DEPENDENT PERSONALITY DISORDER EXPLAINED
Dependent Personality Disorder is one of the personality disorders that regularly rears its head in criminal events, even though it is one of the lesser-known personality disorders in the Diagnostic and Statistical Manual of Mental Disorders or DSM V as it is commonly known. Personality disorders are generally defined as having personality traits that are persistent, inflexible and maladaptive.
For behaviour to be classed as a personality disorder there must be significant, long term, functional impairment or subjective distress. Dependent Personality Disorder is one of a group of psychological conditions known as Anxious Personality Disorders which are characterised by feelings of nervousness and fear as well as submissiveness, helplessness, a need to be taken care of, needing constant reassurance and an inability to make decisions.
A Dependent Personality Disorder (DPD) exists when a person’s behaviour is clinging and submissive and they show an excessive need to be looked after. In determining excessive need, the developmental and functional level of the individual must be considered. Obviously a child or adolescent will have a greater need to be taken care of than an adult. People who suffer from DPD find it difficult to make even simple, everyday decisions like what to wear or what to eat. They are generally passive and seek out people to take over the responsibility of most areas of their lives. The key trait or factor in DPD is that the person is happy to give the total decision making responsibility over to a third person. Additionally they become extremely anxious whenever autonomous behaviour is required or necessary. Because they fear the loss of support more than anything, they find it very difficult to express disagreement. The individual may also feel totally helpless when alone rendering them unable to care for themselves. Although this fear is unrealistic it regularly becomes debilitating and can result in poor hygiene, diet and health care. In severe cases this can become life threatening. People suffering from DPD often fail to take on new projects because of exaggerated fears of inadequacy rather than from lack of motivation.
DPD sufferers have a very strong fear of abandonment. They react to this threat with submissiveness and appeasement. DPD is further characterised by feelings of inadequacy and a need for reassurance.
In DPD the individual actively seeks and maintains connections to those on whom they are dependent. Although a strong need for approval is found in people suffering from DPD they do not actively demand this approval unlike those with Histrionic Personality Disorder. It is important to note that in DPD dependence is focused solely on one person, a parent, spouse, or some other person with whom the individual has a close personal relationship. Obedience to that person’s wishes is commonly observed. Where the person with DPD loses the person on whom they are dependent, they will immediately begin to seek a replacement as they are essentially incapable of functioning independently.
People suffering from DPD are often incapable of identifying problems. People close to them such as a husband or a supervisor at work, often identify their shortcomings before they do so. This frequently results in them being unable to function properly in the workplace, where independent thought and the identification and resolution of problems is often a necessary. They are also prone to procrastination and are slow to take action. As a result their job performance suffers and employers become exasperated with them. Personal relationships also suffer in that the constant needs of the DPD person my become suffocating to the person on whom they depend. DPD sufferers often remain unaware of their problem even when it leads to divorce or the loss of employment.
DPD is a frequently diagnosed disorder with a best estimate being that approximately 2% of the population being affected. It is equally common in men and women. DPD onset usually occurs in early to middle adulthood. There are many theories to explain the origins of DPD. These theories all share the common theme that an overbearing, dominating parent is often present. Research has established a strong correlation between shame and DPD. Researcher Alice Miller indicated that she has observed numerous examples of DPD in children where one parent exhibits a narcissistic personality disorder. Further research is needed in the field.
THE DEPENDENT PERSONALITY AND CRIME
DPD sufferers become emotionally dependent on other people, spending vast amounts of energy trying to please them. Because of this they are very easy to manipulate and often find themselves exploited by criminal partners. They regularly become victims of sadistic, narcissistic or anti-social partners with criminal tendencies. They are easy targets for criminal predators who seek out vulnerable people with remarkable skill. Once involved, people with DPD often remain in relationships where they are raped, tortured and abused by their partners because they fear the loss of the relationship more than the pain they are enduring. Because they are so easily controlled and influenced, they often find themselves becoming either partners in crime or accessories to dangerous criminals, who rope them in to do their bidding, and later sacrifice them as the patsy in order to escape prosecution. DPD sufferers will forfeit their own ethical and moral boundaries in order to gain admiration and praise from the person on whom they are dependent. In the case of Cezanne Visser, she followed every command issued to her by her lover Dirk Prinloo in order to please him, even though as a young advocate she knew her actions were illegal and immoral. Furthermore she sought out new ways to please him in the procuring of the young victims for him to sexually abuse.
