In psychology, codependency is a theory that tries to explain unbalanced relationships where one person helps another person with harmful behaviors, such as addiction, poor mental health, immaturity, irresponsibility, or not reaching goals.

Definitions of codependency can be different, but they often include giving up a lot of one's own needs to help others, focusing on what others need, hiding their own feelings, and trying to solve others' problems.

People who say they are codependent often have low self-esteem. However, it is not clear if low self-esteem causes codependency or if it is a result of codependency.

History

The term "codependency" probably started in Minnesota in the late 1970s. It came from the idea of "co-alcoholic," which grouped alcoholism and drug use under "chemical dependency." In Alcoholics Anonymous, it became clear that alcoholism was not only about the person using substances but also about the actions of the people around them. The word "codependent" was first used to describe people whose lives were affected by being close to someone with a substance use disorder. These people often developed unhealthy ways to cope with life because of that person's substance abuse.

In 1986, psychiatrist Timmen L. Cermak wrote a book called Diagnosing and Treating Co-Dependence. He argued that codependency should be considered a type of personality disorder in people who had relationships with individuals who had personality issues, chemical dependency, or other problems. However, his idea was not accepted.

In 1986, Melody Beattie helped spread the concept of codependency with her book Codependent No More. Her work was based on her own experiences in recovery and caring for someone with a substance use disorder. It also included interviews with members of Al-Anon, a support group for family members of alcoholics. Beattie's book led to the creation of a twelve-step group called Co-Dependents Anonymous, which was founded in 1986.

Definition

Codependency is not officially defined or included in any mental health guides, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Disease (ICD). These manuals are used by mental health professionals to diagnose conditions, but codependency is not listed as a recognized disorder in any edition.

A review of research from 1994 found that experts disagreed on what codependency means. Many studies did not provide clear evidence to support the concept, and instead focused on discussing theories about its causes and nature. A 2004 study aimed to define codependency to determine if it could be considered a psychological condition. Researchers found that definitions varied, but common features included a strong focus on others’ needs, suppressing personal emotions, and trying to control or solve others’ problems.

Psychiatrist Timmen Cermak explains that the term "codependency" has three meanings:
– A tool to help families understand their feelings and recognize their own unhealthy behaviors.
– A way for mental health professionals to describe certain behaviors.
– A possible disorder, meaning a pattern of behaviors that could cause serious problems in a person’s life.

Writer Melody Beattie suggested that codependency could be described as "being a partner in dependency." She noted that this idea is close to the truth but still unclear. She added that a codependent person is someone whose life is affected by another person’s actions, and who feels a strong need to control that person’s behavior.

Therapist Darlene Lancer defines codependency as a condition in which a person cannot act based on their true self and instead centers their thoughts and actions around another person, a substance, or a process. She includes people who struggle with addiction in this definition and believes that losing one’s sense of self is central to codependency.

In the Medical Subject Heading (MeSH) system, which is used by the U.S. National Library of Medicine to organize medical information, codependency is described as "a relational pattern in which a person finds purpose through relationships with others." This description reflects how the term is used in research, not an official definition.

Co-Dependents Anonymous, a group that helps people build healthy relationships, does not provide a formal definition or rules for diagnosing codependency. Instead, it lists common behaviors and patterns that people can use to reflect on their own experiences. Mental Health America, a community health organization, describes codependency as "relationship addiction," linking it to low self-esteem and patterns of unhealthy or harmful relationships.

Theories

According to theories about codependency as a psychological disorder, a codependent person in a relationship often shows thoughts, feelings, and actions that make relationship problems worse instead of better. It is often believed that people who are codependent may have grown up in families that did not function well or were exposed to addiction early in life, which can lead them to allow similar problems in their own relationships.

Codependent relationships are often described as having problems with closeness, dependency, control (including taking care of others), denying problems, poor communication, unclear boundaries, and being easily upset. These relationships may be unbalanced, with one person being abusive or controlling, or supporting another person’s addiction, mental health issues, immaturity, or lack of success.

In this view, a codependent person finds their purpose in a relationship by making large sacrifices to meet their partner’s needs. These relationships often involve unhealthy closeness and needing others to feel complete, with one or both people relying on their partner for happiness.

In a family that does not function well, children may learn to focus on their parents’ needs instead of their own. Being a parent requires giving a child’s needs priority, but a codependent parent may neglect their own emotional or physical needs, which can make them less effective or even harmful to their child. Codependent relationships may involve enabling behaviors, such as allowing a child’s harmful actions to continue. Another way to think about this is that a baby’s needs are temporary, but a codependent person’s needs are ongoing. Children who grow up with codependent parents who ignore their own feelings may become codependent themselves.

Codependency can happen in relationships with people who have personality disorders that are listed in medical guides like DSM and ICD:

• Borderline personality disorder – people close to someone with this disorder may take on the role of a caretaker, focusing on the person’s problems instead of their own. A codependent person may feel valued by being seen as "the sane one" or "the responsible one." A 2017 study found that 45% of codependent people studied also had borderline personality disorder.
• Narcissistic personality disorder – people with this disorder may attract partners who put others’ needs first. A codependent person may support the narcissist by being attentive and obedient. The relationship involves the narcissist’s need to feel special and the codependent person’s need to help others feel that way.

Among common personality disorders, codependency is most similar to dependent personality disorder. A 2017 study found that only 14.5% of codependent people studied also had dependent personality disorder. These conditions are different: a dependent person wants someone else to manage their life, while a codependent person wants to manage someone else’s life for them. Both have weak self-confidence and focus on another person’s stronger self, but one prefers to be passive and the other active.

Psychiatrist Karen Horney described the idea of unhealthy dependency in her 1942 book Self-Analysis, later writing more about it in Neurosis and Human Growth in 1950. Others later connected this idea to codependency.

Codependency can be seen as a type of learned helplessness, where a person feels unable to change their situation, and pathological altruism, where a person gives too much to others without considering their own needs.

Recovery and prognosis

There is no agreement on how to define codependency, and there are no official rules for diagnosing it. Mental health professionals have different views about how to treat codependency. Caring for someone with a physical addiction does not always mean the caregiver has a mental health issue. Caregivers might find it helpful to learn assertiveness skills and to take responsibility for the addiction.

People who feel they have codependency may benefit from therapy, such as cognitive behavioral therapy and mindfulness practices.

Many self-help books have been written about codependency. Support groups like Co-Dependents Anonymous (CoDA), Al-Anon/Alateen, Nar-Anon, and Adult Children of Alcoholics (ACoA), which follow the twelve-step model used by Alcoholics Anonymous, and Celebrate Recovery, a Christian twelve-step group based on the Bible, also offer help for people working to recover from codependency.

Controversy

Codependency is not officially diagnosed as a mental health condition, so there is no agreement among medical experts about its exact meaning. There is also no proof that codependency is caused by a disease. Because of this, the term is often used to describe many different behaviors and has been overused by some self-help writers and support groups. In an article from Psychology Today, a clinician named Kristi Pikiewicz said the word "codependency" has been used so much that it has become a common phrase. Labeling someone as codependent might take attention away from how their past experiences have influenced their current relationships.

Some researchers and treatment professionals believe codependency should be seen as a good intention that went wrong. They argue that personal relationships should not always be compared to addictions or diseases. They also question whether certain personality traits, often linked to women, should be considered problems. A study on codependency found that people without codependency were more likely to have traits often connected to masculinity, while those with codependency were more likely to show traits such as not putting their own needs first, being overly self-sacrificing, or having low self-esteem.