Codependency
Codependent relationships are a type of dysfunctional
helping relationship where one person supports or enables
another persons addiction, poor mental health, imma-
turity, irresponsibility, or under-achievement.[1] Among
the core characteristics of codependency, the most com-
mon theme is an excessive reliance on other people for
approval and identity.[1]
1 History
The expansion of the meaning of codependency hap-
According to disability studies specialist Lennard J. pened very publicly.[8]
Davis, historically, the concept of co-dependence comes
directly out of Alcoholics Anonymous, part of a dawning
realization that the problem was not solely the addict, but
also the family and friends who constitute a network for
the alcoholic.[2] It was subsequently broadened to cover
the way that the codependent person is xated on an-
other person for approval, sustenance, and so on.[2]
The concept of codependency overlaps with, but de-
veloped in the mainstream independently from, the
older psychoanalytic concept of the passive dependent
personality which is attaching oneself to a stronger
personality.[3] Dependency is well-established in psy-
chological literature. Whereas early on psychoanalytic
theory emphasized the oral character and structural ba-
sis of dependency, social learning theory considered a
tendency to be acquired by learning and experience, and
ethological attachment theory posited that attachment or
aectional bonding is the basis for dependency. All three
theories have contributed to the concept of dependent
personality disorder as dened by the Diagnostic and
Statistical Manual of Mental Disorders (DSM) of the
American Psychiatric Association. The denition and
criteria have changed in the dierent versions of the
DSM. In DSM-I, passive dependency personality was
characterized by helplessness, denial, and indecisiveness,
and was considered a subtype of passive aggressive per-
sonality. By DSM-IV, there were nine criteria with an
essential feature of a pervasive or lifetime pattern of de-
pendent and submissive behavior. The DSM-IV deni-
tion emphasized the excessive need to be taken care of,
leading to submissive and clinging behavior and fear of
separation.[4]
The codependency movement may have its roots in the
theories of German psychoanalyst Karen Horney. In
1941, she proposed that some people adopt what she
termed a Moving Toward personality style to overcome
their basic anxiety. Essentially, these people move to-
ward others by gaining their approval and aection, and
unconsciously control them through their dependent style.
They are unselsh, virtuous, martyr-like, faithful, and
turn the other cheek despite personal humiliation. Ap-
proval from others is more important than respecting
themselves.[5]
Al-Anon was formed in 1951, 16 years after Alcoholics
Anonymous was founded.[6] Al-Anon holds the view that
alcoholism is a family illness[7] and is one of the earliest
recognitions of codependency.
Janet G. Woititz's Adult Children of Alcoholics had
come out in 1983 and sold two million copies while
being on the New York Times best seller list for
forty-eight weeks.[8]
Robin Norwood's Women Who Love Too Much,
1985, sold two and a half million copies and
spawned Twelve Step groups across the country for
women addicted to men.[8]
Melody Beattie popularized the concept of codepen-
dency in 1986 with the book Codependent No More
which sold eight million copies.[9]
In 1986, Timmen Cermak, M.D. wrote Diagnosing and
Treating Co-Dependence: A Guide for Professionals. In
the book and an article published in the Journal of Psy-
choactive Drugs (Volume 18, Issue 1, 1986), Cermak
argued (unsuccessfully) for the inclusion of codepen-
dency as a separate personality disorder in the Diagnostic
and Statistical Manual of Mental Disorders (DSM-III-R;
American Psychiatric Association, 1987).[10] Cermaks
book paved the way for a Twelve-step take-o program,
called Co-Dependents Anonymous.[11]
The rst Co-Dependents Anonymous meeting was held
October 22, 1986.[11]
2 Symptoms and behaviors
Given its grassroots origin, the precise denition of code-
pendency varies based on the source but can be gen-
erally characterized as a subclinical and situational or
episodic behavior similar to that of dependent personal-
ity disorder.[1] In its broadest denition, a codependent is
someone who cannot function from their innate self and
1
2 3
whose thinking and behavior is instead organized around
another person, or even a process, or substance.[12] In
this context, people who are addicted to a substance, like
drugs, or a process, like gambling or sex, can also be con-
sidered codependent. In its most narrow denition, it re-
