Despite significant advancements in political and health initiatives by governments and non-governmental organisations, shame, stigma, and internalized stigma continue to profoundly impact millions of lives worldwide. These negative perceptions and self-judgments can lead to feelings of worthlessness, self-blame, and social withdrawal, which in turn hinder access to services and participation in treatment.
Shame and stigma are particularly prevalent among individuals with substance use disorders, mental health conditions, and those experiencing psychosis. For instance, internalised stigma can lead to low self-esteem, depression, and hopelessness, which significantly impede recovery and emotional well-being. Even with the implementation of cognitive therapy and other supportive measures, the battle against internalised stigma remains ongoing in a similar fashion to intergenerational trauma, as though it has been built into human DNA.
Political and health initiatives have attempted to be instrumental in addressing these issues. For example, the Australian Government Department of Health and Aged Care has launched numerous programs aimed at improving health outcomes and reducing stigma. These initiatives focus on health promotion, early intervention, and disease prevention, aiming to create supportive environments for those affected by stigma.
However, the persistence of shame and stigma highlights the need for continued efforts to combat these issues especially in the workplace and within individual families. Addressing stigma therapeutically, promoting empathy and non-judgmental attitudes, and supporting individuals to view themselves beyond their conditions are crucial steps in mitigating the negative impacts of stigma.
Helping someone with a substance use disorder (SUD) while protecting yourself and your family involves a delicate balance of support and self-care. Here are some steps you can take:
1. Educate Yourself
Understanding SUD and its effects can help you make informed decisions and provide better support. Reliable sources include medical professionals, reputable websites, and support groups.
2. Set Boundaries
Establish clear boundaries to protect your well-being. This might include rules about substance use in the home, financial support, and personal interactions. Boundaries help prevent enabling behaviours and reduce stress.
3. Practice Self-Care
Taking care of yourself is crucial. Engage in activities that bring you joy and relaxation, such as exercise, hobbies, or spending time with friends. Self-care helps you maintain your mental and emotional health.
4. Seek Support
Join support groups like Al-Anon or seek therapy to process your emotions and develop coping strategies. Connecting with others who are going through similar experiences can provide invaluable support and understanding.
5. Encourage Professional Help
Encourage your loved one to seek professional help, such as counselling, therapy, or medical treatment. Treatment programs often include individual, group, or family therapy sessions, which can be beneficial for everyone involved.
6. Detach with Love
Detaching with love means setting emotional and psychological boundaries while still offering support. This approach helps you avoid becoming emotionally drained and allows your loved one to face the consequences of their actions.
7. Be Patient and Compassionate
Recovery is a journey that takes time. Be patient and compassionate with your loved one and yourself. Celebrate small victories and stay hopeful.
8. Avoid Judgment
Avoid being judgmental when discussing substance use. Offer support and understanding instead of criticism, which can help reduce feelings of shame and stigma.
References
Al-Anon Family Groups. (n.d.). Al-Anon and Alateen. Retrieved from https://al-anon.org/newcomers/what-is-al-anon-and-alateen
Australian Government Department of Health and Aged Care. (2024). Initiatives and programs. Retrieved from https://www.health.gov.au/about-us/what-we-do/initiatives-and-programs
Australian Institute of Health and Welfare. (2024). Health promotion and health protection. Retrieved from https://www.aihw.gov.au/reports/australias-health/health-promotion
Australian Government Department of Health. (2019). Alcohol and other drugs – Information for families. Retrieved from https://www.health.gov.au/resources/collections/alcohol-and-other-drugs-information-for-families
Mental Health Foundation. (2016). How to cope when supporting someone else. Retrieved from https://www.mentalhealth.org.uk/publications/how-cope-when-supporting-someone-else
Morrison, A. P., Birchwood, M., Pyle, M., Flach, C., Stewart, S. L. K., Byrne, R., Patterson, P., Jones, P. B., Fowler, D., & Gumley, A. I. (2013). Impact of cognitive therapy on internalised stigma in people with at-risk mental states. The British Journal of Psychiatry, 203(2), 140-145. https://doi.org/10.1192/bjp.bp.112.112110
National Institute on Drug Abuse. (2020). Family support in addiction recovery. Retrieved from https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/family-support-in-addiction-recovery
Substance Abuse and Mental Health Services Administration. (2015). Substance use disorders. Retrieved from https://www.samhsa.gov/find-help/disorders
Wood, L., Byrne, R., Burke, E., Enache, G., & Morrison, A. P. (2017). The impact of stigma on emotional distress and recovery from psychosis: The mediatory role of internalised shame and self-esteem. Retrieved from https://repository.essex.ac.uk/21927/1/woodpr2017.pdf
Your Room. (2021). Shame and self-stigma. Retrieved from https://yourroom.health.nsw.gov.au/whats-new/Pages/Shame-and-self-stigma.aspx
Identify your stressors or potential stressors. Sometimes, “stress” is frustration or fear in disguise.