She denounced her God while having sex with him on the altar of a church even though she had had a fairly religious upbringing and professed to be a Christian. Furthermore people with DPD will sacrifice anyone in order to keep their partner happy. Visser even drugged her own mother and allowed Prinsloo to rape her on two separate occasions, because this was his fantasy.
At the moment there is a case in South Africa where an entire family was held hostage by a man. He abused and tortured his wife and his children for many years. The wife is being prosecuted as an accomplice to the crimes he committed against the children who have been sexually exploited as well as physically and psychologically abused for years. The children have never left the familial home and have never been to school. In my opinion the mother of these children once evaluated may very well present with traits of DPD. She possibly feared losing her relationship with her husband more than anything else, including the safety and the well being of her children.
Because DPD sufferers fail to identify their problem they are powerless to implement any measures to counteract the exploitative partner’s manipulative behaviour and they find themselves becoming more and more deeply involved in the activities of the criminal partners on whom they are dependent.
They have a tendency to avoid taking personal responsibility for anything that happens in their lives. Once apprehended and in custody, or later in the trial when they are assessed for sentencing purposes, it often becomes clear that they simply shift the blame or justify their behaviour by pointing out that they were simply doing as they were told or trying to please the partner on whom they depend. For them this is totally normal and acceptable behaviour.
Because of their intense fear of abandonment and helplessness the thought of being alone is terrifying to them. No matter how uncomfortable their relationships become, they will seldom contemplate leaving the person on whom they are dependent. They lack the self confidence to extricate themselves from abusive or exploitative relationships and are totally devastated when their relationships dissolve or are terminated by the other party. As they lack the ability to manage their own lives they immediately begin to seek a replacement for the person they depend on. It is not unusual that the cycle continues as they time and again become involved in unhealthy and even criminal relationships.
When Visser found herself incarcerated, she simply sought out a fellow inmate in the prison and bound herself to her. She reinvented herself and became the person this woman needed her to be. Like a chameleon she took on the walk , the mannerisms and the attitude of her new “mentor”. In exchange she was taken care of and protected in prison. Now that she has been released from prison and has returned home to live with her mother, and has reverted to the dependent relationship with her mother once again.
PROGNOSIS AND TREATMENT
According to Anthony Orr, the treatment of individuals with DPD is tricky and challenging. The first thing that generally occurs is that the person places full responsibility for the result of the treatment firmly on the clinician. The primary treatment goal is to get the person to take responsibility for their actions and to be comfortable acting autonomously. A number of treatment models have been shown to be at least moderately beneficial.
Dr. Orr points out that Psychodynamic therapies using techniques similar to those used with depression have had some effect in the treatment of people with DPD. This includes transference of the dependency needs onto the therapist. Cognitive and behavioural techniques used in combination with each other has proven useful. The cognitive treatment is designed to challenge the individual’s assumptions about incompetence and helplessness. At the same time the behavioural portion of treatment is designed to teach the individual to better express their wishes in relationships.
Assertiveness training is generally used for the latter. These programs are offered in most prisons and can assist with the therapy of DPD individuals while incarcerated.
Dr Orr goes on to say that group therapy has proved useful, but the most effective treatment seems to occur when concurrent treatment is given the dominant party in the relationship. This treatment may be in the form of joint sessions with the client suffering from DPD or individual treatment. For concurrent treatment to be effective, the dominant party must accept the need. Often this is not a simple task as often the dominant party may be intractable and unwilling to participate, especially if they have criminal tendencies or have been committing criminal acts, which they do not want exposed to the therapist. Additionally if they are benefitting from the relationship with the DPD patient they may not want them to get treatment and improve.
If you know of or identify anyone as possibly having DPD, please assist in getting to either a support group or a psychologist for assistance especially if you see them associating with undesirable elements of society.
I am available to assist anyone who requires help. Expert Profiling is contactable on Tel: 390 9957 email – [email protected] or [email protected] or on Twitter @LauriePieters.
