Dependent Personality Disorder Symptoms and Treatment Options
Personality Disorder Test
Dependent personality disorder (DPD), formerly known as asthenic personality disorder, is a personality disorder that is characterized by a pervasive psychological dependence on other people. The difference between a 'dependent personality' and a 'dependent personality disorder' is somewhat subjective, which makes a diagnosis sensitive to cultural influences such as gender role expectations.
Clinical interest in dependent personality disorder has existed since Karl Abraham first described the oral character. As a disorder, the personality type first appeared in a War Department technical bulletin in 1945 and later in the first edition of the Diagnostic and Statistical Manual in 1952 (American Psychiatric Association, 1952) as a subtype of passive-aggressive personality disorder. Since then, a surprising number of studies have upheld the descriptive validity of dependent personality traits, viewed as submissiveness, oral character traits, oral dependence, or passive dependence, or as a constellation of both pathological and adaptive traits under the rubric dependency.
Treatment Techniques (Zimmerman, 1994, pp. 118–119) suggests the following questions when assessing individuals for DPD:
▪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 find yourself in situations where other people have made decisions about important areas in your life, e.g. what job to take?
▪Is it hard for you to express a different opinion with 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? Why?
▪Do you often need help to get started on a project?
▪Do you ever 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?
▪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 person for you?
▪Do you worry about important people in your life leaving you?
Other Personality Disorder Information
Individuals with DPD see relationships with significant others as necessary for survival. They do not define themselves as able to function independently; they have to be in supportive relationships to be able to manage their lives. In order to establish and maintain these life-sustaining relationships, people with DPD will avoid even covert expressions of anger. They will be more than meek and docile; they will be admiring, loving, and willing to give their all. They will be loyal, unquestioning, and affectionate. They will be tender and considerate toward those upon whom they depend (Millon, 1981, p. 114). Dependent individuals play the inferior role to the superior other very well; they communicate to the dominant people in their lives that they are useful, sympathetic, strong, and competent (Millon, 1981, p. 114). With these methods, individuals with DPD are often able to get along with unpredictable, isolated, or unpleasant people (Kantor, 1992, p. 170). To further make this possible, individuals with DPD will approach both their own and others' failures and shortcomings with a saccharine attitude and indulgent tolerance (Millon, 1981, p. 113). They will engage in a mawkish minimization, denial, or distortion of both their own and others' negative, self-defeating, or destructive behaviors to sustain an idealized, and sometimes fictional, story of the relationships upon which they depend. They will deny their individuality, their differences, and ask for little other than acceptance and support (Millon & Davis, 1996, p. 332).
Not only will individuals with DPD subordinate their needs to those of others, they will meet unreasonable demands and submit to abuse and intimidation to avoid isolation and abandonment (Millon, 1981, pp. 107–108). Dependent individuals so fear being unable to function alone that they will agree with things they believe are wrong rather than risk losing the help of people upon whom they depend (DSM-IV, 1994, p. 665). They will volunteer for unpleasant tasks if that will bring them the care and support they need. They will make extraordinary self-sacrifices to maintain important bonds (DSM-IV, 1994, pp. 665–666). It is important to note that individuals with DPD, in spite of the intensity of their need for others, do not necessarily attach strongly to specific individuals, i.e., they will become quickly and indiscriminately attached to others when they have lost a significant relationship (DSM-IV, 1990, p. 666). It is the strength of the dependency needs that is being addressed; attachment figures are basically interchangeable. Attachment to others is a self-referenced and, at times, haphazard process of securing the protection of the most readily available powerful other willing to provide nurturance and care. Both DPD and HPD are distinguished from other personality disorders by their need for social approval and affection and by their willingness to live in accord with the desires of others. They both feel paralyzed when they are alone and need constant assurance that they will not be abandoned. Individuals with DPD are passive individuals who lean on others to guide their lives. People with HPD are active individuals who take the initiative to arrange and modify the circumstances of their lives. They have the will and ability to take charge of their lives and to make active demands on others (Millon & Davis, 1996, p. 325).