Plan ahead
Decision making and problem solving
Accept what we cannot change
Changing how we see stressful situations
We may not be able to change our circumstances, but we can see them differently (Forsyth & Eifert, 2016). For example, stress can be viewed as an experience that will support our learning, growth, and personal development.
Technique: Accept – Choose – Take action
Acceptance and Commitment Therapy (ACT) has proven valuable for people learning to manage anxiety and stress; it encourages:
Letting go of the struggles that keep them stuck
Cultivating peace of mind
Accepting what is, and doing what works
Rather than struggle to reduce stress and anxiety, we:
a. accept what we are already experiencing and then
b. choose the direction we would like our life to take, and then
c. take action that reflects are values
Technique: Radical acceptance
Radical acceptance is often practiced within Dialectical Behaviour Therapy (DBT). Radical acceptance is based on the notion that suffering does not come directly from painful experiences but our attachment to them. For example, workplace stress may be more about your identity and status in the workplace rather than the stress itself.
Radical acceptance means fully accepting everything that you are experiencing in the present moment i.e., thoughts, feelings, emotions, body sensations, reactions, attitude, environment etc. We fully accept the present moment because what we resist persists. The more we deny reality the more painful (or unpleasant) we will perceive it to be. Radical acceptance is about saying “yes” to exactly what is happening for us in the moment.
Radical acceptance is about accepting life on life’s terms and not resisting what one cannot or chooses not to change.
Accepting doesn’t mean agreeing. It’s simply exhausting to fight reality, and it doesn’t work.
Resisting reality delays healing and adds suffering to one’s pain.
Technique: Challenging core beliefs
Our core beliefs can shape how we face up to the difficult times and how we react to stress (Beck, 2011) and reconstructing them in a balanced way that allows room for perceived shortcomings.
Humans subconsciously “look for” evidence to support their core beliefs about themselves and the world.
You may have to take mental control to actively on-purpose look for evidence to the contrary.
Technique: Acceptance of our thoughts and feelings
The goal of ACT is to accept what lies beyond our control and commit to life-enhancing actions instead.
There are six core processes in ACT:
1. Contact with the Present Moment
Conscious awareness of your experience in the present moment enables you to perceive accurately what is happening Gives you important information about whether to change or persist in behaviour Enables you to ‘catch’ cognitive fusion ‘in flight’ Allows you to engage fully in what you are doing.
2. Acceptance
Actively contacting psychological experiences directly, fully, and without needless defense Definition: defused, open, undefended contact with the present moment, as a fully conscious human being.
‘Opening yourself fully to experience, as it is, not as your mind says it is’.
3. Defusion
Looking at thoughts, rather than from thoughts Noticing thoughts, rather than being caught up in thoughts Seeing thoughts as what they are, not as what they seem to be Aim of Defusion is NOT to feel better, nor to get rid of unwanted thoughts Aim of Defusion IS to reduce influence of unhelpful cognitive processes upon behaviour; to facilitate being psychologically present & engaged in experience; to facilitate awareness of language processes, in order to enhance psychological flexibility.
4. Self-as-context or The Observing Self:
Observe and accept all changing experiences.
How rigid is your thinking? Allow for psychological flexibility. Think in new ways. Consider other perspectives. Ask people for their perspective.
It is a process, not a thing: an awareness of awareness itself: ‘pure awareness’.
It is that aspect of a human being that does all the noticing/observing of one’s inner and outer world. You could call this “meta-awareness” or “pure awareness” if you prefer: it’s the awareness of one’s awareness, or the noticing of one’s noticing, or the consciousness of one’s consciousness.
