Codependency and Therapy

Codependency and therapy. Why is codependency relevant to therapy? Codependency is an oft-used term, however most definitions are superficial. Codependency is known as the ‘disease of the lost self.’ Why? Because we learn to disconnect from our needs, feelings, and limits. Therapy can help.

What is codependency and how can therapy help with it?

In his best-selling book, John Bradshaw wrote, “Much has been written about codependency. All agree that it is about the loss of selfhood,” (1). While being trained at the former Bay Area affiliate of the John Bradshaw center one of my supervisors would quote Bradshaw as saying that codependency was the ‘disease of the lost self.’ But what does this really mean? In order to understand this, we need to know about the conditions in which codependency forms.

Codependency refers to a pattern or set of patterns wherein we disconnect from the truth or reality of our own embodied experience. Why would one do this? We do this because we have learned that something about our experience is threatening to the stability of our relationship to a significant other.

In the process of disconnecting from ourselves, we experience several trickle-down impacts. These impacts are summarized in this list from Pia Melody:

Codependents have difficulty

1. Experiencing appropriate levels of self-esteem

2. Setting functional boundaries

3. Owning and expressing their own reality

4. Taking care of their adult needs and wants

5. Experiencing and expressing their reality moderately (2)

Many definitions of codependency are vague, misleading, or simply non-existent (3). When I refer to codependency I am referring to an observable internal dynamic that takes shape in external relationships. In other words, the pattern is observable in how we relate to ourselves and how we relate to others. These dynamics are formed through the course of our emotional development, and thus in response to our primary caretakers. This is why Bradshaw goes on to say that codependency is a “disease of the developing self that does not manifest fully until one is in an adult relationship,” (1).

Many people think they had a normal childhood. However when we look deeper, they realize they experienced a lack of emotional support. As adults they now find it difficult to feel and express their true feelings. Furthermore, if they were shamed for having certain feelings, this adds to the difficulty. Now their feelings can also be experienced as threatening to their sense of security.

People-pleasing, fawning, feigning, and other protections.

Codependency is often connected with people-pleasing. Why is that? If we learn that our emotional experience can lead to a threat to our sense of security with a significant other, we need to find a way to mitigate that threat. In trauma-informed practice most people are familiar with the fight, flight, and freeze responses. More recently clinicians have begun to connect “fawning” and “feigning” as a systemic response to threat. People pleasing falls under the category of these two. Each are strategies to to avoid conflict and the potential threat it entails. Each ultimately require us to disconnect from our true needs, desires, and emotions - some may say our true selves.

While the strategies of fawning and feigning are very much a part of the codependency presentation, they are not the only defenses that can operate under this moniker. The truth is each person may rely on defenses a little differently. If we have learned to disconnect from our feelings we may also do so unconsciously through repression, denial, and dissociation. We may rationalize our true feelings away. We may minimize our hurt or anger in order to avoid conflict. All of these processes are meant to mitigate the potential for threat.

The problem with such protective strategies is that over time they erode our ability to experience genuine fulfillment and connection in our relationships. So for this reason, in my work with clients I focus on both practical skills around helping them identify and express feelings when they struggle to do so. I help them learn how their feelings are vital to their relationship to themselves and others. I help clients to connect their feelings to their relational needs, desires, and boundaries. I have seen these practical skills have a transformative effect on my clients time and time again. They help clients develop a healthy sense of self-esteem, competence in setting limits, verbalizing their needs and emotions. This often results in a lessening of internal conflict and a capacity to manage conflicts in relationship with significantly less drama and sense of threat.

At a certain point in our work, I will help the client to start to connect with their inner child. As we learn practical skills to manage our emotions, we can then begin to deepen awareness into how these patterns, or as I call them ‘templates,’ began to develop in the first place. This often brings up feelings of fear, grief, and/or anger that have been disconnected from for a long time. We develop a relationship to the embodied inner child experience so that this part of us can begin to an internalize a compassion, patient, and tolerant relationship. As this part of us begins to develop trust that we can hold it lovingly, they don’t have to rely on other ways to protect themselves which create damaging consequences which could include: low self-esteem, dissociation, dis-satisfying relationships, shame spirals, depression, and anxiety.

The good news is that it is possible to experience significant growth and healing from these patterns. Please don’t hesitate to contact me if you are interested in learning more about how I work with codependency in therapy.

(1) Bradshaw, John. Healing the Shame That Binds You (p. 34).

(2)Mellody, Pia; Wells Miller, Andrea; Miller, J. Keith. Facing Codependence: What It Is, Where It Comes from, How It Sabotages Our Lives . Kindle Edition.

(3) https://en.wikipedia.org/wiki/Codependency

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Scott Menasco, Ph.D., LMFT Scott Menasco, Ph.D., LMFT

Boundaries 101

Boundaries are an often cited, yet commonly misconstrued psychological idea. Difficulty with boundaries is one of the most common issues I see with clients dealing with a variety of presenting problems—from anxiety, and depression to life transitions and relationship conflict. I had the good fortune of completing a two year training with the former Bay Area affiliate of the John Bradshaw Center where a premium was placed on learning boundaries.

Perhaps the easiest example of a boundary system is that of the cell wall. Simply put, cell walls keep out the bad stuff and let in the good stuff. While that may be an oversimplification, it is a helpful guiding principal. Similarly, our boundaries are a part of our emotional self-care system. They express a limit, whether that be physical, emotional, sexual, intellectual, or spiritual. When we have poor boundaries, we open ourselves to harmful experiences or dissatisfactory relationships. On the other hand, if we have too rigid of boundaries, we might not let in some of the emotional nourishment we need.

I teach people that boundaries are always connected to our feelings and needs. You might say that feelings are our best guides to our needs and limits. Often when people come to therapy, they have difficulty identifying their feelings. This is common, and not a reason to feel shame. However, when we have difficulty identifying our feelings, it is very hard to ask for what we need in relationship and to set limits.


The first step in having good boundaries is to develop awareness of our feeling states. How do I experience myself when I am angry? Sad? Ashamed? Scared? Hurt? Knowing the cues to these emotional experiences allow us to plug into our emotional self-care system, to clearly define our needs and limits. For example if I know I am sad, I might just need to ask for some reassurance or for someone else to listen while I express my feelings. If I’m frustrated or resentful with someone else, its very possible I have been neglecting my boundaries. If these feelings arise, there is always an opportunity to check in with myself and say… “Do I have a limit here that I haven’t expressed?” “Is there something I am needing that I haven’t asked for?”

Boundary work is a practice. It’s an ongoing learning process that takes time, self-observation, and self-love. We are all works in progress. I am confident that you can learn boundary skills and that knowing these skills will benefit you greatly. I will post more in the future about this very important topic, but for now… be well!

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