PTSD Awareness Month: The Relationship Between Trauma and Codependency
By Annabelle Parr, MA, AMFT
June 27 is National PTSD Awareness Day, and in service of increasing awareness, we believe it is important to discuss the link that can exist between interpersonal abuse, trauma and PTSD, and codependent behaviors. Not everyone who experiences abuse or trauma will go on to meet criteria for PTSD, and not everyone who has experienced abuse, trauma, or PTSD will necessarily develop codependent behaviors.
What is codependency?
Codependency has been defined in a number of ways, and the definition has changed over time. One definition that I find compelling is Robert Subby’s definition from Codependency, An Emerging Issue, as cited by Melody Beattie (1986):
codependency is ‘an emotional, psychological, and behavioral condition that develops as a result of an individuals prolonged exposure to, and practice of, a set of oppressive rules – rules which prevent the open expression of feeling as well as the direct discussion of personal and interpersonal problems.’ (p. 30)
These rules can show up in a number of contexts, and the codependent patterns that develop in response typically tend to serve as protective within that context. One context in which codependency can develop is that of interpersonal abuse. Any relationship can be abusive, whether it is between parent and child, siblings, friends, or romantic partners.
What does interpersonal abuse involve?
Abuse can involve emotional and psychological abuse, physical abuse, sexual abuse, financial abuse, or in the case of parent and child relationships, neglect. Interpersonal abuse and violence can serve as traumatic stressors, and can result in the development of post-traumatic stress disorder, or PTSD. Here are some examples of the different types of interpersonal abuse from the National Domestic Violence Hotline.
Emotional and psychological abuse: constant criticism, demanding to know where you are at all times, isolating you from friends or family, unreasonable jealousy, threatening to hurt you or your loved ones, damaging your property when angry, gaslighting or making you feel like you are going crazy, blaming you for the abuse, etc.
Physical abuse: hitting, slapping, punching, biting, preventing you from eating, sleeping, or seeking medical care, or driving recklessly with you in the car or abandoning you in unfamiliar places, etc.
Sexual abuse: forcing or manipulating you into sexual acts, harming you during sex, ignoring your feelings about sex, sexual coercion, etc.
Financial abuse: restricting your access to finances, preventing you from working, sabotaging your credit, etc.
Neglect: neglect is specific to children and elders, and can involve failing to provide food, clothing, medical care, education, or supervision, etc.
What is PTSD?
As defined by the Diagnostic Statistical Manual (DSM)-V, PTSD is characterized by a number of symptom clusters:
Exposure to actual or threatened death, serious injury, or sexual violence
Intrusion symptoms related to the trauma (intrusive memories, dreams, flashbacks, etc.)
Avoidance of internal or external reminders of the trauma
Negative changes in mood and cognitions (negative beliefs about self, others, and the world; persistent negative emotions and/or inability to experience positive emotions; etc.)
Changes in arousal and reactivity (hypervigilance, reckless behavior, trouble concentrating, etc.)
These symptoms cause significant impairment in important areas of life, such as work, school, relationships, etc.
For a comprehensive list of diagnostic criteria for PTSD, refer to the DSM-V.
How do abuse, PTSD, and codependency relate to one another?
PTSD is a response to exposure to violence, to a profound lack of safety. An abusive relationship can make one feel like they are constantly walking on eggshells, and the person being abused may experience a persistent fear of triggering further abuse (despite the fact that abuse is never the victim/survivor’s fault). Melody Beattie (1986) noted that codependency is typically defined by a series of unwritten relational rules:
These rules prohibit discussion about problems; open expression of feelings; direct, honest communication; realistic expectations, such as being human, vulnerable, or imperfect; selfishness; trust in other people and one’s self; playing and having fun; and rocking the delicately balanced family canoe through growth or change—however healthy and beneficial that movement might be. (p. 33)
Codependency may initially develop as a form of self-protection.
While these sort of rules do not always develop in a context of abuse, abusive dynamics do punish one for open expression, vulnerability, trusting others or oneself, playing, and growing or changing. When these healthy, adaptive behaviors are constantly punished and followed with further abuse, it makes sense that a person might begin to restrict these behaviors. Instead, in order to try to protect themselves, they may begin to ignore and suppress their own needs, become hypersensitive and attentive to others’ needs (particularly their abuser’s), obsess over the emotional state of others and attempt to control situations in order to try to predict and protect against abuse, have trouble communicating and setting boundaries, and feel a sense of worthlessness and powerlessness.
In the long run, codependent behaviors are self-destructive rather than protective.
Although only the abuser can truly prevent abuse from occurring, it makes sense that the person being abused will do their best to try to protect themselves. Codependent behaviors may feel self-protective in the short term, but they can become harmful when they become an entrenched pattern of behavior over the long term. You deserve to have a voice, to have needs, to have your feelings, to take up space, and to love and care for others without feeling responsible for their emotions and behavior.
Codependency tends to become a habitual pattern of behavior.
Just as PTSD symptoms show up in the absence of any immediate threat, codependent behaviors can continue to show up in the absence of the dynamics under which codependency may have developed. Codependency can become habitual, and ultimately it can make destructive relationships feel familiar, it can keep one feeling stuck in abusive relationships as they may believe if they just did enough or were good enough the abuse would stop, or it can sabotage what otherwise may have been a healthy relationship, either with oneself or another person.
Neither PTSD nor codependency is permanent.
The good news is that both PTSD and codependency are treatable. No therapy or therapist can take away the trauma, abuse, or unhealthy dynamics that occurred in the past. However, they can help you learn new ways of responding to your environment and teach you to engage in new patterns of behavior. They can help you to reengage in your life with a sense of meaning and purpose and self-compassion. They can help you learn to relate to yourself and others in a way that allows you to honor and care for yourself and to love and care for others.
Therapy can help…
If you or a loved one is struggling with PTSD, trauma, or codependency, Jodi Staszak, LMFT is here to help. Jodi offers individual and group therapy for anxiety, depression, PTSD, trauma, self-esteem, and codependency. She can be reached at 619.818.0375 or JodiS.MFT@gmail.com.