5. Values
Chosen life directions ‘Your heart’s deepest desires for the sort of person you want to be and the things you want to do in your time on this planet; in other words, what you want to stand for in life’ Provide motivation & inspiration Provide guidance for your actions Give life meaning Give a sense of abundance Are different to goals 6.Committed Action Overt behaviour in the service of values (may require skills training) Committed action is: values-guided, effective & mindful
Technique: Meditation for acceptance
Meditation is a powerful tool for accepting stressful situations and difficult emotions. Bring your attention, non-judgementally, to your mind, body, and environment. Here are some alternative definitions:
“Bringing one’s complete attention to the present experience on a moment-to-moment basis.” (Marlatt & Kristeller)
“Paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally” (Kabat-Zinn).
“The nonjudgmental observation of the ongoing stream of internal and external stimuli as they arise.” (Baer)
“Awareness of present experience with acceptance.” (Germer, Segal, Fulton)
“Consciously bringing awareness to your here-and-now experience, with openness, interest, and receptiveness.”
Allow everything to be just as it is. Do the following to start for 2 minutes, 5 minutes, 10 minutes, or as long as you like, whenever you like:
1. Take a seat. Find place to sit that feels calm and quiet to you.
2. Set a time limit.
3. Notice your body.
4. Feel your breath.
5. Notice when your mind has wandered.
6. Be kind to your wandering mind.
7. Close with kindness.
Technique: Grounding and centering
5-4-3-2-1 Technique
Using the 5-4-3-2-1 technique, you will purposefully take in the details of your surroundings using each of your senses. Strive to notice small details that your mind would usually tune out, such as distant sounds, or the texture of an ordinary object.
Vision
What are 5 things you can see? Look for small details such as a pattern on the ceiling, the way light reflects off a surface, or an object you never noticed.
Touch
What are 4 things you can feel? Notice the sensation of clothing on your body, the sun on your skin, or the feeling of the chair you are sitting in. Pick up an object and examine its weight, texture, and other physical qualities.
Sound
What are 3 things you can hear? Pay special attention to the sounds your mind has tuned out, such as a ticking clock, distant traffic, or trees blowing in the wind.
Smell
What are 2 things you can smell? Try to notice smells in the air around you, like an air freshener or freshly mowed grass. You may also look around for something that has a scent, such as a flower or an unlit candle.
Taste
What is 1 thing you can taste? Carry gum, candy, or small snacks for this step. Pop one in your mouth and focus your attention closely on the flavours.
Naming categories
Choose a category (e.g., colours, shapes, textures), then look around the room and name all of the things you can see in that category.
Cold water
Have a few slow sips of cold water, feeling the sensation of the cold water in your mouth and notice the sensation as you swallow.
Washing your face with cold water can also reduce your heart rate and lower stress levels.
Counting
Count backwards from 20. You can do this as many times as you need to. Say to yourself that you are becoming calming as you count down each number.
Notice your breath
Take a deep breath and as you exhale, imagine breathing out strongly through the soles of your feet. Feel the connection of your feet with the floor. Do this three times.
2. Behaviours that can protect our vulnerability to stressful situations
It is essential to consider what skills and tips we can use to manage stress and ultimately improve our wellbeing inside and outside work:
Exercise i.e., running, swimming, resistance training, aerobics etc.
Eating healthy foods
Avoiding alcohol and other drugs
Recommended sleep at the recommended times i.e., 8 hours during the night hours.
See your GP if you are experiencing physical or psychiatric illness
Spend time with family and friends
Engage in a hobby or create a hobby
Meditation, yoga, group exercise, group mindfulness classes
Listening to music
Setting a time to watch tv and having boundaries re length of time watching tv
Read a book
Self-care tips
Life, and particularly work, can be stressful. Self-care is essential to keep us functioning well and improving our overall wellbeing (Bush, 2015).
The following aspects of our health are vital to our wellbeing and crucial for managing stress better. Ask yourself the following questions when your intuition tells you that you may be in a deficit:
Without sleep, we cannot think clearly – are you getting sufficient sleep?
Exercise is one of the best cures for stress – are you prioritizing physical activity?
Our brain is maintained by the food we eat – are you eating a balanced and varied diet?
Healthy relationships are vital for our wellbeing – are you making time for the people you care about?
