Unacknowledged Loss and Grief

Recently I noticed an article in the opinion section of our local newspaper written by the syndicated columnist Leonard J. Pitts, Jr. It caught my interest because of the subject matter. The title is: There's Nothing Moral About Hating Gays. I agree with the sentiments expressed by Mr. Pitts but something else in the column struck a chord.

In the article he described a situation where a lesbian couple went on a cruise with their children. One of the partners had an aneurysm and was taken to a hospital. The other spouse, who is an emergency room social worker, was told by the hospital social worker "I need you to know that you are in an anti-gay city and state and you won't get to know about Lisa's condition or see her." The social worker then walked away. Janice, the worried spouse, spent 8 hours in the waiting room and did not get to see Lisa until the priest was administering last rites. Lisa spent all that time without the benefit of a partner of twenty years being at her bedside.

Ken Doka (1989), in his book Disenfranchised Grief, describes this phenomena as situations when the loss cannot be openly acknowledged, socially sanctioned or publicly shared. The story of Lisa and Janice is a prime example of a relationship not being recognized. In pursuit of one's personal code and opinions those who practice a different lifestyle are subjected to cruelty. The loss of a life partner is devastating enough with out being complicated by callousness and dismissal. My reaction to the story was outrage and sadness because I know this is not an isolated case.

In my capacity as grief counselor at Cottonwood de Tucson I have been given the privilege to support grievers in the expression and processing of a variety of losses. I am grateful that I work for an organization that recognizes the humanity of our patients without exception. It is my hope that people will become more educated regarding more appropriate ways to support those in pain.

Dan Stone LCSW, LISAC, CT
Marketing Representative
Cottonwood de Tucson
4110 West Sweetwater Drive
Tucson, AZ 85745
Toll Free (800) 877-4520

http://www.cottonwoodrecovery.com/

Family Members: Codependent or Grief Stricken?

Codependency Labels Like Codependent or Addict ~ Are they Needed?

Cottonwood de Tucson is a unique treatment approach to recovery, putting health and wellness as the central component of healing from addiction and disorders. It feels incongruent to promote people thinking about themselves as a disorder, such as when family members introduce themselves in small group situations and give themselves a title. For example, a family member may say, "My name is Cathy, I am a codependent." Titles are useful when they reflect a disorder that is chronic, progressive, and life threatening, such as the case of addiction, where using the label assists in recovery. It is not as useful when the focus of treatment is on an overused set of caring behaviors, as is the case when family members take on a label of "codependency."

The threat of loss of a relationship is a threat to one's current life balance, which creates fear and sadness. Parents, spouses, children, friends, and extended family are sources of social relationship that provide contexts within which to maintain balance. To prevent loss people engage in controlling behaviors, hyper-vigilance, and manipulation. Attempts to maintain attachment with people who are needed, or who have moved from available to unavailable, is normal. Understanding a normative reaction to loss experienced by people in social relationships is necessary: Pathologizing that reaction is harmful. In the addictions field we continue to pathologize the normative reaction to social loss with the label "codependency," putting it in the category of illness, rather than as grief work from an ambiguous loss.

The reaction to loss that is widely experienced by friends and family members of persons who are addicted to mind altering substances is profound grief. It has characteristics of flawed interactional patterns because the loss is ambiguous. If a person dies, the grief is unambiguous: the social role the deceased played is no longer occupied and the deceased cannot fulfill obligations or promises. The spouse who becomes addicted to mind altering substances often ceases to fulfill obligations or promises, but physically the social role is still occupied. "Codependency," describes a set of skills that were learned in that close relationship, become unsuccessful, and are vigorously pursued because members of the network have not yet identified and grieved their loss. To address these behaviors, fear and uncertainty need to be addressed.

Persons with emotional attachment to those who are addicted need to:

Recognize the loss of the role that the addicted person can no longer fulfill.

Grieve the loss of the original relationship.

Reorganize such that the addicted person is no longer central to the member's well being.

Identifying and grieving are the key issues in correcting "codependent" behaviors. That understanding is achieved through education, which is why the family program at Cottonwood de Tucson is so successful. Once the education has taken place, family members can:

Detach with love.

Recognize the limits of the relationship with the addicted person in their lives.

Take care of their own needs for balance and attachment in relationships where trust and balance are more available.

Learn to set limits for their own well-being.

Learn to distinguish between caring and obsession.

Codependent-type behaviors are logical responses to ambiguous and chronic attachment loss. Codependent-type behaviors are learned, and can be unlearned.

Vicki Loyer-Carlson, Ph.D., LMFT
Daniel Cook, LMSW
Ed Rusnak, MS, NCC, LISAC
Cottonwood de Tucson
4110 W. Sweetwater Drive
Tucson, AZ 85745
(800) 877-4520
www.cottonwooddetucson.com