- Dependent Personality Disorder Symptoms
- How Dependent Personality Disorder Works
- Dating Someone with Dependent Personality Disorder: Balancing Support and Self-Care
- When You’re Never Enough: Dealing With Dependent Personality Disorder
If you're concerned that someone you know might have dependent personality disorder, it is important to learn to spot the signs and to encourage the sufferer to seek help. There are 17 references cited in this article, which can be found at the bottom of the page. Understand a possible cause of Dependent Personality Disorder. The person's childhood may have laid the foundations for developing dependent personality disorder. Overly anxious or insecure parents are often the cause of a child's inability to individuate from them.
While she ultimately needs to move on from her childhood experiences, recalling how they may have brought on her dependent personality can be helpful in elucidating the cause of her disorder.
If you can take the time to listen to her and gently ask questions about her childhood, a pattern of unhappy attachment might be revealed. Note that there may be a combination of genetic, biological, and environmental factors that lead to this disorder. You will need to look for five or more of the following characteristics to be able to draw an initial conclusion that someone might be suffering from Dependent Personality Disorder. Needing an excessive amount of advice and reassurance from others before undertaking any task is a sign of deep dependence.
However small these tasks may be, if he is unable to initiate or complete these tasks on his own, this is indicative. Ask him these questions: Some people enjoy making decisions; others prefer to have someone they trust guide them; which do you prefer? Do you seek advice for everyday decisions? Do you often need help to get started on a project? Does he allow other people to make decisions for him in areas that directly affect his life? Needing others to assume responsibility for most major areas concerning his life shows immaturity and a lack of understanding about the importance of self-responsibility.
Ask him this question: Do you find yourself in situations where other people have made decisions about important areas in your life, for example, what job to take? Does he go to excessive lengths to obtain nurturing and support from others? This may even occur to the point of him doing unpleasant things. Do you volunteer to do unpleasant things for others so they will take care of you when you need it? Are you uncomfortable when you are alone? Are you afraid you will not be able to take care of yourself? Do you worry about important people in your life leaving you?
Does he urgently seek another relationship as a source of care and support when a close relationship comes to an end? Does he feel helpless when alone because of exaggerated fears of being unable to take care of himself, whether financially, emotionally, or even physically? Have you found that you are desperate to get into another relationship right away when a close relationship ends?
Even if the new relationship might not be the best for you? Does he constantly have difficulty in expressing disagreement with others? If he fears disapproval, rejection and a loss of support from others, he will likely try too hard to please people. Note that this must exclude realistic fears of retribution.
Is it hard for you to express a different opinion from someone you are close to? What do you think might happen if you did? Do you often pretend to agree with others even if you do not? Could it get you into trouble if you disagree? Sometimes people seem like they have Dependent Personality Disorder when they really don't. They allow themselves to be intimidated and avoid even justified anger for fear of alienating others.
To gain the support they think they need, they may volunteer for unpleasant tasks, submit to unreasonable demands, and tolerate verbal, physical, or sexual abuse. Personality disorders have overlapping symptoms, and a person who fulfills the diagnostic requirements for one will often fulfill the requirements for others. Dependent personality belongs to a group of anxious or fearful disorders that also includes avoidant personality — painfully shy, inhibited, and withdrawn.
Dependent Personality Disorder Symptoms
But it also has characteristics in common with histrionic personality — self-dramatizing, suggestible, seductive, and constantly starved for attention. In histrionic personality, the need for approval and protection appears to be directed at the world in general rather than at individuals.
Personality disorders also heighten vulnerability to a variety of psychiatric illnesses. Personality has been compared loosely to the immune system and psychiatric disorders to other medical illnesses. Just as a poorly functioning immune system opens the door for many diseases, so may dependent personality.
The diagnosis is particularly intimately associated with depression; separation anxiety, the fear of being apart from a loved person; somatoform disorders, unexplained physical symptoms with an emotional basis; and social anxiety disorder, the crippling dread of personal encounters and social situations. People with dependent personality disorder develop separation anxiety because they feel abandoned when not in the presence of those they rely on.
They are at risk for social phobia because they don't like to leave familiar people and surroundings.
How Dependent Personality Disorder Works
They may use physical symptoms as a way to receive sympathy, protection, and care. All of us feel some distress when we don't receive the support we believe we require, when we lose a close relationship, or when we must assume responsibilities for which we feel unprepared.
But the risk of depression is much higher in people with dependent personality, especially if they lack the social skills needed to maintain relationships with others. The seed of personality is temperament — biological dispositions with a hereditary basis. People with dependent personality have usually shown a tendency to caution and fear of novelty since childhood. In their families, there is a high rate of generalized anxiety disorder and phobias, as well as avoidant personality. But as we are often warned, genes are not destiny.
What turns a temperamentally shy or fearful child into an adult with a personality disorder is uncertain.
The most popular explanations are psychodynamic and behavioral. Psychodynamic theorists and therapists believe that unconscious emotional conflicts — experiences and feelings out of awareness — and the unconscious defenses we erect against them shape personality traits.
