Dr. Mike Gropper answers questions about co-dependence

Science and Health

Esti is a 56-year-old divorced woman. She is the mother of two adult sons who are in their late 20’s. Both her sons and her ex-husband live in England. 

She first came to me to help her quit smoking. Early on in our meetings, she began to tell me about some of the other problems that were troubling her. Esti told me about her years of suffering in a terrible marriage. She stated that she got married in her late 20s and was married for 15 years. 

She told me that she was raised in a traditional family and was taught that she should never question the authority of her father. In other words, she was told that her opinion was not valued at all. Furthermore, she learned that in order to get any attention, she had to be compliant and always sought out her father’s view. 

Eventually, this behavior led her to put her own feelings aside and to always please others. During her teen years, her dad told Esti to consult with her older brother whenever confronted with a decision that she needed to make. So that’s what she did. 

Her people-pleasing ways continued with friends and later in her marriage. Over the years, Esti’s marital problems intensified. She was the victim of both emotional and physical abuse. Out of desperation and contemplating suicide, Esti divorced her husband. Nevertheless, he continued to harass her and call her names. 

Psychology (Illustrative) (credit: MOHAMED HASSAN/PIXABAY)

Esti felt desperate and wanted to move far away from him. Eventually, she moved to Israel, where she had some cousins, and was able to buy an apartment. She tried to maintain relations with her sons, but they felt abandoned. She was not able to forgive herself for leaving her sons.

ROSS ROSENBERG writes in his 2013 book, The Human Magnet Syndrome: Why we love people who hurt us, that people like Esti who cannot say “no” are suffering from a condition called co-dependency. 

“Co-dependents are essentially stuck in a pattern of giving and sacrificing…. without the possibility of ever receiving.” Rosenberg states that this behavior is learned from childhood, usually in the context of a narcissistic parent whose “conditional love” demanded both compliance from the child and mirroring of the parent at the expense of the child developing autonomy. 

As a result, this learned behavior thwarted the child’s ability to learn healthy self-boundaries. For the child, it seems that he/she was emotionally rewarded when his/her behavior pleased the parent. However, the parent rarely gave anything back to the child. 

This highly enticing reward draws the children into a behavioral pattern that is costly to their emotional health. These child and later co-dependent adults subconsciously continue this behavior but with great resentment and suffering because of their abandonment of self. In essence, these are chronic “yes people.”

In fact, many of the men that Esti is attracted to are narcissistic and emotional manipulators. Psychotherapy has been directed to help her identify and overcome her vulnerabilities in order to break the pattern of behavior that she was taught throughout her childhood.

Listen to your inner voice

Since starting therapy, Esti’s challenge is to learn to listen to herself, to her own feelings, and to her own inner voice. In her way of seeing the world, she thinks that it is selfish to think about her own feelings before the other person’s. I explained to Esti that there is a middle ground. 

Rosenberg writes about a healthy midpoint behavior between the total “other-orientation” and total “self-orientation.” The author states clearly that the balance of doing for the other person and doing what is in your own best interest enhances mental health. For Esti, the severity of other-orientation at the expense of herself was a central factor leading to her emotional dysfunction.


I often utilize cognitive-behavioral therapy (CBT) in my clinical approach. One of the areas I worked on with Esti was to try to challenge her beliefs about the anger she would induce in others if she would say “no.”

I pointed out to her that social scientists have found that people pleasers have “harshness biases,” a tendency to believe that others will judge them more severely than they actually do. Using CBT, I was able to help Esti change her beliefs about what others thought of her if she put herself first. She began to test out this theory by saying “no” and saw that most people were not so upset with her for declining their request. 

Therapy helped Esti realize that most of her worry about the angry response towards her for saying “no” was learned and in her head, not the actual response of the other person. She was able to continue to try to live by this new way of thinking, and she gradually began to see that the world would not fall apart if she were to show more of a self-orientation in dealing with requests. 

For Esti, this approach has also helped her to be conscious of the kind of men to date and to make sure her needs are equally important to any partner she chooses in her future.

In essence, the goal for co-dependent individuals is to teach them that their feelings, beliefs, and values all have merit. To be a happy person, it is important to have a balance between listening to the other person but also listening to your own inner voice, without feeling guilty. 

In this light, I am often drawn to a very special quote from the Jewish text Pirkei Avot (The Ethics of the Fathers): “If I am not for myself, who will be for me? And if I am only for myself, what am I? And if not now, when?” I understand that this mishna has many meanings, but as a therapist I think there is tremendous value in helping co-dependent individuals break away from their guilt that their own voice is not worthy. 

People feel and function well when they balance a healthy “other-orientation” with a healthy “self-orientation.” The good news is that while some people do this naturally, there is help for others to learn these skills. 

The writer is a cognitive-behavioral psychotherapist treating adults and children, as well as couples. Dr. Gropper sees clients in Ra’anana and at his clinic in Jerusalem. He can be contacted for consultations and/or scheduling online therapy: [email protected]; www.facebook.com/drmikegropper