Dependent Personality Disorder - Chapter 1(Deep Dive)(2021 Rerun)

Hey deserving listeners, today's episode is a deep dive on dependent personality disorder. This is the first chapter. I think there'll be three or four chapters. I'm not quite sure yet. This is just for patrons of the podcast. But I have a little bit of a long intro here for everyone. So, at first I thought it was just going to be a short episode. You know, I've done a lot of deep dives and some deep dives take me months to work on me, you know, maybe 1 month or 3 weeks or something. I didn't think there'd be that much prep. But the more I got into it, the more I realized that dependent personality disorder is a very important disorder for me to understand as a clinician, but also I think for everyone else to understand. There's a lot to it. It's pretty complicated. And the more I thought about people in my life, the more I realized that dependent personality disorder is everywhere. I mean, you know, it's not everywhere everywhere, but it's a lot more prevalent than I thought. I've had many clients with this disorder that I didn't really understand that they had this. I mean, I might have conceptualized them kind of, but not in the way that I could have if I understood this disorder and its causes. And a lot of people in my personal life have suffered from this disorder or they're on the spectrum, if you will. And understanding this disorder really helps me understand them and their weird behaviors or weird behaviors according to me, I should say. And I consider dependent personality disorder to be as important for clinicians and maybe even for lay people to understand uh just as important as narcissistic personality disorder or borderline personality disorder. We all of us, even lay people, especially if you've listened to this podcast, you've heard of narcissism, you've heard of borderline. But I think dependent personality disorder is an equally important concept for everyone to understand because I think there's a lot of people that confuse us that are operating from the schemas involved in this disorder. It's very useful to know about, very rarely talked about. We hear a lot about narcissism in our culture and in our clinical work, we hear a lot about borderline. We don't hear a lot about dependent personality disorder, strangely. And I have my theories, which I'll get into later. So, in this lecture, I'm going to present on a number of things. I'm going to have a number of in-depth case examples. And this is really where my learning sort of pinnacled, when I was able to pull together all that I learned and come up with some case examples. They're fictionalized, but I think you might be able to recognize other people in your life, maybe even yourself in some of these case examples. Because when you hear about dependent personality disorder on the internet, it seems kind of one-dimensional, but it's not. There's a lot of different types. ways that people will present. In the same way that borderline can look a lot of different ways, narcissistic personality disorder dependent ways. And if you just read the symptoms, you really do not understand how it will present. Because people with dependent personality disorder, as with all dis- all personality disorders, they don't know they have a personality disorder. They think that their perceptions and their behaviors are reasonable. That's the definition of personality disorders, particularly before they get treated. And so, I'm going to provide some in-depth case examples that might help to really humanize this condition. I'm going to provide a lengthy description, and I really want you to know what this disorder actually is and what it feels like. Again, if you go on the internet and you hear people just rattle off the DSM criteria, you get, you know, a little bit of a idea of what this is, but in my view, not really. And so, it it's in the details that I think that's this disorder lives. I'm also going to present on the types. I'm not a huge fan of typologies at all times, but I find that the typologies that have been developed by two different groups of people with dependent personality disorder, I think are very, very helpful, particularly one. I'm going to delineate it between uh codependency. You know, we hear that word all the time, and you hear me always kind of railing about it, and so I'm going to go into that a little bit. I'm going to talk about the prevalence, the differentials, comorbidities, assessment methods, treatment methods, the outcomes, you know, what kind of problems result from dependent personality disorder. I'm going to go into the history of how this, you know, construct has been seen within the field of talk therapy and psychology. I'm going to go into the DSM history, the psychoanalytic history. I'm going to go into the causes quite a bit as well, because I think that's where you really start to understand why people develop this disorder. And there are several causes that we can talk about genetics, parenting methods, it's a big one, abuse, big five temperament sort of issues, object relations, attachment style, schemas, relational traumas, and

