The following is a 22-page research paper on the topic of codependency. It was intended to provide a solid introduction to codependency, covering diagnostics, history, effects, and treatment. Though you are welcome to read it in one sitting, I also included a brief Table of Contents so you can quickly jump to a desired section. I hope this helps!

  1. Introduction
  2. Defining Codependency
  3. A Brief History of Codependency
  4. Diagnostic Criteria/Symptoms
  5. The Effects of Codependency
    1. Relational
    2. Neuro-Chemical
    3. Cognitive
    4. Behavioral
    5. Physical
    6. Emotional
    7. Spiritual
  6. Treatment and Recovery
  7. Conclusion
  8. Bibliography


What do you think is the most common addiction? According to Charles Whitefield, “Co-dependence is not only the most common addiction, it is the base out of which all our other addictions and compulsions emerge. Underneath nearly every addiction and compulsion lies co-dependence.”[1] Although this may seem like a bold claim, you will see that this statement, rather than being unfounded, is not only true, but may be groundbreaking in the way that we deal with other addictions.

This is obviously an important topic for the addictions specialist community, but why should pastors know about codependency? There are two main reasons why codependency matters to you as a pastor. First, codependency is prevalent in society. It shows up in our media, portrayed in both negative (Michael Douglas’ character in The Game) and positive (Anna in Disney’s Frozen) lights. When a recent article in Relevant Magazine said, “You love others in order to get their approval,”[2] it struck a chord because people struggle with this and they are looking for conversations to be started.

The second reason pastors need to know about codependency is that there is inevitably someone in your church who struggles with codependency, and that person might not even realize it. In fact, as we will see, one of the key symptoms of codependency is a denial that anything is actually wrong. In addition, you may find that some of your most eager volunteers struggle with it, because they base their value upon the work that they do and the way other view them in doing that work. Although you may lose some ministry partners for a season, after working through their codependent struggles, your leaders will be serving from a more effective and healthy place.

Defining Codependency

Before we go any further, we must take some time to define codependency. The definitions vary from being as broad as, “the tendency in all of us to love, care, or give in a relationship for the wrong reasons,”[3] or as specific as “a recognizable pattern of personality traits, predictably found within most members of chemically dependent families, which are capable of creating sufficient dysfunction to warrant the diagnosis of Mixed Personality Disorder as outlined in the DSM III”.[4]

Typically, the DSM (now up to the fifth edition) would be the first place to look for a clear definition of a disorder, but in the case of codependency it proves unhelpful. Lacking its own category, at best, codependency falls under the large category of “Other Specified Personality Disorder,” which essentially states that the client has symptoms of a personality disorder, but that it is not a clearly a specific disorder.[5]

The Merriam-Webster online dictionary defines codependency as “a psychological condition in which someone is in an unhappy and unhealthy relationship that involves living with and providing care for another person.”[6] Although this is helpful, it is a bit too narrow and, therefore, misses some key aspects of codependency.

Nancy Groom’s definition is clear, touches on three key dimensions of codependency, and even explains several key consequences: “Codependency is a self-focused way of life in which a person, blind to his or her true self, continually reacts to others being controlled by and seeking to control their behavior, attitudes, and/or opinions, resulting in spiritual sterility, loss of authenticity, and absence of intimacy.”[7] This is the definition of codependency reflected henceforth.

A Brief History of Codependency

Before we move on to symptoms of codependency, we are going to take a brief look at the origins of codependency. Part of the difficulty in defining codependency is due to the fact that it has been an idea formed by people who recognized that they suffered from it and have been developing theories as they go through their own recovery, rather than a disorder that has been clinically observed and defined by mental health experts.[8]

The concept of codependency first surfaced in the chemical dependency field, specifically, alcoholism. Although treatment originally only dealt with the alcoholic, it soon became apparent that a sober alcoholic would eventually relapse if they returned to an untreated family. Under closer observation, it became clear that the families were often continuing to treat the recovered alcoholic as an alcoholic, which enabled the drinking problem to resume. The term co-dependent was, thus, originally a description for the family members of chemical dependents (alcoholics, drug addicts, etc.) – the codependents acted almost as if they were addicted to the behaviors of the chemical dependent.[9]