quires one person to be physically or psychologically ad-
dicted, such as to heroin, and the second person to be psy-
chologically dependent on that behavior.[13] Some users
of the codependency concept use the word as an alterna-
tive to using the concept of dysfunctional families, with-
out statements that classify it as a disease.[14]
Codependency does not refer to all caring behavior or
feelings, but only those that are excessive to an unhealthy
degree.[15] One of the distinctions is that healthy empathy
and caregiving is motivated by conscious choice; whereas
for codependents, their actions are compulsive, and they
usually aren't able to weigh in the consequences of them
or their own needs that they're sacricing. Some schol-
ars and treatment providers feel that codependency is an
overresponsibility and that overresponsibility needs to be
understood as a positive impulse gone awry. Responsi-
bility for relationships with others needs to coexist with
responsibility to self.[16]
Codependency has been referred to as the disease of
a lost self.[12][17] Codependent relationships are marked
by intimacy problems, dependency, control (including
caretaking) denial, dysfunctional communication and Particularly problematic pairings include:
boundaries, and high reactivity. Often, there is imbal-
ance, so one person is abusive or in control or supports or Personality disorder and codependent pair-
enables another persons addiction, poor mental health, ing
immaturity, irresponsibility, or under-achievement.[18]
Some codependents often nd themselves in relationships
where their primary role is that of rescuer, supporter, and
condante. These helper types are often dependent on the
other persons poor functioning to satisfy their own emo-
[1]
tional needs. Many codependents place a lower priority
on their own needs, while being excessively preoccupied
with the needs of others. Codependency can occur in any
type of relationship, including family, work, friendship,
[19]
and also romantic, peer or community relationships.
Commonly cited symptoms of codependency are:[1]
intense and unstable interpersonal relationships,
inability to tolerate being alone, accompanied by
frantic eorts to avoid being alone,
chronic feelings of boredom and emptiness,
subordinating ones own needs to those of the person
with whom one is involved,
overwhelming desire for acceptance and aection,
external referencing,
dishonesty and denial, and
low self-worth.
PATTERNS AND CHARACTERISTICS
3 Patterns and characteristics
Codependency can occur in any type of relationship, in-
cluding family, work, friendship, and also romantic, peer
or community relationships.[19]
3.1 Enmeshed romantic relationship
These relationships typically have a rapturous beginning,
a feeling of a whirlwind romance. The codependents
feel drawn to each other as if they're soul mates or some
omnipotent entity has brought them together, the feel-
ing is euphoric and doesn't really last longer than a few
months. As the relationship unfolds, the codependents
develop an unhealthy attachment and rely on each other
for their sense of self-worth.[20] In a codependent rela-
tionship, the codependents sense of purpose is based on
making extreme sacrices to satisfy their partners needs.
Codependent relationships signify a degree of unhealthy
clinginess, where one person doesn't have self-suciency
or autonomy. One or both parties depend on their loved
one for fulllment.[21] There is almost always an uncon-
scious reason for continuing to put another persons life
ahead of your own, and often it is because of the mistaken
notion that self-worth comes from other people.
Borderline personality disorder.
There is a tendency for loved ones of
people with borderline personality dis-
order (BPD) to slip into caretaker roles,
giving priority and focus to problems in
the life of the person with BPD rather
than to issues in their own lives. Too
often in these kinds of relationships,
the codependent will gain a sense of
worth by being the sane one or the
responsible one.[22]
Narcissistic personality disorder.
Codependents of narcissists are some-
times called co-narcissists.[23] Narcis-
sists, with their ability to get others to buy
into their vision and help them make it a
reality, seek and attract partners who will
put others needs before their own.[24]
Codependents can provide the narcissist
with an obedient and attentive audience
the perfect backdrop.[25] Among the
reciprocally interlocking interactions of
the pair are the narcissists overpowering
need to feel important and special, and
the co-dependents strong need to help
others feel that way.

