Dependent Personality Disorder Treatment

Dependent personality disorder, which was earlier known as Asthenic Personality Disorder, is one of the most common disorder which is also included amongst a group of anxious personality disorders.

Abbreviated as DPD, this personality disorder can be explained as a condition wherein an individual is way too much dependent on his/her relationships with others in order to feel secured, protected, nurtured in terms of fulfilling their psychological, emotional and physical requirements.

This personality disorder is equally prevalent in both men and women and tends to occur in them during their early or middle adulthood.

The exact cause for the same are unknown, however, some studies and researchers associate this disorder with a combination of certain development and biological parameters, one of them would be spending one's childhood in an overprotective environment under authoritarian parenting and upbringing.

A person suffering from DPD tends to depend on a significant other to an extent that he or she needs their reassurance and advice in even the smallest of decisions in life. They are unable to take their own decisions and feel that they are not efficient enough to survive alone without being under the care and protection of a 'strong person'.

To make sure that the person never leaves them, they tend to go out of their way to please the person. They can do unreasonable actions, including those that they don't approve of, just to please the significant other and to have themselves protected and nurtured.

They don't demand, they don't show their anger and they don't complain. Instead they become meek and docile to be able to sustain not the person, but the security in the relationship.

You would be surprised to know that generally people suffering with this personality disorder don't seek medical attention unless they are actually facing difficulties in their personal life due to this disorder. This is because people suffering from this personality disorder are also prone to experience depression, certain phobias and anxiety disorders.

Not only this, these people are also prone to be emotionally or physically abused by their caregiver as they tend to do anything (whether right or wrong) to sustain their relationship. Because of this, they can also be a victim of substance abuse.

Therefore, when it comes to the treatment of dependent personality disorder, the prime focus should be on not giving them the care and protection that they seek in others, but helping them to become self-dependent when it comes to taking their own decisions and taking control of their relationships.

According to the Diagnostic and Statistical Manual of Mental Disorders, which is a manual referred worldwide to diagnose mental disorders, a person needs to have at least 5 of the given signs and symptoms in order to be diagnosed as a patient of dependent personality disorder. These criteria are mentioned in the DSM IV- TR in Axis II Cluster C.

1. Inability to make decisions about one's life without being dependent on others for advice and reassurance.

2. Depending on others to take responsibility for almost all the major and minor parts of life.

3. Inability to express disagreement with others due to the fear of losing the care and support of the caregiver. (Note: Not to include reasonable and realistic fears of retribution)

4. Inability to take the initiative of things or new assignments and projects on their own, because of their lack of self-confidence, motivation, energy or judgment.

5. Tendency to go way beyond normal lengths just to sustain or obtain support and care from others, even if it involves some unpleasant actions or deeds.

6. Extensive fear of being all alone which causes a great deal of discomfort and a sense of helplessness because of the belief that the person is incapable to take care of oneself on their own.

7. In case a close relationship ends, the person immediately looks for another relationship as a means to feel protected and secure.

8. Is always preoccupied with the feeling and fear of being left alone with the responsibility to take care of oneself.

Now that we are aware of the behavior and mindset of people suffering from dependent personality disorder, it is obvious that the main goal of its treatment should be to make the individual more confident about one's capability to take care of themselves on their own.

The treatment should be able to bring in a sense of autonomy in a person so that he or she needn't depend on another person to feel secured and protected. For this there are many different approaches and therapies. These are mentioned as follows.

Psychotherapy
Psychotherapy is probably the most effective treatment option that has proved to be beneficial when it comes to treating this personality disorder. Mentioned next are a few (among the various) therapies that are used for treatment purposes.

Adlerian Therapy: In this therapy, the therapist tries to gather information about the patient's family history to help the patient set goals and perform based on their past performance in certain situations. These goals are set with a motive to encourage the patient to feel equal in the society.

The therapist and the patient work together and set goals that are neither too easy nor too difficult for the patient to achieve. These goals are set keeping in mind their marital life, social lifestyle, parenting style and even their involvement in substance abuse. It is a teamwork among the therapist and the patient to achieve these goals.

Cognitive Behavioral Therapy: This therapy helps the person overcome certain behavioral issues and beliefs, which are the prime reason behind the condition. An example for the same would be the belief that they cannot take independent decisions in life.

Various approaches like coaching, relaxation techniques, self-management and control, cognitive restructuring are used, to name a few! The main goal of this therapy is to focus on restructuring one's behavior making the patient believe that the abnormal behavior was a result of incorrect learning.

Reality Therapy: As the name suggests, this therapy helps the patient focus on reality and enables them to be self-sufficient to live in the real world. The therapist analyzes as to when and why does the patient act in a certain way and also makes the patient evaluate the same.

This helps the therapist make the patient understand and challenge him or her to face reality in a much more effective and confident manner.

Gestalt Therapy: The main focus of this therapy is to help the patient realize and identify their own problems and learn how they can avoid being a victim of these problems. The patients are made aware of their personal responsibilities.

Awareness and positive enlightenment is the main focus of this therapy so that the patients do not depend on others but rather take care of themselves and their family on their own.

If you have noticed, all the therapies focus on the patient to systematically realize their individual problems and work towards solving them. Group therapies and family and marital therapy wherein the focus is towards eliminating all barriers and building strong relationships, have also proved to be of great help in treating this disorder.

Medications and Drugs
Though psychotherapy is considered to be the most effective method to treat dependent personality disorder, medication can also prove to be of help in the long run.

Because people with this disorder also get into depression, antidepressants may be helpful, but they should, more or less, be avoided, as these people may get dependent on these medications resulting into drug abuse.

So this was a brief write-up explaining the psychology of such patients and how they should be dealt with. Another point to be noted is that as these patients are in constant need for support and reassurance, they may tend to complain a lot regarding their physical wellness.

In this case, both the therapist and the family members should make sure that they don't dismiss their complaints, and also make it a point that they don't encourage them as well. Like any other mental disorder, even this disorder needs to be dealt with a lot of care and caution.

You need to be extremely cautious as the slightest mistake in handling their emotions and needs can cause severe consequences like depression, anxiety, substance abuse, and low self-esteem.