The following is reposted from the last time this lesson was taught. Nothing new has been added, and nothing has been changed. It is a synopsis of a weekly Dialectical Behavior Therapy (DBT) group lesson, based on the work of Marsha Linehan out of the University of Washington. This week’s lesson is actually outside of the normal DBT content, it is solely based on the codependency literature, specifically the work of a wonderful fellowship called CODA.

New Disclaimer: I LOVE doing this, I think it is desperately needed, and I WANT to do it. However, I have zero time to do it so, while I am committed to giving it my all, I may fall behind or skip a week or two. I apologize in advance for that, and for the fact that I will not be spell checking, fixing formatting, or doing a read through before I post. No offense, but I gotta draw the line somewhere!

Co-Dependency: The Ignored Addiction

This week’s topic is one I added to the normal rotation of DBT topics about 6 years ago, because I noticed that every group member (yes, EVERY) had been exhibiting co-dependent traits or behaviors. At the time I just thought it was a comorbid condition that went along with Borderline Personality Disorder. These co-dependent patterns I have since realized, are not an individual or diagnostic concern, but a societal one, as our women are raised to take care of men and our men are raised to be taken care of. Since most of my group members are female, I have noticed a lot of consequences of this type of relational interaction.

So what is it? Today, the mental health world refers to these symptoms as “Dependent personality Disorder”, but the term Co-Dependency came first, arising out of the addiction world. Since addicts attract co-dependent people to take care of them, and co-dependent people are attracted to those who need to be taken care of, it makes sense. But this is a topic that I feel is a huge problem for many people, yet there isn’t a lot of good information about it.If you want more information about this topic, here are the 3 pivotal resources, in my opinion:

  1. Best book to read is Codependent No More: How to Stop Controlling Others and Start Caring for Yourselfby Melody Beattie
  2. Most knowledgable local authority on the subject is Vince Dipasquale. He has some books on the topic that are fabulous, but he also has a group in NJ and videos on Youtube, check him out he’s a dynamo.
  3. Best free resource and support group is Codependents Anonymous (CODA). You can read their literature, join their online forums or go to their local meetings to learn how to work a recovery program. This 12 step fellowship is great, but tends to lack in meeting frequency and the inter-group is not so strong so it’s sometimes disorganized or the meetings might be weak. This is just my opinion, and I feel this way about any 12 step fellowships that are spin offs of AA, but NA and Ala-non seem to be the second strongest, while CODA, Gambler’s Anonymous and Over-eaters Anonymous seem to be stronger than some of the newer ones like Marijuana or Cocaine Anonymous…just my opinion.

So again, what is it? I like to define it as being addicted to people. CODA offers no definition (, 2016), but a checklist of attitudes, behavioral patterns and lifestyle choices that tend to be co-dependent in nature. This includes several different types of co-dependent patterns, which we went over in group. The following list is taken directly from the CODA website, but I modified it to look more like the older version of this document, with Co-dependent examples on the left, and healthy patterns on the right (the yellow highlight are the things I added to the new document):

Patterns and Characteristics of Codependence

The following checklist is offered as a tool to aid in self-evaluation. It may be particularly helpful to newcomers as they begin to understand codependency. It may aid those who have been in recovery a while to determine what traits still need attention and transformation.

Denial Pattern Codependents often: 

Co-Dependence                                                                               Recovery

Have difficulty identifying what they are feeling


Are aware of feelings and identify them, often in the moment
Minimize, alter, or deny how they truly feel.


Embrace feelings as being valid and important, am truthful with self
Perceive themselves as completely unselfish and dedicated to the well-being of others.


Keep the focus on one’s own well being and knows the difference between caring and caretaking
Lack empathy for the feelings and needs of others.


Can feel the feelings of others without focusing on one’s own reactions and feelings
Label others with their negative traits.


Recognizes and owns one’s own negative traits without placing them onto others
Think they can take care of themselves without any help from others. Recognize the need to care for self and accept help from others
Mask pain in various ways such as anger, humor, or isolation.


Can sit in one’s own pain without changing it or dwelling in it
Express negativity or aggression in indirect and passive ways.


Can assert one’s self respectfully, honestly, directly and clearly
Do not recognize the unavailability of those people to whom they are attracted.


Understand and accept that people may be unavailable to us at different times and in different ways

Low Self-esteem Patterns Codependents often:

Co-Dependence                                                                               Recovery

Have difficulty making decisions.


Trust one’s own ability to make effective decisions
Judge what they think, say, or do harshly, as never good enough.


Accept one’s self as one is emphasizing progress overperfection
Are embarrassed to receive recognition, praise, or gifts.


Feel appropriately worthy of the recognition, praise or gifts received
Value others’ approval of their thinking, feelings, and behavior over their own.


Have confidence in oneself no longer seeking others approval of thoughts, feelings or behaviors
Do not perceive themselves as lovable or worthwhile persons.


Recognize oneself as being a lovable and valuable person
Seek recognition and praise to overcome feeling less than.


