CEUs can be found for this presentation at CoD-CEU hey there everybody and welcome to this presentation on codependency an addictive behavior resulting from insecure attachment i'm your host dr donnelly snipes in this presentation we're going to start out by defining attachment and codependency and then we'll explore codependency as a consequence of insecure attachment we will also discuss ways codependency might also be conceptualized as a person or a relationship addiction and then finish out by starting to identify a few strategies for people to begin recovering from codependency codependency is often regarded as a consequence of being in a relationship with someone with an addiction sometimes it's thought of as being an addiction itself in which the relationship is what needs to be abstained from and other times it's thought of as just somebody who has poor relationship skills and i really want to ch challenge all of those and kind of put a big bow on it and say yes there's elements of all of those things that may exist but being in a relationship with a person with an addiction is not necessary in order to develop a pattern of codependent relationships presentation is going to challenge you to look at codependency as a symptom of insecure attachment stemming often from childhood trauma that we commonly call aces or adverse childhood experiences so what is attachment attachment describes the quality of the relationship between people and when we're little we are supposed to develop a secure attachment with our primary caregivers these are the people who are supposed to feed us when we're hungry give us a blanket when we are cold keep us safe when we're scared they're the people that are supposed to as we get older help us learn to identify our emotions tolerate that distress cope with the distress develop perspective taking skills and the ability to empathize with other people communicate how we feel and what our wants and needs are set health healthy boundaries and develop self-esteem now that's a lot of stuff so if somebody doesn't have a secure attachment in infancy and childhood they are often left scrambling to try to develop these skills but as some people often say you don't know what you don't know people don't know that they're they have low emotional intelligence unless somebody's presented the concept of emotional intelligence to them so a lot of people who grew up in these environments in which the caregivers were struggling with mental health problems or addiction issues or maybe even environmental issues like uh poverty that so they were working two jobs and they had difficulty being present when they were home they were just so freaking exhausted all the time we want to look at those things and i do want to underscore that adverse childhood experiences are not intentional a parent doesn't think to themselves hey i want to be emotionally unavailable unavailable to my kid most parents don't have children and go you know what you bother me go away you know most parents want to engage with their children when they can so a lot of adverse childhood experiences and trauma is the result of parents who or caregivers who were ill-equipped or unable or overwhelmed in some way insecure attachment is what results if you don't have secure attachment you have insecure attachment and there are basically three styles of insecure attachment the anxious attachment this is the child or the adult who is terrified of being alone terrified of abandonment and is always on the lookout for are you going to abandon me they they desperately want to be in relationships they desperately crave that closeness but they also desperately fear losing it so they are constantly on guard and that's exhausting then you have avoidant attachment and this is the person who grew up to recognize or to believe that nobody can be trusted and it's not even worth investing emotional energy in other people i don't i just don't even have time i don't want to be around you because you're going to leave me i know you will disappoint me i know you will let me down so i just don't even want anything to do with it you're not useful to me so these are two different approaches to reacting to caregivers who are unable to meet a child's needs now the third type is a combination and this is the person who vacillates between um i love you and i need to be around you and please don't leave me to go away and the anxious avoidant subtype is often prevalent in people who've experienced trauma they get angry they get overwhelmed and then they start to shut down and then because it's so overwhelming they can't deal with you so they become avoidant when they've gotten re-regulated then they start craving that closeness again they start fearing being alone again and they start the cycle again and this is a very common pattern in people who have complex ptsd and or borderline personality disorder so what is addiction addiction is the continued use of a substance or activity to escape numb or self-medicate emotional or physical pain despite problems in one or more areas of living as a result of use so let's dissect that a little bit to escape you know when people drink alcohol or use other substances when people gamble they're often trying to escape life they're trying to get a break from it and focus their attention somewhere else numbing is another function of some substances because it just stops them from feeling for a little while and self-medication and this is what we see a lot with a lot of addictions and it's a little bit different than escaping or numbing because this the addiction itself is actually fulfilling a purpose of causing the brain to secrete uh neurotransmitters that the person is lacking so to speak so self-medication is using a substance because the person needs to feel less anxious so it helps them feel connected may cause in codependency it may cause the secretion of dopamine and oxytocin which are chemicals in our body that prompt connectedness and closeness so what is codependency codependency describes a type of relationship in which one partner defines their worth or goodness