Friday Counseling Issues: The Personality Disorders

Today, we’re looking at Dependent Personality Disorder. Keeping in mind that in this cluster of disorders, all the disorders are based on fear/anxiety, what seems irrational to a person who does not struggle with any of them is completely rational to those who do. As a therapist, I’ve had to sort of rewire my own brain in order to empathize and have compassion with dependent people, because the truth is that this disorder irritates the fire out of me.  I am so NOT dependent that it’s very hard for me to understand how anyone can function  when they so desperately need the help/approval of others.

Years ago, I was given the leadership position of a ministry in my church.  I took “leader” to mean that I was to make decisions and implement them. It wasn’t long before I discovered that I was wrong. What was expected of me was to put any ideas or decisions that needed to be made across the desk of my pastor, and HE would tell me what to do. This created a problem between us until I realized that most people in leadership ministries expected the pastor to do their thinking for them.  I couldn’t understand that. It all ended well because the pastor was a wise man, and I was willing to meet him more than halfway. I share this because I want you to understand how  difficult it is for me to truly understand dependent people.  It’s just not the way I roll.

The core feature of the Dependent Personality Disorder* is a strong need to be taken care of by other people. This need to be taken care of, and the associated fear of losing the support of others, often leads people with Dependent Personality Disorder to behave in a “clingy” manner; to submit to the desires of other people. In order to avoid conflict, they may have great difficulty standing up for themselves. The intense fear of losing a relationship makes them vulnerable to manipulation and abuse. They find it difficult to express disagreement or make independent decisions, and are challenged to begin a task when nobody is available to assist them. Being alone is extremely hard for them. When someone with Dependent Personality Disorder finds that a relationship they depend on has ended, they will immediately seek another source of support.

The person with Dependent Personality Disorder (DPD) will hear, throughout the course of his life, that is is “needy,”  “clingy,” and “can’t stand on his own two feet”  His need for the approval and support of someone else is overwhelming, and when he loses that support he flounders around until he finds someone else who will fill the role for him. He really can’t stand to be alone. He will follow someone all over the house, keeping up a conversation of little or no interest to the other person, just to keep contact.  His need for obvious approval is unrelenting, and it wears out the other people in his life.

This is the high school girl who asks her best friend every single day, “Do I look okay?  Makeup?  Hair?  Outfit?  How about my shoes? How do I look from the back? Is this color good for me?”  She will then gather up her books from her locker and stick like a woodtick to her friend’s side as they walk to their first class.  If they don’t share the same class, she will say, “Okay, see you after class.  Can we meet at my locker?  Will you sit with me at lunch?  I’ll miss you!”

Her confidence and ability to function depends on her knowledge that her friend will always be available to her, no matter what.

In order to get a diagnosis of DPD, these traits have to be inflexible. All of us, especially during our teen years, tend to have a best friend that we rely on for support.  DPD goes way beyond the normal teen behavior. These traits cause functional impairment, and visible anxiety in the person who has them.  The traits create a problem in functioning well in normal society, and in interpersonal relationships.  Most important, the person who has DPD is miserably unhappy with her own behaviors, but is unable to break the pattern.

Treatment is in learning to confront anxiety; to tell oneself the truth; and to develop a set of personal goals that involve learning to become less dependent on others. As with all personality disorders, it’s not easy.  Good talk therapy with a patient, understanding counselor is important. The counselor needs to know how to draw the boundary so that the client doesn’t become dependent on her.  It’s a fine line to walk, and takes some experience  and compassion.

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