Dependent Personality Disorder

Dependent Personality Disorder as described by the DSM-IV (Diagnostic and Statistical Manual IV- used for formal diagnosis- for insurance, research, and communication between mental health professionals) is a pervasive and excessive need to be cared for by another person that leads to clinging and fears of separation. This begins in early adulthood and is present in a variety of contexts. Symptoms could include, problems is self directed behavior, decision making, and excessive reliance on others for nurturing and support in the face of fears of inability to care for oneself. People with this disorder are generally fairly functional and appear to be able to care for themselves. However, they continue to rely excessively on others. An individual afflicted with this pattern of functioning seeks out a powerful other to make decisions and guide them through life. They may jump quickly into new relationships when one ends, with out much concern for the appropriateness of the relationship. These individuals often seek out, or end up with controlling and abusive partners.

When it comes to a woman in an abusive relationship, there are several considerations before making a diagnosis of Dependent personality. Firstly, women are encouraged in this culture toward dependence on others. Further, abuse may create “learned” dependence. Often women who might otherwise be relatively independent in healthy relationships become highly dependent due to ongoing abuse and restrictive control.

Cultural issues must also be considered. Some cultures value dependence on the family much longer than would be considered healthy in the American culture. Therapists must be careful, when conducting cross-cultural counseling, not to be excessively biased by their own cultural viewpoints. One must always consider the context in which the individual is embedded.

People with Borderline Personality may have similar dependency needs, however are likely to be enraged rather than clingy when threatened with abandonment. Further, they would undoubtedly be frightened by allowing someone so much control over their life. While both avoidant and dependent personalities need excessive reassurance and have low self-esteem, dependents seek out rather than avoid or withdraw from relationships, as is characteristic of Avoidant Personality Disorder.

For treatment, overall, a more independent functioning is the goal. Assertiveness and social skills training and cognitive behavioral therapy is helpful. Couples or family therapy may be helpful if the individual is in an ongoing relationship. It is likely that if these individuals came to therapy after the breakup of a relationship, that involvement in a new relationship will temporarily reduce the anxiety and depression that propelled them to treatment. Because of this, these folks may feel better when starting a new relationship or getting back with their previous lovers, they may flee therapy if they feel safe in the new relationship. The problem ultimately is their pattern of relating and it will likely arise again in the future.