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Disorders are thought to arise if, for example, problems in early relationships lead a person to develop defenses that are not effective, adaptive, or useful. According to one psychodynamic theory, dependent personalities are defending themselves against unconscious hostility. They need to ward off this emotion, which was originally directed against overbearing parents, so they submit to others as a way to avoid showing or even acknowledging anger.
For many years, the psychodynamic understanding of personality disorders has been influenced by object relations theory, which emphasizes the power of internalized images of persons who matter to us, especially parents. It is also influenced by the theory of attachment, the biological need for comfort and support embodied in the relationship between parents and young children.
Establishing healthy early attachments and retaining comforting psychological images of reliable caretakers provide a solid base from which to explore the world and achieve a balance between independence and closeness to others. If parents are unresponsive, inconsistent, or abusive, children may develop a fearful or insecure form of attachment, which they internalize as a model and adopt in later relationships.
They also have more trouble soothing or calming themselves when they are frustrated, angry, or anxious. One result of this pattern of development is dependent personality. According to behavioral and social learning theory, children develop the habits that constitute a personality through two kinds of learning: In this model, a child who is rewarded for making excessive demands for care can develop a dependent personality.
Dating Someone with Dependent Personality Disorder: Balancing Support and Self-Care
Others develop expectations that reinforce the tendency toward dependence. If parents are inconsistent, children may learn that they cannot control their lives. A child who has never been rewarded for independent action may avoid it even when it would be valued because the early lesson has been learned too well. Cognitive psychology views dependency as a result of the way people think about themselves and others.
Dependent personalities tell themselves that they are powerless and others are powerful and effective. Parents may provide a model for this kind of thinking by subtly conveying to children that they will be abandoned and alone unless they submit. One possibility is that dependent personality begins with a gentle and easily frightened temperament that evokes protective feelings. Borderline personality disorder is characterized by fear of abandonment, as well, but with feelings of emptiness and rage. In contrast, the dependent personality responds to this fear of abandonment with submissiveness, and searches for a replacement relationship to maintain dependency.
Likewise, persons with histrionic personality disorder have a strong need for reassurance and approval, and may appear childlike in their clinging behavior. Histrionics are characterized by a gregarious demeanor and make active demands for attention, whereas dependents respond with docile and self-deprecating behavior. The avoidant personality disorder can also be confused with dependent personality disorder.
Both are characterized by feelings of inadequacy, an oversensitivity to criticism, and a frequent need for assurance.
When You’re Never Enough: Dealing With Dependent Personality Disorder
However, patients with avoidant personality disorder typically have such an intense fear of rejection that they will instinctively withdraw until they are certain of acceptance. People with dependent personality disorder, in contrast, actually seek out contact with others because they need the approval of others. The general goal of treatment of dependent personality disorder is to increase the individual's sense of autonomy and ability to function independently.
A long-term approach to psychodynamic treatment can be successful, but may lead to heightened dependencies and difficult separation in the therapeutic relationship over time. The preferred approach is a time-limited treatment plan consisting of a predetermined number of sessions. This has been proved to facilitate the exploration process of dependency issues more effectively than long-term therapy in most patients. Cognitive-behavioral approaches attempt to increase the affected person's ability to act independently of others, improve their self-esteem, and enhance the quality of their interpersonal relationships.
Often, patients will play an active role in setting goals. Methods often used in cognitive-behavioral therapy CBT include assertiveness and social skills training to help reduce reliance on others, including the therapist. Treatment using an interpersonal approach can be useful because the individual is usually receptive to treatment and seeks help with interpersonal relationships. The therapist would help the patient explore their long-standing patterns of interacting with others, and understand how these have contributed to dependency issues.
The goal is to show the patient the high price they pay for this dependency, and to help them develop healthier alternatives. Assertiveness training and learning to identify feelings is often used to improve interpersonal behavior. Time-limited assertiveness-training groups with clearly defined goals have been proven to be effective. Individuals with dependent personality disorder are usually brought to therapy by their parents.
They are often young adults who are struggling with neurotic or psychotic symptoms. The goal of family therapy is often to untangle the enmeshed family relationships, which usually elicits considerable resistance by most family members unless all are in therapy. Marital therapy can be productive in helping couples reduce the anxiety of both partners who seek and meet dependency needs that arise in the relationship.
Individuals with dependent personality disorder can experience anxiety and depressive disorders as well. In these cases, it may occasionally prove useful to use antidepressants or anti-anxiety agents. Unless the anxiety or depression is considered worthy of a primary diagnosis, medications are generally not recommended for treatment of the dependency issues or the anxiety or depressive responses. Persons with dependent personality disorder may become overly dependent on any medication used.
The general prognosis for individuals with dependent personality disorder is good. Most people with this disorder have had a supportive relationship with at least one parent. This enables them to engage in treatment to varying degrees and to explore the source of their dependent behavior. If persons who enter treatment can learn to become more autonomous, improved functioning can be expected. Since dependent personality disorder originates in the patient's family, the only known preventive measure is a nurturing, emotionally stimulating, and expressive caregiving environment.
Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association, The Merck Manual of Diagnosis and Therapy. Merck Research Laboratories, John Wiley and Sons, Inc.