What Is Codependency? 20 Signs & Symptoms

As a business and technology consultant for many years, I witnessed various instances of codependency in the workplace.

While codependency often presents itself in therapeutic settings, with clients experiencing poor mental health, addiction, or seeking help as adult children, it is also found in other professional settings (Arman et al., 2021).

Codependency can occur in any environment: individuals expecting too much support from one another, setting inappropriate boundaries, and displaying unfounded loyalty (Kelly, 2015; Arman et al., 2021).

In this article, we examine the potential of codependency to be damaging in any relationship and the actionable steps that we, as mental health professionals, can take in supporting recovery in our clients.

Before you continue, we thought you might like to download our three Positive Relationships Exercises for free. These detailed, science-based exercises will help you or your clients build healthy, life-enriching relationships.

What Is Codependency? Definition & Meaning

The term codependency is widely used in health care settings, particularly when treating clients with an overreliance on drugs and alcohol. However, it lacks a single, universal definition. It is not listed as a psychological disorder in the Diagnostic and Statistical Manual of Mental Illnesses, the standard used by psychologists and psychiatrists to classify mental disorders (Bacon & Conway, 2023).

As a working definition, codependency is typically recognized as involving excessive emotional or psychological reliance on a partner, parent, child, or other person (Bacon & Conway, 2023; Hunt, 2013).

Some practitioners describe it as a relationship in which both individuals struggle with low self-worth, have difficulty setting boundaries, and involve control and manipulation (Bacon & Conway, 2023; Hunt, 2013).

20 Signs & Symptoms of Codependency

In understanding codependency and examples of codependent relationships, it is vital to recognize how it manifests.

Here are 20 signs and symptoms to watch out for in your clients (Hunt, 2013; Bacon & Conway, 2023):

1. Caretaking: caring for others at the expense of their own needs
2. Feeling unworthy or inadequate
3. People pleasing to seek validation and avoid confrontation
4. Poor boundary setting and over-involvement in others’ lives
5. Suppressing emotions
6. Over-reliance on others for approval and a sense of identity
7. Attempting to control others’ behaviors to feel needed and secure
8. Experiencing fear of abandonment
9. Struggling to form and maintain intimate relationships
10. Experiencing chronic stress and anxiety
11. Feeling excessive responsibility toward another
12. Trying to fix others’ problems
13. Doing for others what they can do for themselves
14. Appearing rigid and judgmental
15. Feeling guilty when standing up for themselves
16. Difficulty receiving kindness
17. Trying to be perfect to avoid criticism
18. Seeking approval
19. Attracting needy people
20. Constantly feeling emotionally exhausted

14 Causes & Consequences

Many factors cause codependency, resulting in unwanted, unhelpful, or harmful consequences (Bacon & Conway, 2023).

What causes codependency?

Emotional and relational codependency have several different causes, including (Kelly, 2015; Bacon & Conway, 2023):

• Familial substance abuse
  Living with a family member with a substance abuse disorder can lead to emotional codependency in an attempt to manage the chaos and dysfunction.
• Neglect and emotional abuse
  Children experiencing neglect and abuse by family members can adopt coping mechanisms that prioritize others’ needs over their own.
• Denial and shame
  Powerful negative emotions such as denial and shame can damage self-worth and contribute to codependent behaviors.
• Early trauma
  Trauma bonding is a strong connection that may occur between a victim and their abuser during vital development stages in childhood, predisposing individuals to codependency.
• Learned helplessness
  Family members can experience repeated failures regarding an addict’s attempt to manage their substance abuse, leading to feelings of helplessness and reinforcing codependent behaviors.
• Genetic triggers
  It is unclear the role that genetic factors have on codependency beyond their impact on mental health and personality traits. However, they can play a role indirectly. Research suggests that some individuals are genetically predisposed and vulnerable to substance abuse (Botticelli et al., 2020).

What are the consequences?

Codependency can have many consequences, not all of which are immediately obvious to mental health practitioners, particularly regarding the emotions of those affected by it.

They can include, but are not limited to (Hunt, 2013):

• Loss of personal identity
  Both individuals in a codependent relationship may feel a loss of personal identity as they become increasingly focused on the other person.
• Low self-worth
  Those involved may experience a sense of low self-esteem and self-worth.
• Emotional rollercoaster
  Waves of emotions can cause extreme highs and lows.
• Abandonment fears
  Within the context of a fraught and chaotic relationship, either or both individuals may fear abandonment.
• Possessiveness and jealousy
  Spiraling emotions brought on by beliefs and behaviors associated with possessiveness and jealousy can further strain the relationship.
• Denial
  Despite the signs, both parties may be in denial about the codependent nature of their relationship.
• Difficulty in boundary setting
  It can be challenging to set and maintain boundaries when in a constant state of turmoil.
• False sense of security
  Despite the unpredictable and disordered state of the relationship, codependents may experience a false sense of security.

