Бесплатный фрагмент - Codependency

Disclaimer

This material is provided for informational and educational purposes only. It is not intended to serve as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition.

Psychological codependency: definition and manifestations

Psychological codependency is a condition characterized by an individual’s excessive involvement in another person’s life, issues, and emotions, frequently at the expense of their own needs and well-being. This codependency is evident in a compulsion to control, assist, or rescue another individual, which can result in diminished personal boundaries and a decline in overall quality of life.

Codependency frequently arises in relationships where one partner grapples with an addiction (such as alcoholism or substance abuse), as well as emotional or psychological challenges. Nevertheless, it can also present itself in friendships, familial connections, or professional engagements.

Key indicators of codependency

Codependency manifests in behavior, emotions, and relationships.

Key attributes:

• Overzealous care and concern. An incessant urge to resolve others’ issues, even in the absence of a request for assistance. The inclination to “rescue” another individual from the repercussions of their actions, frequently to one’s own detriment.

• Control and Interference: Efforts to dictate a loved one’s life (e.g., habits, decisions, social circle). An unwillingness to permit the other individual to confront the natural repercussions of their actions.

• Neglecting personal needs. Sacrificing individual goals, interests, and desires for the benefit of another. Struggling to establish personal boundaries and safeguard one’s rights.

• Emotional dependence: An incessant yearning for approval, recognition, or appreciation. Experiences of anxiety, guilt, or fear arise when a partner or loved one expresses dissatisfaction.

• Erosion of self-identity. Diminished awareness of one’s personality, interests, and values. Structuring one’s life solely around the needs of another individual.

• Low self-esteem: Persistent sensations of “insufficiency” in the absence of self-worth affirmation through assisting others. The belief that personal value is contingent upon the fulfillment of the rescuer or helper role.

Factors contributing to the emergence of codependency

Codependency develops as a result of various influences, frequently originating in childhood:

• Family characteristics of upbringing: Parents who are excessively demanding, critical, or prioritize their own interests. Residing in a household with a dependent or emotionally unstable family member.

• Traumatic experience: Endured emotional, physical, or sexual trauma. A developed sense of responsibility for the welfare of others, emerging as a means of self-protection.

• Social attitudes: A nurturing environment that underscores the significance of sacrifice and self-denial for the benefit of others. Societal pressure that engenders a sense of guilt for declining to assist loved ones.

Codependency across various relationship types

In romantic relationships, one partner may exhibit a pathological need to “rescue” the other, particularly if the latter struggles with addiction or psychological and emotional issues. This often manifests as a persistent urge to resolve conflicts by repressing one’s own emotions.

In familial dynamics: Parents who exhibit excessive protectiveness towards their children, thereby inhibiting their independence. Children who assume the role of “rescuer” for a parent struggling with addiction.

• In professional activities: Over-involvement in the issues of colleagues or subordinates. The inclination to assume responsibility for the errors or tasks of others.

In friendship: Continuously assuming the role of “helper” or “comforter,” even at the expense of one’s own interests.

Consequences of codependency

Emotional exhaustion: Continuously engaging with the challenges of others depletes your internal resources.

• Decline in physical and mental well-being: chronic stress, anxiety, depression, psychosomatic disorders.

• Erosion of personal boundaries A codependent individual struggles to advocate for their own interests, frequently resulting in feelings of resentment and depression.

• Dependence on external validation The perception of one’s self-worth becomes intrinsically tied to the appreciation or acknowledgment from others.

• Relationship Problems: An unhealthy relational dynamic in which one individual assumes full responsibility while the other adopts the role of a passive recipient of assistance.

Strategies for Managing Codependency

Recognizing the Problem The initial step is to acknowledge the presence of codependency and its effects on your life.

• Working with Personal Boundaries: Learn to assertively decline and reject roles that are detrimental to your own interests.

Seeking professional assistance, individual or group psychotherapy can aid in identifying the underlying causes of the issue and facilitating behavioral change.

• Cultivating self-esteem: Concentrate on your personal interests, hobbies, and aspirations while sustaining a healthy sense of self-worth.

• Cultivate independence. Encourage others to take responsibility for their actions and decisions. Foster the belief that assistance is not always required.

• Cultivate emotional independence. Discover how to derive joy and fulfillment from your own life, rather than seeking validation from others.

Cognitive Behavioral Therapy (CBT) for Codependency

Cognitive behavioral therapy (CBT) is a highly effective method for addressing codependency, as it facilitates the alteration of detrimental thought and behavior patterns that sustain the issue. The principal objective of CBT in the context of codependency is to assist individuals in identifying and reshaping irrational beliefs, learning to safeguard their boundaries, and fostering healthy relationships.

Objectives of CBT for codependency

• Recognition of codependent thoughts and behaviors; identification of patterns that result in self-sacrifice and emotional dependence.

• Transforming detrimental beliefs by substituting irrational attitudes with constructive and supportive alternatives.

• Formation of New Skills Development of competencies for fostering equitable and healthy relationships.

• Alleviating anxiety and guilt by addressing the negative emotions linked to relinquishing codependent behavior.

• Enhanced self-esteem. Cultivating confidence in oneself and one’s needs.

Fundamental methods and techniques of Cognitive Behavioral Therapy (CBT)

Cognitive reframing

Goal: To identify and modify irrational thoughts and beliefs that underpin codependency. Process: The client examines their thoughts and assesses their correspondence with reality. Healthier attitudes are cultivated to replace destructive beliefs. Examples of beliefs: “I must take care of others; otherwise, they won’t love me” → “My worth is not contingent upon how much I do for others.” “I am responsible for the happiness of my loved ones” → “Each individual is accountable for their own happiness.”

2. Addressing cognitive distortions

Goal: To identify and address cognitive distortions such as personalization (e.g., “If someone is upset, it is my fault”); black-and-white thinking (“Either I help everyone, or no one loves me”); and catastrophizing (“If I refuse to help, something terrible will occur”). Technique: Maintaining a journal of automatic thoughts. Analyzing each thought: “What evidence supports or contradicts this thought?”

3. Behavioral Studies

Goal: To examine and confront limiting beliefs through practical experience. Process: The client engages in activities that enable them to recognize the unfounded nature of their fears or beliefs. Example: Belief: “If I decline, they will lose respect for me.” Experiment: Politely refuse a request from a colleague or friend once and assess the impact on the relationship.

4. Self-regulation competencies

Goal: To assist clients in managing the anxiety, shame, and guilt frequently associated with codependency. Methods: Breathing techniques (e.g., deep diaphragmatic breathing), progressive muscle relaxation to alleviate physical tension, and mindfulness techniques to maintain focus on the present moment.

5. Behavioral Activation

Goal: Minimize attention to the issues of others and redirect focus to personal needs. Process: The client integrates activities that foster joy and fulfillment into their life, including hobbies, sports, and social interactions with friends. Example: Rather than assisting everyone, the client schedules a day dedicated to self-care: taking a walk, reading a book, and unwinding.

6. Establishing healthy boundaries

Goal: To instruct the client in establishing and safeguarding personal boundaries. Methods: Role-playing: engaging in scenarios where the client articulates “no” or conveys their needs. Formulating specific behavioral scenarios: “How can I decline while preserving respect for myself and the other individual?” Acknowledging one’s entitlement to boundaries and the right to refuse.

7. Enhancing self-esteem

Goal: To enhance the client’s self-esteem regarding their value and significance. Methods: Maintaining an achievement journal: documenting all successes, both significant and minor. Affirmation techniques: formulating positive statements for the client to recite daily (e.g., “I have the right to be myself”). Examination of the client’s role in relationships: recognizing instances where they undervalue their importance.

8. Conflict Resolution

Goal: To instruct the client in resolving conflicts constructively and without self-sacrifice. Methods: Assertive behavior training: the capacity to advocate for one’s interests without resorting to aggression. Role-playing to rehearse challenging conversation scenarios. Analyzing past conflicts: what alternative approaches could have been taken?

9. Advancement of autonomy

Goal: To diminish the client’s reliance on external validation. Methods: Cultivating awareness of personal desires and needs. Engaging in exercises that promote independent decision-making, irrespective of others’ opinions. Analyzing sources of pleasure for the client beyond interpersonal relationships.

10. Collaborating with triggers

Goal: To assist the client in recognizing and managing situations that elicit codependent behavior. Process: Identifying triggers (e.g., requests for assistance, feelings of guilt). Cultivating alternative responses: rather than immediate compliance, take a moment to evaluate the situation. Establishing new response habits.

The primary phases of cognitive behavioral therapy for codependency

Psychoeducation: Instructing the client on the concept of codependency. Examining notions such as personal boundaries, emotional independence, and interdependence. Analyzing the relationships among thoughts, emotions, and behavior.

2. Identification of maladaptive beliefs. Common beliefs include: “If I do not assist, I will not be loved.” “I am responsible for the happiness of others.” “My needs are less significant than the needs of others.”