Self-expression enriches who we are and how we live – are you giving the focus you would like to the things you are passionate about?
Community and spirituality ground who we are and how we live – how can you make yourself more open to both?
Managing stress in the workplace
Stress is a significant factor in many workplaces, resulting in countless hours lost due to time off or non-productive hours. We may think the responsibility is on workplaces to create environments that reduce stress and help workplace stress, but it’s also very much an individual responsibility.
Putting in place each of the following will help (modified from HBR guide to beating burnout, 2021):
Increase psychological safety Trust and collaboration will reduce the perception that the workplace is a threat.
Build regular break times We cannot focus for beyond 120 minutes without appropriate rest breaks. Build them into the day and encourage people to use them.
Encourage the use of private workspaces Open offices often have many distractions that can frustrate staff when unable to concentrate. Supply private workplaces where staff can focus without interruption.
Set boundaries around time outside of work The borders between work and personal life are often blurred, especially if working remotely. Set clear expectations and stick to them.
Create flexible work policies Juggling work and family life is not easy. Flexibility can remove or reduce that stress without feelings of guilt.
Make sure people are in the right roles When staff are doing jobs they enjoy and are well supported they thrive and take challenges in their stride.
Encourage autonomy Micromanaging is stressful for everyone. Give teams the autonomy to manage their own projects and staff their individual tasks.
3. Further Stress Relief Activities
Positive emotions such as joy, awe, hope, and optimism are essential to living the good life and are known stress relief techniques. They strengthen our psychological resources for overcoming tough, stressful times (Seligman, 2011).
Boosting positive emotions
Practice gratitude. A helpful way to practice gratitude is to think of everything you have in life and imagine if something was taken away.
Spent time with people who you love.
Do something kind for someone else.
Spend time in nature.
Take a break from screens (tv, mobiles, computers).
Take a break from listening to the news.
Take a work holiday.
Laugh more – find something to laugh about and share it with someone. How often are you laughing?
Build hope
Hope is a positive, optimistic frame of mind in which we expect good events and scenarios to occur. The ability to remain hopeful can help you bounce back more effectively from life’s difficulties when they crop up (Seligman, 2011).
Improving self-awareness
Mindful reflection can leave us grounded and better aware of ourselves and our situation. The Who am I without this stress? exercise helps us focus on what is “right” with us rather than what is “wrong”.
Once centred by our breathing, ask yourself to consider:
What do I value most in life? Are my current stressors more important than what’s most important? What do I enjoy doing? What do I look forward to every day? When do I feel at my best?
Change the way you talk to yourself
When we are stressed, we sometimes say negative or self-defeating things to ourselves. Unhelpful self-talk might include things like, “I can’t cope”, “I’m too busy to deal with all this”, “This is all their fault”, or “I’ll never get this done”. Negative self-talk can make it more difficult to manage stress.
Notice your self-talk and work on using helpful, soothing, and calming self-talk, such as, “I am coping well given what I have on my plate”, “Relax, this stressful time will pass”, or “This is a stressful situation, but what is one thing I can do to help me get through this?”
Ask yourself:
Am I overestimating the likelihood of a negative outcome?
Am I overestimating how bad the consequences will be?
Supporting someone who’s having thoughts of suicide is one of the most important, and at times most challenging, parts of a support persons role. People who experience suicidality can vary from passing ideas to serious planning and often come from a place of deep emotional pain. We all have a duty to respond with care, compassion, and an attempt to understand the experience in a way that keeps safety at the heart of every conversation.
Firstly, if you or someone you know is having thoughts of suicide, please know that you’re not broken or beyond help. These thoughts often come when emotional pain feels unbearable and we can’t see a way out. But things can shift, and help is available. We may spend much of our time alone, and we can feel alone even in a crowded room, but you are not alone in this. Suicidality is not uncommon.
The Numbers Today
According to the latest figures (ABS, 2023):
Suicide is the leading cause of death for Australians aged 15 to 44.
In 2022, over 3,100 people died by suicide—about 8.6 deaths each day.
Men account for 75% of those deaths, though women attempt suicide more often (but less often fatally).
According to the Black Dog Institute, roughly 65,000 Australians attempt suicide each year, while around 3,200 die by suicide annually.
