Key points
- Dependent personality disorder is more common in males than people may think.
- Signs of a dependent personality may include an inability to be alone, submissiveness, and indecisiveness.
- Dependent personality is largely learned; it's a condition that often responds well to therapy that helps with unlearning it.
Annie’s new boyfriend, Jake, is physically attractive, shares similar interests, and makes her laugh. There’s also that, “I’m easy going, we’ll do whatever” demeanor; an endearing yielding of sorts to what Annie would prefer to do. This is quite a change from her previous beau who wanted to be in charge.
Annie is enjoying his company, but beginning to feel she needs a rest sometimes. If she mentions she plans to have a weekend to herself, Jake recoils and literally cries that he’d miss her. She feels torn about the relationship and called Dr. H for help. “I found out from our mutual friend that he just sits home and wonders when I’ll call; it’s like there’s little initiative to do anything on his own,” Annie explained.
“I’ve been reading about this kind of stuff in relationships,” she finished. “His getting emotional and kind of thinking I’m abandoning him makes me wonder if Jake has borderline personality?”
Putting someone on a pedestal, abandonment fears, and seeming to have little identity without their partner such as Jake did may sound like signs of borderline personality disorder (BPD). Before jumping to conclusions, however, look closely, for the BPD camouflage is thin; there’s no aggression, impulsivity, or self-destructive activity. Be careful, too, because, though BPD also carries a female stereotype, people are more apt to jump to that conclusion in a male faster than considering he may have a dependent personality. A sharp clinical eye is necessary, as it’s not unusual that the two disorders co-occur (e.g., Millon, 2011; APA, 2013).
Beware of gender stereotypes
That’s right. The dependent personality, another traditionally-feminine stereotype, is no stranger to men. Two of the most well-known dependent characters in Hollywood are Bill Murray’s character of Bob in What About Bob, and Jason Alexander’s role of George Costanza on Seinfeld.
Although there is scant current material on gender prevalence in dependent personality disorder, some earlier researchers, such as Klonsky et al. (2002), pointed to a possible 2:1 female-to-male ratio. This is seemingly much less gender disparity than one might be led to believe. Interestingly, it was noted in the DSM 4 (APA, 2000) that it was diagnosed equally amongst gender, but in the DSM 5 (APA, 2013) it is written that, while it is primarily correlated to females, some evidence exists it may be more gender-equal than thought.
In the end, Borstein (1996) likely had it right when he concluded that gender-equal numbers are quite possible, but males, for social desirability reasons, minimize dependency tendencies in interviews and inventories. We must also consider it may be missed in male patients because of therapists’ gender bias lens. Perhaps the therapist does not associate dependent personality disorder with males, and chalks up symptoms like wanting someone to do things for them as laziness, or a form of entitlement instead of an autonomy handicap. For more on gender bias in personality disorder diagnoses, see Why Personality Disorder Diagnoses Can’t Depend on Gender.
1. Inordinate discomfort in being alone
Those with a dependent personality often fasten themselves to people they see as vital. This is because they see their world through the lens of, “I’m incompetent and incapable, so I must rely on adhering myself to others, so they can care for me and make my decisions.”
This belief engenders an intense fear of being alone, as illustrated by Jake, and leads to clinging and submissive behaviors that can suffocate the people around them. When a relationship does end, the dependent person can be panic-stricken and desperately seek a new caretaker.
2. Indecisiveness
When doing couples work where a dependent personality was present, I couldn’t help but notice the chief complaint by a partner was usually, “S/he can never decide on anything.” The indecision can range from matters like whether to trade in a car, if they should take a weekend trip with a friend, to if they should work in the yard, or about what they’d like for dinner.
A wife, Jennie, once complained about her husband, Brian (names disguised) in my office: “My husband here is a big, strong construction worker; look at him! But would you guess he literally can’t tell me what he’d like for dinner? I have to make every decision except for his work schedule. I used to think he was lazy, but if I tell him what to do, he’ll do it all day.”
Experimenting with the situation, I looked at Brian and said, “I’m getting hungry myself, what do you have on your mind for dinner tonight?” So ingrained was his dependency on Jennie’s decisions, he instantly looked at her and said, “What did you take out?” Jennie shot back, “Who cares? You know I can cook anything!” then to me, “See what I deal with? I take care of two toddlers all day and another one in the evening.”
3. Yielding behaviors and lack of initiative are the norm
As demonstrated by Brian, above, those with dependent personalities often have a marked tendency to yield to others and lack initiative. This is related to the inability to make decisions in that they feel they will make a choice that will anger or otherwise disappoint their partner. They can’t afford to upset the person, for that could lead to irritation, abandonment, and, ultimately, being alone and not cared for. The irony, of course, is that, like Jennie, the partner becomes irritated by the dependent’s lack of autonomy, which ultimately spells the end of the relationship.
Couples or sex therapists can witness this lack of initiative, whereby a partner wishes their dependent personality lover to take initiative in bed and spontaneously try new things instead of always being directed. Job supervisors of people with dependent personalities may refer such employees to employee assistance programs because, though perhaps technically skilled, they struggle to work independently.
Unfortunately, this is a hard habit to let go of. The reason is, those with dependent personalities tend to grow up in environments where, as psychologist Joseph Shannon (2019) explained, independent thinking was discouraged and maybe even punished. It is clear from the start that they’re inadequate and others know better, there’s a risk of retaliation, and, “so long as I seek others’ leads it will please them, they’ll want me around, and I won’t be alone.”
Treatment implications
Personality disorders are complex amalgamations of inherited traits and learned behaviors, or habits; some have more of one than the other. While those with dependent personalities seem to have genetic propensities for anxiety (e.g., Gjerde et al., 2012; Palardy et al., 2013), the meat of the condition (the belief they’re inadequate and therefore must depend on others) is learned material.
Mercifully, if something is learned, it can be unlearned. Thus, dependent personality pathology responds well to cognitive-behavioral interventions (Beck et al., 2015; Shannon, 2019) and, perhaps more importantly in issues of personality, a psychodynamic-relational component. Working within both approaches can provide great results (Millon, 2011), illustrated as follows.
Therapists can be sure that the dependent person will begin to cling to them and expect direction, which is actually a good thing. This allows for working towards autonomy within your relationship, which eventually globalizes outside the office. Dr. H eventually began working with Jake. Jake’s yielding to Dr. H began with his suggestion that Dr. H decide which of the possible dates provided for the second appointment was best.
“I’m concerned about what fits best in your schedule,” Dr. H commented. “When you decide which you’d prefer, just give me a ring.” Jake realized that if he did not choose the next appointment, he’d be responsible for not having Dr. H available. Thus, therapy is a series of such exchanges fostering autonomy, along with assertiveness training and exploring how their old modus operandi was depriving them of the stable relationships they sought.
Disclaimer: The material provided in this post is for informational purposes only and not intended to diagnose, treat, or prevent any illness in readers. The information should not replace personalized care from an individual’s provider or formal supervision if you’re a practitioner or student.
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