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In coming to this page, you are likely suspecting or aware that you are struggling in relationships, possibly to the point that life is quite unmanageable and feels out of control for you. At the very least, you are feeling frustrated, hopeless, and tired of the repetitive cycle. It takes strength and courage to get to this point, so congratulations on taking the step of starting to explore this aspect of your health. Sana Psychological specializes in Codependency Counselling and would be happy to support you in your journey of change. To start your healing journey, we invite you to reach out through our webpage, email, or phone call.
What is Codependency?
In a nutshell, codependency is characterized by an obsession about another person’s health, wellbeing, and life; and/or compulsiveness around behaviours that may include: caretaking,, control, rescuing (financial, emotional, or both), excessive worry, and fantasy. Codependency is when the brain becomes unhealthily and overly attached to relationships, to the point that the codependent person finds it difficult to let a family member or a loved one live their own lives and take care of their own needs, and/or has difficulty focusing on their own needs, health, and life. Codependency is isolating, can be debilitating due to the extreme feelings and behaviour it can lead to and has a significant impact on the overall health of the individual struggling, as well as those around them.
The side effects of codependency commonly include:
- Low self-esteem and self-worth
- High levels of anger and resentment
- Behaviours or substance use for relief and escape
(e.g., drug use, alcohol, food, work)
- Physical illnesses due to a lack of self-care
Codependent behaviour is different from true help and support. True help in healthy relationships comes with boundaries. This means having the knowledge and ability to act in accordance with your own needs and limitations. Codependency is a condition of extremes where you may be unable to see and/or act on your own emotional and health needs and become debilitated by this over-focus on others. As codependent behaviour has the same obsessive, compulsive, and life-limiting effects of other addictive behaviours, including substance use, it can also be called Relationship Addiction or, most accurately, Addiction.
Codependent Relationships vs. Healthy Relationships
A codependent relationship is often one where there is at least one individual (or more if it is a family, friendship group, or workplace) who is struggling and in need of extra support. This person may have mental or physical health disorders that are impacting them. The person who struggles with codependency responds to this person with an overfocus on being a caretaker. This “taking care” may be accepted and welcomed by the other person or people which fuels the cycle of caretaking to accelerate quickly, or it might be resisted as the person or people tries to resist the controlling, smothering, claustrophobic behaviours of the person with codependency.
The person with codependency will be there to provide money, resources, guidance, and steer the life actions and behaviours of the person they are attached to. There can be a symbiotic dependence created from this where the person receiving the caretaking is disabled from living their own life and the person with codependency cannot imagine their life without taking care of the other. Codependency leads to an enmeshed relationship where each person has a difficult time knowing themselves as independent from the other. Visually, it can be depicted as the following:
In a healthy relationship, there are two individuals and a point of overlap. Each individual involved in the relationship knows who they are, what they value and they have their own interests, hobbies, needs, preferences, and sense of self. The overlap is the relationship: Shared activities, hobbies, sexual intimacy, children (if in a romantic relationship), emotional intimacy, communication, shared responsibilities. There is clear knowledge of the individual and the relational and it can be referred to as an interdependent relationship. Visually it could be depicted in the following way:
You can see how different this is from the overlapping, enmeshed circles that are codependency. Codependency recovery involves detangling the selves from each other and working towards this interdependence.
Common Signs of Codependency
Here is an informal self-assessment that addresses some of the common symptoms of codependency. Please read each statement below and answer for yourself whether these are true or false for you within the past 3 months.
If you answered ‘True’ to five or more of these statements, then there is a strong possibility that you may be struggling with codependent behaviour. Please note that this self-test is informal and not a substitute for professional assessment, diagnosis, and treatment. This self-test can be used to give you an idea of problem areas and symptoms of codependency that you may want to seek further professional consultation to address.
Causes of Codependency
People are usually curious about where behaviour originates. Is it from past hurt? An intimacy issue? A mental health issue? Rooted in Post-Traumatic Stress Disorder (PTSD) and trauma? From emotional abuse? From other forms of abuse? From other family members? Is it genetic and hereditary? As you can see, it is definitely a complicated question with a lot of potential factors.
