We all want to feel needed, appreciated, and connected. But when your sense of worth hinges on how much you do for others; when saying no feels dangerous or caring for yourself brings guilt; you might be caught in an over-accommodating loop. Caring deeply and showing up for others isn’t the problem. The trouble begins when your own needs fade so far into the background that you forget they’re even there.

Research shows that people pleasing behavior is more common than you might think, often having roots that stretch back into childhood and significantly impacting mental health outcomes.

What It Feels Like to Over-Accommodate

If you’re someone who regularly adjusts your plans, preferences, or even your personality to keep others happy, you might be stuck in an over-accommodating loop. This can look like being easygoing, selfless, or “low maintenance” on the outside – but inside, you may feel overwhelmed, unappreciated, or exhausted.

While this pattern can be rooted in a genuine desire to help, it’s often driven by deeper fears: fear of conflict, fear of being a burden, fear of not being enough unless you’re useful. And those fears can quietly shape your relationships, your self-worth, and your overall well-being.

Common Signs of People Pleasing Behavior

Understanding the patterns of people pleasing behavior is crucial for recognizing when caring crosses into self-sacrifice:

Taking on Emotional Responsibility: You often feel responsible for keeping others happy or avoiding their discomfort, even when it’s not your job.

Struggling to Say No: Turning down requests makes you feel guilty, selfish, or worried someone will be upset.

Putting Yourself Last: Your own rest, needs, and boundaries get pushed aside to make room for others.

Guilt Around Self-Care: Doing something for yourself feels indulgent – or even wrong.

Resentment or Burnout: You feel drained or underappreciated, but you keep giving anyway.

Harvard-trained psychologist Debbie Sorensen notes that people pleasers are at significantly higher risk for workplace burnout due to their difficulty setting boundaries and saying no to additional responsibilities.

The Trap in Romantic Relationships

People pleasing behavior can really show up in romantic relationships, especially with partners who are more self-focused or entitled. If you’re overly other-oriented, you might feel pulled to caretake, smooth things over, or manage the other person’s moods. Your needs take a backseat, sometimes so far back you lose sight of them entirely.

Without meaning to, you may even reinforce the idea that the relationship revolves around their wants – because you keep showing up, quietly stretching yourself thinner. Over time, this dynamic can leave you feeling resentful, emotionally alone, or unsure what you even want from a partner.

Change starts by noticing these patterns, getting curious about them, and slowly learning to voice your needs and limits. That’s not selfish – it’s how mutual relationships are built.

Where People Pleasing Behavior Comes From

This habit of over-accommodating usually isn’t random. Most people learned it somewhere. Sometimes, the pattern forms in response to unspoken expectations – subtle cues that your role was to be the helper, the fixer, the one who stayed calm. Even if no one ever said it out loud, you may have absorbed the message that your value came from being easy, helpful, or emotionally low maintenance.

Research indicates that people pleasing behavior often stems from childhood experiences where love or approval was conditional. If caregivers only validated them when they were obedient, accommodating, or high-achieving, they may have learned that their worth depends on meeting others’ expectations.

Maybe you grew up in a household where conflict felt dangerous, so you kept the peace. Maybe you had a parent who struggled, and you stepped into the role of emotional support. Or maybe you were simply rewarded for being the one who didn’t “cause trouble.” When your safety or connection depended on being agreeable, helpful, or invisible, it makes sense that you internalized those ways of coping. They helped you survive then, but they might be hurting you now.

Moving Toward Balance: Overcoming People Pleasing Behavior

You don’t have to stop being caring or supportive. But what if your own needs got equal airtime? What if tending to your well-being wasn’t something you earned after taking care of everyone else? These changes don’t happen overnight, but they’re possible with time, practice, and support.

Here are a few steps toward that kind of shift:

Practice Assertiveness: Speak up about your preferences and needs – even in small ways. Start where it feels hard, but possible. Studies show that learning assertiveness skills is crucial for breaking free from people pleasing patterns.

Make Self-Care Non-Negotiable: Rest, connection, creativity – whatever refuels you – deserves space on your calendar.

Challenge the Guilt: Just because it feels bad doesn’t mean it is bad. Taking care of yourself isn’t selfish – it’s sustainable.

Notice the Roots: Start gently unpacking where these patterns came from. What were you taught about your role in relationships?

Seek Out Mutuality: Surround yourself with people who want to know the real you – not just the version who shows up for them.

FAQ: Understanding People Pleasing Behavior

Q: Is people pleasing behavior a mental health condition? A: While not a diagnosable condition itself, chronic people pleasing behavior is often linked to anxiety, depression, low self-esteem, and codependency. It can also be a trauma response known as “fawning.”

Q: How do I know if my helping is healthy or unhealthy? A: Healthy helping comes from choice and maintains your boundaries. Unhealthy people pleasing feels compulsive, leaves you drained, and often involves sacrificing your own needs consistently.

Q: Can people pleasing behavior be changed? A: Yes! With awareness, practice, and often professional support, people can learn to set healthy boundaries, practice assertiveness, and build self-worth independent of others’ approval.

Q: What’s the difference between being kind and people pleasing? A: Kindness comes from genuine care and choice, while people pleasing is driven by fear, guilt, or the need for approval. Kind people can say no when needed; people pleasers struggle with this.

Q: How long does it take to overcome people pleasing habits? A: Recovery is a gradual process that varies for each person. Some may see changes in weeks with consistent practice, while deeply ingrained patterns may take months or years to fully transform.

Reclaiming Your Authentic Self

Being someone who cares deeply is a gift. But when that care becomes a quiet erasure of your own needs, it can be a heavy burden to carry. You deserve relationships that go both ways – and a life that honors your needs just as much as anyone else’s.

Healing people pleasing behavior doesn’t mean giving less. It means giving in a way that includes you – where your voice, your needs, and your inner steadiness are part of the equation. You’re allowed to show up fully, not just as the one who helps, but as someone equally worthy of care.

 Have you ever felt responsible for someone else’s happiness? Do you catch yourself saying ‘yes’ when you want to say ‘no’? For many, this isn’t just a bad habit, it’s a deeper pattern called codependency.

Sarah’s story illustrates just how quietly and powerfully codependency can take over a life, but more importantly, how recovery is possible.

