Co-dependence is a form of ill health, or maladaptive or problematic behaviour that is associated with living, working with, or otherwise being close to a person with alcoholism or some other addiction. It expresses as a pattern of learned behaviours, feelings, and beliefs which make life painful. Some claim that a co-dependent is anyone affected by a person afflicted with addictive behaviour (from which it would be hard to exclude anyone in the world). More specifically, a co-dependent person is "human-relationship-dependent" and focuses her/his life around an addictive agent. Common examples of co-dependents are persons who (a) are in a love or marriage relationship with an alcoholic (or addict of another sort), (b) have one or more alcoholic parents or grandparents, or (c) grew up in an emotionally repressive family. Such persons almost invariably have a dysfunctional pattern of living and problem solving which is nurtured by a set of rules within the family system. Among these rules are the following: (a) "we don't talk about problems"; (b) feelings should not be expressed openly; (c) communication is best if indirect, with one person acting as messenger between two others; (d) be strong, good, right and perfect; (e) "you should make us proud" (i.e. holding unrealistic self-expectations); (f) "don't be selfish"; (g) "do as I say, not as I do"; (h) it's not okay to play or be playful; and (i) "don't rock the boat".
The most central characteristic of co-dependence is "external referenting" or "other directed", often to the extent of having virtually no concept of a self that others can relate to. Persons who are so completely externally referented will do almost anything to be in a relationship, regardless of how awful the relationship is. Co-dependents have a poor sense of personal boundaries, literally not knowing where they end and others begin, so taking on the emotions and confusions of the addictive partner. Because they have no internal referents, co-dependents structure their lives according to what others may think about them and their family. They usually work very hard in colluding with their addictive partner to give the appearance that nothing is amiss, and so shore up their lives at great personal cost. For reasons such as this, co-dependents are involved in a process of dishonesty, lying also to themselves (and believing) that things will change. Co-dependents are typically caretakers, demonstrating to the world their worth by making themselves indispensable, sometimes to the extent of being a martyr or suffering physical illness. Co-dependents tend to interpret the world as though they were the centre, finding in themselves the cause and blame for life's inexplicable trials. They tend to be rigid and judgemental, also believing that they are able to control everything, and attempting to do so; repeated failure to control the uncontrollable leads to negativity and depression. Like their addictive partners, co-dependents get progressively out of touch with their feelings. They have also distorted their feelings to maintain the impression that they want to have of themselves. For example, if co-dependents want to see themselves as kind, loving persons and yet inwardly resent the drinking behaviour of their spouses, they are caught in a self-centred emotional bind. In order to maintain that self-image they will distort their feelings of anger into self-righteousness. Just as alcoholics use chemicals to numb their feelings, co-dependents use relationships, worrying, eating, or any number of things to avoid dealing with their feelings.
Co-dependence is now being recognized by some insurance companies as a primary disease (one that has an onset, a definable course, and a predictable outcome).