How to Treat Codependency: CBT and Codependency

If you are experiencing codependency, you can recover through treatment which includes CBT (cognitive behavioral therapy). Before we address codependency recovery though, lets define codependency….


If you are experiencing codependency, you can recover through treatment which includes CBT (cognitive behavioral therapy).

Before we address codependency recovery though, lets define codependency.

What is codependency?

If you have ever been confused by the concept of codependency, you are not alone. Truthfully, there is no unified definition for codependency. Furthermore, as of June 2022, codependency is not an official clinical diagnosis.

Yet, for people who experience codependency, being able to name this experience is incredibly validating.

In my book, The Codependency Recovery Plan: A 5-Step Guide to Understand, Accept, and Break Free from the Codependent Cycle, I define codependency as “Prioritizing others’ needs, expectations or problems over one’s own mental and physical health.”

Going deeper in The Codependency Workbook: “Codependency is the process in which people’s focus on the world is external, so they seek their worth, and proof of their worth, from others rather than using an internal compass. Their focus is on “other worth,” instead of “self-worth.”

Related: The meaning of “codependency” and how to find healing

You can recover from codependency

Codependency is simply a pattern of caring for others more than yourself. This pattern creates many issues including a sense that you don’t know yourself, low self-esteem, and resentment.

Related: 5 ways low self-esteem impacts your dating life

It’s incredibly painful to live this way yet, you can absolutely recover. When you recover from codependency, you become interdependent. In this way of living, you balance other-care and attention with self-care and attention. It’s much more peaceful and grounding. You naturally feel more self-respect living with interdependence. And your relationships run much more smoothly.

Related: How to take care of yourself: 6 simple self-care strategies

CBT for Codependency Recovery

My best-selling workbook, The Codependency Workbook: Simple Practices for Developing and Maintaining Your Independence, features exercises from CBT.

In this article, I am providing a free excerpt from this workbook. This except will explain what Cognitive Behavioral Therapy. You will also learn why CBT is effective at treatment codependency.

Defining Cognitive Behavioral Therapy (CBT)

The initial image of therapy that pops into many people’s minds is of a patient on a couch describing their childhood while the therapist takes notes. Entering my office for the first time, clients often remark in surprise that I ask them to take a seat rather than lie down. My clients also commonly say that they had a good childhood and don’t want me to dig into the past. While there are countless therapy models, it’s clear to me that the one still most often portrayed in popular media is psychoanalysis, the therapeutic approach developed in the early twentieth century by Sigmund Freud. His model is centered on the belief that all people experience trauma as infants because of the inherent helplessness of the experience. Psychoanalysis then seeks to make conscious how this affected one’s desires and impulses unconsciously, thus allowing the patient to move to catharsis. This approach is vastly different from other more commonly used models today.

Therapy models provide a clear and comprehensive framework to facilitate positive change in clients. There has been a push in the psychology field for decades to ensure that models can be proven effective by research; these are the evidence based or empirically validated treatments. Cognitive Behavioral Therapy (CBT) is one of the most famous of these empirically validated treatments. Dr. Aaron T. Beck, a fully trained and practicing psychoanalyst, created CBT in the early 1960s. He wanted the medical community to accept psychoanalysis as legitimate and knew that for this to happen research would need to prove its efficacy. However, his research revealed a different approached from psychoanalysis to treat depression, focused on the distorted thoughts and beliefs, or cognitions, that are a primary feature of depression. CBT treatment focuses on solving one’s current problems by changing the unhelpful thinking and behavior patterns that reinforce them.

CBT’s fundamental principle is that events in life trigger our thoughts, which impacts our emotions, which then influence our behaviors. These behaviors add up to our life circumstances, which may or may not be problematic. How we think and feel about a life event – or “trigger” – will impact our lives and relationships. Any event can be interpreted in countless ways, either to help the individual cope or to add to their distress. The CBT cognitive model addresses the thoughts, beliefs, and behaviors that contribute to our psychological problems. Simply put: When we change our thoughts and actions, we change our lives.

In CBT, the therapist works to empower the client so they may be able to solve their own problems moving forward; this is why the treatment model is designed to be short-term. From the very beginning, the therapist helps the client identify the current thoughts that reinforce the presenting problem – the problem that brings a person to therapy, such as anxiety or social concerns. The therapists shows the client how the thoughts reinforce the presenting problem, as they lead to problematic behaviors. For example, a person may feel that they are “awkward” (thought/core belief), which makes them nervous in social situations (feeling), which causes them to avoid eye contact and pause excessively throughout conversation (problem behaviors). The person may continue to believe that they are “awkward,” even though this is a false belief combined with the resulting feelings and behaviors that creates this socially uncomfortable reality.
Some thoughts become central to a person’s view of themselves, others, and the world. These thoughts, or “core beliefs,” create a schema in which the person organizes the events of their life and work through often negative filtering. For example, a person may have a core belief that they are “dumb.” This schema will support them in organizing their world based on this belief. They will focus on the times they failed a test or were passed up for a promotion but will dismiss times that they excelled academically and professionally. Negative filtering is an example of a cognitive distortion, or an error in thinking. These thinking mistakes tend to be consistent and systematic.