based on someone else i am good as long as i am a good mother as long as i am a good spouse as long as i am a good whatever then i am okay as long as i am so and so such and such i am okay i'm not okay if i'm just me i don't know who i am the person often chooses relationships in which the other person needs to be rescued why well if i get into a relationship with somebody who needs to be rescued who needs to be taken care of there's a lot less chance that they are going to abandon me therefore and they need me and that need is shown through through gratitude sometimes but that when that person responds in a positive way to me caretaking them it causes the release of dopamine oxytocin serotonin all a bunch of feel-good chemicals that say okay i'm safe i'm loved i'm okay for the minute some people call this getting in relationships where you need to care take somebody negative control because you're determining someone else's reality for your own comfort you are telling them what they should do you are shaping their world in order to make you look good now in addiction so we're going to start looking at codependent relationships as an addictive behavior in an addiction there's the possibility of developing tolerance needing more of the same substance or activity in order to get the same feeling and in a codependent relationship as time passes the person's identity becomes increasingly defined by the relationship with the other person when you first meet your future spouse you are two relatively independent people but as the person with codependency spends time with the with their partner they slowly start to morph and somewhat merge to become almost a an offshoot of that person they are no longer sally they are joe's wife withdrawal means not getting the subs not um getting the substance or being around the person results in physical or psychological distress when apart from or unable to control the other person the person with codependency experiences extreme anxiety and depression well they got into a relationship with somebody who they knew needed them and they in order to feel like they're okay in order to feel like they're safe in order to feel like they are not going to be abandoned they need to be needed if that other person doesn't need them then they start becoming terrified of rejection and abandonment thinking more about codependency is an addiction we look at you know in addictions we have continued use of the person or activity to cope with distress despite negative consequences and we see this in codependent relationships but how might this emerge from insecure attachment the person who is insecurely attached and and in this case we're talking about anxious attachment is so terrified of abandonment they are they feel so ill-equipped to handle life they feel so unlovable for who they are that they feel like they need to continue to be in that relationship because that that relationship gives them breath it gives them life even if that relationship causes problems at least it allows them to exist and this can get really challenging in codependent relationships because the relationship may be so destructive that the person with codependency may actually their their persona may actually really stop existing but they are so terrified of being alone that they continue there's a persistent desire to cut down or control codependent behaviors controlling the desire to control is really difficult and the person with codependency may want to stop trying to micromanage and control the person they're in a relationship or the people they're in relationships with but they have difficulty doing it because as soon as they stop trying to control other people they feel like they are terribly out of control themselves think back to insecure attachment if a child's growing up and they have no guidance or they have extremely harsh guidance and they can't do anything right they feel like their world is out of control now they finally got into a place where they feel like they've got control of something and it's like okay maybe i can breathe for a minute but is this the healthiest place to be so children who don't have a secure attachment feel out of control they feel overwhelmed by their emotions they feel overwhelmed by life because they don't have anybody guiding them helping the helping them develop the tools to handle life on life's terms so when they become adults they're looking for a surrogate person that can step in and sort of do it for them a lot of times by the same token they need to feel like they're in control of that person because they don't want that person to leave more time than anticipated is spent thinking about engaging in or recovering in this case from the relationship well in codependency many times the relationship is with someone who needs help who is struggling with their own depression addiction something else and as a result the person with codependency is constantly being called upon to do things they are constantly worried about if it's if they're in a relationship with a person with an addiction is jim bob going to relapse is this going to happen are they going to be be home safe so they're constantly thinking about that other person and wondering if that other person is doing what they're supposed to be doing um and they're also spending a lot of time covering up for when that person doesn't do the right thing covering up for it and making excuses for it and then recovering from the shame from the anger that the person didn't behave from the um exhaustion from constantly wondering constantly worrying and constantly covering up and trying to fix things as a result of all of this you can imagine it's time consuming so significant events and activities are given up or minimized and there's often a failure to fulfill other major role obligations because the person with codependency is so focused on this relationship that they can't focus at work they can't focus on their hobbies they can't focus maybe even on their kids because they are so concerned about this and consumed with this other relationship and terrified of losing it back