Codependent and/or impulse disordered in-
dividuals and codependent pairing[26]
Attention-decit hyperactivity disorder
(ADHD).
Obsessive-compulsive disorder.
Manic state of bipolar disorder.
3.2 Dysfunctional family
In the dysfunctional family the child learns to become at-
tuned to the parents needs and feelings instead of the
other way around.[18] Parenting is a role that requires
a certain amount of self-sacrice and giving a childs
needs a high priority. A parent can, nevertheless, be
codependent towards their own children if the caretak-
ing or parental sacrice reaches unhealthy or destructive
levels.[19] Generally, a parent who takes care of their own
needs (emotional and physical) in a healthy way will be
a better caretaker, whereas a codependent parent may be
less eective, or may even do harm to a child.[19] Another
way to look at it is that the needs of an infant are neces-
sary but temporary, whereas the needs of the codepen-
dent are constant. On the other hand, there are many self-
ish, codependent parents who ignore or negate their chil-
drens feelings and needs, shaming them, which passes on
codependency.
For some, the social insecurity caused by codependency
4 Recovery and prognosis can progress into full-blown social anxiety disorders like
social phobia, avoidant personality disorder or painful
Not all mental health professionals agree about standard shyness.[30] Other stress-related disorders like panic dis-
methods of treatment.[27] order, depression or PTSD may also be present.[30]
Caring for an individual with a physical addiction is not
necessarily treating a pathology. The caregiver may only
require assertiveness skills and the ability to place respon-
sibility for the addiction on the other.[15][28]
There are various recovery paths for individuals who
struggle with codependency. For example, some may
choose cognitive-behavioral psychotherapy, sometimes
accompanied by chemical therapy for accompanying de-
pression. There also exist support groups for codepen-
dency, such as Co-Dependents Anonymous (CoDA), Al-
Anon/Alateen, Nar-Anon, and Adult Children of Alco-
holics (ACoA), which are based on the twelve-step pro-
gram model of Alcoholics Anonymous and Celebrate Re-
covery a Christian, Bible-based group.[29] Many self-help
guides have been written on the subject of codependency.
Sometimes an individual can, in attempts to recover from
codependency, go from being overly passive or overly giv-
ing to being overly aggressive or excessively selsh.[15]
Many therapists maintain that nding a balance through
healthy assertiveness (which leaves room for being a car-
ing person and also engaging in healthy caring behav-
ior) is true recovery from codependency and that becom-
3
ing extremely selsh, a bully, or an otherwise conict-
addicted person is not.[15][28]
Developing a permanent stance of being a victim (having
a victim mentality) would also not constitute true recov-
ery from codependency and could be another example of
going from one extreme to another.[15] A victim mental-
ity could also be seen as a part of ones original state of
codependency (lack of empowerment causing one to feel
like the subject of events rather than being an empow-
ered actor).[15] Someone truly recovered from codepen-
dency would feel empowered and like an author of their
life and actions rather than being at the mercy of out-
side forces.[15] A victim mentality may also occur in com-
bination with passiveaggressive control issues.[15] From
the perspective of moving beyond victim-hood, the ca-
pacity to forgive and let go (with exception of cases of
very severe abuse) could also be signs of real recovery
from codependency, but the willingness to endure further
abuse would not.[15]
Unresolved patterns of codependency can lead to more
serious problems like alcoholism, drug addiction, eating
disorders, sex addiction, psychosomatic illnesses, and
other self-destructive or self-defeating behaviors.[30] Peo-
ple with codependency are also more likely to attract fur-
ther abuse from aggressive individuals, more likely to stay
in stressful jobs or relationships, less likely to seek med-
ical attention when needed and are also less likely to get
promotions and tend to earn less money than those with-
out codependency patterns.[30]
5 Failed proposal for inclusion in
DSM
Timmen Cermak, M.D., proposed that codependency be
listed as a personality disorder in the Diagnostic and Sta-
tistical Manual of Mental Disorders (DSM-III-R; Amer-
ican Psychiatric Association, 1987). Cermak reasoned
that when specic personality traits become excessive and
maladaptive and caused signicant impairment in func-
tioning or caused signicant distress, it warrants a per-
sonality disorder diagnosis.[26]
Cermak proposed the following criteria for this
disorder:[26]
1. Continued investment of self-esteem in the ability to
control both oneself and others in the face of serious
adverse consequences.
2. Assumption of responsibility for meeting others
needs to the exclusion of acknowledging ones own.
4 8 REFERENCES

