Partners in an intimate relationship naturally count on one another, wishing for comfort, support and companionship. Achieving both interdependency and independence, and letting them coexist healthily, is one of the later phases of relationship development.
In some cases, though, interdependency develops maladaptively as codependency: caring for another person, or accommodating their needs, comes at the expense of one’s own needs, boundaries and wellbeing.
What Is Codependency?
Codependency is a relational coping pattern shaped by developmental vulnerabilities, trauma and sociocultural expectations, rather than an individual pathology.
It is one of those psychological concepts that sounds straightforward until you try to define it. The term has been used to describe people who lose themselves in relationships, partners who overfunction in response to a loved one’s addiction, caregivers who become consumed by another person’s needs, and people who struggle with attachment, boundaries and self-worth. That makes codependency a contested rather than universal construct. Although it emerged largely from addiction-recovery literature, its use has expanded to cover a wider range of relational and psychological difficulties. A recent review found the literature approaches it from six main perspectives: sociocultural, relational, addiction and pathology, developmental, psychoanalytic, and cognitive-personality frameworks.
This diversity isn’t just an academic distinction. It has direct consequences for how codependency needs to be addressed, both in a relationship and individually. In approaching it integratively while working with individuals and couples in Vienna and remotely worldwide, the starting point is understanding what purpose the pattern has served, how it developed, and why it continues.
Different Perspectives on Codependency
Sociocultural perspective
Codependency can be understood in relation to social expectations about relationships, caregiving, gender and family responsibility. Cultural and social norms shape whether prioritising others is viewed as healthy responsibility or excessive self-sacrifice.
Relational perspective
Relational perspectives focus on patterns between partners, particularly difficulties maintaining a separate sense of self while staying emotionally connected. Codependent patterns can be sustained by enmeshment, unequal responsibilities or power dynamics within the relationship.
Addiction and pathology perspective
These perspectives view codependency as a maladaptive pattern that can develop in response to prolonged exposure to addiction or other dysfunctional relationship environments. Some models frame it more broadly as a relational or behavioural addiction involving compulsive attachment and relationship-focused behaviour.
Developmental perspective
Developmental perspectives link codependent patterns to early attachment experiences, family relationships, neglect, abuse, or difficulties developing relational security. Strong attachment or caregiving on its own isn’t evidence of codependency, though, and research doesn’t support simply equating codependency with insecure attachment. For a closer look at how early attachment styles play out in adult relationships, see The Attachment Pattern You Keep Calling Chemistry.
Psychoanalytic perspective
Psychoanalytic approaches understand codependency as an adaptation to early relationships, in which suppressing one’s own needs helped maintain important relationships. Later relationships may repeat familiar patterns, with caregiving, being needed, or adapting to others becoming important sources of self-worth and emotional security. This is explored further through a psychodynamic therapy lens.
Cognitive-personality perspective
Cognitive-personality approaches focus on enduring beliefs, schemas and emotional patterns that make closeness and autonomy difficult to balance. Self-sacrifice, subjugation, perfectionism, approval-seeking, shame and difficulty regulating emotions can all reinforce codependent patterns.
How Self-Concept and Identity May Be Related to Codependency
Codependency is closely connected to how people conceptualise or identify themselves. A person may begin with low self-esteem and consequently rely heavily on another person’s approval, but the relationship itself can further weaken their sense of worth. Their identity becomes organised around the relationship rather than a broader sense of who they are, which is part of why individuation work often features in treatment.
May Codependent Behaviour Serve an Adaptive Function?
The perspectives above remain distinct rather than interchangeable. Relational approaches focus on enmeshment and differentiation; developmental approaches examine attachment and early adversity; psychoanalytic approaches consider defence and repetition; cognitive-personality approaches emphasise schemas and emotional processes; and sociocultural approaches examine gender, culture and social expectations.