3. Addressing irrational thoughts. Cognitive restructuring techniques are employed: Identifying automatic thoughts in codependent scenarios. Evaluating their validity and utility. Substituting harmful thoughts with more rational alternatives. Example: Harmful thought: “If I say ‘no,’ I will be perceived as a bad person.” Rational thought: “Declining unnecessary responsibilities is normal and aids in maintaining balance.”

4. Examining personal boundaries. Recognizing instances and methods by which boundaries are infringed upon in relationships. Acquiring skills to establish and safeguard these boundaries. Exercise: “Rejection Scenarios”: The client practices articulating “no” with both gentleness and confidence. Compiling a list of their needs and priorities.

5. Cultivating new behavioral patterns. Substituting rescuing with fostering healthy autonomy. Assertive Behavior Training: Engaging in role-playing exercises where the client hones constructive communication skills.

7. Engaging with emotions. An “Emotional Diary” exercise to monitor anxiety, guilt, or fear linked to relinquishing codependent behavior. Acquiring emotion regulation techniques, including: Breathing techniques. Mindfulness practices.

8. Planning a Balanced Life: Evaluating the client’s life balance through techniques such as the “Wheel of Life” exercise to pinpoint areas where codependency is prevalent. Establishing goals focused on fostering personal interests and autonomy.

Examples of cognitive behavioral therapy exercises for codependency

Cognitive Behavioral Therapy (CBT) provides a range of exercises designed to assist individuals with codependency in transforming their thoughts, emotions, and behaviors. Below are examples of effective techniques and exercises.

1. Exercise “Journal of Automatic Thoughts”

Objective: Recognition and rectification of detrimental beliefs.

The client documents scenarios that elicit stress associated with codependent behavior. For instance: “My sister requested that I resolve her issue, but I am already fatigued.” Automatic thoughts are noted: “If I decline, she will be upset.” “I am a bad person if I do not assist.” Cognitive distortions, including personalization, catastrophizing, and overgeneralization, are examined. The client formulates alternative thoughts: “Declining does not imply I am a bad person.” “My sister is capable of managing it on her own.”

2. Activity “Circles of Responsibility”

Objective: To distinguish between personal responsibility and the responsibilities of others.

Draw three circles: My sphere of responsibility encompasses what I can and should control (my thoughts, feelings, and actions). The sphere of others’ responsibility pertains to what concerns other individuals (their emotions, behaviors, and decisions). The uncontrollable sphere includes elements that no one can change (the weather, the past, and the reactions of others). For instance, if a partner is angry, the client learns to recognize that this emotion belongs to the other person, and they are not accountable for it.

3. Exercise “Alternative Responses”

Objective: To cultivate new behavioral patterns.

The client illustrates a typical codependent scenario. For instance: “My husband is late coming home again, and I begin to control him by calling and expressing concern.” In collaboration with the therapist, we examine automatic responses (control, anger). A potential new response is: “I will focus on my own activities rather than attempting to alter his behavior.” The client engages in practicing alternative behaviors and documents the outcomes.

4. Exercise: “Addressing Guilt”

Goal: To alleviate excessive feelings of guilt associated with declining or failing to meet the expectations of others.

The client reflects: Thought: “I feel guilty for not assisting my mother.” Cognitive distortion: Overgeneralization — “If I declined, then I am a bad child.” Developing an alternative thought: “My refusal does not imply that I am a bad person. I have the right to prioritize my own well-being.” The therapist urges the client to recognize instances when guilt surfaces and to address it by adopting alternative beliefs.

5. Activity “Establishing Boundaries”

Objective: To cultivate assertive behavior skills and safeguard personal boundaries.

Step 1: The client recognizes instances in which their boundaries are infringed. Example: “I do not wish to complete my colleague’s tasks, yet I consent to it to avoid causing offense.” Step 2: Formulating phrases for refusal: “I am unable to do that at the moment.” “I appreciate your reaching out, but I do not have the time.” Step 3: Engaging in role-play with the therapist, allowing the client to rehearse assertive refusal.

6. Activity “Wheel of Life”

Goal: To assist the client in achieving equilibrium across various aspects of life and diminishing preoccupation with others.

The client creates a circle and segments it into various sectors: work, family, personal interests, health, friends, leisure, and so forth. They evaluate the amount of time and energy allocated to each sector (on a scale from 0 to 10). Analysis: “Why is the majority of my energy concentrated on one individual or area?” Planning: “What steps can I take to enhance balance?”

7. Activity “My Requirements”

Goal: To recognize one’s own needs that are overlooked as a result of codependent behavior.

The client responds to the following inquiries: What is essential for my happiness? What aspirations am I postponing due to others? How can I start to fulfill my needs immediately? A list of specific actions is generated: “Take a walk, enroll in a gym, engage in a creative activity.”