What Is Codependency?

Codependency is a relational pattern where a person’s sense of identity, self-worth, or emotional stability becomes excessively tied to another person’s needs, approval, or behaviors.

According to Mental Health America, codependency is “an emotional and behavioral condition that affects an individual’s ability to have a healthy, mutually satisfying relationship” and is often called “relationship addiction.”

It often looks like:

• Over-responsibility: feeling compelled to fix or rescue others
• People-pleasing: neglecting one’s own needs to keep others happy
• Poor boundaries: difficulty saying no or separating your emotions from others’
• Low self-esteem: valuing yourself only by how much you give or sacrifice

At its core, codependency is about losing yourself in someone else’s life, mistaking enmeshment for love.

Struggling with relationship patterns? Find qualified therapists who specialize in codependency recovery through our therapist directory.

The Origins of Codependency: Understanding the Roots

The term “codependency” emerged in the 1970s-1980s within the addiction recovery movement:

• Originally used to describe partners or family members of people with alcoholism
• The concept came from Alcoholics Anonymous (AA) and Al-Anon groups
• These loved ones were called “co-alcoholics” because their lives had become just as unmanageable as the person with addiction
• By the 1980s, therapists like Melody Beattie (author of Codependent No More, 1986) broadened the term beyond addiction

Research from the International Journal of Mental Health and Addiction shows that codependent behaviors often develop from “early exposure to addiction behavior, resulting in their allowance of similar patterns of behavior” in adult relationships.

Why Codependency Matters for Mental Health & Faith

Mental health perspective: Codependency increases anxiety, depression, burnout, and identity confusion.

Faith perspective: It shifts trust from God to people, believing “If they’re okay, then I’m okay”, rather than resting in God’s unconditional love.

Learning to set healthy boundaries in relationships is essential for both mental and spiritual wellbeing.

Sarah’s Story: Living in the Shadow of Codependency

Sarah had always been the reliable one. Growing up in a home where her father struggled with alcohol and her mother withdrew, Sarah stepped in early to hold things together. She learned to keep the peace, anticipate everyone’s moods, and take care of problems before they erupted.

As an adult, Sarah carried those patterns into her relationships. She married Tom, a charismatic man who often struggled to keep jobs and manage stress. At first, she felt needed, she paid the bills, soothed his outbursts, and covered for him when he didn’t follow through.

But over time, Sarah’s life became smaller. She stopped seeing friends because Tom got jealous. She worked extra hours to keep their household afloat, telling herself it was “just for a season.” Inside, she felt constantly exhausted and anxious, but the thought of leaving Tom, or even saying no, filled her with guilt and fear.

When Tom was angry, Sarah took it as her failure. When he was happy, she felt a rush of relief, like she had done her job. Her emotions rose and fell entirely on his stability.

Sarah’s breaking point came when her teenage daughter confronted her: “Mom, you care more about keeping Dad calm than taking care of yourself. We need you too.” Those words pierced Sarah’s heart. She realized she had spent so long living for someone else that she didn’t know who she was anymore.

If you recognize yourself in Sarah’s story, you might want to read about common signs of codependent relationships to better understand these patterns. Understanding expert perspectives on codependent relationships can also provide valuable insights into the healing process.

8 Evidence-Based Coping Skills for Healing from Codependency

Healing from codependency requires learning to value yourself as much as you value others and building new habits of self-respect.

1. Set Clear Boundaries

• Practice saying “no” without over-explaining
• Recognize that someone else’s emotions are not yours to carry
• Remember: Boundaries are not walls, they are doors with locks, opened by choice, not obligation

Need help setting boundaries? Our therapists specialize in boundary-setting techniques. Search by location and specialty.

2. Build Self-Awareness Through Reflection

• Journal about where you feel over-responsible
• Notice patterns of guilt or fear when you assert your needs
• Reflect on whether your choices come from love or fear of rejection

3. Shift Your Identity Foundation

Anchor your worth in something deeper than others’ approval, your faith, your values, your God-given identity.

Remember: You are not defined by what you do for others, but by who you are.

4. Practice Intentional Self-Care

• Schedule rest without guilt
• Engage in hobbies, creativity, or friendships outside caregiving roles
• Care for your body with sleep, exercise, and nutrition as acts of stewardship

Research shows that self-care strategies for relationships are crucial for maintaining healthy boundaries and preventing codependent patterns from developing.

5. Seek Professional and Community Support

• Therapy and support groups (like Codependents Anonymous) provide guidance
• Healthy community breaks the isolation of codependency and models balanced relationships
• Research shows “Codependency can be difficult to change alone as codependent behaviors are often learned early on and reinforced over many years.”

Many people find it helpful to start with relationship inventory exercises to better understand their patterns before seeking professional help.

6. Allow Others to Own Their Choices

• Let go of the need to fix or rescue
• Trust that others can face their consequences and learn from them
• This doesn’t mean abandonment, it means respecting their autonomy

7. Develop Emotional Regulation Skills

• Learn to sit with uncomfortable feelings without immediately acting
• Practice distinguishing between your emotions and others’ emotions
• Use grounding techniques when you feel the urge to “rescue”

8. Rebuild Your Support Network

• Reconnect with friends and family outside the codependent relationship
• Join groups or communities aligned with your values and interests
• Invest in relationships that are mutually supportive

Sarah’s Transformation: The Path Forward

With counseling and the support of a women’s group, Sarah began to set boundaries. She learned to say “no” without guilt, to let Tom take responsibility for his choices, and to give herself permission to rest.

At first, it felt wrong, like she was being selfish. But slowly, Sarah discovered freedom. She started painting again, reconnected with friends, and, most importantly, rebuilt her sense of worth not on how well she managed others, but on her identity as a beloved daughter of God.

Sarah’s journey reflects many inspiring stories of codependency recovery where people learn to distinguish between healthy caring and unhealthy enabling.

FAQ: Common Questions About Codependency

What are the main signs of codependency?

Key signs include feeling responsible for others’ emotions, difficulty saying no, low self-esteem tied to helping others, and fear of abandonment or rejection when setting boundaries.

Can codependency be cured?

While codependency isn’t a clinical diagnosis, the patterns can be changed through therapy, support groups, and developing healthy coping skills. Recovery is possible with commitment and support.

