I recently started watching a Hulu series called “The Act.” It’s a twisted tale about a uniquely dysfunctional and codependent mother-daughter dynamic that results in (spoiler alert) murder. Don’t worry, murder is made very clear in the opening scene of the first episode. When I discovered this series was actually based on real-life events that had been reported in a 2016 Buzzfeed article written by Michelle Dean (now co-writer of the Hulu series), I was deeply horrified and intensely intrigued.

Essentially, the story follows the life of a mother, Dee Dee Blanchard (played by Patricia Arquette), who has dedicated herself to caring for her daughter, Gypsy Rose (played by Joey King), who is believed to have multiple disabilities and illnesses, including muscular dystrophy, leukemia, asthma, and the mental capacity of a 7-year-old, due to her premature birth. The only issue is, Gypsy’s not actually sick, like, at all. Dee Dee goes to tragic lengths to keep up this “Act” like the surgical installation of a feeding tube, shaving Gypsy’s head, confining her to a wheelchair?! The list goes on. I kept thinking to myself, “who could do something like this to another person?” Let alone a person you love?

It turns out Dee Dee suffered from a mental illness called Munchausen syndrome by proxy. According to Justin Baksh, therapist and chief clinical officer at Foundations Wellness Center, it’s a disorder in which “a parent invents (consciously or unconsciously) a mental health condition or medical symptoms for their child, and maintains an unhealthy role that is reinforced within the parent-child relationship. Mom believes, ‘my child needs me,’ and the child may think, ‘I need my mother.’ This keeps the child dependent on the mother instead of developing healthy independence that grows with the child.”

Albeit, this is a unique, clinical, and extreme example of codependency and the reactions to the show reflect that—shock, shame, and disgust for both Dee Dee and Gypsy Rose’s actions. All very understandable responses, but it got me thinking about codependent relationships, the emotional trauma, both received and inflicted, that it imparts and that codependency can exist in any kind of relationship—romantic, friendship, and family.

The extreme nature of Dee Dee and Gypsy’s situation makes it easy to distance oneself and look at the scenario with disbelief, outrage, and a lack of empathy. But, I can’t help but look at each character with some compassion. I think Dee Dee and Gypsy’s situation is unique because it’s also very visual, Gypsy is physically affected. I think it is a lot easier to validate physical pain versus emotional pain and disregard what’s not on the surface.

Obviously, codependency doesn’t always lead to such drastic and severe consequences. I do believe there are still wounds as a result of dysfunctional or abusive relationships that can go undetected and untreated because they aren’t out in the open and are easier to hide. But, they are no less relevant or painful than physical scars.

So where’s the line between loving attachment and insecurity to the point of detriment? What constitutes a codependent relationship? There are some varying definitions out there, but according to Psychology Today codependency is “when two people with dysfunctional personality traits become worse together. Enmeshment happens when clear boundaries about where you start and where your partner ends are not clearly defined.” To elaborate, therapist Justin Baksh says this happens when “someone else's needs supersede your own. When you do more for the other but neglect your own needs and have a hard time setting healthy boundaries.”

You might be wondering, isn’t this a real part of everyone's relationship? How do I know if I have a problem? Baksh says, “There is give and take in any relationship as we usually find partners that complement us. Areas we fall short in are areas that our partners may excel in and vice versa. When you feel like you are only giving and not receiving, you are probably in a codependent relationship. When you start resenting the fact that the other person is not grateful for what you do, or are feeling that it is now an expectation that you perform or deliver on this new level that is neglectful of yourself. You might be left thinking, ‘Hey, I'm not liking this feeling, but I'll keep doing it because it makes them happy’.”

According to sexuality and relationship expert Niki Davis-Fainbloom, MA, these are signs that can be identified in a codependent relationship:

• Unable to enjoy time apart from your partner and you never make separate plans.

• You or your partner give up something you used to enjoy because you are unable to spend time away from one another.