3. Anxiety and boundary distortions around intimacy Compliance (psychology)

and separation.
Counterdependency
4. Enmeshment in relationships with personality disor-
dered, chemically dependent, other co dependent, Covert incest
and/or impulse disordered individuals. Enmeshment
5. Three or more of the following: Fantasy bond
(a) Excessive reliance on denial Folie deux
(b) Constriction of emotions (with or without dra-
matic outbursts) Karpman drama triangle

(c) Depression List of twelve-step groups

(d) Hypervigilance Misplaced loyalty
(e) Compulsions
Obedience
(f) Anxiety
(g) Substance abuse Stockholm syndrome

(h) Has been (or is) the victim of recurrent physi- Submissiveness
cal or sexual abuse
Sycophancy
(i) Stress related medical illnesses
(j) Has remained in a primary relationship with an Toxic leader
active substance abuser for at least two years Transactional analysis
without seeking outside help.
Traumatic bonding

6 Controversies
Some believe that codependency is not a negative
trait, and does not need to be treated, as it is
more likely a healthy personality trait taken to ex-
cess. Codependency in nonclinical populations has
some links with favourable characteristics of family
functioning.[31]
Stan Katz feels that codependence is over-
diagnosed, and that many people who could be
helped with shorter-term treatments instead become
dependent on long-term self-help programs.[32]
8 References
[1] Johnson, R. Skip (13 July 2014). Codependency and
Codependent Relationships. BPDFamily.com. Re-
trieved 9 September 2014.
[2] Davis, Lennard J. (2008). Obsession: A History. London:
University of Chicago Press. p. 178. ISBN 0-226-13782-
1.
[3] Berne, Eric (1976). A Laymans Guide to Psychiatry and
Psychoanalysis. Penguin. pp. 64 and 241. ISBN 0-345-
30922-7.

The language of, symptoms of, and treatment for
codependence derive from the medical model sug-
gesting a disease process underlies the behavior.
There is no evidence that codependence is caused
by a disease process.
[4] Sperry, M.D.,Ph.D, Len (13 May 2013). Handbook of Di-
agnosis and Treatment of DSM-IV Personality Disorders.
Kentucky: Routledge. p. 108. ISBN 9780415935692.
[5] Rotunda, Ph.D, Robert J. Codependency. University of
West Florida.

[6] AA Timeline. Alcoholics Anonymous. Retrieved 2014-

01-17.
7 See also
[7] Al-Anon Family Groups. Suggested Al-Anon Preamble
Alcoholism in family systems to the Twelve Steps. www.al-anon.alateen.org. Virginia
Beach, Virginia: Al-Anon Family Group Headquarters,
Adult Children of Alcoholics Inc. Retrieved 2010-04-27.

Antinarcissism [8] Travis, Trish (2009). The Language of the Heart, A Cul-
tural History of the Recovery Movement from Alcoholics
Attachment theory Anonymous to Oprah Winfrey. Chapel Hill, N.C.: Uni-
versity of North Carolina Press. p. 168. ISBN 978-0-
Assertiveness 8078-3319-3.