How long does codependency recovery take?

Recovery is a process that varies for each person. Many people see improvements in 3-6 months of consistent therapy and support group attendance, but deeper healing often takes 1-2 years.

What’s the difference between being caring and being codependent?

Caring comes from choice and maintains healthy boundaries. Codependency involves compulsive helping, losing yourself in others’ problems, and enabling unhealthy behaviors.

Can codependents have healthy relationships?

Yes! With recovery work, codependents can develop balanced, mutually supportive relationships based on choice rather than compulsion.

Take the First Step Toward Freedom

Codependency recovery isn’t about becoming selfish, it’s about becoming whole. When you learn to care for yourself with the same compassion you show others, you create space for authentic love to flourish.

Ready to break free from codependent patterns? Connect with experienced therapists in your area who understand codependency recovery.

Reflection Questions for Your Journey

• Where do I struggle most with people-pleasing or rescuing?
• How does fear of rejection or abandonment show up in my relationships?
• What boundary could I set this week that would protect my peace?
• How would my life feel different if I trusted God with others instead of carrying them myself?

Much of self-help literature portrays codependency and narcissism as polar opposites. Codependency is often associated with excess selflessness. Narcissistic personality disorder (NPD) is often linked to excess selfishness.

Many narratives depict codependent people as victims who fall prey to those with narcissistic traits. This oversimplification neglects a core truth at the heart of both codependency and narcissism: both codependents and narcissists can lack a healthy sense of self.

Codependency and Narcissism: Same Needs, Different Behaviors

Narcissism and codependency are both linked to an undefined self. They often struggle to get a sense of who they truly are. People with these conditions often rely on other people to define their own identities. As such, they place a lot of importance on what others think of them.

People with NPD often develop an intense, almost exclusive focus on themselves. They may display a lack of empathy or regard for others’ needs. They may only care about others’ feelings in relation to themselves. Narcissistic people often need someone else to inflate their self-esteem. They may need a continuous stream of affection and admiration to feel good about themselves. Some self-help websites refer to this stream as a “narcissistic supply.”

Meanwhile, people with codependency are often hyper-focused on others. They typically form an identity around serving others’ needs. They may try to control another person’s behavior, believing they know what is best for the person. Instead of praise, codependents often crave gratitude and a sense of “being needed.”

Almost everyone wants to feel loved or important. Narcissism and codependency are two strategies to achieve that goal. However, both conditions can create an excessive reliance on others’ approval.

The Common Origins of Codependency and Narcissism

Both codependency and narcissism are linked to adverse childhood experiences. A 2001 study of 793 mothers and children found a threefold increase in NPD among children whose mothers were verbally abusive. A 1999 study of 200 college students linked codependent behaviors to childhood parentification. Parentification is when a child takes on a caretaker role for their parents or siblings, often due to neglect or abuse.

People with NPD and codependency often have similar childhood experiences. They’ve simply adopted different ways of adapting. For example, say a pair of twins grow up neglected. One sibling may develop a low self-esteem and learn they are only “worth something” if they are useful to others. They may grow into a codependent adult who is used to sacrificing their own needs. The second sibling might develop an inflated self-esteem as a protective mechanism. The neglect makes the child feel unimportant, so as a narcissistic adult, they may crave constant validation to prove their self-worth.

The codependent and narcissistic siblings may develop very different behaviors and personalities. But in both scenarios, trauma and a fractured sense of self are at the core of the problem.

Understanding the Dance of Narcissism and Codependency

People with codependency sometimes form relationships with people who have NPD. Typically the two partners develop complementary roles to fill each other’s needs. The codependent person has found a partner they can pour their self into, and the narcissistic person has found someone who puts their needs first.

Narcissism and codependency aren’t always opposites. The desire to feel needed is not that different from the desire to feel important.However, this dynamic can quickly become unhealthy. The codependent person may try to live vicariously through their larger-than-life partner. When their partner doesn’t show enough gratitude for their service, the codependent person may feel resentment. Meanwhile, the narcissistic person often exploits their partner’s people-pleasing tendencies for their own narcissistic supply. As their ego grows, their demands may increase, until the codependent person eventually burns out.

Even if they develop an abusive relationship, neither partner may try to leave. Both people may stay in an unhealthy situation for fear of being alone. Without help, this dynamic can grow increasingly toxic.

Can Codependency and Narcissism Overlap?

Narcissism and codependency aren’t always opposites. The desire to feel needed is not that different from the desire to feel important. While many studies find lower rates of narcissism among people with codependency, some have actually found higher rates of narcissism among those with codependent traits.

A person who is codependent in one situation might be narcissistic in another. For instance, a person might become codependent in their marriage, serving their spouse’s every need. Yet that same person may feel an unending need for respect and praise from their children. causing them to manifest narcissistic tendencies.

In some cases, an abusive person may try to gaslight a codependent partner into believing they are narcissistic. The abuser may sabotage any show of self-confidence by calling their partner “egotistical.” Typical acts of self-care, such as taking days off or spending time with friends, may be labeled “selfish.” The codependent person may believe these accusations and try to fix the relationship by ignoring their own needs. A person isolated from loved ones—who might offer a more objective view—is likely to falsely believe they are a narcissist.

The fact that all people display narcissistic or codependent traits on occasion can make it even more difficult for a person to decide if they’re narcissistic, codependent, or both.

Codependency and Narcissism: Therapy Can Help

Codependency and narcissism can become pathological when they undermine a person’s quality of life or cause the person to harm others. It may be time to seek help if you show the following signs:

• A history of relationships in which abuse has been present.
• Difficulty feeling close to others.
• Feelings of emptiness or low self-esteem.
• Feeling as if your identity depends on what others think of you.
• Feeling like others don’t fully appreciate you or acknowledge your importance.
• Feeling like you are never properly thanked for all you have given up.

A therapist can help people with narcissism or codependency understand the root of their insecurities. In therapy, you can learn how to replace flawed coping mechanisms with healthier behaviors. Talking through your experiences can help you access to new ways of thinking and being.

Therapy offers compassion, not judgment.  No matter where you are in your relationships or how much you have struggled in your life, the right therapist can help. Find a therapist skilled at helping people with your needs here.