to insecure attachment we have this child who can't exist on their own they're six months five years even 10 years old they can't exist on their own they're dependent on their caregivers who are not consistently there and responsive for them so they are they feel terrified and then they finally get into a place where they think okay well this person might stick around and be attentive so i need to make sure that they they stick around and i need to invest all my energy because maybe if i work a little bit harder then they this this person won't leave me think about it in what areas does codependency cause problems for the person physically we often see a lot of physical ailments in people with codependency because it causes so much stress they're not sleeping well they're not eating well because of the stress their immune system is often out of whack they have high levels of cortisol which ends up throwing them the immune system out of whack it can trigger autoimmune issues it triggers pain there's a lot of physiological stuff that happens when people are under constant or chronic stress affectively people who are codependent often have emotions that are all over the place they have this underlying current of anxiety that they're going to be abandoned but that is punctuated by bursts of anger when somebody when the person doesn't do what they're supposed to do or depression when they feel like they can't control the other person they can't fix it they feel helpless there's very rarely time for feelings of happiness and contentment and those things that we want to feel cognitively the person with codependency because they are in this negative mood state so often because they are not sleeping well and which impairs our ability our cognitive functioning in and of itself they often probably have difficulty with problem solving and they tend to focus and this is what our brain does when we're in a negative mood state we tend to focus on the threats in the environment and interpret things in a negative light so we see the glass as half empty if somebody does something we see the or we expect the most nefarious interpretation of it as opposed to the most benign and interpersonally when people are in codependent relationships there's almost always a power struggle between them and the person that they are rescuing but it also impairs other relationships because their friends their family may be able to see how unhealthy this relationship is but the person who is who's codependent is so afraid to let it go doesn't trust these other people so they end up pushing others away because they're trying to maintain this relationship as well as maintain the facade that everything's perfect what does recovery look like well the first step for people who are codependent is to recognize that they probably are doing this out of a place of fear and terror and we need to understand where that's coming from but these experiences that caused that the injuries from others often resulted from other people's need to take care of themselves not a desire to hurt them their parents didn't have a desire to hurt them or their caregivers their caregivers were unable to cope with life on life's terms and as a result the child did not get their needs met they need to recognize their behav their current behaviors as a creative way of surviving unmanageable pain and distress think about children when they get upset they may get feel overwhelmed by their emotions and in a healthy relationship the caregiver will pull the child aside and you know help them breathe breathe with mommy for a minute and let's talk about what's going on or let's go on a walk for a minute so you can calm down and then we'll talk about what's going on in a dysfunctional relationship the caregiver can't be counted on to do that so the child doesn't have good models for how to handle distress they don't have somebody there to help them deal with all of these experiences that they've never had before and have no idea how to cope with and the person needs to identify the functions of their particular codependent behaviors and alternate ways to meet those needs so let's look at some of those behaviors that might come up people with addictions as well as to chemicals to other activities as well as people with codependency um often have a lot of these traits in common low self-esteem is a big one the low self-esteem can appear as worthlessness and this is what we typically interpret as low self-esteem a person doesn't feel good about themselves so they try to make themselves lovable through what they do and they rely on other people for external validation because they can't look in the mirror and say i'm i'm of value so that is our traditional view of low self-esteem but then you also have this other category of people with low self-esteem who often grew up in environments that were highly critical and they were taught that love was based on conditions they weren't loved for who they were they were loved for how they look who they knew or what they what they did so they grew up into adults who are constantly flaunting this you know don't look don't look behind the curtain because i'm not lovable for who i am but look at all these things that i do look at how wonderful i am see this is why i'm worthy of love instead of believing that they're worthy of love so grandiosity sometimes can be a way of veiling or protecting a person with low self-esteem how does that come from insecure attachment well the characteristics of insecu of secure attachment are consistency you know the caregiver is there if the child needs them the caregiver's there and it's not you know maybe the caregiver will show up they're consistent um and if the caregiver themselves can't be there they make sure that somebody else who can meet that need is there there's a surrogate so and and i recognize that many families parents work long hours sometimes two jobs and they have babysitters or daycare or something else that um where there's a surrogate in place and that's fine as long as there is a caregiver there that is going to meet the child's needs as long