A Disease of One's Own

Psychotherapy, Addiction and the Emergence of Co-dependency

John Steadman Rice

• Publisher: Routledge
• Year: 2017
• Print ISBN: 9780765804549
• eBook ISBN: 9781351321181
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

In the present decade, "co-dependency" has sprung up on the landscape of American popular culture. Portrayed as an addiction-like disease responsible for a wide range of personal and social problems, co-dependency spawned a veritable social movement nationwide. 'A Disease of One's Own' examines the phenomenon of co-dependency from a sociological perspective, viewing it not as something a person "has," but as something a person believes; not as a psychological disease, but as a belief system that offers its adherents a particular way of talking about the self and social relationships. The central question addressed by the book is: Why did co-dependency--one among a plethora of already-existing discourses on self-help--meet with such widespread public appeal? Grounded in theories of cultural and social change, John Steadman Rice argues that this question can only be adequately addressed by examining the social, cultural, and historical context in which co-dependency was created and found a receptive public; the content of the ideas it espoused; and the practical uses to which co-dependency's adherents could apply those ideas in their everyday lives. In terms of the larger American context, his analysis links the emergence of co-dependency with the permeation of psychological concepts and explanations throughout Western culture over the past thirty years, focusing particularly on the cultural and social impact of the popular acceptance of what the author calls "liberation psychotherapy." Liberation psychotherapy portrays the relationship between self and society as one of intrinsic antagonism, and argues that psychological health is inversely related to the self's accommodation to social expectations. Rice argues that a principal source of co-dependency's appeal is that it affirms core premises of liberation psychotherapy, thereby espousing an increasingly conventional and familiar wisdom. It simultaneously fuses those premises with addiction-related discourse, providing people with a means of making sense of the problems of relationship and identity that have accompanied what Rice terms the "psychologization" of American life. This brilliant analysis of the phenomenon of co-dependency will be of interest to psychologists, sociologists, psychotherapists, and those interested in American popular culture.

1
Co-Dependency, Discourse, and Cultural Change

Clifford Geertz once observed that “[o]ne of the most significant facts about [human beings] may finally be that we all begin with the natural equipment to live a thousand kinds of life but end in the end having lived only one.”¹ Why do we end up having lived only one kind of life? Geertz’s answer is that culture, understood as an inherited system of symbolic forms that operates as “a set of control mechanisms—plans, recipes, rules, instructions—for the governing of behavior,”² channels individual conduct, and sculpts our innate physiological capacities into specific, repetitive forms.

The analysis of the co-dependency phenomenon presented in this book is informed by much the same understanding of culture. Of particular importance to the analysis is the connection between symbolic and relational systems. As Geertz’s references to “control mechanisms” and the “governing of behavior” indicate, the symbolic systems comprising culture—ranging from whole cosmologies through discrete systems of meaning such as theories, religions, “isms,” and ideologies— necessarily take social form in “relational systems,” social structures, recurrent patterns of social action and interaction. At the most abstract level, these two systems, the symbolic and the relational, cultural and social structures, fit together and affect one another in specifiable ways to form a social and cultural whole—a reality.³

Co-dependency, as a form of folk-psychological discourse, is one of these discrete, secondary symbolic systems, derived from a more encompassing symbolism and taking on social structural form in the people identifying themselves as co-dependents in self-help groups like CoDependents Anonymous and in a veritable “co-dependency movement”—all organized around and embodying the discourse’s constitutive themes. But it is not enough to say that co-dependency is a cultural structure, a discourse that expresses a distinctive symbolic logic; nor, as pointed out in the introduction, is it enough to say that this discourse was selected by a significant minority of the population and that it affects the behaviors of those who selected it. Such observations are true enough, but they are only the starting point for a more comprehensive, theoretically informed understanding of the phenomenon of co-dependency. This chapter is devoted to providing this more comprehensive framework, as a necessary preamble to the analysis that follows it.

Discourse, Articulation, and Cultural Change

A clear understanding of the phenomenon of co-dependency requires a consideration of general types of discourse and of the roles the different types play in social and cultural change. Especially throughout the modem age, discourses such as co-dependency have played a pivotal role both in maintaining and in changing the nature of a given social reality; they are the vehicles in and through which the satisfactions and the discontents of an age are expressed, extolling the merits or deriding the demerits of a status quo.

Which role they play, which themes these discourses express, is a matter of their articulation with the most abstract symbolic and relational systems of the larger reality in which they are created and selected. Antonio Gramsci’s term “articulation” refers to the fit between, a “jointing together” of belief and practice, of symbolic and relational systems, into a plausible, more or less coherent, and palatable whole.⁴

Gramsci’s particular intellectual concern, long a centerpiece of neoMarxist thought, was how to account for the relative stability of capitalist societies. Among neo-Marxists, this stability represents a problem that must be understood and overcome, for, according to the original logic of historical materialism, the antagonisms and progressively worsening inequities of capitalism would engender the working class’s awareness of themselves as a class for themselves and as the engine of historical change, an awareness that would eventually lead to a revolution against capitalism; in turn, the revolution would engender a just society. A central question for neo-Marxist theorists was (and is) why this scenario had not come to pass.