References:

1. DSM-IV and DSM-5 criteria for the personality disorders [PDF]. (2012). American Psychiatric Association. Retrieved from http://www.psi.uba.ar/academica/carrerasdegrado/psicologia/sitios_catedras/practicas_profesionales/820_clinica_tr_personalidad_psicosis/material/dsm.pdf
2. Gunderson, J. G., Shea, M. T., Skodol, A. E., McGlashan, T. H., Morey, L. C., Stout, R. L., . . . Keller, M. B. (2000). The collaborative longitudinal personality disorders study: Development, aims, design, and sample characteristics. Journal of Personality Disorders, 14(4), 300-315. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11213788
3. Johnson, J. G., Cohen, P., Smailes, E. M., Skodol, A. E., Brown, J., & Oldham, J. M. (2001). Childhood verbal abuse and risk for personality disorders during adolescence and early adulthood. Comprehensive Psychiatry,42(1), 16-23. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11154711
4. Marks, A. D., Blore, R. L., Hine, D. W., & Dear, G. E. (2011, July 21). Development and validation of a revised measure of codependency. Australian Journal of Psychology, 64(3), 119-127. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1742-9536.2011.00034.x
5. Stafford, L. L. (2001). Is codependency a meaningful concept? Issues in Mental Health Nursing, 22(3), 273-286. Retrieved from https://www.tandfonline.com/doi/abs/10.1080/01612840121607
6. Wells, M., Glickauf-Hughes, C., & Jones, R. (1999). Codependency: A grass roots construct’s relationship to shame-proneness, low self-esteem, and childhood parentification. The American Journal of Family Therapy, 27(1), 63-71. Retrieved from http://search.proquest.com/docview/230100367?accountid=1229

Have you ever been in a relationship that felt as though it sapped all of your energy? If so, you may have been in a codependent relationship. Codependency is generally defined as a type of relationship in which one person supports the other in an unhealthy behavior of some kind. This could be enabling someone to maintain an addiction, to not take responsibility for his or her actions, or to become overly reliant on you.

Codependency is often learned in a dysfunctional family environment. There are generally underlying issues that have been ignored or minimized, such as an addiction, physical or sexual abuse, or a family member struggling with a chronic mental health condition. Frequently, the person in the caretaking role disregards personal needs and focuses on providing for the other financially, emotionally, and/or physically. The person being taken care of comes to depend on the caretaker’s help in order to enable him or her to maintain life choices. Feelings in this type of family or relationship are generally repressed, and problems tend to go unacknowledged.

Some of the signs that indicate you might be in a codependent relationship include:

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1. Recognizing the harmful behaviors that your partner or loved one is engaging in, but providing for that person in such a way that he/she is not having to suffer consequences.
2. Remaining in an unhealthy relationship despite the emotional and psychological toll to your own health.
3. Feeling unappreciated, angry, and resentful, but also afraid of retaliation if you stop “rescuing” or taking care of the other individual.
4. Difficulties with setting appropriate limits or boundaries in the relationship.
5. Putting the needs of others before your own.
6. Being overly protective and taking on all responsibility for your partner or loved one.
7. Minimizing or denying the problem.
8. Having poor communication skills, especially regarding the problem and/or your emotions.

Although the caretaker in the codependent relationship usually has good intentions and generally acts out of a sincere desire to help a partner or loved one, the situation typically ends up backfiring. Over time, the caretaker an start to feel unacknowledged and taken for granted. By constantly protecting the loved one from the consequences of his or her actions, the relied-upon partner actually helps to foster even more of the destructive behaviors. This, in turn, prevents the loved one from experiencing important life lessons and learning to take responsibility.

So how can you stop the unhealthy dynamics of a codependent relationship? A few methods include:

• Setting appropriate boundaries in the relationship. Take stock of your feelings and determine where you will draw the line when offering financial, emotional, and/or physical support.
• Stop rescuing your loved one from the consequences of destructive or inappropriate behaviors. Providing resources for getting help with an addiction, for example, is much more loving than covering up for the person’s actions and watching that person slowly ruin his/her life.
• Spend more time with friends doing activities you enjoy. Broaden your horizons and develop a larger support system that you can turn to when you need someone to depend on.
• Acknowledge your own needs and start implementing more self-care strategies. This is often one of the most difficult things for people on the caretaking end of a codependent relationship to do, but it’s one of the most necessary, too.
• Get help from a mental health professional. Codependent relationships can be difficult to leave or change. If you have been struggling to make changes on your own, contact a therapist to work through these issues in a caring environment.

Although codependent relationships can be extremely challenging, change is possible by following some or all of the methods listed above. A great deal of pain and suffering can be alleviated by learning to set healthier boundaries in order to stop any destructive behaviors and support the growth of the partners or family members involved.

If you haven’t read the novel yet, you might be 50 shades of curious about why Fifty Shades of Grey is the most-talked-about tale in print currently.

A quick search will reveal that the romance between the main characters, Mr. Grey and Miss Steele, revolves around bondage, discipline, dominance, submission, sadism, and masochism (BDSM). In fact, Christian Grey appears to really only get satisfaction from sex when it involves inflicting pain or dominance over his partner, which, following criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR) used by mental health professionals to make diagnoses, could be considered a mental disorder called sexual sadism.

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The DSM IV-TR states that “sexual sadism involves acts (real, not simulated) in which the individual derives sexual excitement from the psychological or physical suffering (including humiliation) of the victim.” In order to officially be diagnosed with sexual sadism, individuals must meet the following criteria:

1)    “Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.”
2)    “The person has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.”

In the first novel of the series, Christian Grey appears to engage in sexual sadism only with consenting participants (like Anastasia Steele, the main female character), but he openly admits to being abused (including sexual abuse) as a child and teenager and appears to be at least somewhat distressed by the fact that it’s difficult for him to have a “normal” relationship. He even explains to the character Anastasia Steele at one point that this is just the way he is, almost with sorrow. And although he does have “normal” or “vanilla” sex with Anastasia, he makes it obvious that he prefers sex that involves pain and pleasure at the same time, always with him dominating.