as the child trusts that where my primary caregiver puts me you know if it's daycare or school or grandma's house or wherever it's going to be a safe place so consistency being consistent being there is only half of the battle responsiveness is the next part the caregiver needs to be able to respond to the child's needs if they're hungry if they're cold if they're scared if they're angry respond in a developmentally appropriate way to help the child cope with whatever's going on to help them feel safe and not completely overwhelmed the next part of secure attachment is attention and attention is not just being responsive responsive is in this mnemonic is being there when the child is feeling distress attention is proactive time spent with the child saying i value you as a person i'm curious about what you're interested in i want to spend time with you not because i have to because i want to and in so many cases children don't get this from their caregivers their caregivers do the very best to put food on the table a roof over their head but when it comes to spending positive proactive time together uh that kind of falls through the cracks v stands for validation in a secure relationship the caregiver validates how the child feels even if they don't agree i mean as caregivers we've had many more years on this earth than our five-year-old so we may not see what they're getting upset about as a big deal or agree with their perspective but we validate how they're feeling we help them identify that emotion you're feeling angry now and from there we can start talking about it but when the child when the caregiver validates the child's feeling it helps the child learn to identify that emotion and then learn okay when i feel this emotion what do i do next e stands for encouragement you know a caregiver needs to encourage the child to take risks to step outside of the comfort zone to be there and go you got this and then s stands for safety and in a secure attachment the caregiver is there and welcoming the child back if the child fails if the child falters the child gets scared they can come back to this safe home base and this safe home base is one that is accepting and loving and nurturing of the child it the environment the caregivers may not always approve of the child's behaviors but it's always embracing the child so that mnemonic spells craves consistency responsiveness attention validation encouragement and safety so this is what children need and if they don't get this then they start feeling incapable to handle their own emotions and this when they when they feel incapable of handling their own emotions and they act out they may get criticized they may get ridiculed which lowers their self-esteem when they have problems they may feel un incapable of handling them and again receive criticism or fail maybe they don't ask for help because they don't trust anybody to be there to help them and so they fail which impairs their self-esteem because there's nobody there to say all right let's learn from this and then just the simple fact of children gain a sense of self-esteem when their caregivers and other people want to spend time with them and if that doesn't happen if the caregiver is too exhausted too overwhelmed too depressed too drunk then the child starts wondering you know what's wrong with me why doesn't my caregiver want to spend time with me i can't trust my caregiver to be there for me all of these things negatively impact self-esteem a need for validation and admiration by other people is often a side effect of a low self-esteem because the person can't look in the mirror and go i am a person of value they look in the mirror and go i hope somebody will love me i hope somebody sees that i can be useful to them in some way and that's that's a very different perspective so they are needing other people to validate them and say you know what you are useful i do need you in order to feel okay about themselves people who are codependent often value other people's approval of their thinking feelings and behaviors over their own so what do i mean by that i mean people who have codependency very often are like chameleons instead of saying these are my opinions they say you know your opinions are more important than mine you're right you're more right than i am so whatever i think must be wrong and i am going to cherish and value your opinion and put you up on this pedestal how does that stem from or how can that stem from insecure attachment well in that those initial relationships if the child or person learn to appease their caregiver learn that okay things can go okay i can be safe and i might even get a little bit of attention if i shower my caregiver with praise and i don't disagree and i don't argue then guess what they're going to continue to do that in adult life in order to avoid abandonment poor boundaries and we see this and this kind of goes back to the anxious or avoidant attachment style but poor boundaries are also a characteristic of codependency when people feel terrified they may have no boundaries at all if they feel terrified of abandonment they may say i have no boundaries at all you tell me what to think you tell me how to feel you tell me whatever you want as long as you don't leave me or they may shut off completely and say this hurts right now and i can't trust you so you need to go away and and it's important to remember that people who've experienced trauma as children who didn't learn how to cope with emotions are often walking this tightrope where they never really feel safe and any misstep they they feel like they're going to fall so they're they're treading lightly on this tightrope but if they start to fall then they are going to react really strongly oftentimes pushing other people away but sometimes bringing them do it doing things to try to bring them closer or guilt them or shame them into coming back now how do how can these be addictive behaviors as well as i mentioned a lot of times codependency or codependent behaviors prompt a surge of norepinephrine and adrenaline which you know gives us energy dopamine as well as