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Ask the Mental Health Expert Archives 2001-2004

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Counterdependent Behaviors

Q. Can you list common counterdependent behavior and/or characteristics?

A. The term "counterdependent" is not a precisely defined term, though it is often used in the popular psychology literature. Recently, Gregory & Berry (Psychosom Med. 1999 May-Jun;61(3):341-5) examined counterdependency in patients with chronic pain.

Historically, such patients are described as tending to suppress emotions; idealizing relationships; having a strong work ethic; a caregiver role-identity, and strong beliefs in self-reliance. Using the Counterdependency Scale (CDS), designed to elicit each of these traits, these researchers found higher rates of counterdependency in chronic pain patients than in those without chronic pain.

In my own experience, some individuals with very strong counterdependent traits--the "tough it out, pull yourself up by your bootstraps!" type--tend to have the hardest time dealing with mental or physical disability, and may become the neediest and most dependent of patients.

Psychodynamically, it seems likely that the tough coating these individuals wore for so many years may have covered a personality with many unmet and unexpressed needs. However, more research is needed to substantiate that intuition.

November 2003

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