By: THEODORE MILLON
et al
Dependents
arrange their lives to ensure a constant supply of nurturance and guidance from their environment. They can be described as
self-effacing, obsequious, docile, and ingratiating. Many search for an all-powerful magic
hero, someone who will take care of them, save them from the competitive struggles of
life, and protect them from any possibility of harm. Given a nurturing and
understanding partner, dependents often function with ease, being sociable,
warm, affectionate, and generous.
One normal
variant of the
dependent is Oldham and
Morris’s (1995) devoted style, who is caring and puts the needs of others first. Another is
Millon’s (Millon et al., 1994) agreeing style, who is cooperative and amiable.
A healthy dependent is capable of genuine empathy for others and has
the capacity to give
unconditional love. The more pathological variants fuse their identity with
that of others and become inextricably enmeshed with others.
There exist
several adult subtypes of the dependent personality. The adult subtypes include the disquieted dependent, who displays a
mixture of avoidant and dependent personalities; the accommodating dependent, who has an
insatiable need for affection and nurturance and often shares traits with the
histrionic; the immature dependent, who never develops competencies and remains childlike; the
ineffectual dependent, who reflects a combination of schizoid and dependent
features; and the selfless dependent, who is known for idealization and total
identification.
Psychodynamically,
the dependent can be thought of as fixated at the oral stage of development.
For the dependent, this fixation is thought to have occurred through indulgence
at the oral stage rather than through frustration. They tend to rely on
introjection and idealization, generally of
partners, as defense mechanisms. They may also use denial to avoid feelings of
anxiety that introjection does not abolish.
Interpersonally,
dependents are often seen as generous and thoughtful, overly apologetic, or
even obsequious. Beneath their warmth and friendliness, however, lies a solemn search for assurances of acceptance and approval. To
achieve their interpersonal goals, dependent personalities attach themselves to others,
submerge their own individuality, deny points of difference, and avoid expressions of
power. Interpersonal formulations of the development of the dependent personality emphasize
parental overprotection, overconcern, overnurturance, and active discouragement
of autonomy as the major developmental pathways. Some parents never allow their
children to develop independently. In effect, they remove any need to explore the world by
bringing the world to the child. Other family members and peer group experiences can
also contribute to the development of a dependent personality.
The cognitive
perspective asserts that the helpless façade that dependents project eventually works its way into their self-concept.
Accordingly, the self-schema of dependents includes both positive and negative
qualities. On the positive side, dependents see themselves as considerate,
thoughtful, and cooperative; on the negative side, they often tell themselves that
they are helpless and completely alone in the world. To remedy these deficits,
dependents often form conditional beliefs; for example, they can survive only if someone
protects them, or if they are alone, they will die. Dependents are cognitively
immature. They seldom look inward and possess only vague ideas about their self-identity and
direction.
The evolutionary
developmental perspective conceptualizes dependents as arranging their lives to ensure a constant supply of nurturance
from the environment, but doing so in a passive way. They avoid developing competencies
that would allow them to actively adapt to their surroundings.
The dependent
personality disorder is related to several other personality disorders
including the histrionic, avoidant, and masochistic. Dependents are extremely
vulnerable to developing anxiety
disorders such as generalized anxiety disorder, phobias, agoraphobia, and panic
attacks. Additionally, dependents often develop depression, dissociative
reactions, and display
physical symptoms such as assuming the “sick role.”
Psychotherapy can
be effective in treating the dependent personality. Most dependents are highly motivated to remain in therapy, as the
therapeutic relationship itself naturally supplies them with the very
resources they feel are deficient in their everyday lives. The strength and authority of the
therapist is comforting and reassuring and provides the idealized omnipotent figure
that dependents seek to rescue them in time of need. Moreover, dependents are usually ready
to trust and to talk with a therapist. Cognitive techniques can be used to challenge
dependents’ propensity toward black-and-white thinking with the goal of engaging
dependents in a more active style of problem solving that disconfirms life as
an existence of total helplessness and moves them toward a more competent
self-image.
Psychodynamic exploration may also be effective in helping dependents
understand the developmental basis from which maladaptive patterns arose,
though insight alone
is unlikely to be sufficient in producing personality change.
References
Personality Disorders in Modern Life, second edition, 2000,
2004 by John Wiley & Sons, Inc.
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