oxytocin and all of those chemicals kind of combine into this feel-good soup where the person with codependency may for a moment feel okay they may feel for a moment feel even maybe good and this is kind of at the heart of addictions where people are using a substance or activity to try to get those neurotransmitters to flow they're trying to feel better and they don't know any other way to do it people with addictions as well as uh codependency often are terrified of abandonment and i've talked about that a bunch of times and when people experience abandonment anxiety there are four typical reactions fight flee fawn or freeze so let's look at fight first in a codependent relationship when someone starts feeling like the they're going to be abandoned they may start becoming more critical more angry more agitated more controlling of the other person that's the fight mechanism you know i'll get you back in line and to make sure that you need me and you don't leave me flee is the opposite and this is when the person with codependency says i just i don't know what to do with you anymore and many times flee is almost a passive aggressive behavior because in their mind they're thinking you can't live without me so if i flee then you're going to pursue me you're going to chase me fawn is when people start feeling anxious feeling threatened that they're going to be abandoned or hurt in some way they may fawn over the other person i'll do whatever you want just please don't leave me i'll change i'll do it so there's this period where they're trying to appease the other person instead of control them and finally freeze in a codependent relationship uh sometimes the person with codependency will just shut down they don't know what to do this time so they will shut down they will wall off and this is kind of similar to flea when um and a lot of times people with codependency are thinking that the other person will come pursue them but when they're in that freeze mode they're shutting down and and sometimes they just wall off because they're recognizing that this relationship is exhausting um and they're terrified to let it go and thinking of addiction when somebody is thinking about going into treatment they get to the point where they're sick and tired of being sick and tired but they don't know how to stop they don't have the tools to do deal with life on life's terms because they got a lot of stuff they got to deal with so they just freeze kind of like a deer in headlights going oh crap what do i do how do i get out of this the relationship the codependent relationship often comforts and numbs that abandonment anxiety if the person in the codependent relationship feels confident that the the other person needs them that the other person can't live without them then it helps them feel less anxious because they feel like they've got that parental figure caregiver figure that they never had that they can call on they're never going to be alone the relationship becomes the primary focus and they start minimizing denying and blaming other people to protect the relationship they start making excuses for the other person's behavior whether it's because they're calling in sick or they've spent through their kids college account or their kid they didn't show up to their kids soccer game whatever it is that that person is doing as a result of whatever's going on with them their depression their anxiety their their addiction the the person with codependency is there to make excuses and cover it up and say nothing to see here you know we should make sure that we recognize there's nothing going on you know i'm gonna deny it or i'm gonna blame if you wouldn't be so demanding on john then it wouldn't be so overwhelming for him to come so he can't come but it's your fault that he can't come because you um overwhelmed him you wore him out you triggered him to go use again stinking thinking becomes the norm and this goes back to those cognitive problems and again this is a behavior we see in people with addictions a lot their life often becomes one of all or nothing i'm loved or i'm hated i'm safe or i'm not safe so the rest of their thinking tends to become very polarized and there's a lot of every time i do this this happens or you never do this and and stinking thinking is a cognitive reaction to threat remember i said when we feel stressed when we're in a dysphoric mood we tend to notice the threats and we tend to interpret or perceive things in the environment the most nefarious way possible and that makes us feel even more unsafe in our environment which promotes more anxiety which promotes an even darker view of the world people's intentions etc stinking thinking is a big area for adjustment in a lot of people and it's not just addictions we see this in people with depression anxiety and anger too people with codependency and addiction many times have difficulty identifying and expressing their reality they grew up not having any models not having anybody help them develop their emotional intelligence their ability to identify and regulate their emotions they never had anybody help them develop their communication skills and learn how to assertively state what they feel and they never had anybody help them feel like it was safe to they never had anybody validate them and say you know what it's safe to tell me your reality i may not agree with it but it's safe to tell me your reality and there's not going to be mega negative repercussions so for a lot of different reasons people who are codependent often have difficulty even putting it identifying or putting into words what they're experiencing but even if they do even if they do know what they're experiencing many times they're too afraid to even say it for fear of rejection people with addictions often spend so many years numbing their feelings because they don't know how to identify them or regulate them that they have this same problem where they don't even know what they feel anymore what they want because they are they've been out of touch with themselves for so long difficulty identifying and guilt about meeting their adult wants and needs is another characteristic especially prominent in people with codependency because when you've got low self-esteem a lot of times you don't feel like you're worthy of love and taking care of your needs is an act of love and if you don't feel like you're a worthwhile person then it you may feel guilty taking time out to take care of yourself especially taking care of needs beyond the basic food shelter that sort of thing a lot of people with who are in codependent relationships forego sleep and other things in order to focus on maintain manipulate the relationship and they feel guilty if they are taking time out for themselves they don't feel like they deserve it people in codependent relationships often experience emotional dysregulation because they were never taught how to regulate their emotions for one so from the from jump they weren't taught to identify their emotion and how to deal with it but when people are experienced are are exposed to chronic stress and trauma there are brain changes actual structural changes in the brain and the wiring if you will that promote emotional dysregulation it promotes hyper vigilance i'm going to be hyper aware of what's going on constantly scanning for threats well that's exhausting and the person who is constantly scanning for threats may see those and may feel overwhelmed when they're constantly scanning for threats when they're constantly dealing with distressful things they see it is keeping their fight or flight system hyper activated at a certain point the body itself and the brain changes structure and the body itself starts shutting down and the the fight or flight system and says we can't be this hyped up this stressed out this hyper vigilant for this long so we're not going to trigger that fight-or-flight response unless something major happens so the person goes into this place where they're feeling kind of flat which may almost feel safe for them for a period of time because at least they're not overwhelmed but then when something does happen they have a tsunami of neurotransmitters that are secreted and they react in a strong way so you have people who are hyper vigilant highly sensitive um constantly perceiving threats in their environment there's changes in the brain that actually promote or cause the neurochemical reaction that we see as emotional dysregulation can it be fixed fixed to a large part yes as the person starts learning to identify their triggers and regulate their emotions and starts to feel safe and they're not hyper vigilant anymore that hpa axis will retune people with codependency often experience a lot of depression anxiety anger and resentment well anger anxiety and resentment are all part of that fight or flight response and when they start feeling hopeless to change it when they start feeling like you know i'm all i can't be anxious like this anymore i'm exhausted then they may move into this place where they feel helpless hopeless and depressed we already talked about hyper vigilance now interestingly people who are codependent um and people who have addictions often lack empathy for the feelings and needs of others why is that well in codependency as well as in some people who end up developing chemical addictions they didn't learn the skill of empathy they didn't have anybody saying well what do you think how do you think johnny felt when that happened empathy is a learned skill but we have a little bit of it but in order to really become fully empathetic we need to hone that skill and practice it but aside from that the person with codependency or addiction is often so overwhelmed by life and all the crap going on and the terror of being abandoned or the terror of the pain returning they don't have any energy left to empathize with anybody else let's just face it they are trying to keep their head above water and it's not that they don't want to empathize with others or they don't care about others but they are so completely paralyzed and overwhelmed with their own stuff that they just don't have it in them they don't have a breath to focus on it people with codependency often need to be in control and we've talked about that they weren't in control when they were younger they weren't in control of their bodies you know they get emotionally overwhelmed they start throwing a tantrum they didn't know how to regulate they never learned how to regulate they weren't in control of their parents they couldn't get their parents to respond in nurturing ways so as adults they are trying as hard as they can to create an environment that's safe that's all they're doing they're trying to create a sense of safety they may have difficulty admitting mistakes well mistakes mean you're wrong and meaning you're wrong may mean rejection so that can be really threatening for anybody let alone somebody with low self-esteem and fears of abandonment they may be unable to identify or ask for what they need and want and we talked about this a little bit earlier and in treatment it's really important to help people start understanding you know what is the function of this behavior when you try to control your significant other what is the function of that why do you need to try to control them why what is prompting this behavior what would happen if you didn't what does that feel like and where do those feelings come from and how can we what what tools can you develop to cope with those feelings that that are different than trying to control your significant other when you're going through a day and mindfulness is one of the first skills that i have a lot of people develop whether they're recovering from addictions or depression or codependency because it's so important to be able to develop this secure attachment with yourself be consistent with yourself you know be there show up be mindful of you know checking in on what's going on be responsive to your needs once you've actually checked in and figured out what your needs are be responsive validate your needs provide encouragement for yourself and create safety when a person starts being able to do that for themselves then