Sound in Mind and Body

by Katherine Lewis

That Independent Streak May Hurt Your Health

“Dependency” is a word that makes most Americans shudder. We don’t want to be “needy” or “clingy”; we’d much rather be independent pioneers. The field of psychology agreed with those sentiments for decades, casting dependency as a maladaptive personality trait. On closer look, however, research has since revealed that dependency, in certain forms, can actually be just the opposite—a useful adaption that improves our personal outcomes. From earning good grades in school to seeking healthcare when needed, studies in recent years have shown that the right kind of dependency is associated not with pathology, but with success.

Professor Robert Bornstein of Adelphi’s Gordon F. Derner Institute of Advanced Psychological Studies has been one of the leading researchers on “healthy dependency,” and, in 2009, he and several colleagues examined healthy and unhealthy dependency and its correlation to health outcomes in low-income, urban women. Prior studies had shown both positive and negative health outcomes associated with interpersonal dependency, but no previous study had distinguished between healthy dependency and destructive overdependence.

Using a tool developed by Dr. Bornstein and his wife, clinical psychologist Dr. Mary Languirand, that distinguishes between unhealthy and healthy dependency in medical and psychiatric settings, Dr. Bornstein and his colleagues divided the women in the study into three groups: those exhibiting destructive overdependence, dysfunctional detachment, and healthy dependency. When dependency was broken down in this way, Dr. Bornstein and his colleagues found that, in contrast to patients who exhibit destructive overdependence or dysfunctional detachment, patients who exhibit healthy dependency are likely to have fewer medical diagnoses, less frequent use of emergency rooms, and fewer hospital days. In other words, the right kind of dependence can lead to better health and lower healthcare costs.

Now, in collaboration with colleagues at Nassau University Medical Center—including Derner alumnus Dr. Greg Haggerty M.A. ’03, Ph.D. ’08—Dr. Bornstein and a group of Adelphi students are exploring healthy dependence and its role in substance abuse treatment outcomes. “One of the things that’s particularly exciting about the research is that we’re able to involve lots of students at all levels of the program,” says Dr. Bornstein. “We have a doctoral student, a master’s student, and several undergraduates.” Are patients who exhibit healthy dependency more likely to have positive outcomes in substance abuse treatment programs as well? The Adelphi researchers are currently collecting and examining data from the medical center’s substance abuse unit, and we’ll soon find out.

Just Say No, Mom

The interactions among substance abuse, intimate partner violence, and HIV risk can be difficult for social scientists to untangle. In 2009, Adelphi School of Social Work Assistant Professor Subadra Panchanadeswaran undertook a qualitative study of women in a short-term, nonresidential substance abuse treatment facility in the Bronx to explore those issues. Many women in the study talked about a number of adverse experiences, from childhood victimization and family violence to peer and intimate partners’ influences in substance abuse. But she found in her interviews that one theme soared above all the others: parenting and motherhood.

“For the women, their identity as ‘mother’ was very, very important to them,” says Dr. Panchanadeswaran. “On one hand, they lamented the fact that they had substance abuse problems and worried about the effect it had on their kids. But they were really motivated to get better, and their children were the main motivator for them to seek and stay in treatment.”

The women’s desire to change their lives for their children often led to significant sacrifices. In extricating themselves from all the people linked to substance abuse in their lives, many of the women’s social networks shrank dramatically. Many of the women in Dr. Panchanadeswaran’s study also reported a history of violent intimate relationships, and while most were aware of HIV risks, they had been unable to engage in safe sex or negotiate condom use with violent partners. At the same time, Dr. Panchanadeswaran’s study found that the women in treatment were less inclined to engage in risky behaviors with current partners and were vigilant about negotiating condom use with casual partners.

Survive and Thrive

What doesn’t kill me makes me stronger, goes the saying. But, now, a new body of research is emerging to show that the old saying is more than just a platitude: it often holds true in real life. After traumas of all kinds, many people report not only returning to pre-trauma functioning, but also experiencing personal growth.

While some scholars have argued that posttraumatic growth (PTG) is an American construct, Adelphi University School of Social Work Professor Roni Berger, one of the leading researchers in the emerging study of the phenomenon of PTG, says that’s just not the case. In 2010, she coauthored the book, Posttraumatic Growth and Culturally Competent Practice: Lessons Learned from Around the Globe, which gathered together and analyzed research on posttraumatic growth in countries around the world.

“We had someone who studied PTG in Turkey after the earthquake and PTG in China after all kinds of stressors. We studied Latina immigrants in the United States. Someone else studied PTG in Israelis who have been exposed to suicide bombs. Someone else studied PTG in Palestinians who survived Israeli prisons.” From this research, Dr. Berger says she and her coauthor reached two conclusions: “PTG is indeed a universal phenomenon, but the specific manifestations and what affects it and shapes it [are] more culturally related.”

In addition to her research on PTG around the globe, Dr. Berger has also found evidence of PTG in surprising contexts in the U.S. For example, while most research on infertility has focused on the negative aspects, in a 2009 study, Dr. Berger found that the struggle with infertility can often result in personal growth.

Dr. Berger gathered data from a sample of 121 individuals who were suffering from infertility, using three questionnaires: one that assesses posttraumatic growth, one that assesses social support, and one that measures the stressfulness of the event. Participants rated the stress of infertility as very high, with reported stress levels comparable to those reported by survivors of breast cancer. In terms of PTG, participants reported mean levels of growth lower than those reported by breast cancer survivors, but nonetheless distinct and measurable.