Too kind? Maybe it’s codependency.

Too kind? Maybe it’s codependency.By Barbara Oakley
Your best friend—let’s call her Sarah—is a hopeless do-gooder. She rescues stray animals and is always lending what little money she has. (Payback is rare.) “Friends” take her good nature and willingness to help for granted—Sarah often finds herself babysitting or running their errands—and it’s beginning to take its toll. Even church, which has given so much meaning to Sarah’s life, has come to feel like a chore. She is often asked to take care of the tedious responsibilities that no one else has the time or inclination to do. Worst of all, Sarah is married to an alcoholic. It’s not her fault, really. Even youwere charmed when you first met Ken. Sarah’s so loyal that she would never dream of a divorce. It’s become more difficult recently, though. Ken’s job has been to look after the baby, since he doesn’t have a regular job because of his bad back. But Sarah came home last week to find Ken passed out on the couch. The baby obviously hadn’t been fed or changed since she’d left, 12 hours before. Ken blamed Sarah for working so many hours. But what else could she do? The bills had to be paid. You may have wondered about Sarah and why her life is so troubled. Something seems very wrong with her, even though she’s a wonderful human being. You’re correct. There is something wrong. Sarah is a codependent, a person whose emotions are strongly affected by other people’s emotions. As recovering codependent Melody Beattie writes in her classic bestseller,Codependent No More, people such as Sarah don’t behave codependently just with spouses. It’s everyone—parents, children, guests, friends and acquaintances. Somehow, codependents just seem to lose themselves in other people. They get enmeshed in them (Beattie, 1986). There are millions of Sarahs in the world. Because of their compassionate nature, many of them become nurses. But, sadly, there is no straightforward psychological diagnosis for codependency. The Diagnostic and Statistical Manual of Mental Disorders—the bible for mental health professionals who attempt to understand personality disorders—has no category for the condition. But new insights from neuroscience and genetics are beginning to provide clues about how codependency arises and what can be done to help. I feel your pain! As it turns out, some unusual cells known as “mirror neurons” help us feel what others are feeling. When we watch another person catch a finger in a slammed door, for example, we unconsciously recoil because the neurons that signal “Ouch!” in the other person’s brain are also signaling in our own brain. This may be one reason we generally try to help one another, especially when a person is truly in need. There’s more. Mirror neurons, along with many other aspects of our neurological makeup, are formed by our genes and our interactions with the environment. Some genes appear to predispose us to more ruthless behavior, others to kinder, more empathetic and altruistic actions (Anckarsäter & Cloninger 2007; Cesarini et al., 2008; Israel et al., 2008; Knafo et al., 2008). What happens when someone gets an overdose of the genes that relate to empathy and altruism? And what happens if environment fans the flames—as can occur with gender roles that emphasize nurturing above all else, or with spiritual counselors who specialize in guilt? Just as we can reprogram a computer away from default settings, codependents can ... overcome their original biological “settings.” What can happen then is codependence. Codependents help others feel better because they are trying to make themselves feel better. In a sense, then, codependents are trying to control other people’s emotions in an attempt to control their own emotions. Controlling others is an iffy proposition at best; the only person you can truly control is yourself. So codependents are locked in a losing spiral of “helping” that doesn’t really help and, in fact, may simply enable others to take advantage. But hold on a minute! If genes are responsible, even in part, for codependency, doesn’t that imply that codependents have a “hardwired” predisposition that can’t be changed? Of course not! There’s hope! A predisposition is just that—a natural tendency, but not a certainty. As we now know, the brain is capable of extraordinary plasticity. Just as we can reprogram a computer away from default settings, codependents can, with focused attention and determination, overcome their original biological “settings.” The nice thing about realizing that being too kind can arise from natural tendencies is that it explains not only why codependents are the way theyare, but also why many recommendations commonly given to codependents work. For example, the first step taught to recovering codependents—realizing that people can’t change others, only themselves—now makes sense. (Of course, you can’t change other people’s brains; you can only change your own brain!) Codependents are often told that their disease is progressive, that it worsens with time. That makes sense, too. The dysfunction gets worse because the same neural pathways involved in the emotional response to other people’s emotions keep getting reinforced—that is, unless active, conscious steps are taken to change one’s thinking patterns. Understanding why changing your thinking can change your life can be the first, vital step toward recovering from codependent behavior that can cripple our lives and ultimately hurt those we hold most dear. If you know a “Sarah,” encourage her—or him—to read this article and seek out an organization such as Codependents Anonymous. They’ll be glad you did.RNL Barbara Oakley Barbara Oakley, PhD, PE, is a fellow of the American Institute of Medical and Biological Engineers and associate professor of engineering in the School of Engineering and Computer Science at Oakland University in Rochester, Michigan, USA, where her research centers on neuroscience and society. Her tongue-in-check book titled Evil Genes: Why Rome Fell, Hitler Rose, Enron Failed, and My Sister Stole My Mother’s Boyfriend, has received critical acclaim for its sympathetic, scientifically based explanation of why people do the nasty things they do. She is principal co-editor of the forthcoming books Pathological Altruism (Oxford University Press) andKilling Kindness (Prometheus Books). Oakley also blogs as “Scalliwag” forPsychology Today. References: Anckarsäter, H., & Cloninger, R.C. (2007). The genetics of empathy and its disorders. In T.F.D. Farrow & P.W.R. Woodruff (Eds.), Empathy in mental illness, pp. 261-288. New York: Cambridge University Press. Beattie, M. (1986). Codependent no more: How to stop controlling others and start caring for yourself. Center City, MN: Hazeldon. Cesarini, D., Dawes, C.T., Fowler, J.H., Johannesson, M., Lichtenstein, P., & Wallace, B. (2008). Heritability of cooperative behavior in the trust game.Proceedings of the National Academy of Sciences, 105(10), 3721. Retrieved 28 January 2010 from http://www.pnas.org/content/105/10/3721.full Israel, S., Lerer, E., Shalev, I., Uzefovsky, F., Reibold, M., Bachner-Melman, R., et al. (2008). Molecular genetic studies of the arginine vasopressin 1a receptor (AVPR1a) and the oxytocin receptor (OXTR) in human behaviour: From autism to altruism with some notes in between. Progress in brain research, 170, 435. Knafo, A., Israel, S., Darvasi, A., Bachner-Melman, R., Uzefovsky, F., Cohen, L., et al. (2008). Individual differences in allocation of funds in the dictator game associated with length of the arginine vasopressin 1a receptor RS3 promoter region and correlation between RS3 length and hippocampal mRNA. Genes, Brain and Behavior, 7(3), 266-275. Published 1/29/2010 , Vol. 36, No. 1

