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Codependency is characterized by sacrificing one’s personal needs in order to try to meet the needs of others and is associated with passivity and feelings of shame, low self-worth, or insecurity. The term codependency was originally coined to describe a person’s dependence on the addictive behaviors of a partner or family member, usually with regards to drugs and alcohol. Today it is more broadly associated with the behaviors of someone whose actions and thoughts revolve around another person or thing.

Signs of Codependency


Codependency does not constitute a diagnosable mental health condition, largely because the symptoms of codependency are so broad and widely applicable. The primary symptoms associated with codependency may be people-pleasing behaviors and the need for the validation and approval that comes from caring for and rescuing others. The codependent person may also have poor boundaries, fear being alone or without an intimate partner, and deny his or her desires and emotions. Other characteristics of codependency may include:

  • Perfectionism and a fear of failure
  • Sensitivity to criticism
  • Denial of personal problems
  • Excessive focus on the needs of others
  • Failure to meet personal needs
  • Discomfort with receiving attention or help from others
  • Feelings of guilt or responsibility for the suffering of others
  • Reluctance to share true thoughts or feelings for fear of displeasing others
  • Low self-esteem
  • Internalized shame and helplessness
  • Projection of competence and self-reliance
  • A need to control others
  • Self-worth based on caretaking
  • Feeling undeserving of happiness
  • Caring for and enabling someone who abuses drugs or alcohol

While the person experiencing codependency chooses to provide care for others, they may also resent those people and label them as “needy.” They may feel trapped in the role of caregiver, even though that role provides a sense of importance and an escape from working on personal issues. On the other hand, some people claim to enjoy the caregiving role, when in reality, they are trying to hide the fact that they are chronically unhappy.

People with codependency may also experience clinical depression, chronic anxiety, and/or drug or alcohol addiction. Addiction can develop as a way to avoid difficult emotions or to feel a sense of belonging with a partner who is addicted to drugs or alcohol.

What Causes Codependency?


Codependency is usually rooted in childhood. A child who is constantly called upon to meet the needs of others will learn to suppress their own needs and may become addicted, in a sense, to filling the caregiving role. For example, someone who grew up with a drug-addicted or alcoholic parent, or who experienced abuse, emotional neglect, or the reversal of the parent-child role (in which the child is expected to meet the needs of the parent) may develop codependent behaviors, and these patterns tend to repeat in adult relationships.

In addition, survivors of sexual abuse may never develop their own sense of sexual identity and satisfaction, always putting the needs of a partner first, even when this partner may be sexually manipulative and/or controlling.


Psychotherapy for Codependency


“Codependency can be difficult to change alone as codependent behaviors are often learned early on and reinforced over many years. Resolving codependency can improve relationships, decrease anxiety and depression, and improve self-esteem,” Erica Holtz, a Huntingdon Valley, Pennsylvania marriage and family therapist, said.

Psychotherapy can help people understand why they overcompensate, fulfill everyone’s needs but their own, or put themselves last. Family therapy and cognitive behavioral therapy are both well suited to treating codependency, although any form of therapy is likely to help. A therapist can help a person identify codependent tendencies, understand why the behaviors were adopted in the first place, and develop self-compassion in order to heal and transform old patterns. According to Holtz, a therapist might work on some of the following aspects to help someone change codependent patterns:

  • Improving self-care: Because codependent individuals tend to focus on the needs of others, their own needs often get pushed to the side. This can become dangerous. Understanding self-care is important for one’s overall well-being.
  • Setting boundaries: Setting limits with others forces them to learn to take responsibility for their own lives and facilitates self-reliance. It also allows the person who is codependent to invest time and energy into themselves instead of another person.
  • Fixing vs. support: Support includes empathetic listening and encouragement. On the other hand, fixing is swooping in and solving problems for other people that they are capable of solving themselves.
  • Helping others in productive ways: Fulfill the need to help others in a productive and healthy way, such as volunteering, instead of through personal relationships that may be unhealthy.
  • Learning about family patterns: Understanding the unhealthy codependent patterns in the family will help make a person sense of how the family relates to one another and how these patterns of relating have transferred to other outside relationships.

Codependent people can also benefit from meeting with peers in a group therapy or support group setting. In fact, the support group Co-Dependents Anonymous (CoDA) was developed based on the Alcoholics Anonymous 12-step model. Al-Anon, a group designed to support the family and friends of alcoholics, is also centered on helping members break their cycles of dependency.

  • Balancing Codependent Tendencies: Improving Relationships through Self-Care
  • Codependency: Changing Beliefs and Behaviors

Case Example


  • Codependency, therapy, and Al-Anon: Charlene, 49, experiences chronic, mild depression, with a sudden increase in symptoms. She identifies her live-in boyfriend as the source of her recent emotional downturn, reporting that he is emotionally abusive and drinks to intoxication every day. Charlene says that she knows they “love each other,” and upon investigation, reports that “the whole thing is my fault.” The therapist recognizes codependency and refers Charlene to Al-Anon, which she tells Charlene will help with “dealing with an alcoholic partner.” Charlene’s therapist provides Charlene with plenty of opportunity to express her feelings and needs and encourages Charlene to do so, validating Charlene’s experience and allowing her freedom to cry, laugh, and verbalize her thoughts.The therapist helps Charlene check her beliefs about herself, her boyfriend, and relationships generally, pointing out that Charlene cannot possibly rescue her boyfriend, and that people are responsible for their own behavior. Through therapy, Charlene is able to identify patterns of behavior and emotions that began in childhood, thus beginning the road to recovery.


  • Codependency (2015)
  • What is Counselling and Therapy? (2015). Retrieved from
  • Springer, C. A., Britt, T. W., & Schlenker, B. R. (1998). Codependency: Clarifying the construct. Journal of Mental Health Counseling, 20(2), 141-158. Retrieved from
  • Wells, M., Glickauf-Hughes, C., & Jones, R. (1999). Codependency: A grass roots construct’s relationship to shame-proneness, low self-esteem, and childhood parentification. The American Journal of Family Therapy, 27(1), 63-71. Retrieved from


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