Anastasia also admits to herself that there is something unusual about Christian and his sexual preferences, but she lets her desire for him take over, and she hopes that she can make him want a “normal” relationship with her. She herself has issues with low self-esteem and confidence, which is perhaps why she is so drawn to the seemingly overly confident Christian. Both characters appear to function as well as the average person in their fictional world, but both have issues that could potentially need to be addressed by a professional if they lived in the real world.

So it appears that one of the main characters of Fifty Shades of Grey may have a diagnosable disorder related to sexuality, or at least has abnormal sexual preferences and a traumatic past that hasn’t been resolved yet. He has major difficulties maintaining any lasting romantic relationship, and yet the relationship between Christian and Anastasia seems to have been received in a somewhat positive light, considering the large following of readers.

The Experts Weigh In
Several mental health experts have offered their insight into the unusual relationship found in Fifty Shades of Grey (and the two other novels in the series). Reef Karim, a board-certified psychiatrist, the founder and medical director of the Control Center for Addictions, and author of Why Does He Do That? Why Does She Do That? and host of the new show Broken Minds on the Discovery channel, said that the novel is definitely making people think about normal and abnormal sexuality and possibly changing some people’s minds.

He said in an e-mail that the main question people are wondering is, “What is normal and abnormal sexual behavior, and when is aberrant sexual experimentation and behavior considered a mental health diagnosis?” “The really interesting part of psychiatric diagnoses is that many are based on a behavioral spectrum where the interruption of an individual’s social, relational, occupational, and functional life is a key factor in making the diagnosis,” Karim said. “This book has become a literary piece of pop culture that is challenging many to review their thoughts on normative and ‘out of the box’ sexual behaviors.”

He said that there could be concerns about a link between sadomasochism (S&M) and childhood abuse as well, since that is mentioned in the novel. “There is definitely a connection, but many people with no psychiatric or psychological history report enjoying BDSM primarily as a novel and alternative way to connect with each other,” Karim said.

Despite (or because of) the unusual relationship involving pain and pleasure (and emotional issues), many women appear to be captivated by the novels. Karim suggests this is because women enjoy having sexual fantasies, but that doesn’t necessarily mean they want the type of relationship found in the novel to become more than a fantasy. If anything, women might be more prone to sexually experiment during or after reading the novels.

However, he doesn’t think the novel is capable of completely changing sexual norms, so sexual sadism and sexual masochism will most likely still be considered mental disorders according to the DSM in the future. “I believe the novel opens up the conversation of BDSM, kink and sexual norms, but it’s much more in the curiosity range than actually changing research-driven professional medicine,” Karim said. “Expecting an increase in sex shop purchases is different than changing a clinical manual.”

Karim explains further why the novel is so appealing to women (and men), even with the dysfunctional (and sometimes even depressing) personalities of the characters. “In regards to sexual research, many women fantasize about submission, and many men fantasize about dominance,” he said. “Even though men and women are more equal than ever in regards to occupation and finances, we are still very different sexes, and definitive gender and role-based fantasies do exist,” he added. “Many people in our society have hidden (or not so hidden) fantasies involving kink, S&M, or altered sexual behavior. 50 Shades of Grey has opened up the conversation of previously hidden sexual desires and fantasies of many women.”

He said the novel could help couples become more creative in their sex lives, but going to any extremes is generally not beneficial. “The introduction of BDSM can add to a couple’s sexual tool box, but occasionally it can get out of control,” Karim said. “When extreme behavior leaves the bedroom or involves extremes in the bedroom, it can negatively impact the relationship. I’ve treated couples who use BDSM as a novel, fun experience in a healthy and intimate way, and I’ve treated other couples or individuals who became obsessed with the act or re-created a previous abuse history with a lot of painful markings.”

Overall, the BDSM series is encouraging men and women to discuss sexuality more openly with each other. “The book mentions childhood abuse and difficulties with self-esteem that contribute to the psychological make-up of these characters, but it has also found a way to tap into the S&M lifestyle curiosity shared by many men and women,” Karim said. “It may actually normalize the behavior, when done in moderation, as not something strange but perhaps just another form of sexual expression. Life isn’t always black and white; sometimes it’s fun to live with a little grey.”

Kari Tabag, a licensed clinical social worker, works with adolescents and college-age men and women and has read the series. She said the novel has passages that hint at mental health issues like posttraumatic stress, codependency, BDSM, and alcoholism.

Although she agrees that the novel can improve people’s sex lives through fantasy, role play, and experimentation, the sexual expectations people might have after reading the series might be set too high, leading to disappointment. Also, she emphasizes that the actual relationship depicted in the series is very unhealthy in many ways. “Christian and Anastasia’s relationship is not a healthy one. They are codependent and are too enmeshed with each other,” Tabag said. “A lot of women are codependent and are what I call ‘daddy hungry.’ This novel depicts two people who have abandonment along with trust issues.”
There are even more unhealthy aspects of the fictional relationship, according to Tabag:

• When Anastasia finds out that Christian only dates women with brown hair, it is a dead giveaway of his childhood abuse and abandonment. In fact, Anastasia refers to him as her “boy,” which is not healthy.
• Anastasia repeatedly feels that she is not worthy of Christian and vice versa.
• Christian is obsessed with Anastasia and even follows her to another state when she visits with her mother.
• They both are looking for someone to take care of rather than focusing on healing themselves. A healthier relationship involves two people who have their own separate, independent personas, making them well-established, well-rounded, self-reliant individuals.
• Christian wants Anastasia to give in to him and give up all control, and he lavishes her with gifts as a reward.

Although the relationship in the novel is not healthy, BDSM is not necessarily as terrible as it’s made out to be. Tabag suggests our society is not necessarily mature when it comes to accepting and understanding sexual preferences outside of ‘man on top.’”

Viewpoint From a Submissive
Kasi Alexander, the author of several books and short stories about alternative lifestyles, such as Becoming Sage and Saving Sunni, has herself been involved in the lifestyles of polyamory, BDSM, and power exchange. She currently identifies herself as a “slave,” and the partner in her polyamorous relationship is the “master”; she could also be referred to as a submissive. She said in an email that the relationship between Christian and Anastasia is not necessarily a model of the typical BDSM or power exchange relationship. The characters themselves are also not typical. For example, Christian Grey was abused as a child and became involved in BDSM at 15, and he now avoids “vanilla” sex and relationships.

