301.6 Dependent Personality Disorder
Diagnostic criteria DSM-IV-TR:
A pervasive and excessive need to be taken care of that leads to
submissive and clinging behavior and fears of separation, beginning
by early adulthood and present in a variety of contexts, as indicated
by five (or more) of the following:
(1) has difficulty making everyday decisions without an excessive
amount of advice and reassurance from others
(2) needs others to assume responsibility for most major areas of his
or her life
(3) has difficulty expressing disagreement with others because of
fear of loss of support or approval. Note: do not include realistic
fears of retribution.
(4) has difficulty initiating projects or doing things on his or her
own (because of a lack of self-confidence in judgment or abilities
rather than a lack of motivation or energy)
(5) goes to excessive lengths to obtain nurturance and support from
others, to the point of volunteering to do things that are
(6) feels uncomfortable or helpless when alone because of exaggerated
fears of being unable to care for himself or herself
(7) urgently seeks another relationship as a source of care and
support when a close relationship ends
(8) is unrealistically preoccupied with fears of being left to take
care of himself or herself
Dependent Personality Disorder:
must be distinguished from dependence arising from mood disorders.
In my case, dependence stems from unresolved conflict in parental
relationships, along with long-term adjustment issues, eating
disorder leading to major depression, which became more complicated
as time went on. My dependence is not something I accept, and it is
definitely a major part of my wish to die. I also don't really
want to stay in any relationship in which I am dependent, and
the longer a relationship goes on, the more hopeless the idea of
'paying back' what I owe, or achieving the kind of equality I
associate with love.
My pattern in long-term relationships is to tell the other that I
think it best if we do not stay together, and I behave in ways such
that I withdraw from the relationship, to make it easier for an
eventual split. I do this consciously. However, the two people I have
had long-term relationships with have experienced isolation to a
degree that makes it difficult to let go, and they may also have
a different kind of dependency issue. In reality, we probably stayed
together until we had other options that were viable, such that the
benefit to each was better than if we each lived alone.
Individuals with DPD see relationships with significant others as
necessary for survival. They do not define themselves as able to
function independently; they have to be in supportive relationships
to be able to manage their lives. In order to establish and maintain
these life-sustaining relationships, people with DPD will avoid even
covert expressions of anger. They will be more than meek and docile;
they will be admiring, loving, and willing to give their all. They
will be loyal, unquestioning, and affectionate. They will be tender
and considerate toward those upon whom they depend (Millon, 1981, p.
114). Dependent individuals play the inferior role to the superior
other very well; they communicate to the dominant people in their
lives that they are useful, sympathetic, strong, and competent
(Millon, 1981, p. 114). With these methods, individuals with DPD are
often able to get along with unpredictable, isolated, or unpleasant
people (Kantor, 1992, p. 170). To further make this possible,
individuals with DPD will approach both their own and others'
failures and shortcomings with a saccharine attitude and indulgent
tolerance (Millon, 1981, p. 113). They will engage in a mawkish
minimization, denial, or distortion of both their own and others'
negative, self-defeating, or destructive behaviors to sustain an
idealized, and sometimes fictional, story of the relationships upon
which they depend. They will deny their individuality, their
differences, and ask for little other than acceptance and support
(Millon & Davis, 1996, p. 332).
I found the above judgmental and prejudiced, not only against those
who are considered to have dependent personality disorder, but
against those who would accept them as mates.
In society today, despite feminism, there is still a lot of pressure
exerted by the myth of ideal love/romance. Many people are highly
impressed by extreme displays of loyalty and devotion, and think of
these as representative of true love. It is not just an individual
thing, it is a cultural thing.
If you are going to ridicule people for their unconditional love, why
not target those with unconditional love for Jesus, Buddha, L. Ron et
I don't think ridicule is the way to go in any circumstance. I
think it is better to focus on trying to understand how a person's
belief system was formed, and what forces in their experience/lives
led to the coping mechanisms that have kicked in or been inherited.
There are dependent features to my 'diagnosis', but I don't think I
have dependent personality disorder. I think my dependence is one of
the things that contributes to low self-esteem and that it is a
result of pre-existing conditions. It may be considered passive-
aggressive if it is unconsciously a way of punishing my father
for misunderstanding me, such that I 'force' him (and all those who
followed) to support me through playing dependent. But consciously,
in relationships, my insistence on not withholding important info
from people, and my need to explain when I am angry are important
examples of confronting relationship issues directly.
I do not have a need to idealize my relationships (including the
ones I am dependent upon), and I do not deny my own individuality or
our differences, and I definitely want a more complete relationship
than I have had - and have been willing to speak up.
It is my carefully considered opinion that all people need
more feedback. Much of the time, people go without support that could
be of benefit to them if others would only take a moment to share
their thoughts. I also think that I can notice individual qualities
that other people may miss and fail to appreciate. There is a
difference between this and just sucking up to a person because you
are not a person yourself. I consider this kind of communication to
be a part of what is necessary to improve the human environment as a
whole. Not just support, but constructive criticism, more detailed
discussion, the willingness to say what usually remains unsaid.
I am able to initiate tasks and projects on my own, and to form my
own opinions, even when they are contrary to those of others I have
known and respected.
My wish for another relationship does not have the focus of wanting
to be dependent on someone - it is consciously about the wish to
interact intimately with another human being, with the possibility of
greater intimacy than I have achieved before. Each relationship I
have had has contributed something to my understanding which has
perhaps made it possible I might find a more complete match. If a
person wished to break up with me, I would not fight the break up,
but would try to help make it smoother. In a way, even in my
long-term relationships, I have both feared and wished for the
independence that would come if the person would break up with me. At
the same time, I think of myself as moving toward this myself, and
that my actions demonstrate this.