THE DEPENDENT PERSONALITY

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What is Dependent Personality Disorder?

Dependent Personality Disorder (DPD) is a mental health condition characterized by a

pervasive and excessive reliance on others for emotional support, guidance,
decision-making, and a sense of identity. Individuals with DPD often have an intense
fear of abandonment and feel helpless or incapable of functioning independently.

● Dependent Personality Traits: Dependent personalities exhibit extreme caring

and self-sacrifice, prioritizing others' well-being.
● Relationship Focus: They deeply invest in personal relationships, especially
within marriages.
● Passive Role: Dependents often assume passive roles within relationships,
deferring to others' wishes.
● Harmony Seekers: They value harmony in relationships and are often
apologetic, even when disputes are not their fault.
● Selfless Acts: Dependents engage in selfless acts, finding happiness in the
well-being of loved ones.
● Helplessness Perception: They see themselves as helpless and fear acting
independently.
● Constant Need for Guidance: Dependents struggle to make decisions, seeking
advice even for trivial matters.
● Impact of Relationship Loss: A breakup deeply affects their self-esteem,
leading to withdrawal, tension, and despondency.
● Difficulty with Initiative: They have trouble taking initiative or providing direction
in their lives.
● Early Dependence: Dependency patterns often start early in life, shaped by
family dynamics.
● Conflict Avoidance: Dependents avoid conflict, prioritizing pleasing others over
asserting themselves.
● Initiation Challenges: They find it challenging to start tasks or make decisions
without external validation.
● Desire for Status Quo: The ultimate goal is to maintain a passive, pleasant, and
attached status quo.
● Fear of Abandonment: Dependents fear being alone and may go to great
lengths to secure relationships.
● Panic and Desperation: Absence of primary support sources leads to panic and
desperation.
● Continuum of Dependency: These traits exist on a continuum, with varying
degrees in different individuals.
From Normality to Abnormality

Healthy dependent individuals are caring, empathetic, and trusting, capable of

unconditional love and acceptance. They are easygoing and charitable, finding
goodness in others while not demanding much.

However, these traits can transition to pathology(Abnormality) when dependence

becomes extreme. Dependents fear being alone, blurring boundaries with loved ones.
They may avoid acquiring adult skills, becoming helpless. Loss of a relationship can
lead to feelings of domination and desperation, and they may infantilize themselves to
maintain dependence.

● Healthy Dependent Traits

Healthy dependents are caring, empathetic, and trusting individuals.
● Unconditional Love: They possess a capacity for sustained, unconditional love
and deep empathy.
● Trust and Acceptance: They are highly trusting, humble, and accepting of
others.
● Easygoing and Charitable: Easy to please and charitable, they find virtue and
goodness in others.
● Low Self-Demand: They don't set unattainable standards for approval and are
not demanding.

Abnormality Traits
Dependents may fuse their identity with others, leading to anxiety and pathology.

● Fear of Separation: They intensely fear being alone, as their identity is

enmeshed with loved ones.
● Loss of Self: Relationship loss leads to feelings of domination, depletion, and
desperation.
● Boundaries Blur: Dependents blur boundaries with others, leading to
suffocation and subservience.
● Avoidance of Adult Skills: Some may avoid acquiring adult skills to maintain
dependence.
● Contrasting Criteria - Disorder vs. Normal Style: Criteria 1 - Seeking advice
excessively vs. Seeking advice but making independent decisions.
● Contrasting Criteria - Disorder vs. Normal Style: Criteria 2 - Requiring others
to take responsibility vs. Enjoying support but functioning independently.
 ● Contrasting Criteria - Disorder vs. Normal Style: Criteria 3 - Subordinating
feelings to avoid separation vs. Preferring harmony but willing to assert
themselves.
● Contrasting Criteria - Disorder vs. Normal Style: Criteria 4 - Lack of
confidence to start projects vs. Ability to work independently.
● Continuation of Contrasts: Criteria 5 - Desiring nurturance and support to an
extreme vs. Being considerate and occasionally self-sacrificing.
● Continuation of Contrasts: Criteria 6 - Greatly fearing being left alone vs.
Preferring company but enjoying occasional solitude.
● Continuation of Contrasts: Criteria 7 - Desperate search for a new partner after
a breakup vs. Nostalgia for lost intimacy but not immediate pursuit.
● Continuation of Contrasts: Criteria 8 - Terrified of abandonment vs. Enjoying
affection from others but not terrified of being left alone.