Codependency in Relationships

Codependency is a complex problem that can have a significant and damaging impact on relationships (Bacon & Conway, 2023).

The role of attachment styles

Research suggests that upbringing and the formation of attachment styles can significantly influence the onset and maintenance of codependent behaviors. Insecure attachment styles (including ambivalent or avoidant) are more likely to lead to codependent romantic relationships (Collins, 2023).

Interdependent vs. codependent

Unlike codependent relationships, interdependent relationships are often linked to secure attachment styles and involve trust, healthy boundaries, self-worth, emotional regulation, and a more balanced relationship (Collins, 2023; Bacon & Conway, 2023).

In this codependency masterclass, Snipes explores the influence of codependency on relationships:

Codependency Tests & Quizzes

Tests and quizzes are valuable tools for working with clients to understand the degree of codependency in their relationships.

The following are helpful:

• The Codependency Questionnaire is our very own positive psychology quiz and assesses more than 20 symptoms of codependency, using true/false questions such as:

I give more weight to my own feelings than those of others.
I feel very satisfied with my romantic relationships.
I frequently say “yes” when others ask for help, even if it’s inconvenient for me.

• Friel Codependency Assessment Inventory (from Mental Health America of Northern Kentucky and Southwest Ohio) includes 60 true-or-false questions. Such as:

I am happy about the way my family communicated when I was growing up.
I am satisfied with the number and kind of relationships I have in my life.
I am satisfied with the way I take care of my own needs.

A score below 20 suggests no need for concern, 21–30 shows a moderate need for concern, 31–45 indicates a moderate-to-severe need for concern, and a score over 46 indicates a severe need for concern.

• Codependency Assessments (based on the Efron’s Codependency Assessment and the Competency Codependency Scale) include two tests that provide additional insight into the degree of codependency an individual is experiencing (Lancer, 2024).

The first one asks 34 questions grouped under fear, shame/guilt, prolonged despair, rage, denial, rigidity, impaired identity development, and confusion. For example:

Do you try to “keep things under control” or “keep a handle” on situations?
Do you feel guilty about the problems of others in your family?

The next one includes 25 prompts such as:

I feel that without my effort and attention, everything would fall apart.
What I feel isn’t important as long as those I love are okay.

How to Overcome Codependency

Overcoming codependency requires both self-reflection and honesty. The following actions are therefore important for client recovery (Kelly, 2015; Calm, n.d.):

1. Recognize and admit that elements of a relationship might be codependent.
2. Identify negative thoughts and replace them with more positive, helpful ones.
3. Pause and step back. It is vital to recognize that a partner’s actions and feelings are not your own and do not shape your self-worth.
4. Identify where boundaries are lacking or regularly broken. Establish new ones that meet your personal needs.
5. Spend time away from your partner, building self-esteem through engaging in new (or previously enjoyed) hobbies, activities, and friends.
6. Practice self-care and compassion.
7. Seek support from a mental health care professional if necessary.

Codependency therapy

Many individuals experiencing codependency will reach out to trained counselors and mental health experts. Therapy can help many struggling with codependency by focusing on the unmet needs of the client, including (Hunt, 2013; Seed, 2024):

• Learning to offer support to others without taking responsibility for their problems
• Knowing what they want for themselves and finding ways to pursue those interests
• Being able to focus on themselves
• Being more assertive without being aggressive
• Replacing negative thoughts with more positive ones
• Building self-esteem through strengthening their social network, setting energizing goals, and focusing on personal health and mental wellbeing
• Identifying and finding ways to use their personal strengths

There are several therapeutic approaches and interventions for helping clients with codependency issues, including (Abadi et al., 2015):

• Group therapy
  Cognitive group therapy and group counseling can be effective, with individuals benefiting from emotional feedback, learning how to break down denial, and expressing true feelings.
• Family therapy
  Therapeutic approaches such as Bowen family therapy focus on the impact of family dynamics on codependency. Establishing more open communication channels can benefit all family members, particularly children.
• Cognitive behavioral therapy (CBT)
  Clients often benefit from being taught how to change their cognitions about themselves and others. CBT can improve self-discovery and interpersonal communication.

The SAMHSA’s National Helpline offers a valuable, free, and confidential treatment referral and information service for people seeking help with codependency.

5 Codependency Worksheets

Understanding codependency triggers, causes, and symptoms helps clients form positive, healthy, and helpful ways of thinking and behaving.

The following five worksheets are good places to start:

1. Codependent Relationships – Beliefs, Attitudes, and Outcomes: This helpful checklist compares healthy beliefs, attributes, and outcomes with their codependent counterparts.
2. Shifting Codependency Patterns: Use this resource with clients to help them understand how codependent patterns impact relationships and how to transform them into more adaptive behaviors and tendencies.
3. Removing Dependencies: It is vital for those experiencing codependency to take back control of their lives. Here, the client learns to regain ownership of key tasks.
4. Visualizing Your Boundaries: Setting and maintaining clear boundaries is vital to any healthy relationship, particularly one that involves elements of codependency. Here, the client reflects on what is missing and needed from their relationship.
5. Assertive Communication: Communication on either or both sides of a codependent relationship is typically not functioning well. Use this worksheet with clients to ensure their needs are heard.