“Very few people in the lifestyle immerse themselves so deeply that they have no desire for a relationship outside the parameters of power exchange,” Alexander said. “The ones who do are using the lifestyle to mask other personality defects, not the other way around. Accepting your dominant or submissive tendencies does not kill the desire for intimacy, closeness, or connection.” Also, the character of Anastasia Steele is low in self-esteem, self-worth, and confidence, which is not usual for submissives, Alexander said.

“Many people assume that submissives give up all responsibility for themselves, are doormats that cannot stand up for themselves, and so are taken advantage of by predatory dominants,” Alexander said. “That couldn’t be further from the truth. Submissives are stereotypically extremely strong, capable people. Many of them crave submission as a way to temporarily escape the huge responsibilities they take on in their “vanilla” lives.”

Alexander adds that the BDSM lifestyle can even be considered therapeutic in different ways. “In my own relationship, we have used our power exchange to work on my self-image and body issues, increase my self-confidence, and achieve many goals, including writing and publishing three books (so far),” she said. “Other kinky people that we know use sensation play as therapy or catharsis to work through feelings of inadequacy, childhood abuse issues, and various kinds of mental health issues.”

The BDSM element of 50 Shades of Grey just takes the typical romance/erotic novel a little further. “Women have a genetic inclination toward alpha males, so we love our fictional heroes to be large, powerful, and a little scary—someone who has the ability to hurt us but doesn’t,” Alexander said. “And almost all BDSM play is based on the intensification of physical experiences. So the fantasy of the physical ‘danger’ (intensity of experience) goes along with the mental domination of having a strong alpha male taking over your life. It’s erotic, even if it’s not what we want in our actual day-to-day lives.”

She said BDSM and power exchange have the potential to make relationships more sexually fulfilling, but just like in any relationships, it’s a matter of communicating wants and desires. And just like in other bad relationships, abuse and manipulation can happen, but that is a matter of individual personalities and relationships, not a characteristic of BDSM as a whole. She said it’s important to make a distinction between mental conditions and different sexual preferences and alternative lifestyles. “The most important aspect of the mental disorder consideration is the difference between true sadism and kinky sadism,” Alexander said. “A vast majority of ‘sadists’ in the BDSM community derive no pleasure from inflicting pain unless the recipient is enjoying the experience, whereas a true sadist is not concerned with the benefit of the other person.”

She believes that people will eventually become more accepting of these types of lifestyles and realize that they can be beneficial to people who can learn how to make them work.

“More education is needed to show people that polyamory is not cheating, BDSM is not abuse, and power exchange is not manipulation,” Alexander said. “The important thing to keep in mind is the benefit for the people involved. BDSM and power exchange can be done badly and for the wrong reasons, but they can also be used for personal, professional, and spiritual growth and for the enhancement of relationships.”

Related articles:
What Do Your Sexual Fantasies Mean?
The Good and Bad Sides of Porn
Exploring Alternative Lifestyles in Your Relationship

If you have completed Codependency Workbook Exercise One, congratulations to you. Please take a moment to pat yourself on the back. You deserve it, because it must have taken a great deal of courage to write about your family history. Most people shed some tears in our therapy session when they share it with me. Then they feel very relieved.

Many people are not ready to share the letter with their family of origin right away. If you have a therapist available or a sponsor, discuss it with that person. If not, review it with a supportive, nonjudgmental friend. Before sharing this with your family, it is important that you be ready to deal with their reactions. Unless they are in recovery, most families will not be able to validate your experience. However, it is very therapeutic to put your family history on paper and share it with another person.

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Now we are ready to begin the next workbook exercise, which concerns relationships. Please make a list of the most important people in your life. This may include friends, lovers, a spouse, family members, coworkers, or a boss. Spend a few minutes thinking about each relationship. How many people on your list do you believe are dysfunctional? How many are addicts, have untreated mental illness, refuse to work, even if they are able, or have other major issues? Are you taking care of some of the people on your list? Are some of the relationships lopsided, where you do most of the giving?

You may wonder why some of your relationships are lopsided. Dysfunctional people can sense that you are a caretaker and are drawn to you. It is almost as though they can smell you. You may find yourself drawn to them as well.

Last night, I saw a married couple where the wife was unsuccessfully trying to stop her alcoholic husband from drinking. She was anxious, frustrated, and very angry. Of course she would be frustrated. She was trying to control something that she had no control over. The facts are that we are powerless over other people, places, and things. Realizing this is helpful to codependents because they can learn to let go and relax. Trying to fix others is impossible, and just upsets the fixer. It also is not helpful to the dysfunctional person. Normally addicts only get help because of the consequences of their using. If the caretaker undoes the consequences, they caretaker unknowingly helps enable the dysfunctional person to remain sick.

Since caretaking may make you miserable and help your loved one stay sick, maybe we can work on not doing it. How? You can begin to learn to set boundaries. For example, you might tell the loved one that you will no longer bail him or her out if he is arrested. You may tell him that you will no longer call in sick if he is too hung over to work. You may tell her that you will only talk with her when she is sober.

I suggest that you put your list away for at least 24 hours. Then pick the relationship that causes you the most stress. Think about a boundary that you may set and write it down. Practice telling your loved one about the boundary. He or she will probably not like it, but in the long run it will be good for both of you. Be sure that you are prepared to maintain the boundary before you set it. The first time you do this, you are taking a major step in your recovery. Be sure to spend some time with someone who will support you setting a boundary.

Being considered a “perfect child” by one’s parents feels fantastic. Basking in the glow from parents’ approval and love can feel safe and special, like one is living in a magical world where everyone is happy and satisfied. These feelings are very seductive. The child is usually not aware that they pay a price in order to maintain the parents’ continued extraordinary approval. That price is the giving up of one’s unique sense of self in order to comply and be the child and then the adult that the parents adore. Being kept on a pedestal distracts from being aware that one has wants and needs that are not defined by one’s loving parents. This interference with developing an individual self can result in difficult and/or empty relationships as one becomes an adult.

Here is Grace’s story. After Grace and I said our goodbyes during our last session, after 5 years of working together in therapy, I began to think about her journey from the pedestal to the development of a unique self. Grace had become a person with her own separate, individual needs, thoughts, and feelings.