they stop relying on others to do it for them they stop being afraid of being abandoned and being helpless like that little child was a lot of people with codependency have trouble setting healthy priorities and boundaries because again they're so afraid that if i set a boundary i'll be rejected or i'll be abandoned that they have these wide open boundaries i'll do whatever you want once the person has started develop mindfulness and a secure relationship with themselves starting to identify what their needs and wants are then helping them learn how to communicate those wants and needs and set boundaries if they don't have the energy to do something how can they assertively communicate that they may have difficulty making decisions and a lot of this is due to fear of making somebody else angry they often grew up in environments where there wasn't anybody there to help them make decisions or figure out what the right decision was so simple decision making practice can also be helpful and figuring out the motivations are you making this decision because it's the right decision for you or are you making this decision because you fear rejection abandonment criticism whatever people with codependency when they do identify their needs often demand that their needs are met by others and because they can't meet their own needs we're often seeing the emergence if you will of the inner child that didn't have that primary secure attachment so the person is acting more like a toddler than an adult they're demanding that their needs be met because they think well maybe if i demand then this will work for me maybe if i demand that you do whatever i tell you to do you know controlling then you won't abandon me then i'll get my needs met then i'll be safe a lot of times people who are codependent believe that others are incapable of self-care and they've convinced themselves of this because if they believe that their significant other is capable of self-care then their significant other may not need them so in my mind if i'm codependent i need to believe that this person can't do it on their own and they need me so back to that secure insecure attachment again as children they were incapable of self-care and they're projecting that wounded inner child that's incapable of self-care they're projecting that onto their significant others they're trying to nurture sometimes they may be trying to nurture that wounded inner child via trying to nurture a the person they're in a relationship with they may try to convince others what to think or feel and often offer often offer unsolicited advice and direction again going back how is this a replication or a manifestation of what the child went through because of their insecure attachment they may have wanted advice when they were younger they may still want advice because they haven't learned how to cope with life or solve problems and that's something that they want so they're assuming other people want it and they are providing that to them they often have difficulty knowing how they think or feel so they try to convince others how to think or feel because in a way they may want that back they want somebody to tell them what am i feeling right now so they assume since they want it other people must want it too they may become resentful when their help is rejected and use blame and shame to control resentment is a form of anger anger is a reaction to threat so when their health is rejected they feel they start feeling scared they start feeling threatened probably of abandonment so they drop back and punt and they get angry so they start using blame and shame to try to pull the person back in to into line so they won't abandon them on the other hand they may lavish gifts favors or sexual attention on those they want to influence they may do whatever and this is the fawn that we talked about in a relationship a person who's codependent figures out what buttons to push in order to be able to manipulate the other person in the relationship interventions it's important to identify the functions of each of the person's behaviors and the alternatives so what is motivating you to act this way whatever the behavior is and what function does it serve how does it help you feel safe loved content whatever and then what is another way that you could feel safe loved and content besides having to engage in this unhealthy behavior they need to admit powerlessness over others as well as the overwhelming feelings the unhealthy relationship shield them from and this is obviously a 12-step sort of twist but recognizing that we actually cannot control another human being we can shame blame manipulate but ultimately they have the ability to choose and it's important that people recognize that they are powerless ultimately over another person and how are they going to deal with that because that thought is terrifying and recognizing that they may be powerless over some overwhelming feelings that they have been hiding from or trying to shield themselves from and that those feelings will come so they need to figure out how to tolerate the distress and how to cope with it then they need to begin developing a secure relationship with themselves through mindfulness and self-esteem work until they can provide self-validation and self-comfort all relationships can potentially become codependent people with codependency issues generally get in relationships with others who need to be rescued they don't feel worthy or lovable for themselves because they were harshly criticized or neglected and ignored often as children not always but often this starts in childhood and as a result they need somebody to validate them so helping them repair that broken attachment method is going to be a huge step towards helping them start forming healthy non-codependent relationships recovery involves developing a sense of self-worth identifying the function of the behaviors addressing the depression guilt resentment and anxiety and what triggers those things and then developing skills to deal with those feelings and learning about and creating a network of healthy relationships