8. Methodology “Behavioral Experiments”

Objective: To evaluate the client’s beliefs through experiential learning.

The client adopts the belief: “If I refuse, the individual will cease communication with me.” Experiment: The client deliberately declines a minor request. Example: “I am unable to assist you with your shopping today; I have other commitments.” The outcome is documented: “The individual comprehended and was not offended.” Conclusion: The belief is revealed to be erroneous, and the client gains confidence in asserting refusal.

9. Exercise “Addressing Catastrophic Thoughts”

Objective: To alleviate anxiety linked to codependent behavior.

The client documents fear-based scenarios. For instance: “If I decline, they will despise me.” Probability assessment: What is the likelihood of this occurring? What evidence supports or contradicts this? Formulating a balanced perspective: “Even if the individual becomes upset, it does not imply that they will cease to love me.”

10. Mindfulness Strategies for Emotional Regulation

Goal: To assist the client in managing intense emotions such as guilt, fear, or anxiety.

The client learns to concentrate on the present moment through breathing techniques: Inhale deeply for a count of four, hold for a count of four, and exhale for a count of six. Recognize emotions without judgment: “I feel guilty, but that does not define my character. It is merely an emotion that will eventually pass.”

11. Exercise “Values and Priorities”

Objective: To assist the client in realigning with their personal values.

The client compiles a list of their priorities (health, development, creativity, relaxation). An analysis is conducted on the degree to which these values are manifested in their life. The therapist assists the client in channeling their energy towards the attainment of their goals rather than perpetually concentrating on others.

An illustration of a CBT therapy session addressing codependency.

A cognitive behavioral therapy (CBT) session focused on codependency seeks to identify and modify detrimental beliefs, emotional responses, and behavioral patterns that reinforce codependent relationships. Presented below is an example of the session’s structure and progression.

1. Defining the objective of the session

Therapist: What issue or circumstance would you like to address today?

Client: “Yesterday, I had a disagreement with my sister because I declined to assist her. Now, I feel awful; I perceive myself as a poor sister, and I fear she may not want to communicate with me.”

Purpose: To examine the client’s feelings of guilt related to abandonment and to investigate how this situation mirrors codependent beliefs.

2. Investigation into cognitive beliefs

Therapist: What thoughts crossed your mind when you declined your sister?

Client: “I believed that my lack of assistance indicated selfishness. I feared that if I did not support her, she would cease to love me.”

Therapist: Let us document these thoughts. For instance:

“I’m selfish if I do not assist.” “If I decline, she will cease to love me.” Now let us consider: is there evidence to substantiate these beliefs?

Client: — She consistently anticipates my assistance… However, she once expressed her appreciation for my support.

Therapist: Can you identify any instances in which you declined her requests without damaging your relationship?

Client: Indeed, last year I was unable to assist her with the move; however, she later expressed her understanding.

Conclusion: The client starts to recognize that his thoughts, “I am selfish” and “She will stop loving me,” represent cognitive distortions, specifically personalization and catastrophizing.

3. Cognitive Reformation

Therapist: Do you believe there might be alternative perspectives in this situation?

Client: “It may be acceptable to decline if I have my own commitments. Perhaps she will recognize that I cannot always assist.”

Therapist: Excellent! Let’s document a new thought:

“I reserve the right to decline when I lack the necessary resources.” “Declining does not reflect negatively on my character.”

The therapist assists the client in articulating and validating these new beliefs, juxtaposing them with prior automatic thoughts.

4. Behavioral study

Therapist: “Are you open to exploring a different approach in a comparable situation? For instance, if your sister requests assistance once more, how might you respond?”

Client: — I will express that I am unable to assist at this moment, but I will propose an alternative approach, such as offering her advice.

Therapist: “That is an excellent plan. You might also consider observing her reaction and documenting your feelings at that moment.”

Homework:

The client is encouraged to practice saying no for one week, honoring their own boundaries. They should maintain a journal to document their thoughts, feelings, and behaviors in comparable situations.

5. Engaging with emotions

Therapist: What emotions did you encounter following your conversation with your sister?

Client: — Emotions of guilt and apprehension.

Therapist: How do you typically manage these emotions?

Client: — I attempt to assist more in order to alleviate my guilt.

Therapist: “Instead, let us engage in a mindfulness technique. Close your eyes and focus on your breathing. Permit the guilt to exist, but merely observe it, akin to a wave that ebbs and flows.”

Result: The client develops the ability to endure negative emotions without reverting to codependent behavior.

6. Concluding the session

Therapist: What significant insights did you gain today?