Variations of the Dependent Personality:

​ The Disquieted Dependent: This subtype combines traits of dependency and

avoidance. They live in institutional settings, relying on the structure for support.
Disquieted dependents are submissive and self-effacing but also anxious and
prone to outbursts when their needs for security aren't met.
​
​ The Accommodating Dependent: These individuals are highly submissive,
agreeable, and eager for affection and security. They fear abandonment, leading
to excessive compliance and obliging behavior. They may be socially gregarious,
seeking attention. Accommodating dependents often submerge their own
identities, valuing themselves only in relation to others. They avoid conflict and
responsibilities and may struggle with competence.
​
​ Immature Dependent: Some individuals remain childlike, preferring child-related
activities and avoiding adult responsibilities, often due to a lack of ambition or
confidence.
​
​ Ineffectual Dependent: Combines dependent and schizoid traits, lacking vitality,
tuning out life's demands, and adopting a somewhat fatalistic attitude, avoiding
engagement with reality.
​
​
​ Selfless Dependent: Exhibits extreme idealization and complete identification
with others, subordinating their identity for emotional stability and purpose,
potentially adopting different values. Vulnerable to anxiety and depression when
relationships face difficulties.
​
​ The Disquieted Dependent:
○ Mixes dependent and avoidant patterns.
○ Often found in institutional settings.
○ Lives a parasitic existence.
○ Submissive and self-effacing.
○ Underlying apprehensiveness and anxiety.
○ Vulnerable to separation anxiety.
○ May express fears through anger.
​
​ The Accommodating Dependent:
○ Highly submissive and agreeable.
○ Craves affection, nurturance, and security.
○ Fears abandonment, leading to excessive compliance.
○ May seek attention and be socially gregarious.
○ Values themselves in relation to others.
○ Avoids conflict and responsibilities.
○ Often lacks competence and struggles with autonomy.
​ The Immature Dependent:
○ Some individuals never achieve adult-level maturity.
○ Prefer childlike activities and find satisfaction relating to children.
○ Dislike adult responsibilities and prefer a pre-adult lifestyle.
○ Often remain childlike in outlook and level of achievement.
​ The Ineffectual Dependent:
○ A combination of dependent and schizoid patterns.
○ Lack vitality, have a low energy level, and are often fatigued.
○ Understand basic emotions of others but tend to tune out life's demands.
○ Often seem disengaged and unresponsive to responsibilities.
​ The Selfless Dependent:
○ Exhibit extreme idealization and total identification with others.
○ Subordinate themselves completely to others, forfeiting their own identity.
○ Fusion with others provides emotional stability and purpose.
○ May adopt values and attitudes different from their own.
○ Often feel fulfilled but can become vulnerable to loss and experience
anxiety and depression when relationships face difficulties.
 Fig 1. Variations of Dependent Personality

Early Historical Forerunners

● Early historical views of personality disorders, including the dependent

personality, were influenced by the concept of "moral insanity."
● Early theorists like Kraepelin and Schneider had limited references to the need
for external support in dependent personalities.
● They emphasized the malleability and susceptibility of dependents to influence,
suggesting that they were responsive to good influences and had good
intentions.
● These theorists saw dependent personalities as products of delayed maturation,
a view that still holds relevance today.
● However, they associated dependent personalities with negative outcomes like
addiction and criminal behavior when not motivated by external forces, which is
atypical.
The Psychodynamic Perspective

The psychodynamic perspective on dependent personality suggests that it arises from

fixation during the oral stage of psychosexual development. This fixation results in
individuals who seek fusion with stronger figures, idealize attachment figures, and use
denial to protect themselves from acknowledging external challenges and hostile
impulses. This perspective helps explain the dependent personality's reliance on others
and its avoidance of adult responsibilities.

