Thursday, September 27, 2012

Dependent Personality Disorder: Therapeutic Impasse


Compass Therapy asserts that a person's personality pattern is largely responsible for the problems in living that they face. In the case of a dependent person, this pattern makes them a personal slave to those around them, and this results in hidden anxiety, guilt, and depression that drives them into therapy.

The therapeutic impasse of every personality pattern centers on the point of greatest resistance to a more rhythmic and actualizing life. For Dependent Pleasers to move beyond this impasse requires giving up the need for others' support and approval in order to develop self-support and self-approval. The success of the therapeutic alliance and treatment outcome depends upon making this transition.

The therapist does well to recognize how spouses, children, or friends take the Dependent counselee for granted and order them around. One young woman’s parents lived sixty miles away, yet left a message on her answer-machine saying, “We’ll be out of town for a week. Be sure and feed the dog in the morning and evening.” 

This demeaning treatment bewilders the love-stuck person and heaps up piles of hurt and resentment in the basement of the unconsciousness. Even so, the dependent keeps trying to put on a happy face. As one husband put it, “I just keep smiling and being a doormat.”

On the other hand, the very reason for coming into therapy often involves a rupture in their co-dependent way of life, some fresh and painful experience of rejection or abandonment in which they feel their very existence is threatened.

It is a fact of life that Dependent counselees—in order to make progress in developing serenity and personal power—will receive disapproval, the withdrawal of support, and loss of protection from unhealthy persons who have thrived on their lack of identity, especially those who are themselves stuck in narcissistic or aggressive patterns. 

Compass Therapy suggests helping counselees develop insights not only about their own pattern, but also about the manipulations of anyone who takes unfair advantage, imposes guilt trips, or causes undue duress.

Once dependent counselees begin to open up, they will pour out long-buried feelings of insecurity, anxiety, disappointment, and dejection. This is an excellent development because even though they feel like they are coming apart at the seams, in actuality they are becoming less of a stereotype and more of an individual self




Therapeutic Questions for Dependent Pleasers

The therapist can frame the characteristics that comprise the thinking, feeling, and behavior of Pleaser-patterned counselees as questions, reflections, or interpretations designed to help them gradually understand and differentiate their core selves from the constraints of the pattern:
  • Are you aware of an inner need to take care of others and make them feel loved?
  • Whenever there is an argument do you automatically take a peacekeeping role?
  • When you were growing up, did you feel responsible for making your parents happy?
  • Were you discouraged from assertive behavior in the name of being a “good boy” or “good girl?”
  • When faced with a decision do you usually worry about what other people will think?
  • Do you feel guilty about spending time and money on yourself?
  • Do you feel happy if people are approving of you—and sad, guilty, and anxious if they don’t?
  • Do you have difficulty in understanding people’s motives, especially if they take advantage of you? 
  • If someone compliments you, do you play it down and quickly forget it?
When the therapist stands in strong support of former people-pleaser counselees, they can draw courage to stand up for themselves, discover their authentic wants and needs, and negotiate more successfully with reality.

An effective book for Dependent Pleasers to read while in therapy: