Monday, April 5, 2010

Behavoral Contagion: Dependent Personality Disorder

Dependent Personality Disorder

We all depend upon others. Indeed, to be socially connected to others is to be interdependent with them. But individuals diagnosed with dependent personality disorder show a near total reliance upon others who make almost all of their major and minor decisions for them, to bolster their self-esteem, and to care for their child-like needs. These individuals strongly feel that they cannot manage their own lives (though they may be capable), they are unable to assert their personal needs in a relationship, and they are desperate to hang-on to those on whom they depend---no matter what. As a result, such individuals lack the ability to manage their own lives and behave as a fully functional adult. Such individuals dread separation from those who they let run their lives, they are often depressed, and can suffer from suicidal thinking. They will often do degrading things in order not to lose the ones they depend on.

All of these features can worsen if they feel they are going to be abandoned by their care-taker (parent, boyfriend/girlfriend, or spouse). As a result, these individuals often suffer emotional and physical abuse at the hands of others, and they may tolerate emotional, physical, or sexual abuse of their children by those upon whom they are pathologically dependent.

If separated from those who they depend upon, they are likely to quickly “latch-on” to another dependent relationship to avoid feelings of intense anxiety and fear.

Representative Examples

It is not hard to identify examples of dependent personality disorder. These problems are most prevalent in women, but they can and do occur in men.

I recall the shocking media pictures from several decades ago, of wife and mother who had been beaten for many years by her husband, a successful New York attorney. Her face was shockingly disfigured by the chronic beatings she had endured.

To compound this tragedy, the mother also allowed her husband to beat her young daughter. This couple was prosecuted when an autopsy of their dead child revealed broken bones dating back to her earliest years of life.

A woman with three children sought the help of a therapist to extricate her and her children from an abusive marriage. The man had beat her repeatedly in front of her children, had held them all at gun point threatening to kill them. The therapist worked diligently to get this woman to take action: providing the phone number of the local women's shelter, prompting to call and talk to the professionals there, and to make the necessary plans to leave her home in a safe manner to gain refuge at the woman's shelter. The woman withdrew from therapy and stayed with this man.

Possible Causes

Dependent personality disorder has traditionally been thought to result from a lack of loving care during the first year or so of life. This could lead to a desperate life-long search for care and nurturance. As with so many other personality disorders, parental separation, loss, or rejection have often been implicated. Some theorists suggest that opposite causes of parental over-protectiveness and over-involvement in their children's lives could yield the same excessive dependency needs in later life. Behavioral explanations suggest that parents may actually reward (reinforce) extreme dependence in their children and punish their efforts at independence by withdrawing their love and support. It is also possible that some parents show their own dependency problems and their children come to imitate their dependent behaviors.

Dr. Tom 4/5/10

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