Client: “I have come to understand that rejection does not define me as a poor sister. Furthermore, my feelings of guilt are not always accurate; they can often be merely a habitual way of thinking.”

Therapist: “That is an excellent observation. Are you prepared to implement new strategies in practice?”

Client: Indeed, I will endeavor to monitor my thoughts and emotions while also honoring my boundaries.

Session outcome

The client recognized that their cognitive distortions, including personalization and catastrophizing, were intensifying their feelings of guilt. New beliefs emerged, enabling them to establish healthy boundaries. The client acquired practical tools, such as a behavioral experiment and mindfulness techniques, to address emotions and behavioral patterns. For the first time, efforts commenced to release compensatory behavior, specifically overprotection.

These modifications will be reinforced in future sessions through the examination of new scenarios, emotional engagement, and behavioral activation.

Outcomes of cognitive behavioral therapy (CBT) for codependency

Cognitive behavioral therapy (CBT) for codependency facilitates transformations in the client’s thought processes, emotional well-being, and behaviors, thereby enhancing the quality of their relationships. The outcomes of therapy are influenced by the severity of codependent patterns and the client’s willingness to embrace change; however, in the majority of cases, therapy yields substantial improvements in overall life satisfaction.

1. Transforming cognitive attitudes

Result: The client acknowledges and transforms the detrimental beliefs that underpinned their codependency. Example: The belief “I am responsible for other people’s happiness” is substituted with “Everyone is accountable for their own well-being.” The client starts to discern the distinction between being supportive and being excessively self-sacrificing.

2. Enhancing boundary-setting abilities

Result: The client develops the ability to identify and safeguard their personal boundaries, thereby diminishing their reliance on the opinions and needs of others. The client ceases to assume the responsibilities of others and starts to decline requests without guilt. Relationships achieve equilibrium: rather than being characterized by unilateral control or support, mutual respect flourishes.

3. Enhanced self-esteem

Result: Engaging in attitude and behavioral experiments enables the client to recognize their intrinsic value, independent of external validation. The client starts to experience a sense of wholeness, free from the incessant pursuit of love and recognition. This process fosters self-confidence and cultivates the ability to make decisions aligned with their own needs.

4. Diminished feelings of guilt and anxiety

Result: Engaging with destructive thoughts and managing emotions enables the client to liberate themselves from feelings of guilt associated with declining to assist others, as well as from overwhelming anxiety regarding their own well-being. The client no longer endures the intense stress linked to the inability to “save” or “fix” another individual.

5. Cultivation of emotional autonomy

Result: The client ceases to seek validation exclusively through approval or reliance on others. They start to comprehend their emotional needs and fulfill them autonomously. Control, overprotection, and excessive interference in relationships diminish.

6. Enhancing communication abilities

Result: The client acquires the skills to articulate their feelings, desires, and needs in a constructive manner. The capacity to engage in open dialogue, free from manipulation and conflict, is cultivated. Communication tension diminishes, fostering deeper and healthier connections with others.

7. Enhancing the quality of life

Result: The client starts to prioritize their physical and emotional well-being. Time and energy that were once devoted to caring for others are redirected towards personal interests, hobbies, and leisure activities. The client begins to experience increased happiness and confidence in their decisions.

8. Modifying behavioral patterns

By acknowledging and adjusting automatic responses, clients can: cease assuming excessive responsibility for others, cultivate healthy behavioral patterns, such as equitably sharing responsibilities in relationships, and avoid self-sacrifice for the sake of recognition or affection.

9. Enhancing individual autonomy

Result: The client attains greater emotional and social independence. They no longer fear solitude and are capable of making decisions without concern for others’ opinions. In relationships, they cease to adopt the roles of “savior” or “victim,” instead fostering partnerships characterized by equality and mutual interaction.

10. Resistance to relapses in codependency

Result: The client cultivates skills that enable them to navigate challenging situations without reverting to codependent behaviors. They identify triggers (e.g., guilt, pressure) and deliberately select alternative responses. The capacity to withstand emotional coercion and manipulation is enhanced.

Gestalt therapy for codependency.

Gestalt therapy is an approach that assists clients in recognizing and integrating their emotions, thoughts, and actions, while enhancing their capacity to perceive the present and engage with others. Within the framework of codependency, this method enables clients to become cognizant of their feelings, needs, and boundaries, as well as to uncover concealed emotions and conflicting facets of their personality that contribute to codependent relationships.

The primary objective of Gestalt therapy for codependency is to reestablish the client’s emotional autonomy while also guiding them to engage with themselves and others without undue attachment, control, or guilt.