Since then, research has surfaced showing that codependency likely originates in dysfunctional family systems. More specifically, since children learn to relate to others through observing their parents’ interactions, the relational and identity dysfunctions of codependency may be deeply rooted in the way a person was raised.[10] Several studies have been produced which highlight the positive correlation between adult codependency and dysfunctional families, held independent of whether or not there was substance abuse within the family of origin.[11]

Diagnostic Criteria/Symptoms

Since codependency has been shown to develop independently from a close relationship with a chemical dependent, there must be more diagnostic criteria to consider. There is some difference of opinion regarding how the lines are drawn regarding symptoms. For example, Dr. Timmen Cermak, arguing that codependency can be clearly diagnosed as a disorder according to DSM standards, gives five criteria for “Co-Dependent Personality Disorder”:

  1. Continued investment of self-esteem in the ability to control both oneself and others in the face of serious adverse consequences.
  2. Assumption of responsibility for meeting others’ needs to the exclusion of acknowledging one’s own.
  3. Anxiety and boundary distortions around intimacy and separation.
  4. Enmeshment in relationships with personality disordered, chemically dependent, other co-dependent, and/or impulse disordered individuals.
  5. Three or more of the following:
    1. Excessive reliance on denial
    2. Constriction of emotions (with or without dramatic outbursts)
    3. Depression
    4. Hypervigilance
    5. Compulsions
    6. Anxiety
    7. Substance abuse
    8. Has been (or is) the victim of recurrent physical or sexual abuse
    9. Stress-related medical illnesses
    10. Has remained in a primary relationship with an active substance abuser for at least two years without seeking outside help.[12]

Although Cermak began pushing for codependency to be included in the DSM III (or at least the next revision), codependency has not been included, even through the DSM V.[13] Even a cursory look at the variety of symptoms proposed by Cermak reveals that codependency is a very broad category.

Sharon Wegscheider-Cruse takes a different path listing three “brain events” (symptoms) and three “life events” (complications). The brain events are denial, repression of feelings, and compulsions. The life events are low self-worth, relationship problems, and medical problems.[14] Although helpful in some ways, I do not feel that her differentiation between the two categories is entirely justified. If a symptom is an indicator that a disease or condition exists then these should all be considered symptoms, but of varying degrees of codependency.

Pia Mellody presents a fairly standard list of five symptoms which are commonly the focus of treatment. These symptoms involve difficulty…

  1. Experiencing appropriate levels of self-esteem
  2. Setting functional boundaries
  3. Owning and expressing their own reality
  4. Taking care of their adult needs and wants
  5. Experiencing and expressing their reality moderately.[15]

One more key to remember is that codependency is all about degrees. If you’re honest with yourself, you have experienced all of these five symptoms at one time or another in your life. Codependents experience these symptoms to an unhealthy extreme.[16]

The Effects of Codependency

Although the relational effects of codependency are probably the most apparent, codependency affects us in multiple facets of life. We are going to begin our discussion with the most significant area of effect: interpersonal relationships. Then we will briefly examine the neuro-chemical impact codependency has, especially focusing on why the brain’s interactions with chemicals may reinforce the codependent behavior. We will proceed by observing how codependency affects a person cognitively. Next we will see how codependency affects behavior, followed by the effect of codependency on a person physically. After that, we will examine how codependency affects a person emotionally. Finally, we finish our discussion by addressing the ways that codependency can affect us spiritually.


Codependency manifests itself differently in different people.[17] Just as an alcoholic may be an “angry drunk” or one who drinks excessively then falls asleep in a drunken stupor, codependency will look different in different people.

Codependents are noted for having poor relational boundaries. There are both internal and external boundaries. Internal boundaries protect and distinguish our thoughts, feelings, and behaviors from those of the people around us. External boundaries protect and distinguish us physically from the people around us.[18] Poor or non-existent boundaries lead to abuse, either as the recipient or the abuser.

This lack of proper, healthy boundaries is a playground for codependency. With poor internal boundaries, a codependent may be overly concerned with her date’s opinions, to the degree that she will not seem to have opinions of her own. In addition to not being able to protect themselves, people with boundary issues are often unable to recognize other people’s boundaries. Someone who lacks proper external boundaries may hug when offered a handshake or, worse, may pressure his or her date into nonconsensual sexual contact (i.e. rape). One of the most common ways that a codependent’s lack of boundaries will manifest itself is through control.