Rates among Aboriginal and Torres Strait Islander peoples are more than double the national average.
People living in rural and remote areas face higher suicide risks due to isolation, limited services, and other pressures.
Why Does the Mind Think About Suicide?
From a humanistic psychology point of view, suicidal thoughts are not signs of illness or failure, they are a deep emotional signal that something in your life or environment needs care, change, or healing.
Each person and living creature on the planet are inherently worthy, with an innate drive to survive, grow, connect, and for humans, find meaning. When life feels full of suffering, such as grief, isolation, trauma, shame, or hopelessness, the mind may start to believe that death is the only way to stop the pain.
In this view, suicidal thoughts are often not about wanting to die—but about wanting the pain to stop.
They arise when:
You feel disconnected from others or from yourself.
You feel stuck in circumstances that seem unchangeable.
You believe your worth or purpose has been lost.
You’re exhausted from holding on or pretending you’re okay.
But the humanistic perspective also holds this powerful truth: you are more than your pain, and within you is a capacity for healing, choice, and change, even if it doesn’t feel like it right now.
Treat Yourself with Compassion, Not Criticism
It’s easy to get caught in a spiral of self-blame. But you are not weak or selfish. You are a human being who is hurting—and just like you wouldn’t shame someone for being in physical pain, you deserve the same care when your pain is emotional.
Ask yourself:
If someone I loved felt this way, what would I want them to know?
Then try to offer yourself the same kindness.
Reach Out – Connection Saves Lives
Talking to someone can ease the intensity of what you’re feeling. You don’t have to explain everything. Just saying, “I’m not okay right now,” is enough to start.
Lifeline 13 11 14
Beyond Blue 1300 22 4636
Suicide Call Back Service: 1300 659 467
Beyond Blue: 1300 22 4636
13YARN (Support for Aboriginal and Torres Strait Islander Peoples): 13 92 76
QLife – National LGBTQIA+ Peer Support and Referral Service: 1800 184 527
Hours: 3pm – Midnight (local time), every day
What they offer: Confidential, non-judgemental, and inclusive support from trained LGBTQIA+ peer workers. They are not a crisis line like Lifeline, but they can support people in distress and connect you with further help if you’re at risk.
How Counselling Can Help: Evidence-Based Approaches
Counsellors and Psychologists don’t rely on guesswork when helping someone who’s feeling suicidal. They use researched strategies to support recovery. Here are a few key approaches:
Collaborative Assessment and Management of Suicidality (CAMS): This method focuses on working together with the person in distress, rather than telling them what to do. It aims reduce suicidal thoughts more effectively than traditional therapy.
Cognitive Behavioural Therapy for Suicide Prevention (CBT-SP): This version of CBT focuses specifically on managing suicidal thoughts by teaching problem-solving and positive thinking strategies.
Dialectical Behaviour Therapy (DBT): Originally designed for people with intense emotions or borderline personality disorder, DBT is now widely used to reduce suicide risk by teaching emotional regulation, mindfulness, and better relationship skills.
Safety Planning: This involves creating a personalised plan for what someone can do when they feel at risk, including who to call, calming strategies, and safe places to go.
Means Restriction Counselling: This involves helping someone reduce their access to anything they might use to harm themselves, like certain medications or weapons, done through sensitive, respectful conversations.
Barriers to Speaking Up
Even with growing public awareness, there’s still a strong stigma around suicide. Many people worry they’ll be judged, locked up, or shamed if they admit they’re struggling. These fears can stop people from reaching out for help, which is why creating a safe, non-judgmental space is so important in counselling.
Rural and Remote Communities
People in regional and remote parts of Australia often find it harder to access mental health support. Telehealth (online or phone sessions) has helped bridge that gap, but it’s not always easy to pick up on non-verbal cues or respond to crises from a distance.
Cultural Awareness Matters
For Aboriginal and Torres Strait Islander peoples, suicide cannot be separated from the impacts of colonisation, loss of culture, and ongoing trauma. Culturally safe, community-led solutions are essential and more effective in these contexts.
Remember That Feelings Change—Even the Darkest Ones
It may not feel like it right now, but these feelings will pass. Emotions are like waves—sometimes crashing, sometimes calm—but never permanent.
What you feel today is not a life sentence. With support and time, things can change. You deserve the chance to see what healing and hope feel like.