much, much more. So, I'm going to go into a lot of different things, and I'm really looking forward to this. So, the first thing I want to get into is one of the case examples, the very first case example that I developed. I'm going to call this fictional composite person Aiden. This is a person named Aiden. So, this is a only child in a somewhat isolated family. So, Aiden is the only son, the only child in a family that lives in a rural area, in a isolated area. The parents had a style of parenting that was very firm, and perhaps a little controlling. I think from the outside, some people might see the parents as being nice, firm, and maybe a little controlling if they knew the full extent of the parenting. The parents were excessively emotionally reactive. Meaning that when the anything happened in their lives, they tended to have big emotions. And they tend to they tended to almost histrionically express themselves. You know, they had high happiness and high anger and high disappointment and all the kinds of emotions. So, very reactive, very undifferentiated in this way. There's nothing wrong with emotional expression, of course, but when you're undifferentiated, you tend to react in ways that you shoot yourself in the foot. So, the parents were like that, very reactive. They would regret having gotten angry frequently. The parents would also, particularly the father, would parent in a way that was a style of my way or the highway. He came from a very old-school way of parenting, shall we say, very firm. And so, he what he put his foot down, and it was his way or the highway. And both the mother and the son, Aiden, followed his direction. When he put his foot down, they obeyed. The parents were also somewhat self-centered. A little bit immature in this way. From the outside, you might not see that at first, but once you got to know them, you might think, "Wow, they're really kind of self-focused. They don't tend when they especially when they're emotional. " The mother became enmeshed with Aiden as a young person. She saw him as the one person who she could really trust even as an infant. As he grew up, as Aiden grew up, she would occasionally use guilt trips to modify his behavior. For example, when he talked about moving out after high school, she became sad and sullen for a week. And now, in her mind, she's thinking, "Well, I'm just sad that he wants to move out cuz I thought he wanted to stay at home. " And then another part of her thinking, "Well, you know, eventually he's going to move out. " But then another part of her thought, well, you know, it's a big scary world out there. But the way that Aiden received it was he was being punished for exploring the idea of moving out after high school. The father was again firm but distant. He was mostly pleasant with the boy, but he would occasionally get angry and would speak in an aggressive tone. The boy grew up to be a young man and he functioned pretty well and he seemed happy. No major problems in his life. He got a job, but he still lived at home and he didn't really have any huge aspirations of moving out. And when asked, he would say, well, you know, I like where I'm living and I'm saving up for money to buy a house. He seemingly liked living at home with his parents. He got along well with his parents on the surface, but deep down he knew that things weren't so great. He knew how to handle them when they got emotionally reactive. He knew that he would shut down and he would become a leaf in the wind, meaning that he would comply, he would nod his head. He just knew to sort of check himself out emotionally cuz it was the only way to cope with their emotions. And he prided himself on his ability to remain calm when his parents would flip out, according to him. He didn't have any ambitions in life, none. He was totally happy living at home with his parents and working at his entry-level job, perhaps for the rest of his life, but he didn't really think about the future very much. But deep down, he knew that something was wrong with his life, but he couldn't put his finger on it. When he thought about it, he quickly changed the subject in his mind and would just get back to his normal routine. He got along well with friends. His friends felt like he was pleasant, but they also saw him as distant, as if he didn't really have a personality. He liked his friends, but he felt more comfortable at home with his parents. And soon, as he aged into adulthood, his friendships started to dwindle. He had a few short romantic relationships. He tended to attract women who had {quote} strong personalities, women like his mother, by the way. Women who were ambitious and independent, women who were blunt and

upfront about things. Women who were very emotionally expressive. These romantic partners, these women, you know, they really loved him at first, cuz he was nice and accommodating. He was stable. And he seemingly had a good relationship with his family, which was a good sign. And he never, ever, ever got angry, and that really pleased a lot of his romantic partners. But over time, they felt frustrated with him. He seemed strangely distant at time at times, as if he wasn't there, again, a leaf in the wind. And sometimes, he seemed like a child waiting for mommy to tell him what to do. Partners complained that he never stood up for himself and never seemed to know what he wanted. He felt anxiety while in romantic relationships, as he did in any relationship. He felt like women were always pressuring him to do things, like to make a decision or to speak up or to have ambition or something. And he developed a narrative that women were too demanding and too much trouble. His relationships usually ended with the woman breaking up with him and him thinking that they were overly emotional. When confronted about things, he deflected and avoided the conversation. He would say anything to get the other person off of the topic, so he could return to normalcy and equilibrium. In arguments, he was very good at remaining calm and changing the subject and at deflecting. He was very good at making the other person feel like they were the crazy one and he was the normal one. He eventually married someone. She was very extroverted and she seemed very confident. They fit very well together. She would get him out of the house and he would quote unquote ground her and stabilize her. That's the that's their narrative together. But over time she became increasingly frustrated with him. He would hurt her feelings in very strange ways. She began to think of him as a man child and not as a man man. He didn't have any ambitions. He didn't seem invested in their life together. She thought that having children might help. So they had children. It did not help. She quickly realized that he wasn't ready to be a father. In fact, he became even more childlike. She felt like a single mother of her baby and her husband. And she would often tell her friends, "I have three children, my daughter, my son, and my husband. " They the conflict that they had grew until they were fighting almost every day. And they eventually got a divorce. After the divorce, he entered therapy. He didn't know why he was going, but he knew he probably needed to go. The first therapist was supportive, but didn't see the core of his issues. Years later, he went to another therapist. This therapist saw his core issue, his schemas of dependency. With this new insight, he suddenly understood everything. He learned how to stand up to his parents. have confidence in himself. After a few years of therapy, he healed from his inner schemas and was able to have to live a happier life. But he always retained the tendency to become dependent, but he knew how to manage it much better. So that is my case example of Aiden, again fictionalized. It's a composite of people I know and clients I've worked with. And this is an example of what I'll get into later of two different types. So, the six types that I have developed and I'll get into later are separation anxiety dependent and meshed dependent childlike dependent compliant and eager dependent life avoidant dependent and passive-aggressive point. This Aiden case fictionalized example is a representation of two of the types, two of the six types. One is the enmeshed dependent. This is the dependent that merges with other people, someone that they're dependent on. And so, Aiden merged with his mother and then later merged with his wife. These individuals, these people with dependent personality disorder are willing to give up their identity. And they become essentially an extension of another person. The other type that this exhibits Aiden the Aiden example is the childlike dependent. These people with dependent personality disorder will present in a childlike immature way. They will seem inexperienced and they will seem incapable of assuming adult responsibilities. So, in this deep dive, I am chapter one, I'm going to go into the description of dependent personality disorder. This is the Psychology in Seattle

Podcast. I'm your host Dr. Kirk Honda. I'm a therapist and professor. This episode is just for patrons of the podcast. So, if you want to listen to the rest of this episode, you have to be a patron of the podcast by going to patreon. com. When you become a patron of the podcast, you'll get instructions on how to listen to this episode and the other chapters in the dependent personality disorder of deep dive along with hundreds of other episodes that are only available to patrons and are probably our best episodes. I think it's I'm confident in saying that you know, our top 10% episodes are just for patrons. So, go to patreon. com become a patron of the podcast if you want and take care of yourself otherwise because you deserve it. You really, really do.