Codependents need control. They “‘play God’ by controlling those around them for the sake of ‘saving’ them from destructive behaviors such as substance abuse.”[19] Rescuing and caretaking are two common ways that codependents manipulate control. Rescuing, as would be assumed, involves saving someone from negative consequences.[20] This can manifest itself as parents who refuse to discipline their children because they do not want to hurt them. Codependents that struggle with rescuing find themselves taking responsibility for someone else’s actions rather than making the other person remain responsible.

Closely related is the idea of caretaking, that is, doing for someone else the things that person “could and should do themselves.”[21] This might be the mother who never lets her high school students do their own laundry or learn to cook, or the wife who tells her husband which lane to drive in and how quickly or slowly.

As stated earlier, family dynamics play a big role in codependency. Alfred Ells puts it succinctly when he says codependency is “cultivated in the incubator of family life and [is] triggered by the wounds of rejection and loss.”[22] In other words, codependency is very much the result of how your family interacted.

In a dysfunctional family, codependency reveals itself in the various roles that family members take. The five overarching roles are: family hero, scapegoat, enabler, lost child, and mascot. A family hero is the golden child, known for his or her excellence and inability to do anything wrong. However, he or she is not driven by the successes, but by a desire to be good enough to bring an end to the family dysfunction.[23]

By contrast, the scapegoat is the troublemaker of the family. The scapegoat’s actions will bring the family dysfunction to light, but only because he or she is blamed for the dysfunction.[24]

An enabler is driven by the desire to present the family as picture perfect. He or she will be very concerned with hiding problems from the public eye and trying to control the behaviors of the other family members.[25]

The lost child and mascot are flip sides of the same coin. Both are resistant and overwhelmed by the chaos of their family’s dysfunction, however, this resistance manifests itself differently. For the lost child, safety is found in seclusion and isolation. The mascot, on the other hand, attempts to draw attention to him or herself, much like the hero. However, unlike the hero, the mascot will resort to humorous antics, teasing, and “clowning around.”[26]

In each of these roles, the person is exercising their codependence in their reactions to the family dysfunction.


The five family roles are important in understanding the neuro-chemical effects of codependency. According to Dr. Robert Cloninger, there are three “temperament dimensions” which are defined according to an individual’s response to novelty, danger or punishment, and reward. These three factors are called novelty seeking, harm avoidance, and reward dependence.[27] Interestingly, there have been studies that indicate that an affinity toward or aversion from one or more of these factors may be determined slightly more by inherited predisposition (i.e. nature) than by environmental contributions (i.e. nurture).[28]

Someone who is prone to novelty seeking gets a “high” off of risks, spontaneity, and crises. These situations cause the brain to release dopamine, which is the chemical that influences motivation, cognition, and motor control.[29] Looking at the family roles, the scapegoats and mascots are often the novelty seekers.[30] While the scapegoat will look outside the family to take risks, the mascot will use his or her own spontaneity along with the uncertainty and crises within the family to cause dopamine production.

Reward dependent persons define their self-worth based on “accomplishment, position, possessions (including people), and power.”[31] This person can be obsessive-compulsive or passive-aggressive, seeking to control those around him or her through either overt or covert methods. This leads to the release of norepinephrine (a.k.a. noradrenalin) which is connected with concentration, memory, and (along with epinephrine) the “fight-or-flight” response.[32] Within the family roles, this person is usually the family hero or the enabler.

A prime example of a reward dependent person is a workaholic, who is constantly striving for the next raise, the next big breakthrough, or the next job. Particularly successful workaholics are probably releasing both dopamine and norepinephrine, leaving them “as medicated as a marijuana user.”[33]

Those people who are harm-avoidant do their best to maintain the status quo. They “play it safe” and their bodies reward their risk aversion by producing serotonin, a natural tranquilizer.[34] This will likely manifest itself as the lost child. It can, however, also manifest as a second type of enabler who enables dysfunction through their inaction.