Able to praise one’s self and in doing so recognizes their equality to others
Have difficulty admitting a mistake.


Admits mistakes and makes direct amends except when to do so would cause harm to self or others
Need to appear to be right in the eyes of others and may even lie to look good.


Uses honesty, not righteousness as a tool for intimacy and communication
Are unable to identify or ask for what they need and want.


Has insight into wants and needs and can clearly ask others for it
Perceive themselves as superior to others.


Perceive all human beings as equal
Look to others to provide their sense of safety.


Feels safe and grounded in the world and holds self responsible for one’s own safety
Have difficulty getting started, meeting deadlines, and completing projects.


Is able to motivate oneself and respects deadlines and work ethic
Have trouble setting healthy priorities and boundaries.


Understands self and other’s roles and is able to balance relationships with self needs and responsibilities

Compliance Patterns Codependents often:

Co-Dependence                                                                               Recovery

Are extremely loyal, remaining in harmful situations too long.


Are committed to one’s own safety and recover work, leaving situations that feel unsafe or are inconsistent with ones goals
Compromise their own values and integrity to avoid rejection or anger.


Are rooted in one’s own values, even if others don’t agree or become angry
Put aside their own interests in order to do what others want.


Consider one’s own interests first when asked to participate in others plans
Are hypervigilant regarding the feelings of others and take on those feelings.


Can separate feelings from the feelings of others
Are afraid to express their beliefs, opinions, and feelings when they differ from those of others.


Respect one’s own feelings and opinions and express them appropriately
Accept sexual attention when they want love.


Sexuality is grounded in genuine intimacy and connection, knowing the difference between lust and love
Make decisions without regard to the consequences.


Thinks about the potential outcome of decisions before making them
Give up their truth to gain the approval of others or to avoid change.


Accepts the normalcy of change and honestly pursues goals and desires despite what others may think

Control Pattern Codependents often:

Co-Dependence                                                                               Recovery

Believe people are incapable of taking care of themselves.


Realize that with rare exceptions, other adults are capable of managing their own lives and sees ones job as to let them
Attempt to convince others what to think, do, or feel.


Accept and value the differing thoughts, feelings and opinions of others
Freely offer advice and direction without being asked.


Are  compassionate and empathetic listeners, giving advice only if directly asked
Become resentful when others decline their help or reject their advice.


Feels comfortable when seeing others take care of themselves
Lavish gifts and favors on those they want to influence.


Carefully and honestly contemplate motivations when preparing to give a gift
Use sexual attention to gain approval and acceptance.


Feel loved and accepted for oneself just the way one is
Have to feel needed in order to have a relationship with others.


Develop relationships with others based on equality, intimacy and balance
Demand that their needs be met by others.


Respects other’s needs as much as their own
Use charm and charisma to convince others of their capacity to be caring and compassionate.


Genuinely feels care and compassion in an unpretentious way
Use blame and shame to exploit others emotionally.


Validates other’s feelings rather than controlling them
Refuse to cooperate, compromise, or negotiate.


Looks for and welcomes compromise in an effort to improve relationships and respect other’s needs
Adopt an attitude of indifference, helplessness, authority, or rage to manipulate outcomes.


Works to solve problems and proactively communicate in assertive ways to meet goals
Use recovery jargon in an attempt to control the behavior of others.


Practices recovery for self growth rather than to impress or manipulate others
Pretend to agree with others to get what they want.


Express disagreement when its genuine and necessary rather than complying blindly

Avoidance Pattern Codependents often: 

Co-Dependence                                                                               Recovery

Act in ways that invite others to reject, shame, or express anger toward them.


Acts respectably towards self and others
Judge harshly what others think, say, or do.


Works to adopt a non-judgemental stance towards self and others
Avoid emotional, physical, or sexual intimacy as a way to maintain distance.


Is able to fully engage in intimacy in a safe and consensual way
Allow addictions to people, places, and things to distract them from achieving intimacy in relationships.


Prioritizes primary relationships and puts them first overall
Use indirect or evasive communication to avoid conflict or confrontation. Uses assertive conflict resolution skills and confronts problems directly
Diminish their capacity to have healthy relationships by declining to use the tools of recovery.


Accepts the need to learn and work a recovery program despite it being hard or frustrating
Suppress their feelings or needs to avoid feeling vulnerable.


Expresses feelings and needs to self and others even when it feels uncomfortable
Pull people toward them, but when others get close, push them away.


Strives to focus on one’s self in daily affairs rather than controlling or focusing on others
Refuse to give up their self-will to avoid surrendering to a power greater than themselves.


Understands the importance of having a higher power and practices turning things over to that power in daily living
Believe displays of emotion are a sign of weakness.


Recognizes the importance of emotions and respects them rather than judges them
Withhold expressions of appreciation.


Openly expresses appreciation to others in a genuine way 

I encourage everyone reading this to try to honestly identify the symptoms of co-dependency that you see in yourselves, and to strive toward recovery. Especially for young women, I feel this type of attitude and behavior change is crucial to forming healthy, balanced relationships. For more information visit