CBT therapists work to identify a person’s personal cognitive distortions to support them in empowering themselves to challenge these false ways of thinking that reinforce distress and unhelpful behaviors. (These cognitive distortions are outlined in Chapter 4 of The Codependency Workbook so you may identify your own thinking mistakes.) Therapists also help the client identify their core beliefs and begin to notice exceptions to them. This allows a client to think differently about themselves or their life, which reduces their suffering over time.

Why CBT for Codependency

CBT emphasizes that common filters and cognitive distortions reinforce one’s presenting concern – in this case, codependency. I will explore these filters and distortions in detail in later chapters, but all of these problematic ways of thinking can be seen in codependency. Codependents often have frequent errors in thinking that reinforce their pain, their resentment, and the codependency itself. For example, it is common for a codependent to believe that it’s bad or selfish to have any self-interest, and as a result they will feel guilty when they experience a normal urge to engage in self-care. Many people will cope with this guilt in unhealthy ways such as stuffing it, denying their need for self-care, and over-compensating for the guilt by fixating on others’ needs.

In CBT, we see that an event will trigger a thought. A person who is codependent will experience most life events much differently from an interdependent person. An example of such an event is walking into a kitchen where the sink is overflowing with dirty dishes. A codependent person may think, “This always happens to me! My family thinks I’m the unpaid maid.” This thought can lead to feelings over anger and resentment. The codependent person will then act on these feelings in a specific way – they may “accidentally” break their wife’s favorite mug when putting it in the dishwasher and then feel justified for this behavior.

An interdependent person, on the other hand, will have a much more balanced view. They may walk into the kitchen and think, “Wow, the kitchen is a mess! I know that my wife had an early meeting today though, and my son didn’t get home from his job until late and still had to study for that test.” They may feel annoyance at the reality of dirty dishes, but they won’t take it personally and won’t feel the need to act out. They may instead realize that they have time to clean up the dishes today but will ask for a family meeting to avoid this experience in the future.

Much of the codependent cycle centers on the unhelpful thoughts that reinforce it. Codependency’s external focus can trick us into believing that we are helpless and victimized by others by this is a false belief. The reality is that unless we are in an abusive, controlling, or violent relationship, we make choices as adults that affect our lives. We feel stuck because of these false beliefs which lead to maladaptive behaviors and reinforce the situations that make us feel bitter and resentful. We recover when we remember the truth, which is that we have options, make choices, and are responsible for our choices and behaviors.

CBT is a wonderful model that helps us recover, as it helps us notice our thoughts and beliefs that reinforce our codependent symptoms and behaviors that lead us to feel “stuck.” We realize that we can interrupt this process through mindful attention to our current cognitive distortions and false beliefs and then explore alternative ways of viewing situations. This is very empowering! CBT highlights that we always have a choice in how we react, unless of course our nervous system is hijacked, and then sometimes the best we can do is take a time out. (See more about that in Chapter 6.) In codependency, we are often compelled to feel or act in a certain way because someone “made” us do it. When we use the CBT tools, we no longer have to feel controlled by others. If we choose our actions, then we can choose the state of our life. We will no longer be victims, and we can make positive changes in our own lives.

CBT is a skills-based therapy that seeks to empower the client so they can be their own source of positive change maintenance. One way this happens is by the therapist asking for accountability in the therapy process in the form of therapeutic homework. Research has shown this is a valuable component of CBT treatment. A meta-analysis of the impact of homework on efficacy in CBT treatment (Mausbach, Moore, Roesch, et al) that included 23 studies with 2,183 subjects in total found that when patients fully engaged in the homework portion of treatment they had greater improvement rates regardless of what symptoms led them to seek treatment. This is great new when completing a workbook!

It is important to give yourself grace throughout your recovery process. An important CBT principle is that all behavior makes sense, as it all serves a purpose. We developed codependent thoughts and behaviors for honest reasons, often due to trauma. We can have self-compassion when these old ways of thinking and behaving continue to present themselves.

Your willingness through this process will serve you well. You are your best ally in your recovery process, and your willingness to contemplate all workbook prompts, to journal, and to practice the new CBT skills will help you recover much more quickly and in a lasting way.

About The Author, Krystal

Krystal Mazzola Wood, LMFT is a practicing relationship therapist with over a decade of experience. She has focused her entire career to empowering people to heal from unhealthy relationship processes. She teaches the skills and tools necessary to have a life filled with healthy and loving relationships.

This passion led her to write her best-selling books and create courses. Her books, The Codependency Recovery Plan: A 5-Step Guide to Understand, Accept, and Break Free from the Codependent Cycle and The Codependency Workbook: Simple Practices for Developing and Maintaining Your Independence have helped many people heal.

Her third book, Self-Love Made Possible: The 5-Step Guide to Stop Being Your Own Worst Enemy and Become Your Own Best Friend will be released late 2022. To be notified of its release, please join the waitlist here.

Her course, Confidently Authentic: Stop People Pleasing and Start Being True to Yourself, provides the skills necessary to have a healthy relationship. This course features over a year of relationship skills you would learn in therapy. Students share this course has been “life changing.”

Each week, she answers your relationship questions from a place of expertise and compassion. To submit your relationship questions, please DM us or you may send an email at to submit your question.