Codependency, untreated, will inevitably stretch an individual beyond his limits. The body will respond by releasing epinephrine, norepinephrine, and cortisol, which primes the body for action or reaction.[35] As we will see later, this constant state of “high alert” has an impact on the physical body.


Codependency is an identity issue. It is shaped by a person’s self-concept, “the sum total of all the thoughts, beliefs, images, and perceptions we have about ourselves.”[36] This is closely related to, and I believe, encompasses the idea of self-esteem, which will be addressed under emotions. It is also connected to a misunderstanding of a person’s intrinsic worth. A codependent, doubting their intrinsic worth, will seek to make themselves indispensible through caretaking and control.[37]

Cognitive confusion shows up on two different levels in codependents. In the first, the individual, though aware of what they think, will not share it until they know that thought will be accepted. At the second level, the codependent does not know what they think and their mind will go blank or thoughts will become jumbled when asked.[38] This stretches from simple opinions such as a favorite color to an inability to recognize and label emotions the codependent is feeling.

Codependents often struggle with various thinking disorders. They view the world dualistically: right or wrong, good or bad.[39] “Balance” is not in the vocabulary of a codependent; every situation and action must be “all or nothing”. Their thinking patterns are skewed toward obsessive, analytical, and linear thought processes.[40]

Although dishonesty would seem to be more of a relational problem, the way in which codependents struggle with dishonesty is unique enough that I believe it belongs in the cognitive category. First and foremost, codependents are dishonest with themselves. They are dishonest about their feelings. Codependents can also focus so much on pleasing someone else and meeting that person’s expectations that they can ignore or even deny their own morality.[41]

One particular example of dishonesty is even unconsciously promoted by the church! In church, there is an unconscious pressure to be “nice” or “fine” whether or not a person actually feels nice or fine. Rather than dealing with the struggles, temptations, or emotions that lie under the surface, we are taught to paint on a smile and be “nice,” often to the detriment of the credibility of the church as an authentic institution and the health of our souls.[42]

Codependents are very self-centered, but it looks differently than one might expect. Rather than a boisterous, “Look at me!” codependent self-centeredness may look very selfless. Codependents tend to view themselves as the cause of everything that happens to the object of their codependence (i.e. “Oh, you’re unhappy, what did I do?”). They also are incessant meddlers: they don’t believe that others can solve their own problems and must intervene themselves to fix the situation.[43]


Codependents may display a variety of behavioral tendencies. An attempt at self-sufficiency runs behind many of these behavioral patterns. While many codependents struggle with low self-esteem, others choose to forge forward on their own, refusing help. In this way, codependents betray an unhealthy fear of the world, because only the individual herself can be trusted.[44] This is a method to insulate the codependent, leaving fewer opportunities for others to hurt him.

Related to this self-sufficiency is perfectionism. This could be displayed by either the parents or the children. The former may demand perfection because children reflect their parents and reveal “good” parents. The latter may demand perfection from themselves, haunted by a feeling of never being good enough.[45]

Codependents will often seem rigid (as seen in perfectionists). They will find whatever works best within their limited view of the world, and then force themselves to operate within that framework. The natural consequence of such rigidity (combined with rescuing or caretaking) is a judgmental attitude toward others. If the only way to survive in the world is to live as the codependent does, they must judge anyone outside of that framework as deficient.[46]

This rigidity also plays out in a refusal to risk. Love is risky. Change is risky. Unfortunately, both of these are necessary to overcome codependency. But as Groom states, “rather than risk change and healing, the codependent will rigidly cling to what is familiar, even if it is destroying everybody.”[47]

Since codependency often rises out of family dysfunction, codependents often struggle with an unhealthy understanding of loyalty. While typically understood as a virtue, loyalty can become a liability if abused. Dysfunctional families will perpetuate lies which emphasize the importance of family, or that family issues are not to be discussed outside of the family. The codependent, then, is unwilling and unable to “betray the family” by seeking any outside help. This degree of secrecy can lead to pulling back from many relationships for fear that the family secrets will be known by an outsider.[48]

Isolation can be experienced both corporately (as a family unit pulls away from relationships that could reveal the dysfunction) or individually (the lost child). As we just saw, isolation can come from an unhealthy loyalty. It can also stem from a need for control and image management. Rather than allowing someone to see the dysfunction, the codependent will try to maintain control himself, thereby perpetuating a projected image to those who are outside looking in.[49]


“Co-dependents need to be needed,” and they will do whatever is necessary to make sure they are needed.[50] This compulsion, combined with their need for control, often drives codependents well beyond their human limits.