Objectives of Gestalt therapy for codependency

• Awareness and integration of repressed emotions Many individuals experiencing codependency tend to suppress their emotions and needs, prioritizing the needs of others instead. Gestalt therapy facilitates the identification of these repressed feelings, fosters awareness of them, and teaches individuals how to engage with them effectively.

• Cultivating Boundary-Setting Skills: Codependency frequently stems from a failure to establish healthy personal boundaries. The therapist assists the client in recognizing the significance of their own needs and instructs them on how to set boundaries with others.

• Awareness of Responsibility In codependent relationships, individuals may assume responsibility for another’s emotional well-being. Gestalt therapy facilitates the understanding that one can care for others without being accountable for their emotions.

• Development of Self-Esteem Gestalt therapy enhances self-confidence and self-esteem, which are crucial for overcoming codependency.

Restoring personal autonomy enables the client to recognize his ability to make decisions and lead his own life independently of others.

Gestalt therapy approaches and strategies for codependency

Empty Chair Therapy: This technique facilitates clients in articulating repressed emotions. The client engages in a dialogue with an absent individual, represented by an empty chair, such as a partner or parent. This approach enables clients to recognize their feelings and needs, which are frequently subdued for the benefit of others. For instance, the client may convey feelings of hurt or anger toward their partner, a task that can be challenging in real-life situations.

• Fantasy Technique: The therapist may encourage the client to envision a scenario in which they are in conflict with an individual they would typically assist or support. This approach facilitates the client’s awareness of their emotions, fosters the expression of feelings, and cultivates behaviors that encourage healthier boundaries.

• Working with Boundaries In Gestalt therapy, clients are encouraged to participate in exercises designed to enhance their understanding of physical, emotional, and psychological boundaries. One approach involves utilizing “psychological boundaries” through role-playing or activities that enable the client to practice saying “no” and asserting themselves. For instance, a client may rehearse saying “no” in a secure setting with a therapist prior to implementing it in real-life situations.

• Mindfulness and attention to the present moment. Gestalt therapy emphasizes the importance of being present and closely observing one’s feelings and actions. Mindfulness aids in identifying instances when the client begins to “lose themselves” in relationships, prioritizing others over their own needs. Through mindfulness techniques, the client learns to concentrate on their emotions, preventing themselves from being overwhelmed by the issues of others. The “Where Am I?” exercise enables the client to perceive and comprehend their position within the relationship, the emotions they are experiencing, and the boundaries that must be established.

• Technique “Dialogues with Parts of Yourself” In this technique, the client engages with various aspects of their personality (for instance, “the part that desires to assist everyone” and “the part that seeks self-care”) and facilitates a dialogue among them. This process fosters a deeper understanding of internal conflicts and aids in achieving a balance between personal needs and the needs of others.

Stages of Addressing Codependency in Gestalt Therapy

Recognizing Codependency: The initial step involves assisting the client in acknowledging their involvement in a codependent relationship and its effects on their life. The therapist guides the client in examining how codependency manifests in their thoughts, emotions, and behaviors. The client can learn to identify moments when they start to “lose themselves” and compromise their own interests for the benefit of others.

2. Engaging with emotions and needs. At this juncture, the therapist assists the client in identifying suppressed or overlooked needs. It is crucial to discern which of these needs are healthy and which may foster codependent behavior. Utilizing the empty chair technique and other methods facilitates the recognition of needs and emotions that have remained unacknowledged for an extended period.

3. Establishing Healthy Boundaries. A crucial task involves assisting clients in defining personal boundaries. Clients acquire the ability to say “no” without guilt and to safeguard their personal and emotional boundaries within relationships. They learn to recognize when their boundaries are infringed upon and cultivate the confidence to uphold them.

4. Emotional Autonomy and Self-Esteem. Gestalt therapy facilitates the restoration of emotional autonomy and self-confidence in clients. This process enables individuals to liberate themselves from codependent relationships and fosters the development of healthy, mutually respectful connections. The therapist aids the client in recognizing their emotions and needs as equally valid.

Examples of Gestalt Therapy exercises for codependency

1. Exercise “Correspondence to Yourself”

Objective: To cultivate self-awareness and an understanding of one’s own needs.

The client composes a letter addressed to themselves, akin to writing to their closest friend. In this correspondence, they should articulate all the thoughts and emotions they typically suppress or overlook due to codependency. The letter may encompass their fears, desires, unmet needs, and instances when they feel “lost” within relationships. Discussion: Following the letter’s composition, the client engages in a dialogue with the therapist regarding the challenges encountered during this process, the emotions that surfaced, and strategies for initiating self-care practices.

2. Exercise “Vacant Chair”

Goal: To liberate oneself from codependent behavioral patterns and to reconstruct relationships with significant individuals.