Grace came to see me for therapy when she was 28 years old. She was a pretty young woman who described herself as feeling depressed and confused. She told me she was unhappy with herself and her life. She expressed puzzlement about her feelings, as she described herself as having a successful job, good friends, and a wonderful family. She wished she had a steady boyfriend, but she dated and had been in two almost-year-long relationships. Those relationships “just sort of petered out” and she wasn’t sure why. She shrugged and said, “Something seems off about my life. Nothing feels satisfying; I don’t know what I want. I don’t know what’s wrong.”

As Grace and I worked together in therapy, Grace began to describe how she always felt her life was wonderful. She was an only child and was especially close with her mother, who always referred to her as the perfect child. She told me that she felt special to both her mother and father. They idolized her and believed she could do no wrong. In fact, she told me she did no wrong. She was happy to do whatever they asked: set the table, be home on time, practice piano, not hang out with friends they felt were not a good influence. Grace felt her parents knew what was best for her and she complied.

In therapy, Grace began to talk about how it felt to be seen as so perfect by her parents. She told me she really liked it. She felt safe and loved when they would tell their friends what a good daughter she was. They were so proud of her good grades and her outstanding abilities on the piano and flute. When I asked Grace if she had ever felt like skipping piano practice or coming home later than expected, she looked surprised by the questions as if such behavior was unimaginable. Then she responded that she never behaved that way.

One day, Grace came to our session wondering about why she didn’t have any differences with her parents. She noted, for example, that most of her friends went away to college. She went to a local school and lived at home. She had no memory of wanting to go away to school but realized that now she regretted staying home for college. Grace’s sense of regret about her life began to pervade our work. Over time, Grace posed a number of questions to herself and to me.

Grace wondered if she didn’t consider the possibility of going away to school because she knew her parents wanted her to stay home. She wondered if she majored in music because her parents were so thrilled with her music making. She wondered why she went with her parents on vacations rather than taking vacations with her friends in college. One day Grace began to cry in our session. She was remembering her middle school friend Fran, who her parents didn’t like. They told her she should stop seeing Fran when they overheard her use a curse word. In our session, Grace became angry at herself and her parents. “How could I have agreed to such a thing? Fran was my best friend!” I asked Grace why she thought she should go along with her parents. What did she think would happen if she asserted what she wanted? Sobbing, Grace said she didn’t know. Her parents were good people; they loved her, why couldn’t she say what she wanted to them? Then, Grace stopped crying and gasped: “Oh! I would disappoint them.” I asked “What would be so terrible about disappointing them?” Grace looked very sad and was silent for a long time. Then she looked at me, tears returning to her eyes: “I wouldn’t be the perfect child!”

As Grace and I explored what it would mean to give up being the perfect child, it became clear that such an idea was frightening to her. She loved the feeling of making her parents glow when they saw her. She believed she kept them happy as long as she continued to be their good and perfect child. If she stopped being compliant and who they needed her to be, she worried they would become sad and hurt, and she believed this would harm them. She also would feel guilty. Talking about Grace’s concern and need to keep her parents happy led Grace to the realization that she not only wanted to make them happy, but she was worried that if she didn’t keep them happy, they wouldn’t continue to think of her as so amazingly special. Grace began to understand that to give this up felt like she would be losing their love. She was willing to consider, however, that in fact, she probably wouldn’t lose their love, but that maybe it wouldn’t continue to feel that she was quite so amazing.

Feeling less anxious about the idea that her parents would be hurt and that she would not be loved, Grace began to notice that the way she related to the people in her life was similar to the way she related to her parents. She didn’t like to disappoint or make anyone in her life unhappy. She considered whether the people in her life seemed to like her so much because she always went along. She realized that she didn’t express what she wanted if she knew it would conflict with others. One day she excitedly came into our session and said “I think the reason my relationships with men don’t work out for me is that they never really get to know who I am because I never know what I want and I am always avoiding conflict.” She said with a smile, “I am never satisfied because nothing that happens in the relationship is about me!”

Grace’s smile told me a lot. I congratulated her on the discovery she made and our work turned to focus on Grace’s wishes, desires, and needs for herself in the world. While Grace was eager to embark on a journey of discovery to learn more about herself, she was understandably anxious about how this would affect the relationships she was in. Would the people she was close to, her parents, friends, and new boyfriend, still want her in their lives? Would they love her? Would she hurt and disappoint them? Would it feel like love to her if she didn’t feel she was the most special person to the other in the relationship? These were all important and real issues that Grace would have to contend with.

Over the next 2 years, Grace gradually began to learn what she wanted and liked, what she hated, and what thrilled her. She discovered a passion for cooking and went to school to train as a chef. She weathered her parents’ disappointment that she gave up a career as a musician. And she came to believe she had the right to recognize and follow her own dreams. Her parents didn’t glow as much as they did when Grace first came to therapy, but they didn’t stop loving her.

Grace’s friendships changed. Over time and in spite of her anxiety, Grace pushed herself to reveal more of her wants and feelings as she tested the waters and developed more of a voice with her friends. Some welcomed this new Grace and were excited to learn more about her and make room for another voice. Others were not so welcoming to this new assertive Grace, and some friendships didn’t last. Grace’s dating life changed too. She felt more engaged with her boyfriend. She said “Now the relationship is about us because I am more of a whole person.”

When Grace described her new feelings and new ways of relating, she realized that she is much less compliant as a way of being in the world. She no longer felt perfect in her relationships. She knew she had to continue fighting her resistance to keep her needs quiet. Now Grace feels much more authentic with her family and friends.

Grace often smiles at me ruefully and sighs: “I do sometimes miss the feeling of being so special. Now I struggle to express what I want and it’s hard to accept that sometimes my needs aren’t met. But it is worth it. What I didn’t have, that I do have now, is I feel like a person. I usually know what I want and how to get it. I am not so scared that people won’t like me or that I will disappoint someone. In my relationships, I try to talk about what I want and feel. Sometimes it’s hard, like when I have a fight with my boyfriend or when I feel my parents disapprove of my decisions. But now I make decisions. I don’t go along automatically. I like me. How wonderful is that!”

Grace terminated therapy with the ability to continue the process of discovering and growing her unique self. While she was not yet able to assert herself as much as she wished, she was committed to the struggle to tolerate her uncomfortable feelings and risk that others might not always have the feelings she wished they would have.