Physical sickness “from attempting to control the uncontrollable”[51] can create a “martyr” image for them. The attention garnered through their “martyrdom” feeds their compulsive need to be needed. Ultimately, they feed off of a sense of power that comes through their martyrdom, which “lies at the core of co-dependence.”[52]

Codependents become so singularly focused on “taking care of others, keeping things going, and surviving that they often develop stress-related functional or psychosomatic diseases” (e.g. headaches; backaches; respiratory, heart, and gastrointestinal problems; and hypertension).[53]

As stated before, while under stress, releases chemicals which prime the body for action. While this is a natural response, the constant drive of the codependent leaves them in this state for long periods of time, which places a lot of stress on the organs. Like keeping a car engine running at high RPMs, a person’s body may not show the stress at first, and may even seem to be performing better than normal for a while. But eventually, this high level of operation will lead to health problems like tachycardia, hyperacidity, myalgia, tachypnea, and hypoglycemia. Then, as the organs begin to break down, varying degrees of damage begin to occur, from arrhythmia, gastritis, and shortness of breath, to heart failure, ulcerative colitis, ruptured blood vessels, blood clots, and lung damage.[54]

In addition to these health complications, it is also quite common to see codependents developing other addictions as well (e.g. eating disorders, hyperactivity, workaholism, over-spending, and even alcoholism and drug abuse).[55] In fact, codependency “is the primary causal agent in all of these problems, responsible not only for the excessive self-abnegation and inhibition with which co-dependency [sic] was originally associated but also for the exact opposite behaviors—for the variety of excesses,” that is, compulsive addiction behaviors.[56]


On an emotional level, codependents have skewed and repressed their emotions to incredible and saddening degrees. One of the root causes of the emotional struggles of a codependent person is a chronically low self-esteem. Many codependents feel as if they do not have any intrinsic worth, so they look outside themselves for meaning and value.[57] They can wrap their lives around this “other-esteem”, letting it influence the way they look, the jobs they take, the friends they have, the car they drive, etc.[58] In fact, it would not be incorrect to say that codependents are addicted to the approval of others. This desire to “people-please” and need for affirmation can exist on any plane, depending on the individual. Some people may feel the need for approval from everyone they come into contact with, while others may only need the approval of one or two people (e.g. from mom and dad, or from my spouse).[59]

If untreated and unaddressed, this low self-esteem can eventually grow into self-neglect. This self-neglect may be as mild as feeling guilty over taking a day off, or as severe as refusing medical treatment because the codependent does not feel that he is worth the cost of the treatment.[60]

This pattern of looking for external affirmation, image management, and self-contempt often leads to a distorted sense of emotions. A codependent’s emotions must align with the way the codependent desires to be perceived, either by themselves or others. The result is that codependents struggle with properly expressing their emotions. Many will flat out deny their emotions, refusing to allow themselves to feel negative about their family’s dysfunction (as well as their own personal dysfunctions). Even in the face of undeniable evidence, it is easier to deny, minimize, or ignore the problem than to admit there is a problem that cannot be easily handled.[61] “No, there’s no problem. Everything’s just fine!”

Sometimes, though, the problem is not denial of feelings but simply being out of touch with their feelings. They have gotten used to looking to others for affirmation and to putting others’ views above their own that they have become disconnected from their feelings. Even more saddening than this disconnection is that a codependent believes that understanding another person’s feelings negates his right to have his own feelings.[62]


Codependents are filled with fear, specifically the fear of others. The Bible refers to this as fear of man. As Proverbs 29:25 says, “Fear of man will prove to be a snare…” Individuals who struggle with codependency are truly trapped by their fear. They fear the vulnerability and risk that comes with exposure. Since codependents gather their esteem from outside of themselves, rejection can crush them, further lowering their self-esteem.[63] And this rejection does not need to be loud or attention grabbing; it could just as easily be the absence of affirmation, or a single critical look.[64]

This also means that codependents are particularly prone to succumbing to peer pressure. As Dr. Ed Welch states, they “are more concerned about looking stupid (a fear of people) than [they] are about acting sinfully (fear of the Lord).”[65] Related to this is the misguided belief that human nature is innately benevolent.

