Background: Codependence is an ambiguous and disputed term often used to characterize both those who maintain relationships with alcoholics and those who seek help through resources such as Al-Anon Family Groups.
Objectives: The purpose of this article is to better understand non-pathological reasons for maintaining alcoholic relationships and for help-seeking by detailing the costs and benefits of those choices.
Methods: The costs and benefits both of remaining in an alcoholic relationship and of seeking help in Al-Anon were identified through a review of available research on alcoholic family systems, Al-Anon, and other mutual-support groups.
Results: Alcoholic relationships may benefit concerned others by preserving self-identity, social identity, values, security, stability, and hope. Costs of alcoholic relationships include physical symptoms, injury, mental problems, financial difficulty, legal troubles, and relational distress. Al-Anon is perceived beneficial for six primary reasons: Al-Anon philosophy, format, social support, accessibility, effectiveness, and potential to change the drinker's behavior. Possible costs of Al-Anon include marginalization of the concerned other, blame, codependent pathology, sexist stereotyping, substitute dependency, and perpetuating victimization. Conclusions/Importance: The identified costs and benefits of alcoholic relationships and help-seeking in Al-Anon can help to model decision-making processes using existing behavioral health frameworks without defaulting to the stigmatized and ambiguous codependence terminology.
Keywords: Al-Anon; Twelve Step; alcoholism; barriers; codependence; enabling; mutual help group; social support.