This exercise involves two chairs. One chair symbolizes the client, while the other represents their partner, parent, or another significant individual with whom they experience codependency. The client occupies one chair and articulates their feelings and thoughts regarding this person. They may express their concerns, emotions, and perceptions about the relationship. Subsequently, the client transitions to the second chair, which embodies the other individual, and responds to the statements made, conveying their feelings and reactions to the client’s expressions. Discussion: This exercise facilitates a shift in perspective, enabling them to comprehend the relationship’s dynamics, identify what is significant to both parties, and acknowledge instances where personal boundaries may be infringed upon.

3. Exercise “Shadows”

Objective: Liberation from guilt and acceptance of personal “shortcomings.”

The client illustrates a shadow on paper, representing the traits or qualities they typically conceal or fail to recognize within themselves (e.g., aggression, resentment, anger). These attributes are frequently repressed in codependent relationships. The client then deliberately “acknowledges” their shadow and all that it encompasses, articulating that this shadow is a component of their personality and an essential aspect of the human experience. Discussion: The therapist assists the client in integrating these emotions and comprehending that denying or suppressing them merely perpetuates codependent patterns.

4. Exercise “Boundaries Between You and Me”

Objective: Recognition of personal boundaries and their reinstatement.

The client is encouraged to envision a scenario in which they perceive their boundaries as being infringed upon (for instance, when someone requests something of them and they feel unable to decline). The client delineates a circle around themselves to represent their personal boundaries and subsequently identifies the areas and methods by which these boundaries are being compromised by others. They may mark points along the boundaries where they experience discomfort or pressure and then collaborate with the therapist to explore strategies for fortifying these boundaries. Discussion: This exercise aids the client in acknowledging the significance of honoring their boundaries and initiates the process of reconstructing them.

5. Exercise “Unvoiced Emotions”

Objective: Unleash suppressed emotions and reconnect with the present moment.

The client is encouraged to contemplate a scenario in which they repressed their emotions for the benefit of others. Subsequently, they are invited to visualize all the emotions they restrained and convey them through artistic mediums such as drawing, sculpting, or other creative expressions. This may include illustrating the situation in a drawing, symbolizing the emotions they were unable to articulate, or crafting a “memory object” that represents their feelings. Discussion: The therapist assists the client in examining these emotions and understanding how they have impacted their behavior and relationships.

6. Exercise “The Voice of Your Inner Resilience”

Objective: To cultivate self-assurance and embrace one’s own needs.

The client envisions a scenario in which they must articulate their needs, subsequently verbalizing the language they would employ in this context, all while adopting a stance of strength and confidence. This may involve a dialogue with a partner, friend, or parent, wherein the client showcases their personal strength and self-assurance by rejecting codependent behavior (e.g., “I cannot assist you because I have my own needs”). Discussion: This exercise aids the client in acknowledging the significance of advocating for their own interests and maintaining honesty with themselves and others.

7. Exercise “Practice Self-Forgiveness”

Purpose: The journey of acknowledging and forgiving oneself for codependent behavior.

The client is encouraged to envision a time in the past when they neglected their own needs or made sacrifices for others. They may illustrate themselves as a figure and subsequently compose words of forgiveness and acceptance, acknowledging that these missteps are integral to their journey and that they are worthy of forgiveness. Discussion: The therapist assists the client in understanding that embracing forgiveness and acceptance of their mistakes is the initial step toward recovery and the treatment of codependency.

8. Exercise “Emotional Journal”

Objective: Recognition and articulation of emotions.

The client is encouraged to document their emotions daily in a journal, focusing on their experiences in different contexts, such as relationships with a partner, parents, or friends. This exercise assists the client in monitoring how frequently they suppress or overlook their emotions for the benefit of others, while also affirming their right to feel and express these emotions. Discussion: The therapist reviews the journal entries with the client, facilitating an understanding of which feelings and needs often remain unrecognized.

An illustration of a therapeutic session in Gestalt therapy addressing codependency.

Gestalt therapy for codependency assists clients in enhancing their awareness of inner feelings and needs while learning to establish healthy boundaries in relationships. Throughout the session, the therapist employs mindfulness techniques, self-dialogue, “empty chair” exercises, and various methods designed to foster self-awareness and improve interpersonal interactions.

Greeting and fostering a secure environment

The therapist initiates the session with a warm greeting, fostering a safe and supportive environment. This crucial step ensures that the client feels at ease and is able to share their experiences candidly.

Therapist: “Good day, how are you feeling today? What topics would you like to address in our session?”