A central question across these debates is whether codependency necessarily represents pathology, or whether some behaviours identified as codependent formed because they were useful within particular circumstances. Codependency may have developed as a way of maintaining safety, preserving important relationships, or managing unpredictable environments. In dysfunctional families, addiction, or certain cultural settings, self-suppression, overfunctioning, hypervigilance and self-sacrifice can be reinforced as ways of coping with stress and maintaining stability.
Why Codependency Needs to Be Recognised and Addressed
The mental health consequences of codependency are multifaceted and interconnected. Codependency is associated with:
- emotional distress (depression, anxiety, guilt)
- impaired self-concept (low self-esteem, identity confusion)
- relational dysfunction (family problems, isolation)
- increased risk of maladaptive coping, including substance use or behavioural addictions
These consequences can extend to physical wellbeing, and often reinforce each other, creating a self-perpetuating cycle of distress and dependency.
Codependency: Implications for Couples Therapy
A useful approach to addressing codependency, whether in in-person or online couples therapy, requires more than trying to reduce dependency or encourage greater independence. Treatment needs to consider how these patterns developed, what function they may once have served, and how they’re maintained within the present relationship.
From a relational and developmental perspective, behaviours such as self-sacrifice, excessive caregiving, or taking responsibility for a partner may have originated as ways of coping with earlier environments marked by neglect, inconsistency or emotional insecurity. Understanding these behaviours in their original context can help reduce shame and allow clients to recognise that a strategy that was once protective may no longer be serving its purpose.
A trauma- and attachment-informed formulation can deepen this understanding by examining how earlier relational experiences influence present expectations of closeness and abandonment. For example, difficulty saying no or maintaining boundaries may be connected to an underlying fear that disagreement will result in rejection or loss. Rather than treating the behaviour in isolation, therapy can explore the vulnerability beneath it, and how that vulnerability becomes activated within the couple’s interactions. For more on this in practice, see How to Establish and Sustain Healthy Boundaries.
Several areas become important in couples treatment:
Relational safety provides the foundation, allowing clients to examine sensitive patterns without feeling blamed or judged.
Boundary work can help partners distinguish between caring for one another and assuming responsibility for one another’s emotions, choices or consequences.
Emotional regulation can support clients in tolerating anxiety, guilt or fear without immediately returning to familiar patterns of appeasement, control or self-neglect.
Identity differentiation can help individuals reconnect with their own values, needs, preferences and sense of self beyond roles such as caregiver, rescuer or enabler. Schema-focused work and reflective exercises can further help identify the deeply established beliefs that maintain these patterns.
Cultural context should also be considered, as norms around gender, family loyalty, caregiving and self-sacrifice can strongly influence how clients understand their responsibilities within relationships. This matters particularly in work with intercultural couples, whether in person or remotely, as exploring these influences helps distinguish culturally meaningful caregiving from patterns that have become harmful. Readers navigating this alongside a move abroad may also find It’s Complicated’s support for expat life relevant.
Taken together, the key task of individual or couples therapy is not to label dependence as inherently unhealthy, but to understand when particular patterns have become restrictive or harmful.
If you’d like to find a therapist to talk this through with, you can explore practitioners on It’s Complicated, including specialists in couples and relationship work.
Sources
Molina, E., Taiwo, A., & Grey, B. (2026). Co-Dependency Revisited: An Integrative Review of Conceptualisations and Mental Health Outcomes. Clinical Psychology & Psychotherapy, 33(2), e70265.
Bacon, I., McKay, E., Reynolds, F. et al. (2020). The Lived Experience of Codependency: an Interpretative Phenomenological Analysis. International Journal of Mental Health and Addiction, 18, 754-771.
Diana Tutschek is a psychologist and PhD candidate in clinical psychology, with an MSc in Psychology & Mental Health from King’s College London and postgraduate studies at the University of Vienna’s Institute of Clinical and Health Psychology. She works with individuals and couples in Vienna and online, drawing on CBT, EMDR and couples-focused approaches. Find Diana Tutschek on It’s Complicated.
