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Addiction Codependency
(Co-Dependent Behavior)

The term ‘Codependent’ was first used in the treatment of alcohol addiction, in reference to those whose lives were seriously affected by the addict, and who stayed to take care of the addict. Since the 1980s, the meaning of Codependency and Codependent Behavior has evolved. Today, a codependent person is defined as one who has a damaging relationship with an addict or an abusive person, and also has disabling personal traits that cause them to become obsessed with control or cure of the person with whom they have the relationship. The co-dependent patient is overly involved with their partner, spouse or family member often to the their own detriment. The patient becomes a care-taker for the other person and strives to help them be successful, or maintain health and well-being, often enabling the other person’s behavior by putting out fires, paying their debts, and taking care of their basic needs.

The patient’s sense of self-esteem hinges on their ability to control and please others using sheer willpower. To maintain this balance, the patient denies their own needs and feelings, and stays in the relationship in spite of emotional, and sometimes, physical pain. There are two schools of thought about the Codependent condition. Some doctors feel that the condition exists only as a set of symptoms displayed by family and/or spouses of addicts.

Other doctors recognize and treat the more recently, and broadly, defined disorder with behavioral therapy and other techniques. Much of the treatment is based on a 12-step program modified from Alcoholics Anonymous and other addiction self-help programs.

What are the symptoms?

Symptoms include:

• Persistent anger toward self and others
• May exhibit signs of depression and anxiety
• Has difficulty making decisions and communicating with others
• Values the approval of others more than of self
• Lacks trust in self and in others
• Has difficulty adjusting to change, maintains rigid control
• Feels hurt when others don’t recognize their efforts, gets angry when their help is not useful
• Believes others are responsible for the patient’s happiness, is frustrated that others will not give the same attention to the patient that he gives to others
• Unhealthy dependence on relationships, doing anything to hold on to a relationship and avoid the feeling of abandonment
• Patient consistently does more than their share
• Exaggerated sense of responsibility for the actions of others
• Secondary Physical Symptoms: Headache, ulcers, insomnia and sleep disorders, other stress related illnesses
• Embarrassed to receive recognition or praise
• Talking at an intimate level at the first meeting, being preoccupied with a person to the exclusion of other things, becomes sexually involved on first meeting, touching a person without asking
• Compromises values and integrity to avoid rejection by others
• Accepts verbal, physical or sexual abuse
• Poor self-esteem, judges self harshly
• Cycles between lethargy and hyperactivity
• Does not recognize boundaries in relationships, difficulty with intimacy
• Lying, being dishonest to maintain control
• Fear of abandonment and loneliness
• The patient finds it difficult to identify his own feelings
• Agrees to sex when they'd rather be held, or nurtured
• Need to control others, believes others are incapable of caring for themselves, can’t let people be who they are and allow them to take the consequences
• Obsessive need for approval and recognition, feels behavior is ‘unselfish’ and dedicated to the well-being of others
• Feels guilty when being assertive
• Tendency to confuse love and pity, tendency to love people the patient feels they can rescue
• Gives gifts, favors and advice to others regardless of how long they have known the patient, gets attached to others too quickly
• Falls apart so someone will take care of him
• Seeks love from people who are incapable of loving, says they won’t tolerate certain behaviors but gradually increase tolerance to accommodate abuse or mistreatment
• Accepts unwanted gifts, touch, or sex, allows others to direct his life, expects others will automatically fulfill the patient’s needs

How is it diagnosed and treated?

Doctors will perform a physical exam to rule out other health or mental disorders. Some or all of the symptoms of codependency can stem from other problems, so it is important to understand that not everyone who has symptoms is codependent.

• Do you avoid arguments and remain silent?
• Do you worry about the opinion of others more than your own opinion?
• Do you worry about being abandoned because you are not worthy or ‘good enough’?
• Do you have difficulty taking compliments or gifts from others?
• Are you uncomfortable talking about your own feelings?
• Do you have trouble saying ‘no’ or talking to your boss or those in authority?
• Do you jump into relationships and sex before getting to know the person?
• Have you stayed in a bad relationship for at least 2 years without leaving or seeking help?
• Do you have difficulty adjusting to change?
• Have you ever lived with someone who hits or belittles you?
• Do you feel angry or rejected when your partner, spouse or friend spends time with others?
• Are you embarrassed when your child or spouse makes a mistake?
• Do you feel you have to help or control other people in order to help them get things done?
• Do you live with someone who has an addiction or is abusive?
• Do you put your own needs aside to fulfill the needs of others?
• Do you blame others for your unhappiness?

Treatment(s) can include:

• Psychotherapy
• 12-step self-help program – Codependents Anonymous
• Family therapy
• Group and Experiential Therapy to desensitize patients to triggers and teach coping skills

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