For Gramsci, the answer to this question lay in culture (the “superstructure”), which, in conventional Marxist thought—or at least in one of the most common caricatures of Marxist thought—had been conceptualized as “epiphenomenal,” as “determined by” more fundamental economic and material conditions.⁵ Gramsci, contrary to this line of reasoning, argued that cultural factors—specifically, ideology, but not used in the customarily pejorative or reductionist sense of that word— played a central role in reproducing the status quo by securing the ruling class’s position of “moral leadership” and the working class’s consent to that leadership. In essence, Gramsci focused on what can be called “discourses of reproduction,” symbolic-moral systems, expressed in discursive form and aimed at maintaining a larger—in this case, capitalist—reality. These discourses, for Gramsci, were the products of what he called “organic intellectuals”—symbolic specialists whose function in society is translating abstract philosophical systems into practical commonsense knowledge about everyday life. Acting as mediators between more “traditional intellectuals” and the “masses,” organic intellectuals simplify the abstractions, rendering the symbolic and relational systems of capitalism as, in essence, natural facts and thus presenting the whole of the reality itself as simply to be taken for granted. Organic intellectuals, then, secure the working class’s consent to the moral authority of the “ruling class.” This juxtaposition of leadership and consent, which Gramsci called “hegemony,” stabilized and legitimized the system of social relations under capitalism. Hegemony, as a form of articulation, fosters the reproduction of a social and cultural status quo.⁶

But articulation of the sort that Gramsci describes is only one form that the relationship between discourses and larger social realities may take. As Robert Wuthnow, who has also focused on the articulation between cultural and social structures, puts it, an adequate analysis of discourse and cultural change “must not only ask about the [social] conditions that shape [a discourse]...but also inquire into the reasons why these conditions did not shape it more.”⁷ As Wuthnow’s observation rightly suggests, discourses do not just formulate and express public consensus and satisfaction, fostering stability and hegemony; they also express discontent and engender cultural and social change.

In short, discourses are the “carriers” of both stability and change. Any analysis of the processes of change, then, must consider the dynamics in and through which new discourses, new symbolic systems, are produced and publicly disseminated; the circumstances and conditions that contribute to their public selection; and their “institutionalization,” their transmutation into relational systems—either by reorganizing established social relationships and institutions or by engendering new institutions, new patterns of social action and interaction.

As the foregoing comments suggest, cultural change should also be broadly understood as a dialectical process, in which these discourses of discontent play a particularly significant part. It is in and through discourse that the inadequacies of a given reality receive systematic and coherent exposition, and—depending in part on how the discourse frames and portrays these inadequacies—it is also in and through discourse that the necessary changes in belief, conduct, or both are mapped out. In broad strokes, the cycle of cultural change is one of order-disorder— new order, and discourses of discontent provide the symbolic bridge between the different orderings of cultural and social structures.

If a discourse is to have any tangible effect, it must be adopted by some significant segment of the general population. Discourses are produced by symbolic specialists: intellectuals, elites, and, in the present era, the army of experts and professionals; that is, those with the requisite training, knowledge, education (which, of course, is not quite the same thing as knowledge), literacy, and skills to be assigned or to take upon themselves the responsibilities for producing and maintaining or amending and changing a society’s symbolic and relational order. But any of these outcomes, especially societal and cultural change, is contingent upon successfully persuading people to act. The social and cultural consequences of discourses of discontent, then, depend upon their selection by a public.

The public selection of a discourse is a function of several factors. Most obviously, the discourse must be able to reach its audience: Its creators must have access to the resources and institutional mechanisms through which their ideas can be publicly disseminated and thus become available for selection. But production and dissemination do not guarantee that a discourse will fall on receptive ears or attract a following; its public selection is principally a matter of a confluence between the historical context in which the discourse becomes available and the content of the discourse.

The probability that a new discourse will be selected sharply increases in periods marked by disruptions in established patterns of social action and interaction—periods in which already established symbolic systems, for whatever reasons, no longer fit well with or make adequate sense of lived experience. It has been extensively documented that new discourses (cultural systems, ideologies, and the like) emerge, indeed proliferate, when social relations are unstable and when the sources, nature, and redress of that instability cannot be explained by existing symbolic resources.⁸ Clifford Geertz, for example, observes that ideologies—invariably a form of discourse—merge “precisely at the point at which a [social] system begins to free itself from the immediate governance of received tradition,” when symbolic guides for behavior, thought, and feeling, are weak or absent. Such conditions, Geertz contends, engender “a loss of orientation,” and it is this loss “that most directly gives rise to ideological activity.” Ideologies, then, become crucial sources of social meanings and attitudes when neither a society’s general cultural orientations nor its pragmatic ones work any longer.⁹

Discourses of Reform

In addition to the significance of the larger historical, cultural, and societal context, a new discourse’s probability of public selection is directly related to its symbolic content—to how well it appears to capture the conditions in the larger reality and, on a closely related note, to how well its themes lend themselves to immediate practical action in dealing with the problems the public is experiencing.