Safe Haven NSW Services(for suicidal distress, NOT EDs)
Please check official websites for update information re contact information, hours of operation, and status of operation i.e., still operating. The information on this website has been collected June 2025.
Safe Havens are calm, non-clinical spaces where you can talk with peer workers and mental health clinicians if you’re in emotional crisis — no appointment needed.
No police or emergency involvement unless requested or necessary.
Safe Haven locations across NSW — these are welcoming, non-clinical places where anyone feeling suicidal or in deep distress can drop in and speak to peer workers or mental health clinicians. No appointment, referral, or Medicare card needed. Visit the following for operating hours and locations across NSW: Safe Haven
By Mitchell Webb | Webb Therapy, Surry Hills Sydney
We all have moments in relationships where we give too much, worry too much, or lose ourselves a little in someone else. That is not codependency — that is being human. But when those moments become the architecture of the entire relationship, when your sense of self, your emotional stability, and your very identity become organised around another person’s needs, moods, and wellbeing, something more significant may be at play.
Codependency is one of the most misunderstood and underdiagnosed relational patterns in clinical practice. It is frequently mistaken for love, devotion, or simply being a caring person. Yet the research is consistent: left unaddressed, codependent patterns cause significant harm to both people involved — and they rarely improve on their own.
This article explores what codependency actually is, what the current evidence says about how to identify it, and — critically — what you can do if you recognise yourself in it.
What Is Codependency, Really?
The term “codependency” originated in the addiction treatment field in the 1970s and 1980s, used initially to describe the partners and family members of people with substance use disorders. Clinicians noticed that the people surrounding someone with addiction often developed their own set of dysfunctional patterns — enabling behaviour, emotional enmeshment, a compulsive need to control or fix the other person — that were distinct from, yet deeply intertwined with, the addiction itself.
Over the following decades, the concept broadened. Researchers and clinicians came to understand that codependency was not unique to addiction contexts. It appeared in relationships involving chronic illness, mental health conditions, emotional immaturity, narcissistic traits, and even in ostensibly “normal” relationships where one person had learnt, usually in childhood, that love was conditional on their usefulness or selflessness.
The American Psychological Association (2023) now broadly defines codependency as an emotional and behavioural pattern characterised by excessive reliance on others for approval, identity, and self-worth — typically at the expense of one’s own needs, boundaries, and sense of self.
Mental Health America describes it as a “relationship addiction”: a pattern where people form or maintain relationships that are one-sided, emotionally exhausting, and often damaging — yet feel compelled to stay because their sense of purpose and worth has become fused with the relationship itself.
Importantly, current research frames codependency not as a character flaw or a deliberate choice, but as a learned relational strategy — one that almost always has its roots in early experiences where a child learnt that to be loved, they needed to be needed.
The Difference Between Normal Relationship Behaviour and Codependency
This is perhaps the most important clinical question, and one that causes enormous confusion. Most people, at some point in a relationship, will:
Put their partner’s needs before their own
Worry excessively about someone they love
Suppress their own feelings to keep the peace
Feel their mood affected by their partner’s emotional state
Struggle to maintain boundaries with someone they care about deeply
None of these, in isolation or temporarily, constitute codependency. Relationships involve genuine interdependence — research by Rusbult and Van Lange (2003) in the Annual Review of Psychology demonstrates that healthy mutual reliance is not only normal but essential to human flourishing. We are wired for attachment, and feeling affected by those we love is a feature of that, not a flaw.
The distinction lies in pattern, pervasiveness, proportion, and — critically — motivation.
In healthy relationships, care for another is chosen freely from a stable sense of self. You can be deeply affected by your partner’s pain without feeling responsible for fixing it. You can prioritise their needs without abandoning your own. You can be close without losing the thread of who you are.
In codependent relationships, the dynamic is structurally different. The table below outlines the key distinctions that clinicians look for:
Normal relationship behaviour
Codependent pattern
Motivation for caring
Genuine love and choice
Fear of abandonment or loss of worth
Effect on self-esteem
Stable, internally anchored
Contingent on the other’s approval or neediness
Response to the other’s problem
Concern, support, appropriate limits
Compulsive need to fix, rescue, or control
Boundaries
Flexible, negotiated
Blurred, guilt-laden, or non-existent
Sense of self
Maintained within the relationship
Organised around the relationship
When the other person improves
Genuine joy
Anxiety, loss of purpose, or subtle resistance
That last row is one of the most clinically telling features of codependency. When a codependent person’s partner recovers, stabilises, or no longer needs them in the same way, it can trigger a profound identity crisis — because the caretaking role was not just something they did; it was who they were.