Their low self-esteem stems from a misunderstanding of each person’s intrinsic worth. Genesis 1:27 says that God created man “in his image”. The reason why murder is wrong is not solely because a life is being snuffed out, but because a life that reflects God is being snuffed out. Each individual has an intrinsic value, simply by being human, but someone who struggles with codependency is unable to look at themselves and see value independent from the things that others can affirm.

They will struggle with accepting Jesus’ sacrifice, because they cannot believe that they are worthy of that substitutionary death. In fact, they will struggle with an inability to receive love, intimacy, and forgiveness in general, but this inability is underscored when considering the Christian faith. One of foundations of our faith, the greatest commandments, is to love God and love people.[66] But how can you truly love people if you do not love yourself? And how can you love and receive love if you do not believe you are worthy of receiving that love?

Living in continued sin has consequences. The constant denial and (self-) deception common in codependents eventually leads to a loss of morality as the individual becomes callused to his sin. As their hearts become hardened, codependents neglect those that they love, substituting caretaking in place of loving and caring for a person.[67]

Unsurprisingly, codependents often find that they are spiritually sterile. Also, in seeking to be self-sufficient, in struggling with accepting God’s love, in being caught up in the fear of man, “they cut themselves off from the very Source who offers both life and purpose.”[68] Instead of being filled with joy through a life serving Christ, the Christian walk becomes a burden, a list of “dos” and “don’ts” that cannot ever be perfectly followed. The codependent will not be able to admit his shortcomings, though, and will suffer while trying to meet the expectations and requirements he feels are being placed on him.

Treatment and Recovery

Codependency is a prevalent problem, but it is not a hopeless fight. People from both within and outside of the church have rallied to the cause of combating codependency.

Since codependency is largely about identity, the therapist needs to help guide the codependent into a proper understanding of who he is before God. Thankfully, the Bible is filled with truths about our identities as believers in Christ. If the codependent is not a Christian, we are able to use this opportunity to show her the hope that can only be found in Christ. Genesis 1:27 says that humans are made in God’s image. Galatians 4:6-7 teaches that we are children of God, with his Spirit in our hearts. Romans 8:14-17 underscores that, saying that we are children of God, not with a spirit of slavery and fear, but of adoption as sons and daughters. Second Corinthians 5:17-19 says that we are new creations in Christ, and that we are no longer the old, but new, reconciled to God.

Marlene Klunzinger and Michael Moore advocate a pursuit of shalom, which can mean “to make whole or good, restore thing lost.”[69] They believe that when a codependent redirects her attention onto God as Creator and his past and ongoing work, the codependent is freed to allow God to work in their own lives.[70] They found that this makes participation in worship a valid treatment for codependency.[71]

One thing that must be emphasized is that “recovery from codependency is not a solo job.”[72] Since one of the biggest symptoms of codependency is that a codependent determines their value based on others’ opinions, the first inclination for treatment may be to focus on the helping the codependent grow as an individual. However, involving a codependent in a loving, open, safe community is ideal. Wegscheider-Cruse recommends that codependents participate in both professional therapy and a 12-step group.[73] This group might be Codependents Anonymous (CoDA) or another one that caters to a specific compulsion that the codependent is struggling with. This group will provide support, encouragement, and accountability during the healing process. It is also important for codependents to get professional therapy. They need a safe relationship where they can receive “help to make the necessary decisions, to receive guidance while uncovering feelings, and to have input and a reality check by someone qualified to give it.”[74]

During therapy, the codependent will need to explore “the healthy and unhealthy parts of our families or origins.”[75] The compulsions and perceptions that a codependent suffers from often trace back to dysfunctions within the household in which they grew up. Part of regaining a grasp on reality requires that the codependent be guided through processing which parts of their family interactions were healthy and which were not. This will help them to recognize how the unhealthy interactions affect them now, and will allow the therapist to guide codependent in how to properly handle these ingrained unhealthy interactions.

