Dependent Personality Disorder PDF

Dependent Personality Disorder Dependent Personality Disorder Individuals are – Caring to a fault Allow others’ well-being to come first no matter what the cost may be to themselves or their identity – Ever helping and giving Committed to their personal relationships, especially to their spouse and...

Dependent Personality Disorder Dependent Personality Disorder Individuals are – Caring to a fault Allow others’ well-being to come first no matter what the cost may be to themselves or their identity – Ever helping and giving Committed to their personal relationships, especially to their spouse and the institution of marriage Live their lives through others and for others When people they care for are happy, they are happy – Tend to assume a more passive role in relationships Defer to the opinions and desires of those they love – Then vicariously enjoy their partner’s pleasure and fulfillment Prefer harmony in relationships – Tend to be apologetic even when others should take the greater responsibility for a disagreement Dependent Personality Disorder Have many characteristics that are prized within our culture – Being happy when loved ones are happy – Making sacrifices for the good of others Volunteering to perform many selfless acts Warm and affectionate on the surface – Underneath they see themselves as helpless and fear doing anything on their own Need to be taken care of – Seek competent instrumental surrogates who reward submission by facing down the problems of the world for both of them Dependent Personality Disorder Many are incapable of making routine decisions without first seeking advice – Put their lives in control of others This clinginess suffocates their partners and puts them at risk for abandonment Many behaviors are fueled by this fear/risk of abandonment – Often submit quickly to their partners’ wishes – Often become so pleasing no one would possibly want to leave them When relationships do dissolve, their self-esteem becomes devastated – Deprived of support or attachment, they Withdraw into themselves Become increasingly tense and despondent Case Example - Sharon Sharon, a 32-year-old teacher’s aide, first sought therapy at the suggestion of the school principal, someone she is particularly close to. The principal had “taken her under his wing.” Although she still requires the advice and encouragement of other teachers before starting any new project for the students, sometimes needing reassurance multiple times in the same day. Case Example - Sharon Sharon describes her childhood as “traditional” and “perfect,” with her father being the strong figure on whom the rest of the family relied. Her mom was old-fashioned and took good care of everyone. From almost the day Sharon was born, everyone treated her like a “precious porcelain doll.” All of her needs were met before she even knew there was a void. In school, her sister Brandy became her guardian. If anything went wrong, Sharon ran to Brandy to make it right, whether it was to protect her from bullies or to help her in her classes. Sometimes, Brandy even did Sharon’s homework. Although Sharon was only an average student, the teachers liked her because she was “sweet and well-behaved.” As a teenager, Sharon never learned to drive. Instead, Brandy always took her wherever Case Example - Sharon The Saturday after graduating from high school, Sharon married Tom, an appliance mechanic who reminded her of her father. And like her father, Tom loved the idea of having a wife at home who didn’t work and didn’t mind catering to him, having his meals ready when he got home. He even though it was “cute” that she was so helpless at many daily tasks. For the most part, Sharon adored Tom and loved playing the role of the traditional wife although she occasionally found it difficult to assert herself in the relationships, fearing that Tom might become angry with her. Case Example - Sharon Soon, however, Tom began to see Sharon as needy and suffocating. Without her own circle of friends, she insisted they spend every free moment together. Tom eventually convinced Sharon to take a job as a teacher’s aide when they were experiencing some financial difficulties and he encouraged her to keep it once the problems were settled. However, because Tom drops her off at work every morning and picks her up again in the evening, he can never hang out with guys after work or even stay late to earn extra money. Responding to her neediness, Tom eventually decided that Sharon should have more of an identity of her own and insisted that she enroll in junior college. She asked Tom to pick out her classes and warned him that he would likely have to tutor her in the evenings as well as drive her to and from classes. Sharon has reluctantly agreed to go but doubts that she has the confidence or ability to follow through. Case Example - Sharon Six months into couples therapy, Sharon had begun to take driving lessons. About this same time, however, Brandy was killed in a car accident. The effect on Sharon was devastating. With Brandy gone, Sharon began to slip into depression and began to cling to Tom even more tightly. She dropped all of her classes and stopped going to work. In response, Tom now seems to be in a process of extended emotional withdrawal and is threatening divorce. Sharon feels destroyed, as though, “I have lost a part of myself I can never get back,” and cannot imagine how she will possibly make it alone. Though Tom insists that there is still a chance for reconciliation and though Sharon realizes that there were problems all along that she didn’t want to face, she nevertheless “knows” he will divorce her. Dependent Personality Disorder - Definition A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts as indicated by five (or more) of the following: Dependent Personality Disorder – Diagnostic Criteria (1) has difficulty making everyday decisions without an excessive amount of advice and reassurance from others – Very difficult for them to take initiative on their own behalf or to