you so that you can begin to utilize them with your clients. They form a simple outline that can begin to inform the development of treatment strategies in which your clients can take the lead.
Healing is an incredible process. It is often counterintuitive—driven by parts of us that will surprise and even challenge us. And healing also involves many paradoxes.
One: Healing Takes Time
Let’s face it, it took a while for your clients to get where they are. Likewise, their recovery will also take time. Encourage your clients to give themselves the gift of allowing this process of self-parenting to unfold for them. Let them know that it can’t be rushed. It’s a process, not an event. What is important is that it has begun.
Two: Healing Is Not Linear
Healing, like the development of trauma and codependency, is not a rational process. It involves all parts of the body, including the brain and the spirit. Therefore you can’t plan to go from point A to B to C. The healing of trauma and codependency is more like the healing of a bad injury, proceeding more randomly than perhaps hoped for, but certainly proceeding through its own pattern.
Three: The Mind and Body Act as One
Our body and mind are connected. What we do, what we change in one area, changes the other. So even though your clients may “live in their heads,” their body knows what is happening. This has particular implications for trauma survivors because even though memories of trauma may not easily be retrieved verbally, the body may have stored them. This is why a smell, a touch or light moving in a certain way can trigger the person into not necessarily remembering verbally, but into reacting physically. This reaction needs to be respected and understood, with a plan developed for handling the situation.
Four: Reparative, Restorative, Self-Soothing Experiences Are Key
In order to heal a client needs to be active, not just in terms of insight garnered through therapy and meetings, but through actions the client takes to calm himself, and through experiences in which a positive sense of self is restored and negative attributes are repaired.
Five: Changing Your Actions Changes Your Thinking
This is why it’s key to get your clients up and active and making changes in their life, even if their thinking is not there yet. That old adage—Fake it till you make it—is key. Our actions can help to change our thinking. And our actions can keep us safe even if our thinking is still fuzzy.
Six: Allow Rather Than Force
Sometimes clients become really excited about recovery, so excited that they force themselves to do what they need to do. While making positive changes is what it is all about, it is important that this does not occur at the expense of the clients’ knowledge about how they feel. It is important to encourage heeding the lessons that need to be learned, garnering the insights that need to be gained and taking the actions that really need to be taken. All of this is driven by an increasing understanding that is derived from the clients allowing themselves to know how they are really feeling. For those with trauma and codependency, knowing how they feel can be quite a challenge and must be addressed. This “knowing” is what needs to drive decision-making and can only occur when clients slow down and own their feelings.
Seven: Own the Power of Nonverbal Communications
As important as verbally understanding and communicating are, it is equally important to embrace how our clients process trauma and codependency nonverbally. This involves the healing power of the creative part of our brains to sense, depict and communicate using images, color, movement and sound. Can the client draw, sing, dance or make music to describe their feelings? Their solutions? It is well worth finding out.
Eight: Embrace DEF—Diet, Exercise, Fun
Yes, fun. Part of the recovery from trauma and codependency is to have your clients move back into their
bodies—yes, their bodies. Having fun, using their bodies to move and exercise, caring about what they put into their bodies—including their diet—are key. For those who have been dissociating or depersonalizing, this will be more of a challenge, but an important one to confront. Embracing DEF is an important way to integrate the mind and body.
Nine: It’s Good to Slow Time
Learning how to be in the present, to self-soothe and to slow one’s responses is vital to recovery. This is particularly important for clients who are experiencing triggers. A key component in learning to self-soothe is to know how to literally slow time. This is a skill that can be taught and practiced both in your office and outside. Simple strategies such as moving more slowly, speaking more slowly and driving a little under the speed limit can provide a powerful boost to clients’ perceptions of their ability to make changes in their life, as can learning to be in the present, in their sensing mind, and moving away from the chatter in their heads, their narrative mind (Siegel, 2011).
Ten: We Can Give Our Trauma Away
Spirituality is an important component to recovery. In developing a renewed belief in a force greater than themselves, clients can experience transcendence, the ability to be lifted above the present moment and into that space where they can share their discomforts with another, literally giving them over to be managed by something outside of themselves. Whether the force is a deity or a group is not important. What is important is that the person feels a space between their pain and themselves so that they can process it. The development of this ability is a powerful tool in the recovery arsenal.
Eleven: Sometimes We Need a Pharmacological Assist
Yes, sometimes in dealing with trauma, medication is needed. The severe stress associated with trauma can result in the brain requiring prescribed medication to bring it into balance. Many people intuitively know that they have a biochemical problem and begin to self-medicate by drinking more heavily or by taking illicit drugs. Needing prescribed medication is not a failing, even though some will see it this way. In fact, if prescribed, taking medication is a really smart and courageous thing to do.
Twelve: Don’t Take It Personally
As recovery takes hold and people begin to change, others will notice this change and perhaps not like it. It is highly recommended that you council your clients to NOT TAKE IT PERSONALLY. This is really difficult for someone with codependency to do, but the action is essential. We need to encourage our clients to see that most of the time the reactions that we all receive from others are more about them, and less about us. Taking personally how others react to us reinforces codependency, for this encourages the person to be responsible for the other. Programs like Al-Anon address this with the slogan “detachment with love”—caring about someone while not being controlled by them. This is an excellent principle to utilize in recovery from trauma and codependency as well.
We are finally realizing that trauma, in all of it nuances, has a profound effect on human behavior. What we now understand is that trauma also has been a foundational experience for many who have described themselves as having codependency. This adaptation to trauma means that the treatment of trauma must also address codependency. What is highly recommended is a self-parenting focus, empowering the, client to utilize a mind, body and spiritual approach to learning to heal themselves.
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