Instead, they look to other people to tell them who they are. A co-dependent relationship is created when a dependent person enters a dysfunctional relationship with someone else.

Co-dependency, itself, is not recognized in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) as a distinct disorder but rather linked to dependent personality disorder. DPD is defined as “a pervasive, excessive need to be taken care of, leading to submissiveness and clinging behaviors,”2 with fears of separation, beginning by early adulthood and indicated by five (or more) of the following:3 

  • Difficulty making everyday decisions without input, advice, and reassurance from others
  • Needing others to assume responsibility for most major areas of life
  • Difficulty expressing disagreement with others out of fear of loss of support or approval
  • Difficulty initiating projects or doing things independently (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy)
  • Going to excessive lengths to obtain nurturance and support, to the point of volunteering for unpleasant things out of fear of rejection or disapproval
  • Feeling uncomfortable or helpless when alone because of exaggerated fears of inability to care for self
  • Urgently seeking another relationship as a source of care and support when a close relationship ends
  • Unrealistically preoccupied with fears of being left to take care of self

It is important to remember that co-dependency can be between spouses, romantic or sexual partners, siblings, parents/children, friends, or in work relationships. Healthy, independent people ultimately do not tolerate such an unhealthy relationship. By contrast, a dependent person relies upon the unhealthy nature of a co-dependent relationship to maintain a sense of control over the connection.

In co-dependent relationships, the dependent person exhibits many of the following unhealthy characteristics, which are actively or passively supported or expected by the other person:

  • Focuses attention and effort on solving the problems of the other person
  • Takes responsibility for meeting the other person’s needs and puts those needs above self
  • Feels personally responsible for outside events and circumstances
  • Feels responsible for fulfilling the expectations of the other person and a failure if that does not happen
  • Hyperaware of the feelings and needs of the other person but unsure of those in self
  • Considers the opinions and feelings of the other person as greater in value than self, with a high need for validation
  • Adapts behavior and appearance to the desires of the other person
  • Has extreme anxiety at the thought of being alone or of separation
  • Is unable to create, maintain, or defend appropriate interpersonal boundaries
  • Is unfamiliar with, and fearful of, appropriate and healthy intimacy
  • Derives positive feelings about self exclusively from the other person
  • Harbors unrealistic expectations of self and abilities—will attempt to manipulate and control people and situations to avoid or deny reality

Co-dependency and Dependency Challenges

The need to be in a co-dependent relationship can be so strong that it mirrors some of the characteristics of an addiction. Sometimes called relationship addiction, this type of co-dependency occurs when the dependent person chooses a relationship, as opposed to an individual, as their drug of choice. Within this type of relationship, it is not enough to convince the dependent person of the unhealthy aspects of a single association; the pattern of relationships must be addressed. Looking for a healthy person in a relationship is not the long-term answer. The essential person in relationship addiction is not the other person but the dependent person, who must be gently led through a discovery of how co-dependency is being played out in their pattern of relationships. 

When working with someone to recover from their dependency patterns, especially within a co-dependent relationship, a challenge may arise when the other person is not sympathetic or helpful toward that goal. The chords of co-dependency may be strong, making the task of untangling self from the other more difficult. The relationship is co-dependent because the other person derives perceived benefit from the unhealthy characteristics of the dependent person.

A person who is dependent already feels worthless and often hopeless. Going into counseling could be viewed as a defeat or further “proof” of the dependent person’s worthlessness. Providing encouragement and support, therefore, is vital, as well as calling out and complimenting the person for their honesty and bravery in working through these issues. It is essential to counter a tendency to be fearful and catastrophizing by consistently focusing on the positive and the possible while being open and honest about a realistic time frame for recovery.

Another important challenge to be aware of is the tendency for the person to exhibit dependency traits within the counseling relationship. The priority of work must first be on healing the person’s core sense of self—to strengthen all other relationships. The emphasis should be on what the person is learning and understanding, not what you are instructing or directing. 

Recognize there could be the presence of a co-occurring mental health or substance abuse issue. People with DPD may struggle with depression, especially when a co-dependent relationship implodes. Due to their fearful and catastrophic state of mind, anxiety disorders may also be present, including obsessive-compulsive disorder traits. At my clinic, we screen for substance abuse issues because people in pain often find ways to self-medicate. 

A sense of self, shredded by dependency and co-dependency, can only be knit back together through a healing relationship with God and Christ. The dependent assumption that they are not enough is valid—alone, we are not enough. We are meant for something more and feel it on a visceral and spiritual level. We were not meant to be alone; we were created for relationship—spiritual relationship. Love, approval, acceptance, validation, assurance, relief, and significance are all human needs found in Christ. As Christian counselors, we are uniquely empowered to spread this very Good News.

Gregg Jantz, Ph.D., is the founder of The Center • A Place of HOPE (www.aplaceofhope.com), a healthcare facility in Edmonds, Washington, which emphasizes whole-person care, addressing the emotional, relational, physical, and spiritual aspects of recovery. He is the author of multiple books, including Am I Co-dependent: Key Questions to Ask About Your Relationships, written with Dr. Tim Clinton. Dr. Jantz is a sought-after speaker in person and on television and radio (www.drgregoryjantz.com).

Endnotes

1 Leviticus 19:18, NIV; Matthew 5:43, NIV.

2 Zimmerman, M. (2022, September). Dependent personality disorder (DPD) – psychiatric disorders. Merck Manuals Professional Edition. Retrieved January 15, 2023, from https://www.merckmanuals.com/professional/psychiatric-disorders/personality-disorders/dependent-personality-disorder-dpd.

3 Zimmerman, M. (2022, September).