The perspective that Sana Psychological takes is that codependency is primarily founded in genetics (something that we have inherited) with environmental factors like those listed above being the fuel and activators of this hereditary foundation. While it may seem important to sort out where these codependent tendencies come from, in reality, it is most appropriate to focus on how it is currently manifesting, what it looks like, what changes you would like to see, and what action steps are possible.
Mental Health Conditions Associated with Codependency
Codependency is a serious mental health symptom and may occur at the same time as other unhealthy behaviours, including unhealthy relationships with alcohol, drugs, gambling, food, media, and/or sex as some common examples. People may also be experiencing other mental health conditions, such as mood disorders (e.g., depression), anxiety disorders (e.g., anxiety, PTSD), or personality disorders (e.g., Borderline Personality Disorder). Other symptoms and conditions that can present along with codependency include Attention-Deficit and Hyperactivity Disorder (ADHD), anger, low motivation, excessive sleep or insomnia, isolation, suicidal ideation, and financial difficulties. There may be a perpetuation of abuse (physical, emotional, financial, sexual or other) and/or the experience of abuse and neglect. This all just speaks to the seriousness and gravity of codependency and makes recovery all the more important.
Our Codependency Treatment Approach
Paige Abbott, a Registered Psychologist at Sana Psychological, approaches codependency as a symptom of Addiction. This may or may not be comfortable to you, and either way is okay. We are willing to work within a framework that is comfortable for you, while not compromising our professional expertise, values, and integrity. With codependency, work on emotional identification and regulation, boundary setting, assertive communication, improving self-worth and self-care are some of the core steps to recovery that can be incorporated into counselling as needed and desired. hese will help you recover a sense of health, happiness, and self.
Treating Codependency as a Symptom of Addiction
There is a lot of misunderstanding in the world about the meaning of Addiction. All that we mean when we say that we treat codependency as part of Addiction is that it is important to appreciate there is a strong brain and biological component to the behaviour and it is not about choice, willpower, or personality factors. The brain can get unhealthily attached to people and relationships just as it can to substances and other unhelpful behaviours. The other important point about exploring codependency as a symptom of Addiction is that it means you are vulnerable to problems in other areas outside of relationship issues. This might include other behavioural problems with food, sex, substances, or other concerns, as well as other mental health symptoms like anxiety, depression, or other conditions. These can be explored concurrently in codependency therapy as many of the patterns and necessary steps for recovery, healing, and well-being are similar between all issues.
Your Initial Codependency Counselling Appointment
Treatment for codependency at Sana Psychological starts with an initial session to get to know you, your current life context including strengths and resources, as well as information about the current challenges you are facing. At the initial appointment, a collaborative treatment plan will be established based on your needs and abilities.
The Duration of Your Codependency Treatment
Treatment for codependency may be short-term (3-6 months) if you are looking for some immediate tools and guidance, as well as to start to build a platform of health in your life that can support you moving forward. It can also involve long-term counselling (6+ months) which may involve monthly, bi-monthly, or quarterly check-ins to ensure accountability and movement with your health and wellness plan. There are no set expectations when it comes to codependency counselling and Paige Abbott of Sana Psychological is happy to meet you where you are at. The door is always open so even if you have engaged for counselling briefly, discontinued at Sana Psychological for a period of time, but are considering returning, we invite you to do so as there are no expectations or pressures when it comes to counselling.
What to Expect in Your Codependency Counselling Sessions
Paige Abbott has been trained in Cognitive-Behavioural Therapy as well as Acceptance and Commitment Therapy (ACT) and also incorporates elements of Solution-Focused Therapy, Motivational Interviewing, and Twelve-Step Facilitation into her sessions. Follow-up appointments generally involve a check-in to see presenting issues and immediate things that have come up that you may want to process, follow-up on any suggestions provided in past appointments to get an idea of progress as well as roadblocks that are coming up, followed by a more in-depth exploration of challenges, patterns, and coping. Sessions are active and engaged as Paige likes to ask lots of questions and provide reflections, challenges, and psychoeducation along the way. At any point, if the therapeutic approach or goals need to be changed, please speak up and this will be processed. Sessions come from a non-judgmental, compassionate, trauma-informed, and empathetic place.