The therapist must also prepare to help the codependent deal with the “unresolved hostility and anger that has built up in others, who have been controlled, smothered, manipulated, and made more dependent by the co-dependent.”[76] As the codependency is dealt with, the individuals will become more emotionally sensitive. This increased sensitivity may make the others’ anger feel overwhelming to the codependent. The therapist must help the codependent learn how to handle this healthily, or the codependent will be tempted to return to his codependency.

In his book, When People Are Big and God Is Small: Overcoming Peer Pressure, Codependency, and the Fear of Man, Welch presents an interesting approach to treating codependency, which he calls “fear of man.” Rather than going through many of the solutions presented by therapists and counselors, Welch aims straight for what he believes to be at the heart of codependency: we think too much of people and too little of God. We get crippled in trying to please people, and lose sight of the fact that we are supposed to seek to please God above all else. Therefore, his solution begins with coming to “understand and grow in the fear of the Lord.”[77] He then challenges us to sort through our felt needs, differentiating between wants, needs, and sinful desires, based on our identities in Christ. Our wants and desires should be shaped by 1 Corinthians 10:31, doing everything for the glory of God. This shift in focus from self to God breaks the codependent free from self-imposed rules and expectations, instead allowing the individual to embrace life in Christ. In receiving Christ’s love and acceptance, the codependent gradually finds that they need other people less, and are thus able to love other people more.[78]

This summary of Welch’s treatment does not do his book justice. Although I was skeptical at first, upon reading it, I can see that a lot of thought, testing, Bible study and prayer went into his solution to the fear of man. My only caution is that this is not an adequate solution for all degrees of codependency. The most severe cases will also require professional guidance, and potentially a 12-step program as well.


Codependency is a difficult subject to deal with because it is so broad. Encapsulating everything from seeking to please one’s companions to compulsively engaging in workaholism for the esteem and praise that comes through vocational success and beyond, at times it can feel like everyone is codependent to some degree or other. I think this is especially where Welch’s book comes into play.

We have also seen that codependency has some profound impacts on an individual’s life, particularly in the area of relationships. However, through proper counseling, Bible study, and life among a loving community, codependency can be overcome, to the glory of God and the health of His church. I hope that this paper did not merely make you aware of codependency, but that it also helped to better equip you to serve your congregations.


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Rice, John Steadman. A Disease of One’s Own: Psychotherapy, Addiction, and the Emergence of Co-Dependency. New Brunswick: Transaction Publishers, 1998.

Wegscheider-Cruse, Sharon, and Joseph R. Cruse. Understanding Codependency: The Science Behind It and How to Break the Cycle. updated and expanded ed. Deerfield Beach: Health Communications, 2012.

Welch, Edward T. When People Are Big and God Is Small: Overcoming Peer Pressure, Codependency, and the Fear of Man. Resources for Changing Lives. Phillipsburg, N.J.: P&R Pub., 1997.

[1] Sharon Wegscheider-Cruse and Joseph R. Cruse, Understanding Codependency: The Science Behind It and How to Break the Cycle, updated and expanded ed. (Deerfield Beach: Health Communications, 2012), 95.

[2] Jennifer Dukes Lee, “10 Signs You Might Have a Need for Approval,” Relevant Magazine (blog), March 31, 2014, accessed April 2, 2014,

[3] Alfred Ells, One-Way Relationships: When You Love Them More Than They Love (Nashville: T. Nelson, 1990), 53.

[4] Timmen L. Cermak, Diagnosing and Treating Co-Dependence: A Guide for Professionals Who Work with Chemical Dependents, Their Spouses, and Children, Professional Series (Minneapolis: Johnson Institute Books, 1986), 1.

[5] Diagnostic and Statistical Manual of Mental Disorders: Dsm-5, 5th ed. (Washington, D.C.: American Psychiatric Association, 2013), 684.

[6] Merriam-Webster, s.v. “Codependency,” accessed April 3, 2014,

[7] Nancy Groom, From Bondage to Bonding: Escaping Codependency, Embracing Biblical Love (Colorado Springs, Colo.: NavPress, 1991), 21.

