Case Study Of Dependent Personality Disorder

Obtain insight into co-dependence. Read therapy notes from patient diagnosed with Dependent Personality Disorder.

Notes of first therapy session with Mona, female, 32, diagnosed with Dependent Personality Disorder (or Codependence)

"I know I won't actually die, but it often feels like it." - says Mona and nervously pats her auburn hair - "I can't live without him, that's for sure. When he is gone, it's like life switching from Technicolor to black and white. There is no excitement, this electricity in the air that seems to constantly surround him." She misses him so much that it physically hurts. Sometimes she feels like throwing up at the mere thought of separating or being abandoned by him. She is helpless without him: "He is so masterful and knows how to fix things around the house." He is gorgeous and a great lover.

Is he intellectually stimulating? Do they talk a lot? She moves uncomfortably in her seat: "He is more the silent strong type." She is supporting him financially. "He is studying". In the last seven years he had switched from psychology to political science to physical therapy. How long will she underwrite his quest for self-realization? "As long as it takes. I love him".

She acknowledges that he is verbally and sometimes physically abusive. He has cheated on her more times than she can count, usually with classmates at the university. So, why is she still with him? "He has his good sides". Do they outweigh his bad ones? She is evidently displeased with my question but is reluctant to express her reservations.

I tell her that - her intimate partner having refused to attend therapy - I am merely trying to get to know him better if only by proxy. Evidently something is bothering her, otherwise we wouldn't be having this therapy session. "I want to learn how to hold on to him."- she whispers - "He is a very special man and has special needs. I am looking for guidance on how to hook him. I want him to become addicted to me, like a junkie." She even participated in group sex once or twice to make his fantasies come true.

Does this strike her as the basis for a healthy relationship? She doesn't care. She consulted all her friends and even casual acquaintances but she doesn't know whether to trust them. Does she have many friends? Not any more. Why not? People get tired of her, they say that she is clinging. But that's not true - she only asks their advice on a regular basis. "What are friends for, anyhow?"

Does she have a job? She is a lawyer, but her dream is to become a film director. She vividly and enthusiastically describes what she would do behind the camera. What's holding her back? She laughs self-deprecatingly: "Except for mediocre talent, nothing."

This article appears in my book, "Malignant Self Love - Narcissism Revisited"

next: The Obsessive-Compulsive Patient ~ back to: Case Studies: Table of Contents

Last Updated: 06 July 2016
Reviewed by Harry Croft, MD

Patients with dependent personality disorder do not think they can take care of themselves. They use submissiveness to try to get other people to take care of them.

Patients with this disorder typically require much reassurance and advice when making ordinary decisions. They often let others, often one person, take responsibility for many aspects of their life. For example, they may depend on their spouse to tell them what to wear, what kind of job to look for, and whom to associate with.

These patients consider themselves inferior and tend to belittle their abilities; they take any criticism or disapproval as proof of their incompetence, further undermining their confidence.

It is difficult for them to express disagreement with others because they fear losing support or approval. They may agree to something they know is wrong rather than risk losing the help of others. Even when anger is appropriate, they do not get angry at friends and co-workers for fear of losing their support.

Because these patients are sure that they cannot do anything on their own, they have difficulty starting a new task and working independently, and they avoid tasks that require taking responsibility. They present themselves as incompetent and needing constant help and reassurance. When reassured that a competent person is supervising and approving of them, these patients tend to function adequately. However, they do not want to appear too competent lest they be abandoned. As a result, their career may be harmed. They perpetuate their dependency because they tend not to learn skills of independent living.

These patients go to great lengths to obtain care and support (eg, doing unpleasant tasks, submitting to unreasonable demands, tolerating physical, sexual, or emotional abuse). Being alone makes them feel extremely uncomfortable or afraid because they fear they cannot take care of themselves.

Patients with this disorder tend to interact socially with only the few people they depend on. When a close relationship ends, patients with this disorder immediately try to find a replacement. Because of their desperate need to be taken care of, they are not discriminating in choosing a replacement.

These patients fear abandonment by those they depend on, even when there is no reason to.

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