Evidence-Based Signs You May Be in a Codependent Relationship
The following indicators are drawn from validated clinical frameworks, including the work of Darlene Lancer (a leading researcher in codependency treatment), the Codependency Assessment Tool (CAT), and broader attachment and self-determination research.
1. Your emotional state is governed by the other person’s
You feel happy when they are happy, anxious when they are struggling, guilty when they are upset — regardless of whether you had any role in it. Their mood functions as the weather system you live inside. This is clinical enmeshment: a blurring of the emotional boundary between self and other.
2. You feel responsible for managing their emotions
Not just concerned — responsible. You find yourself working to regulate their feelings, prevent their distress, or shield them from the consequences of their behaviour. You walk on eggshells. You rehearse conversations. You adjust yourself to pre-empt their reactions.
3. Your self-worth is tied to being needed or useful
You feel most secure, most loveable, most like “yourself” when the other person is relying on you. When they don’t need you — when they are doing well, managing independently, or connecting with others — you feel vaguely anxious, unsettled, or unnecessary.
4. You have significant difficulty saying no
Not simply a preference for harmony, but a deep fear of what will happen if you assert a need, a limit, or a disagreement. Saying no feels dangerous — not mildly uncomfortable, but genuinely threatening to your sense of safety in the relationship.
5. Your own needs feel unimportant, illegitimate, or too much to ask
You consistently prioritise the other person’s needs, minimise your own, and feel guilty or ashamed for having them at all. Other people’s needs feel urgent and real; yours feel like an inconvenience.
6. You enable behaviour that harms the other person (or you)
You cover for them, make excuses, absorb consequences, or rescue them from situations they need to face. You know, somewhere, that this is not helping — but stopping feels impossible, cruel, or too frightening.
7. The relationship has become your primary source of identity
Outside of this relationship, you are not sure who you are, what you want, or what matters to you. Your social connections, interests, and sense of purpose have narrowed to the point where the relationship has become your whole world.
8. You experience disproportionate fear of the relationship ending
Beyond the normal grief of losing someone important, the prospect of this relationship ending feels like annihilation — as though without it, you would cease to exist in any meaningful sense.
What Causes Codependency? The Evidence
Current research strongly implicates early attachment experiences as the primary driver of codependent patterns. Studies in developmental psychology consistently show that children who grow up in environments characterised by:
Emotional unpredictability or neglect
A parent or caregiver with addiction, mental illness, or chronic instability
Conditional love (affection given in exchange for performance, caretaking, or compliance)
Parentification (being required to manage a parent’s emotional world)
…are significantly more likely to develop the relational strategies we now recognise as codependency. These children learn, at a pre-verbal and deeply embodied level, that love is not unconditional — that it must be earned through service, vigilance, or self-erasure.
Attachment theorists describe this as an anxious or disorganised attachment style: a chronic hypervigilance to the emotional states of others, combined with an unstable or underdeveloped sense of self.
Critically, Mental Health America notes that codependency is a multigenerational pattern — one that is modelled, transmitted, and reinforced across families and generations, often without anyone recognising it for what it is. This is why it so frequently feels normal. To the person in it, it simply feels like love.
How to Navigate a Codependent Relationship: What the Evidence Recommends
Recognising codependency is significant. What comes next matters enormously. The following steps reflect current evidence-based approaches, including schema therapy, attachment-focused therapy, and self-determination theory.
Step 1: Name it without shame
Codependency is not a character defect. It is a survival strategy that once served a purpose. The self-critical spiral of “why can’t I just stop?” is itself part of the pattern — a form of the same self-erasure that drives codependency in the first place. Begin by acknowledging what is true, with as much compassion as you can manage.
Step 2: Seek individual therapy — not couples therapy, at least not first
This is one of the most consistent recommendations in the clinical literature, and one of the most frequently ignored. The instinct in a codependent relationship is to focus on the relationship — to fix the dynamic, to work on “us.” But codependency is fundamentally an individual pattern that predates the current relationship. Individual therapy is the appropriate first step.
