Codependency, Chronic Pain, & Prescription Drug Abuse

I think that most counselors would agree with my assessment that one of the most difficult counseling cases is someone who experiences chronic pain and is abusing their prescription pain medicines. It is such a trap. The legitimate pain makes medical relief a necessity, yet the tendency to over medicate makes it personally destructive.

However, whenever the subject is addressed by a loved one or counselor the legitimacy of the pain makes for a quick and undeniable defense. “What, do you want me to live in pain? Is that any life to live? How is that humane?” The concerned person is made to feel heartless. Compassion (temporarily) mutes the concern about self-destruction through abusing medications. Eventually, the destructiveness of the substance abuse becomes overwhelming again, but the next attempt to intervene falls into the same cycle.

In this post, I do not intend to try to answer the chronic pain-substance abuse problem. Instead, I hope to use that as a metaphor to help us see why so many people who struggle with codependency fail to see their struggle.

First, I should attempt to define codependency. Since it is a popular term instead of a technical one it has no “accepted” definition. This is part of the reason people do not admit codependency; even the “experts” cannot agree on what they should be looking for.

Codependency (as I am defining it here) is the relying on other people as the source of one’s emotional stability, purpose, and identity. It manifests itself as a compulsive “need to be needed.” It is often very passive in relationships, taking a servants role until it feels slighted and then becoming very indignant upon feeling “used.” Ultimately, codependency seeks to “live off” (although it would never admit it) other people to feed its insatiable hunger to be loved.

How is that like chronic pain and prescription drug abuse? When you confront someone who is relating codependently for their unrealistic expectations, false interpretations of your actions/motives, or for over-reliance upon you; you are met with a similar series of rhetorical questions. “Am I wrong for thinking I should be able to depend on you? Is it wrong for me to want to be loved? It is not good for man to be alone, is it? I thought if I worked so hard to meet my needs you would do the same, but I guess that is selfish of me?”

In part, they are right. We were meant to live in relationships. Christ-honoring relationships are mutually beneficial. It is reasonable to ask people to be dependable. They are probably right about more than that. They likely were very service-oriented in the relationship (likely compensating for or creating laziness in the other person). The other person may well have become comfortable with this “new normal” and had taken it for granted.

So what is being missed? Why are we saying that the codependent person is doing something wrong? They are trying to use relationship for a purpose larger than that for which relationships were prescribed. This is where it parallels prescription drug abuse. Codependents use relationships as a God-replacement instead of viewing them as one of God’s blessings.

When you look at the functions of relationships described in paragraph five (giving emotional stability, purpose, and identity), those are functions only God can fulfill. When the codependent gets angry with their friends, family or spouse, they are in effect saying, “You make a really bad god!” And, again, they are right. What the codependent misses is that it is they who “deified” their friend.

This post is more about seeing the problem than solving it. If you see yourself in this post, I would recommend two books as a place to start reading:

• When People are Big and God is Small by Ed Welch
• Relationships a Mess Worth Making by Paul Tripp & Tim Lane