That is very wonderful!

Related articles:
The Undeveloped Self and the Difficulty of Relationship
The Pink Elephant of Perception
The Fear of Hurting the Other and the Inhibition of Self

Are you a person who takes care of everyone else before yourself? Do you believe you should put yourself last? If you routinely take care of others’ needs before your own, then you may have codependent tendencies. In a relationship, codependent behaviors can potentially sabotage your relationship success. If you neglect your personal needs and wishes and care for others instead, then you may begin to feel resentful and empty. Taking care of yourself enables you to then be available to take care of others.

Codependent Behaviors

Let’s explore some codependent behaviors. Ask yourself the following questions:

• When you are criticized, do you become defensive and angry because your behavior was questioned?
• Do you feel better about yourself when you are helping (and only when you are helping) others?
• Do you settle for being needed when you really want to be truly loved?
• If you are a caretaker, do you anticipate others’ needs?
• Do you feel responsible for others’ feelings, thoughts, actions, choices, wants, needs, well-being or their lack of the aforementioned topics?
• Do you find it easy to change your plans for another person’s needs?
• Do you often feel angry and used even though you choose to ignore yourself?
• Do you always say “yes” even when you want to say “no?”
• Do you say “yes” even when it is not in your best interest?
• Do you feel you do more than your fair share?

If you tell yourself that your circumstance will improve later, get depressed or sick without understanding the reason why, over-eat, feel overextended, or if you stay busy to keep from addressing the issues you need to address, you may be in a state of denial.

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Do you find it difficult to feel joy, to have fun, or to do something at the spur of the moment? Do you find it hard to enjoy sex? Do you have sex when you really don’t want to have sex? Do you make up reasons to avoid having sex? Do you have sex when you really just want to be held and loved? Do you look for happiness in others and not within yourself? Do you choose partners who are not available (physically or emotionally) to love you? Do you stay in a relationship long after it is clear it is not working? Do you think you are not loveable? Is your communication poor? Do you blame, threaten, or beg for your needs to be met? Do you ask for your needs and wants indirectly, thinking people will just know what your needs are because they love you enough? Do you think what you have to say is unimportant? Do you avoid talking about yourself, thoughts, or dreams? Do you ignore your thoughts without voicing them? Do you fail to voice your opinions for fear of being rejected or put down?

From an early age, women are usually taught about the importance of nurturing and taking care of others. Mothers generally focus on meeting the needs of the children, husband, and household before addressing their own needs. Simultaneously, society and the media send women the message that they must be perfect. They are given the message they need to be thin, beautiful, young, perfectly dressed, and in all ways flawless. Men are taught to be outwardly strong. They are taught it is acceptable to be angry, but not sad, vulnerable, or outwardly emotional. These incorrect, constant messages will destroy us if we allow them to.

Do you often feel overwhelmed, depressed, or anxious? Are there times where you feel like an empty shell wanting to isolate yourself from the world? Do you also find it difficult to connect with others? If so, it may indicate that certain needs aren’t being addressed. Addressing neglected aspects of your inner and outer world is related to self-care.

What is “Self-Care?”

Self-care can have a different meaning for each of us. Essentially, self-care is associated with taking care of your needs, asserting yourself to increase the possibility of those needs being met, and monitoring your time and energy given to others. To feel balanced in today’s world, we must address both our inner and outer needs. Taking care of yourself will allow you to be there for your relationship. It will allow you to feel the Goddess or God you truly are inside. Your partner will respond to you in a more positive manner, and emotional intimacy will be more easily deepened when your needs are satisfied.

As parents, we get caught up in the family fast track. We are consumed by school, homework, little league, karate, dance class, and on and on. There is little time left to focus on self-care. Parents get caught in this cycle, leaving little to no energy left to meet their own physical, emotional, mental, or spiritual needs. There is no time left for themselves, much less their intimate relationships.

When we neglect self-care by focusing on trying to meet the needs of others before taking care of ourselves, we can lose our identity and power. We also harvest a great amount of resentment and self-hatred when we neglect ourselves. Ultimately, it is when we connect and address our needs that we can find balance and happiness. When this happens, we can give to others from a full heart. In other words, we can enhance our relationships by taking care of ourselves.

The list of things you can do to develop a self-care practice is endless! Learning to respond to your needs with acceptance, compassion, and a willingness to make healthy changes can begin to bring balance into your life and allow you to connect with joy. Self-care does not mean spending money. A spa day or week is great, but self-care can mean much more than having services performed.

Make a list of your needs: spiritual, emotional, physical, intellectual, and relationship intimacy needs. Under each heading, record activities that will support self-care in that area. Keep space for additions as you think of them.

Here are some suggestions:

• Journaling, meditating, yoga class, moving to your favorite music, taking time to enjoy your favorite music, lunch with the girls/guys, overnight romantic time with your honey, walk in the rain, bubble bath with candles and music, taking a lunch to the river, reading a book, or anything you enjoy. Search your soul for those things that really nurture you.
• Make a list of things that nourish your spirit and make you come alive. Is it music, art, writing, cooking, or dancing? If you’re not sure what would be on this list, then explore new activities or hobbies.
• Connecting with nature can be extremely nurturing. Take a walk on the beach or in a park and really listen to the surrounding sounds and sights. Allow your senses to open and let yourself be nourished by nature. “Taking time to smell the roses” is good advice after all.
• Laughter can be the best medicine. Play. Play with your partner. Find ways to put humor and playfulness into your everyday living. Let that “inner child” out often. Allow yourself to be silly. Allow yourself to enjoy. Allow yourself JOY.When you are filled with joy, even part of the time, all of your relationships will benefit, not just your romantic relationship.

Accept the fact that the road of life will have bumps. Instead of resisting or personalizing these bumps, accept that there are things you cannot change. Realize that the only thing you truly have control over is yourself. Be present in what is happening in your life. Reflect on whether you’re responding to your emotional, mental, spiritual, or physical needs. Are you taking good care of both outer and inner needs? Are you listening to your inner voice when it tells you to slow down, set boundaries, take care of your body, rest, or exercise?

Take care of yourself. Have fun. Life is short, so enjoy every moment. May your day be interspersed with joy.