Client: “I am experiencing a degree of stress and am uncertain about how to proceed. It seems I have been overly focused on the needs of others, resulting in a disconnection from my own self. I wish to cultivate a greater sense of self-care, rather than solely prioritizing the well-being of others.”

Therapist: “I comprehend. This is a significant inquiry, and we can begin by exploring what precisely occurs when you disconnect from your sense of self. Could you share the last instance when you felt your needs were being overshadowed by others?”

2. Identification of codependency and emotional awareness

The therapist directs the client towards an understanding of the emotions and thoughts linked to his codependent behavior.

Therapist: “Reflect on a moment when you felt especially helpless or overwhelmed in your efforts to satisfy others. What emotions did you experience at that time? What thoughts arose?”

Client: “When my partner requested assistance, I felt that failing to help would lead to his disappointment in me. I feared that not offering my support would jeopardize his affection. This left me feeling guilty and anxious about my perceived inadequacy.”

Therapist: “It is essential to recognize these emotions. What do you believe has caused this anxiety and guilt to significantly impact your behavior?”

Client: “I have always believed that I needed to care for others; otherwise, they would abandon me or cease to love me. I lost sight of the importance of my own feelings and needs.”

3. Exercise “Vacant chair”

The therapist now encourages the client to utilize the “empty chair” technique to examine his feelings regarding his relationship with his partner or significant other and to articulate his needs.

Therapist: “Let us engage in the empty chair exercise. Visualize your partner or an individual with whom you are experiencing difficulties seated in one chair, while you occupy the other. Begin by articulating everything you wish to convey to this person — without reservation. What would you like to express to them?”

Client: (sits in one chair) “I often feel as though I am constantly striving to satisfy you. I compromise my own needs and interests out of fear that you will abandon me if I do not. I sense that I am losing my sense of self within this relationship. I desire your understanding and appreciation, yet I also wish to preserve my individuality.”

Therapist: (relocates to another chair) “Please take a seat in the other chair and respond as if you were that individual. What might their response be?”

Client: (changes seat) “I do not wish for you to feel that way. I value your assistance, but I do not want you to neglect your own well-being for my sake. My desire is for you to be happy and comfortable, rather than perpetually under stress.”

Therapist: “What emotions arise when you hear these words? What significance does this response hold for you?”

Client: “I believe that is what I needed to hear, yet I never recognized that my own feelings held significance for him. I am accustomed to being in control and doing everything to ensure his happiness.”

4. Recognition of boundaries and needs

The therapist assists the client in recognizing the significance of personal boundaries and in identifying their own needs.

Therapist: “How do you perceive your boundaries in relationships? In what ways can you start to safeguard your needs and assertively decline when you require additional time for yourself?”

Client: “I struggle to say ‘no’ due to my fear of disappointing others or losing their affection. However, I recognize that failing to uphold my boundaries will only lead to continued feelings of exhaustion.”

Therapist: “Recognizing your boundaries and needs is a crucial step. Let’s approach this practically. Picture a scenario where someone requests you to do something that makes you uncomfortable. How can you decline without experiencing guilt?”

Client: “I must express, ‘I apologize, but I am unable to assist you at this moment. I require some time for myself.’”

Therapist: “Excellent! That is a significant and constructive assertion. Let us practice. Articulate it aloud, as though you were genuinely addressing your partner.”

Client: (with a pained expression) “I apologize, but I am unable to assist you at this moment. I require some time for myself.”

Therapist: “What emotions arise for you when you express that?”

Client: “It presents some challenges, yet I find solace in the fact that I am not required to seek constant approval.”

5. Conclusion of the session and future plans

The therapist assists the client in consolidating their insights and delineates steps for continued growth.

Therapist: “You have made a significant advancement in acknowledging your boundaries and needs. In our next session, we can further explore how to express these needs with greater confidence in your daily life. What strategies do you believe could assist you in addressing this in your everyday experiences?”

Client: “I believe I will endeavor to moderate my responses and refrain from making immediate decisions. I will pay greater attention to my own needs and desires, rather than solely prioritizing those of others.”

Therapist: “That is an excellent plan. I recommend that you practice these skills for a week and discuss what was effective and what posed challenges during our next session. We will continue to focus on enhancing your boundaries and self-esteem.”

Outcomes of systemic gestalt therapy for codependency

• Awareness of personal needs and emotions. The client develops the ability to recognize and accept their feelings and needs, which may have previously been overlooked or suppressed in an effort to please others. This process fosters a reconnection with oneself and an understanding that their own needs hold equal importance. For instance, the client may come to understand that their chronic fatigue is linked to their ongoing attempts to meet the demands of others.