[9] J. S. Rice, A Disease of Ones Own (1998) p. 2
[10] Morgan Jr., JP (1991). What is codependency?".
J Clin Psychol 47 (5): 7209. doi:10.1002/1097-
4679(199109)47:5<720::aid-jclp2270470515>3.0.co;2-
5. PMID 1939721.
[11] Irving, Leslie (1999). Codependent Forevermore, The In-
vention of Self in a Twelve Step Group. Chicago: Univer-
sity of Chicago Press. p. 30. ISBN 0-226-38471-3.
[12] Lancer, Darlene (2012). Codependency for Dummies (1st
ed.). New Jersey: John Wiley & Sons, Inc. p. 30. ISBN
1118095227.
[13] Codependent | Dene Codependent at Dictionary.com.
Dictionary.reference.com. Retrieved 2012-11-14.
[14] Codependency / Dysfunctional Families Archive copy,
July 24, 2008
[15] Moos, R.H.; Finney, J.W.; Cronkite, R.C. (1990). Alco-
holism Treatment: Context, Process and Outcome. New
York: Oxford University Press. ISBN 0-19-504362-6.
[16] Anderson, S.C. (1994). A critical analysis of the concept
of codependency. Social Work 39 (6): 677685.
[17] Whiteld, Charles (1987). The Child Within (1st ed.).
Florida: Health Communications, Inc. p. 28. ISBN
0932194400.
[18] Lancer, Darlene (2014). Conquering Shame and Code-
pendency: 8 Steps to Freeing the True You. Minnesota:
Hazelden. pp. 6365. ISBN 978-1-61649-533-6. Exter-
nal link in |title= (help)
[19] Codependents Anonymous: Patterns and Characteristics
[20] Codependency | The Human Magnet Syndrome. The
Human Magnet Syndrome. Retrieved 2016-04-13.
[21] Wetzler, PhD, Scott. Psychology division chief at Al-
bert Einstein College of Medicine. WebMD. Retrieved
5 December 2014.
[22] Danielle, Alicia. Codependency and Borderline Person-
ality Disorder: How to Spot It. Clearview Womens Cen-
ter. Retrieved 5 December 2014.
[23] Rappoport, Alan, PhD. Co-Narcissism: How We Adapt
to Narcissistic Parents. The Therapist, 2005.
[24] Simon Crompton, All About Me: Loving a Narcissist (Lon-
don 2007) p. 157 and p. 235
[25] Crompton, p. 31
[26] Cermak M.D., Timmen L. (1986). Diagnostic Criteria
for Codependency. Journal of Psychoactive Drugs 18 (1):
1520. doi:10.1080/02791072.1986.10524475.
[27] Gomberg, Edith S Lisansky (1989). Gomberg, Edith
S, ed. On Terms Used and Abused: The Concept of
'Codependency'". Drugs & Society 3 (34): 11332.
doi:10.1300/J023v03n03_05. ISBN 978-0-86656-965-
1.
5
[28] Aeck, Glenn; Tennen, Howard; Croog, Sydney; Levine,
Sol (1987). Causal attribution, perceived benets, and
morbidity after a heart attack: An 8-year study. Jour-
nal of Consulting and Clinical Psychology 55 (1): 2935.
doi:10.1037/0022-006X.55.1.29. PMID 3571655.
[29] Collet, L (1990). After the anger, what then? ACOA:
Self-help or self-pity?". Family Therapy Networker 14
(1): 2231.
[30] Codependence, in: Benjamin J. Sadock & Virginia
A. Sadock (eds), Kaplan & Sadocks Comprehensive
Textbook of Psychiatry on CD, Philadelphia: Lippincott
Williams & Wilkins, 7th ed. 2000, ISBN 0-7817-2141-5,
ISBN 2-07-032070-7.
[31] Prest, Layne A.; Benson, Mark J.; Protinsky, Howard
O. (1998). Family of Origin and Current Relationship
Inuences on Codependency. Family Process 37 (4):
51328. doi:10.1111/j.1545-5300.1998.00513.x. PMID
9934570.
[32] Katz, Stan. The Codependency Conspiracy: How to Break
the Recovery Habit and Take Charge of Your Life,.
9 Further reading
Cermak M.D,Timmen L., Diagnosing and Treat-
ing Co-Dependence: A Guide for Professionals Who
Work with Chemical Dependents, Their Spouses, and
Children (Professional Series), 1998, Hazelden Pub-
lishing, Minnesota, ISBN 978-0935908329
CoDA, Co-Dependents Anonymous, 1997,
CoDA Resource Publishing, Phoenix, ISBN
978-0964710504
Beattie, Melody Codependent No More: How
to Stop Controlling Others and Start Caring for
Yourself, 1986, Hazelden, Minnesota, ISBN 978-
0894864025
Whiteld M.D., Charles L.,Healing The Child
Within: Discovery and Recovery for Adult Children
of Dysfunctional Families, 1987, Health Communi-
cations, Inc., Florida, ISBN 978-0932194404
Lancer, Darlene, Conquering Shame and Codepen-
dency: 8 Steps to Freeing the True You, 2014,
Hazelden, Minnesota, ISBN 1616495332
10 External links
Codependency support: general at DMOZ
Codependency support: co-alcoholic at DMOZ
Codependency support: borderline personality dis-
order at DMOZ
6 11 TEXT AND IMAGE SOURCES, CONTRIBUTORS, AND LICENSES

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