[8] Anne Wilson Schaef, Co-dependence: Misunderstood-mistreated, Perennial Library (Cambridge: Harper & Row, 1986), 3.

[9] David Borsos, Encyclopedia of Substance Abuse Prevention, Treatment, and Recovery, eds. Gary L. Fisher and Nancy A. Roget (Thousand Oaks: SAGE Publications, Inc., 2009), s.v. “Codependency,” accessed March 19, 2014,

[10] Theresa M. Knudson and Heather K. Terrell, “Codependency, Perceived Interparental Conflict, and Substance Abuse in the Family of Origin”, The American Journal of Family Therapy 40, no. 3 (May 2012): 245-57, accessed March 19, 2014,

[11] Knudson and Terrell.

[12] Cermak, 11.

[13] Cermak, 1.

[14] Wegscheider-Cruse, 123.

[15] Pia Mellody, Andrea Wells Miller, and Keith Miller, Facing Codependence: What It Is, Where It Comes From, How It Sabotages Our Lives (San Francisco: Perennial Library, 1989), 4.

[16] Groom, 21.

[17] Wegscheider-Cruse, 39.

[18] Mellody, 11.

[19] Knudson and Terrell, 245.

[20] Groom, 45.

[21] Groom, 47.

[22] Ells, 91.

[23] Wegscheider-Cruse, 36.

[24] Ibid.

[25] Wegscheider-Cruse, 37.

[26] Wegscheider-Cruse, 37-38.

[27] C. Robert Cloninger, Dragan M. Svrakic, and Thomas R. Przybeck, “A Psychobiological Model of Temperament and Character,” Archives of General Psychiatry 50, no. 12 (December 1993): 977.

[28] Cloninger, 978.

[29] Wegscheider-Cruse, 40.

[30] Wegscheider-Cruse, 41.

[31] Wegscheider-Cruse, 39.

[32] Wegscheider-Cruse, 41.

[33] Wegscheider-Cruse, 40.

[34] Ibid.

[35] Wegscheider-Cruse, 89.

[36] Ells, 93.

[37] Schaef, 53.

[38] Mellody, 26.

[39] Mellody, 35.

[40] Schaef, 84.

[41] Schaef, 59.

[42] Schaef, 81.

[43] Schaef, 55.

[44] Groom, 54-5.

[45] Schaef, 73.

[46] Schaef, 63.

[47] Groom, 58.

[48] Ibid.

[49] Groom, 58.

[50] Schaef, 53.

[51] Schaef, 54.

[52] Cermak, xii.

[53] Schaef, 54.

[54] Wegscheider-Cruse, 89-90.

[55] Schaef, 54-55.

[56] John Steadman Rice, A Disease of One’s Own: Psychotherapy, Addiction, and the Emergence of Co-Dependency (New Brunswick: Transaction Publishers, 1998), 97.

[57] Schaef, 44.

[58] Mellody, 8-9.

[59] Groom, 34-5.

[60] Groom, 40.

[61] Groom, 66-7.

[62] Schaef, 58.

[63] Edward T. Welch, When People Are Big and God Is Small: Overcoming Peer Pressure, Codependency, and the Fear of Man, Resources for Changing Lives (Phillipsburg, N.J.: P&R Pub., 1997), 37.

[64] Groom, 37-8.

[65] Welch, 40.

[66] Groom, 59. c.f. Mk. 12:30-1.

[67] Schaef, 62.

[68] Groom, 59.

[69] Francis Brown, Samuel Rolles Driver, and Charles Augustus Briggs, Enhanced Brown-Driver-Briggs Hebrew and English Lexicon (Oak Harbor, WA: Logos Research Systems, 2000), 1022.

[70] Marlene K. Klunzinger and Michael S. Moore, “Codependency and Pastoral Care: A Report from the Trenches,” Restoration Quarterly (January 1, 1996): 159-74.

[71] Ibid.

[72] Wegscheider-Cruse, 96.

[73] Wegscheider-Cruse, 126.

[74] Wegscheider-Cruse, 127

[75] Ells, 95.

[76] Schaef, 56.

[77] Welch, 96.

[78] Welch, 183.


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