Why Choose Sana Psychological?
The level of expertise offered by Paige Abbott at Sana Psychological is somewhat unique. The treatment approach to all issues, including codependency therapy, combines information about the brain functioning and circuitry, psychological principles and concepts, mixed in with a human-focused, individual approach to care.
Having spent over a decade working primarily with Addiction of all manifestations, the tools, perspective, and information that has been gathered to inform each hour of therapy is a very special offering. Clients repeatedly reflect that the feedback and information they are provided in sessions is quite different than what they have heard before, including from other professionals. While many professionals may be the first point of contact and want to do their best to help, many do not have the level of exposure and expertise required to understand the nuances of a complicated behaviour like codependency (and Addiction more generally). Clients often say that they feel heard and immediately understood without having to provide a lot of explanation, defence, or background.
Your issues are known and you are respected for your uniqueness while attempting to understand the common challenges and patterns you are experiencing. This helps us learn, grow, and change and those are Sana Psychological’s primary goals. Paige has been training to be a therapist her whole life, in a sense, from her childhood experiences with Addiction and Mental Health issues right down to her natural personality type, which is perfectly suited to be in the helping profession.
Can we guarantee this approach will work for you? Of course not, but if something here is resonating for you, it might be worth giving it a try. If you would like more information or to schedule an appointment, this can be done through the website, by email or phone. We are happy to help (with boundaries, of course!).
Frequently Asked Questions
There have not been, to our knowledge, any declared best practice treatments for codependency. This has left healthcare providers to establish practices that have been anecdotally proven to be effective. A hybrid approach of emotion, behaviour, and thought-focused care seems to help significantly improve the quality of life for those who have codependent traits and move people from a state of helplessness to a place of empowerment.
Yes! This service would not be offered if there was no benefit. Adults who have struggled with codependent behaviour for years can improve their interactions, comfort level with self and others, communication, boundaries, and move from a state of trying to focus on survival to a state of thriving. Having a healthy sense of responsibility, strength, and hope are just some of the gifts that can come from counselling and treatment.
Yes! As more than one person is involved in a relationship, for an unhealthy relationship to repair and continue, all involved parties will ideally be working on independent growth and change, which benefits the relationship. Usually, individuals must work on boundaries, communication, and their own self-care to improve the relationship. A lot of people with codependent characteristics feel it would be best to do all of this work with their partner, family member, or loved one but this is often symptomatic of the problem (i.e., people struggling with their identity outside of the other) so it is recommended that the majority of treatment be done individually to build that sense of independence.
No. While many people who have codependency may have higher levels of anxiety, codependency falls in alignment with Addiction more so than an anxiety or mood disorder. It involves symptoms of impairment in behavioural control, difficulty abstaining, cravings, difficulty recognizing problems in behaviour and relationships, and a dysfunctional emotional response, all of which are characteristics of Addiction as first identified by the American Society for Addiction Medicine. At Sana Psychological, Addiction treatment principles will be brought into codependency counselling as this, from experience, has been very helpful for those with this issue.
Awareness often precedes action. As people start to become more aware of the triggers, feelings, thoughts, and behaviours associated with this issue, it starts to open up the door to change. After some awareness has been cultivated, a codependent individual may find it is necessary to take some physical separation time from their spouse, romantic partner, family member, friend, or whoever they are noticing the issue is most intense with. While this is certainly not a requirement for recovery, many people find it helpful as this allows them to detox in a way and start to rediscover themselves. After some time, they can start to gradually reintegrate into the relationship with this renewed sense of self. If a physical separation does not happen, boundaries and some detachment are necessary for healing codependency. This can be discussed with the therapist to explore what this might look like in your unique set of circumstances.
Unfortunately, this is not something that is easily done, as our ability to control another person’s behaviour and wellbeing is limited. However, keeping your boundaries clear, being assertive in communication, and modelling healthy self-care and behaviour in relationships can provide a helpful benefit to someone who might be vulnerable with codependency as it provides them with an opportunity to observe, possibly learn from what you are doing, and take steps towards their own health.