The forms of practical action that a discourse does elicit can and do vary. There are two general types of discourses of discontent, and these can be analytically distinguished in terms of their thematic-symbolic content—the symbols they invoke and how those symbols are arranged to convey a larger message—as well as in terms of die courses of action they seek to or do produce. Using these criteria, it is possible to distinguish very generally between discourses of reform and discourses of revolution.

There are two analytically distinct but overlapping judgments underlying discourses of reform: (1) Fundamental cultural principles are basically sound, but (2) existing social structures do not measure up to those ideals. These reformist impulses, and the dialectical nature of the social processes they engender, are clearly reflected in the recurrent cycle of revivalism in U.S. history. In each new instance of revivalism, political, economic, and technological developments contributed to fairly widespread disruptions in established social structures and relationships; in each instance, this instability fostered a fervor for reform, embodied in a wide variety of discourses that expressed, at the most abstract level, “deliberate, conscious, organized effort[s] to construct a more satisfying culture”;¹⁰ in each instance, these efforts were undertaken by a small group of concerned activists who called public attention to what they saw as a set of social and moral problems, and sought to isolate causes, provide convincing evidence of the overarching malaise, and offer solutions to those problems. The solutions, in each case, entailed bringing people and errant institutions back in line with what the activists saw as the appropriate and legitimate symbolic-moral system; it entailed, in a word, reform.

To provide one brief, but illustrative, example, consider Mary P. Ryan’s analysis of the Second Great Awakening, the wave of religious revivalism that swept across the United States in die early 1800s.¹¹ Ryan locates the intense and sudden outburst of religious enthusiasm in western New York state in the early 1800s amid the tumult accompanying such broad-based social changes as industrialization and urbanization. In keeping with the general correlation between reform and malaise to which we have just referred, Ryan observes that these structural changes engendered a period of pronounced instability in social relationships and argues that the revivals, and the accompanying wealth of voluntary associations dedicated to social reform, were a response to this social disorganization. The revivals and reform organizations were the crucible in which cultural adaptations to the new realities were formed and in which those new realities were themselves forced to accommodate the established symbolic-moral system. Gender and family roles were reconceptualized in ways that enabled people to adapt to die separation of home and workplace and the disruption in family relations that came with the rise of an industrial economy. The nuclear family—the “cradle of the middle class”—emerged out of the new symbolic status that reformers assigned to children and women. Because fathers began to work outside the home, and because the rise of large urban centers transformed the public sphere into a threatening world of strangers, many people were concerned about how the proper moral training could be instilled in children. Over time, reformers and activists successfully accommodated the demands of the age and the fears bom of them by constructing religious justifications for a new division of labor in the family. Accord- ing to the new symbolism that was developed, children were not, as had previously been the view, depraved creatures in need of forceful paternal control. Moreover, although some church authorities sought out and pointed to biblical prescriptions against, and thus opposed, women playing a large role in the moral tutelage of children, a compromise position was eventually carved out. As Ryan describes this compromise, it was agreed that “as long as they acted through persuasion, rather than authority, women [could exercise] extensive power, particularly over children, and even over patriarchs.”¹² By thus adapting the established symbolic order to the new relational realities, it became possible to make sense of those new realities and to bring social relations into line with religious and moral ideals.

Discourses of reform, then, are in agreement with the established cultural ideals of the historical period in which they emerge. At the symbolic level, they reveal a high degree of articulation with those ideals, and at the relational level, they seek to bring social practices and structures into line with them. Frequently, the reform itself entails a process of accommodation, of constructing a basis for rapprochement between the symbolic and the relational. As Ryan’s work indicates, for example, reformers in the Second Great Awakening had to find a middle ground between the monumental changes that industrialization and urbanization represented and the est...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Introduction
• 1 Co-Dependency as a Discourse of Reform
• 2 A Genealogy of Co-Dependency: Truth Rules and the Twelve-Step Subculture
• 3 The Anatomy of Co-Dependency
• 4 A New Theory of Addiction
• 5 Addiction and Analogy
• 6 Becoming Co-Dependent: Conversion, Ritual, and Obligation
• 7 Recovery
• 8 The Ironies and Consequences of Cultural Change
• Conclusion: A Disease of One’s Own
• Appendix A: Methodology
• Appendix B: Key CoDA Readings
• References
• Index