provide direction to their lives or careers Instead, they bond themselves to those they perceive as confident or in control – Constantly solicit advice and reassurance before committing to almost anything – Piggyback themselves on the talents, abilities, and fortitude of others Often in trivial matters (e.g., what to eat for lunch) Dependent Personality Disorder – Diagnostic Criteria (2) needs others to assume responsibility for most major areas of his or her life – This is self-perpetuating Initiatives are never taken No confidence in the self is ever developed Taking initiatives becomes a greater risk and a greater challenge Dependent Personality Disorder – Diagnostic Criteria (3) has difficulty expressing disagreement with others because of fear of loss of support or approval. Note: do not include realistic fears of retribution – Independence is a curse – Presentation is often as precious and adorable – In their minds, they must always be pleasing and never disagree with those they depend on – Conflict is Inconsistent with their self-image A risk to continued protection Dependent Personality Disorder – Diagnostic Criteria (4) has difficulty initiation projects or doing things on his or her own (because of a lack of selfconfidence in judgment or abilities rather than a lack of motivation or energy) – Result of self-perpetuating cycle Because others have always been there to take control Their rule is: – “As long as I am sweet and pleasing, everything will be taken care of by others” – Not from depression These people may have plenty of energy, they just lack direction Dependent Personality Disorder – Diagnostic Criteria (5) goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant – This is done in attempt to secure relationships when they seem as though they might be at risk Dependent Personality Disorder – Diagnostic Criteria (6) feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself – The ability to take care of oneself has resisted ever being tested – If/When caring for the self becomes necessary, there is a lack of confidence Dependent Personality Disorder – Diagnostic Criteria (7) urgently seeks another relationship as a source of care and support when a close relationship ends – If one seemingly dependable figure leaves, another is quickly sought – The dependable figure’s role is more important than who they are Dependent Personality Disorder – Diagnostic Criteria (8) is unrealistically preoccupied with fears of being left to take care of himself or herself – These fears are constantly on the mind Whether real or perceived From Normality to Abnormality The devoted style – Caring and solicitous, putting the welfare of others first The agreeing style – Built around cooperativeness, consideration, and amiability These variants have a capacity for healthy and pathological traits From Normality to Abnormality Healthy and adaptive traits – Capable of genuine empathy – Tremendous capacity for unconditional love – The most trusting of people Modest, uncritical, gentle demeanor communicates unquestioned acceptance – Easy to please and demanding of little – Charitable in giving of themselves – Put a positive light on all life events and stress the virtues and good they find in others From Normality to Abnormality Healthy and adaptive traits can quickly turn pathological – Tend to fuse their identity with that of others Identity inextricably enmeshed with those they love – This causes great anxiety when separated – Hate being alone – When the relationship ends often feel Dominated, used, depleted, and desperate – Blurred boundaries between themselves and others Loss of relationship is tantamount to loss of self From Normality to Abnormality (1) has difficulty making everyday decisions without an excessive amount of advice and reassurance from others – Disorder Even everyday decisions provoke excessive adviceseeking – Style Seeks out opinions of others, weighs advantages + disadvantages, but makes the decision based on their own analysis From Normality to Abnormality (2) needs others to assume responsibility for most major areas of his or her life – Disorder Requires that others take responsibility for the largest part of their life – Style Comforted by the support of others and enjoys their company Can perform adequately without others From Normality to Abnormality (3) has difficulty expressing disagreement with others because of fear of loss of support or approval. Note: do not include realistic fears of retribution – Disorder Often subordinate their own feelings and agree with others out of fear of separation – Style Prefers interpersonal harmony Able to speak up when necessary and hold their ground From Normality to Abnormality (4) has difficulty initiation projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy) – Disorder Lack confidence to start new projects or carry out their own responsibilities – Style Capable of functioning autonomously Prefers to work in close proximity to others From Normality to Abnormality (5) goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant – Disorder Desires nurturance and support to the point of volunteering to perform unpleasant jobs – Style Considerate and occasionally self-sacrificing Keeps the best interest of others foremost in mind From Normality to Abnormality (6) feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself – Disorder Greatly fears being unable to cope when left alone – Style Prefers the company of others, but can enjoy solitude From Normality to Abnormality (7) urgently seeks another relationship as a source of care and support when a close relationship ends – Disorder End of relationship results in a desperate search for a new partner – Style Nostalgic about lost intimacy but does not immediately seek to merge with another From Normality to Abnormality (8) is unrealistically preoccupied with fears of being left to take care of himself or herself – Disorder Afraid of being left to fend on their own – Style Enjoys the affection of others as expressed through thoughtfulness Not terrified of abandonment