Evidence-based modalities with strong outcomes for codependency include:
Schema Therapy: Identifies the early maladaptive schemas (core beliefs about self and relationships) that drive codependent behaviour, and systematically reworks them
Attachment-focused therapy: Addresses the insecure attachment patterns at the root of codependency, building what attachment researchers call “earned security”
Acceptance and Commitment Therapy (ACT): Builds psychological flexibility, value-based action, and a stable sense of self that does not depend on external validation
Dialectical Behaviour Therapy (DBT): Particularly helpful where emotional dysregulation and enmeshment are prominent features
Step 3: Begin the work of differentiation
Differentiation — the developmental process of becoming a distinct self within a close relationship — is at the heart of codependency recovery. In practical terms, this means:
Identifying your own feelings, needs, and values separately from the other person’s
Practising sitting with the other person’s distress without rushing to fix it
Rebuilding connections, interests, and a sense of identity outside the relationship
Gradually practising the expression of needs and limits — starting small, building tolerance
This is not a process of becoming cold or detached. Research on interdependence consistently shows that the more securely differentiated a person is, the more genuinely intimate they can be. As The Bridge to Recovery notes, this is what attachment researchers call the “dependency paradox”: the more safely you can depend on someone, the freer and more authentically connected you become.
Step 4: Address enabling behaviours directly
If the relationship involves someone with an addiction, mental health condition, or chronic instability, the codependent person is almost certainly engaging in enabling — behaviours that, with the best of intentions, prevent the other person from experiencing the natural consequences that might otherwise motivate change.
This is extraordinarily difficult to stop, not because the person doesn’t understand it intellectually, but because it is underpinned by deep anxiety and a terror of what will happen if they don’t intervene. Therapeutic support is usually required to navigate this safely.
Step 5: Consider whether the relationship can become healthy
This is a question that must be held with honesty. Some relationships, with both parties doing meaningful work, can move from codependency toward genuine interdependence. This typically requires both people to be willing to acknowledge the dynamic, engage in individual therapeutic work, and — often — couples therapy once both have established some individual stability.
Other relationships cannot sustain that shift. If the other person has no interest in change, or if the dynamic is also characterised by coercive control, abuse, or sustained exploitation, the most honest clinical recommendation is that the healthiest path forward may be to leave.
This is not a failure. It is, in many cases, the most courageous and self-respecting act available.
Step 6: Build the life you paused
Recovery from codependency is not simply the removal of a problematic pattern. It is the construction of something new: a stable, internally anchored sense of self; relationships characterised by genuine reciprocity; a life in which your own needs, values, and wellbeing are not an afterthought but a foundation.
This takes time. It is not linear. But the research is clear that it is possible — and that the therapeutic work, while challenging, produces lasting and meaningful change.
A Note on Seeking Support in Australia
If you recognise yourself in this article, please know that you are not alone and that effective help is available. A number of pathways are worth considering:
Individual therapy with a psychologist or psychotherapist experienced in attachment, schema, or relational trauma
SANE Australia (sane.org) — mental health support and resources
Beyond Blue (beyondblue.org.au) — resources and access to counselling
Co-Dependents Anonymous (CoDA) Australia — a peer support programme based on the 12-step model, with meetings available nationally and online
The fact that you are asking these questions is already significant. Awareness is where change begins.
Mitchell Webb is a counsellor and psychotherapist based in Surry Hills, Sydney, with a focus on relational patterns, attachment, and identity. Webb Therapy offers individual counselling and psychotherapy for adults navigating complex relationship dynamics.
References
American Psychological Association. (2023). APA Dictionary of Psychology. apa.org
Mental Health America. Codependency. mhanational.org
Rusbult, C. E., & Van Lange, P. A. M. (2003). Interdependence, interaction, and relationships. Annual Review of Psychology, 54(1), 351–375.
Feeney, B. C., & Van Vleet, M. (2010). Growing through attachment: The interplay of attachment and exploration in adulthood. Journal of Social and Personal Relationships, 27(2), 226–234.
Lancer, D. (2014). Conquering shame and codependency. Hazelden Publishing.
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press.