Major Points

● The psychodynamic perspective links the dependent personality to fixation during

the oral stage of psychosexual development.
● The dependent personality is often referred to as the oral character in classic
psychoanalytic theory.
● Fixation during the oral stage can result from either indulgence or frustration,
leading to oral-receptive or oral-sadistic traits.
● Oral characters may enjoy oral stimulation such as eating and talking.
● Dependents emphasize two defense mechanisms: introjection and denial.
● Introjection involves seeking fusion with stronger figures, putting their identity
inside themselves, and idealizing attachment figures.
● Dependents use denial to protect themselves from acknowledging external
difficulties and their own hostile impulses.
● Denial helps maintain the illusion of an internal utopia free from external
challenges.
● Anger is particularly threatening for dependents as it disrupts their view of the
world as an extension of the playground and challenges their illusion of security.

The Interpersonal Perspective

The interpersonal perspective on dependent personality suggests that people with this
trait often become overly reliant on others due to their early life experiences. They seek
approval and care from others by being very giving and submissive. When things get
tough, they become even more dependent. This behavior can be traced back to their
childhood, where they might have had parents who were very protective or overly
concerned. Such parents may have prevented them from developing independence.
Sometimes, chance events like a parent's illness can also contribute to this
dependency. In a nutshell, dependent personalities develop a strong need for external
support and approval because they've learned to depend on others from a young age.

Major Points

● The interpersonal perspective on dependent personality emphasizes that these

individuals have learned helplessness from parental models.
● The Interpersonal Circle developed by Timothy Leary describes the
docile-dependent as being characterized by trustful conformity at adaptive levels
and helpless dependency at more pathological levels.
● Dependent personalities appear generous, thoughtful, and overly apologetic,
seeking acceptance and approval from others.
● Under stress, dependents become even more helpless and clinging to evoke
consistent care and affection.
● Parental overprotection, overconcern, over nurturance, and discouragement of
autonomy are key factors in the development of dependent personality.
● Some children never outgrow early overprotection, remaining dependent on more
powerful figures.
● Chance factors like unusual illnesses or family circumstances can contribute to
the development of dependency.
● Siblings and peer group experiences can also influence the development of
dependent traits.
● The dependent begins life with normal attachment but is then prevented from
developing autonomy by caregivers who maintain control.
● This control fosters submission, and efforts to regain autonomy are met with
blame, leading to intense guilt and an internalized belief in one's inadequacy.
The Cognitive Perspective

Dependent people see themselves as weak and always needing help from others. They
tend to think in extreme ways, like believing that if someone doesn't help them, they'll be
completely alone. This way of thinking comes from their upbringing, where they learned
to rely on others because of constant fear. They usually have simple thoughts and
struggle with complex problem-solving. To handle life, they make their world simpler,
even though it's not the full picture.

Major Points:

​ Self-Perception: Dependents often see themselves as weak, fragile, and

inadequate because they project a helpless image to get the care they crave.
​ Limited Awareness: They prefer not to delve deeply into their problems,
focusing on the positive and avoiding acknowledging difficulties. When they do,
they often assume things will work out somehow.
​ Self-Schema: Their self-concept includes both positive (considerate and
cooperative) and negative (helpless and alone) qualities.
​ Core Beliefs: They hold core beliefs like "I am completely helpless" and "I am all
alone." These beliefs lead to conditional beliefs, such as "I can only function if
someone competent helps me."
​ Dichotomous Thinking: Dependents often see things in black and white. If
they're not cared for, they feel utterly alone. If they can't do something perfectly,
they believe it's impossible.
​ Catastrophizing: They tend to think in catastrophic terms, especially regarding
relationships. Any disturbance in their attachments feels like total abandonment.
​ Parental Influence: Their parents may have projected extreme fear and a need
for constant protection, which they internalize. This affects their ability to trust
themselves.
​ Cognitive Style: Dependents have a diffuse thought pattern and often lack
self-awareness. They don't look inward much and may have vague ideas about
their identity and goals.
 ​ Lack of Cognitive Sophistication: Due to their reliance on others since
childhood, they may lack cognitive skills like complex problem-solving and
judgment.
​ Simplicity in Thinking: Dependents create a simplistic, manageable world in
their minds to avoid complex appraisals. They need simplicity to cope.