5 Books on Codependency

We have identified five of our favorite books about codependency based on their value for working with clients, their reviews, and our personal experience with them.

1. Codependency Recovery Workbook – Linda Hill

Author Linda Hill guides the general reader in understanding themselves as people pleasers and how the roles of giver and taker can contribute to unhealthy relationship dynamics.

Discover Hill’s seven-step plan that helps anyone in a codependent relationship recover and regain control of their lives.

Find the book on Amazon.

2. Codependent No More – Melody Beattie

Melody Beattie’s bestseller on codependency is the winner of the 2023 Nautilus Book Award. It’s compassionate and well written, with plenty of insights that explore how we can lose ourselves when helping another.

The exercises, personal reflections, and instructive stories support the reader in finding themselves, breaking old patterns, and putting in place healthy boundaries.

Find the book on Amazon.

3. The Codependency Workbook – Krystal Mazzola

This valuable book explores how to regain a sense of self and reclaim their lives for those in a codependent relationship. It uses CBT to challenge and replace negative thoughts with helpful thoughts, set goals, and manage conflicts.

The sections are modular and can be taken in any order according to the degree and type of need. They are also written in a straightforward style to support those who require urgent healing.

Find the book on Amazon.

4. Facing Codependence – Pia Mellody, Andrea Wells Miller, and J. Keith Miller

Now over 20 years old and having sold more than 600,000 copies, this popular book remains valuable and powerful for anyone wishing to understand codependent thinking, emotions, and behavior.

The authors aim to help readers heal themselves and avoid repeating unhelpful and emotionally dysfunctional behaviors with their children.

Find the book on Amazon.

5. Addiction in the Family: What Every Counselor Needs to Know – Virginia A. Kelly

This is a valuable guide and textbook for mental health professionals working with codependent clients with an addicted family member.

Kelly explores and explains the impact of addicts’ behavior on other family members using case examples followed by questions.

It includes important background information on the history and definition of substance abuse, along with emotional and multicultural considerations.

Find the book on Amazon.

PositivePsychology.com’s Helpful Resources

We have many resources available for therapists providing support to individuals and couples who are facing struggles with codependency.

Here are three further free resources that can help clients build stronger foundations for positive and healthy relationships:

• About Your Partner: In this playful and engaging exercise, the client asks their partner questions to deepen their understanding of one another.
• Relationship Audit: This helpful tool uses a set of questions to audit the degree of authenticity within a relationship.
• Moving Forward: This exercise helps clients understand what kept them from finding happiness with their previous partner.

More extensive versions of the following tools are available with a subscription to the Positive Psychology Toolkit©, but they are described briefly below:

• Setting Healthy Boundaries With Parents
  Codependency often occurs within families. Boundary setting is crucial for safeguarding autonomy and defining personal space.

Try out the following steps with your client:

Step one – Identify aspects of the relationship that require boundaries.
Step two – Define what is and isn’t acceptable for each element.
Step three – Communicate those boundaries to the parents calmly and clearly.
Step four – Be consistent. Always maintain boundaries.

• Creating a Hugging Habit
  Often, couples become disconnected due to their busy schedules and expanding family commitments, so it is essential to prioritize physical contact to support ongoing closeness and connection.

Couples are encouraged to put a daily hugging ritual in place to transition out of a busy workday and into their home life. It requires perseverance.

Couples commit to hugging before and after work and then reflect on the experience at the end of each week.

If you’re looking for more science-based ways to help others build healthy relationships, this collection contains 17 validated positive relationships tools for practitioners. Use them to help others form healthier, more nurturing, and life-enriching relationships.

A Take-Home Message

Codependency is a complex and sometimes hidden dynamic that can have a deep impact on relationships and wellbeing. It has the potential to affect self-efficacy and self-worth and create instability.

Whether present in the workplace, romantic, friendship, or family settings, recovery from codependency begins with recognition.

Either personally or with the support of a mental health professional, individuals then continue their journey toward reclaiming their lives by understanding the causes and the symptoms. This may include a lack of self-worth and overreliance on (and caring for) others at the expense of their own needs.

As counselors and therapists, we can support clients who present with codependency by helping them be heard and imagining the possibility of a relationship where boundaries are appropriate and respected.

By offering a safe place to share their experiences and concerns, clients can gain the confidence to break free of unhealthy patterns of thinking and behaving and rediscover a future filled with more balanced, fulfilling relationships that promote mental wellness and self-worth.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Relationships Exercises for free.

ED: Rewrite December 2024