• You both sacrifice exciting opportunities or experiences because you are unable to be apart.

• Friends and family notice that you spend very little time alone away from your partner and that you isolate yourselves as a couple.

• You are both constantly checking in with one another when you are not in the same room.

So, are codependent relationships salvageable?

In my experience, if I have acknowledged this kind of behavior in a partner or in myself then I usually have to let the relationship go. But what about relationships where that may not be an option? For instance, a parent, a marriage, a child? Fainbloom says you can move from dependent relationships to developing healthy individuality within the relationship, it just takes a lot of work. Here are steps Fainbloom suggests to begin that process:

• The first step is realizing that the nature of the relationship is unhealthy.

• It is important for partners to become comfortable enjoying some time apart. Take it slow. Begin with not texting for an afternoon, or spending an evening apart. After doing so, debrief about how it felt for both partners and work towards having more separate activities.

• Explore the reasoning behind the dependency in the relationship. If one partner is jealous or worried about losing the other, perhaps the other partner can do better at showing their partner that they are committed.

Baksh agrees that codependent relationships can, in fact, be saved, but the first step is understanding what purpose the current framework served for everyone involved. He says, “To break this cycle, you need to first be aware that you are engaged in this pattern. Seek help from a therapist if you need to, as the lines may be very much be blurred. You need to honestly stop and reflect on your role. Put pen to paper. Write down the last decision you made that may be lingering and needs to be reflected on. Then honestly assess why you made that decision. Did you do it for you? Or did you do it for the other person? Why do you allow this behavior or decision-making to occur if you have a negative reaction every time you engage in it? Once you start establishing a baseline, you will probably see trends. Finally, you can make changes based on what you see.”

Here are a few first-hand experiences with codependent relationships, what worked and what didn’t.

“[A relationship that comes to mind] are a few toxic friendships that I had in college. It was a group of girls I lived with in a house and we spent a lot of time together and relied on each other socially. It wasn’t until I went abroad and made friends with a group of girls who I felt genuinely cared about me, valued my humor, and didn’t make backhanded comments. If they had an issue with me they addressed it...with me, not other people. It was the first time I realized what true friendship was and the dread I felt about going back to my old friends was very telling. I had to cut ties entirely, move out of the house and make new friends.” -Bridget 34 years old, New York City, New York

“I think codependency is when one person enables another’s addiction, poor mental health, immaturity, or irresponsibility and for that relationship to become healthy, BOTH participants need to grow. Which I believe is highly unlikely for the one who enjoys being enabled! Personally, I watched my mom be codependent with my alcoholic father. In turn, I was codependent in two marriages until I did my inner work and left. Disconnecting from a narcissist can be terrifying and yet the journey can be one of the most empowering spiritual journeys a soul can make into freedom, empowerment, and full self-expression with a healed heart.” - Allana, 35 years old, San Francisco, California

“I think because codependency is born in relationships it can be healed in a relationship (the right one). I had codependent parents and they transferred those behaviors onto me, so being exposed to it actually allowed me to identify and heal my own codependent behaviors once I was in a secure relationship. I think when there’s an awareness and willingness to work on it, from both parties, it’s possible to resolve (and may require some professional help).” -Sarah, 30 years old, Austin, Texas

As mentioned, codependency is a learned behavior. And, it can sustain itself when there’s an equally codependent partner...which can be hard to shift and maintain a relationship when it’s contingent on both parties making a change. I’d like to think that this dynamic can be unlearned; but when I’ve recognized a romantic codependent relationship in my own life, I realized I needed to look inward and start investing energy in me. Once I started doing this, I saw that it really came down to my own self-esteem and what I thought I deserved. I also realized that the kinds of relationships I had been seeking really weren’t a good fit.

I don’t believe there is a single relationship—romantic, friendship, or family connection—that can be held solely responsible for one’s happiness or anyone else’s for that matter. It really starts with you.