The Evolutionary-Neurodevelopmental Perspective

Dependent personalities rely on others for care and protection, often seeing themselves
as weak. Their cognitive style tends to be simplistic, and they avoid developing
self-reliant skills. Early attachments, overprotective parenting, and peer experiences can
contribute to their dependency. These individuals may lack self-identity and struggle to
function independently in the world.

Major Points:

● Dependent personalities rely heavily on others for care and protection.

● They often see themselves as weak and helpless.
● Their cognitive style tends to be simplistic, and they struggle with complex
problem-solving.
● Dependents avoid developing instrumental competencies, preferring to rely on
others.
● They form singular attachments early in life, sometimes due to exclusive
maternal care or other factors.
● Overprotective parenting, physical deficits, and fearfulness can also contribute to
dependency.
● Peer group experiences, especially during adolescence, can reinforce feelings of
inadequacy.
● Pampered children tend to view themselves as weak and prone to illness.
 ● Dependent personalities may lack a sense of self-identity and struggle to stand
on their own in the outside world.

Contrast With Related Personalities

Dependent vs. Histrionic Personality:

● Both seek social approval and affection.

● Avoid expressing their own thoughts and feelings to please others.
● Sensitive to disapproval and criticism.
● Dependent: Passive, submissive, self-effacing.
● Histrionic: Active, seeks attention and approval actively, charming, seductive.

Dependent vs. Avoidant Personality:

● Both may appear shy, lack confidence, and fear criticism.

● Strong needs for protection and nurturance.
● Dependent: Plays the shy, innocent role to encourage others to take control.
● Trusts others fundamentally, receptive to interpersonal overtures.
● Avoidant: Shrink from others due to fear of rejection and humiliation.
● Doesn't trust others, fears scrutiny, can act autonomously when social judgment
isn't a concern.

Dependent vs. Masochistic (Self-Defeating) Personality:

● Both can be self-effacing and submissive.

● Dependent: Seeks alliances that protect and insulate them from life's trials.
● Helplessness is a strategy to get others to assume an instrumental role.
● Masochistic: Works for their own benefit but then feels guilty or fearful of success
and undermines opportunities.
Dependent vs. Borderline Personality:

● Both fear abandonment and may blur self-other boundaries.

● Dependent: Rarely forceful, trusts the outcome will be good.
● Functions well as long as caretakers provide love and guidance.
● Borderline: Expresses anger, rapidly shifting emotions, intensity.
● May attempt to control partners to avoid abandonment, experiences greater
psychological decompensation under stress.

PATHWAYS TO SYMPTOM EXPRESSION

Anxiety Disorders in Dependents:

● Vulnerable to anxiety disorders, especially panic disorder and agoraphobia.

● Generalized anxiety related to fear of abandonment, inability to cope, or perform
tasks.
● Restlessness, fatigue, sleep difficulties, and intrusive worries.
● Dependent individuals may use panic attacks for manipulative purposes to evoke
nurturance and support.
● Panic attacks are often accompanied by agoraphobia.

Depression in Dependents:

● Strong link between dependency and depression.

● Feelings of hopelessness and helplessness are common in both.
● Dependents have few competencies, strained relationships, and a sense of utter
helplessness.
● Excessive guilt and self-condemnation used to evoke sympathy and preempt
criticism from protectors.
● Dependency complicates recovery from depression, as adverse events are more
devastating, reducing coping resources and motivation.
 ● Highly dependent individuals relapse more quickly, even with the same level of
adversity.

Eating Disorders in Dependents:

● Evidence suggests higher rates of eating disorders among dependents.

● Positive association between interpersonal dependency and anorexia and
bulimia.
● Relationships are modest and nonspecific, with other personality disorder
symptoms also implicated.
● Dependency levels decrease as eating disorder symptoms remit.