Reflections on Nursing Leadership A Sigma Theta Tau International Publication

You are such a Tool

Top 16 Reasons that Nurses are Tools.

1. Tools are forgotten until needed or they can't be found.
2. A tool’s value is its ability to do the bidding of others.
3. A craftsman cures and tools are merely extensions of his hands.
4. Break a tool and you can always go to Sears and buy another.
5. New tools are broken in.
6. Old tools are replaced with shiny new ones.
7. Tools don’t have to eat or go to the bathroom.
8. Something goes wrong, and it’s the tool that gets thrown in anger.
9. In a pinch a screwdriver can be used as a pry bar. Of course, the screwdriver might break, so see Reason 4.
10. The craftsman is given all the credit even though a good tool can make even the least skilled craftsman look good.
11. A toolbox is just another tool the craftsman uses to keep the other tools organized, but it is still a tool even though it does no actual work.
12. Everyone thinks they know how to use a tool.
13. Duct tape works temporarily but a better solution is buying a good set of tools, caring for them and using them properly.
14. Tools don’t know any better. Tools are used by one thing to act on another.
15. The idea of tools has many connotations, some good, some bad, but all involve the tool being used.
16. Like servants, man created tools to make their life easier. God didn’t make tools, to do good works, He doesn’t need them.

What nursing leaders know: Seven truths from top health care professionals

What nursing leaders know: Seven truths from top health care professionals