Physical Symptoms in Dependents:

● Dependents cope indirectly due to their inability to take control of their lives
directly.
● Physical disorders serve to relieve responsibility and bond protectors even more
closely.
● Physical disorders elicit sympathy and allegiance, diverting attention from
relationship strains.
● Feigned physical disorders may represent self-attack in disguise for feeling
helpless and incompetent.
● Relationships between dependency and physical disorder are often unconscious.
● Severe cases may consciously fabricate physical symptoms to assume the sick
role and manipulate attention.
● Case example: Jack, a dependent personality, with chronic back pain as a
functional symptom, not as troubled as expected for someone on the verge of
being declared physically disabled.
Therapy
Psychotherapy for dependent personalities generally has a positive outlook. When
seeking help due to disruptions in their social world, dependents are highly motivated
for therapy. The therapist provides the acceptance and support they need. However,
therapists must avoid falling into traps of reinforcing dependency dynamics. Effective
strategies involve encouraging autonomy, using cognitive techniques, and addressing
developmental origins of issues. The end of therapy can trigger anxiety, but addressing
this ensures more lasting progress.

Psychotherapy for Dependents:

● Generally has a good prognosis.

● Dependents usually seek therapy when their social world has been disrupted.
● Therapy offers resources lacking in their everyday lives: acceptance, security,
empathy.
● Therapist becomes a surrogate caretaker, offering what dependents need.
● Dependents are highly motivated to continue therapy.

Therapeutic Traps:

● Dependents readily please the therapist.

● Promises of quick improvement can be misleading.
● Therapists may feel they've found an ideal client, but this can lead to pathological
therapeutic relationships.
● Therapists with narcissistic or maternal needs are vulnerable.
● Therapists may become more directive or supportive than necessary.

Therapeutic Strategies and Techniques:

● Strategic goals are the same as for any personality disorder: make the individual
a more functional version of themselves.
● Dependents must learn to interact with others in a way that encourages
individuation, not submission.
● Dependency should be used but not indulged; the goal is to outgrow the
therapeutic relationship.
● Address personality pathology at multiple levels simultaneously.
● Therapists must be sensitive to transference and countertransference, pulling for
autonomy.
● Techniques include role playing, modeling, assertiveness training, and group
therapy.
● Cognitive techniques confront black-and-white thinking and engage clients in
active problem-solving.
● Psychodynamic exploration helps understand the developmental basis of
problems.
● Insight alone is unlikely to produce personality change.
● Achieving less idealized images of others involves confronting intense feelings of
guilt.
● The end of therapy can trigger phobic symptoms and depressive feelings, as it
means a loss of attachment and a return to feelings of helplessness and
aloneness.
● Therapists must address these issues as termination approaches to ensure solid
gains.
Summary ( Just an optional Recap)

● Dependents seek constant nurturance and guidance, often relying on an

all-powerful figure to protect them.
● They can function well with understanding partners, appearing warm and
affectionate.
● Different subtypes of the dependent personality exist, including disquieted,
accommodating, immature, ineffectual, and selfless dependents.
● Psychodynamically, dependents are fixated at the oral stage and use defense
mechanisms like introjection and idealization.
● Interpersonally, they are often seen as generous but have a strong need for
approval and acceptance.
● Parental overprotection and discouragement of autonomy are key factors in their
development.
● Cognitive perspectives reveal a self-schema that includes both positive and
negative qualities, often leading to conditional beliefs.
● Dependents are cognitively immature and lack self-identity and direction.
● From an evolutionary developmental perspective, dependents passively secure
nurturance without developing competencies.
● Dependents share traits with histrionic, avoidant, and masochistic personalities.
● They are prone to anxiety disorders, depression, dissociation, and physical
symptoms.
● Psychotherapy, which helps challenge their black-and-white thinking and
encourages autonomy, can be effective in treating dependent personality
disorder.

ALL THE BEST ANAGHA, DO WELL! - ANONYMOUS :)