Dependency, often confused with dependent personality disorder (DPD), is a broader term. It's defined by a person's reliance on relationships for their sense of self and identity, often featuring excessive clinginess, neediness, or paradoxically, extreme independence as a defence mechanism. Dependent personalities might view themselves as inadequate while perceiving others as competent.
Dependency is both an internal personality trait and an interpersonal phenomenon, marked by low self-esteem, feelings of unworthiness, unimportance, incompetence, and inadequacy. Due to clinginess, neediness, and the need for constant reassurance, some dependent individuals can inadvertently push people away rather than strengthen relationships.
Dependency is also associated with numerous co-occurring mental health disorders, symptoms, and experiences, such as anxiety, depression, eating disorders, codependency and codependent relationships, physical illness, a sense of meaninglessness and purposelessness, hopelessness, abusive relationships (Bornstein, 2012; Loas et al., 2011) or relationships where a person is used or uses others, substance abuse, and addiction. The development of dependency is associated with permissive and authoritarian parenting styles and often accompanies parentification.
On the other hand, dependent personality disorder (DPD) is a distinct personality disorder characterised predominantly by dependency. DPD involves a person being clingy or needy and relying on others not only to sustain their sense of identity but also practically. It often comes with feelings of being unable to take care of themselves. DPD is characterised by anxiety and fear, mainly revolving around the person's fear of separation and abandonment. An individual with dependent personality disorder will usually feel uncomfortable being alone, fear being unable to care for themselves, and need others to take control of their life.
Characteristics of Dependency and Dependent Personalities
Dependency is characterised by a person's sense of self, self-worth, and identity depending on their close relationships. One of the core characteristics of dependency is the dependent person's tendency to cling in relationships. However, because of their clinginess and neediness, their inability to make decisions independently, and their need for reassurance, dependent individuals may paradoxically alienate others rather than strengthen their relationships (Bornstein, 2005).
Dependency presents itself both as a personality trait—a feature of a person's internal world, their sense of self and identity—as well as an interpersonal phenomenon.
As a personality trait, dependency is characterised by a lack of identity, low self-esteem, experiences of unworthiness or worthlessness, perception of oneself as incompetent, impotent, small, insignificant, and unimportant. Fears of separation and abandonment are central to dependency, as well as feelings of helplessness, hopelessness, despair, meaninglessness and purposelessness, loneliness, or aloneness (Zivkovic, 2023). Dependent individuals may find it challenging to cope with the responsibilities of adult life and may feel inadequate, as though they are children in an adult world.
Interpersonal dependency or dependency in relationships, however, may manifest itself as clinginess, neediness, and a tendency to accommodate others, as mentioned previously. Dependent individuals tend to be more submissive, subservient, and avoid confrontation. Any prospect of conflict may evoke anxiety and discomfort, and similar reactions may occur with expressions of anger and discontent. They often struggle to identify their own preferences and tend to adopt the opinions and tastes of others. They seek others' approval and engage in relationships by pleasing others and attending to their needs—often at the detriment of themselves. If they eventually express and meet their own needs, they may feel guilty, ashamed, or selfish.
Between Engulfment and Freedom
Depending on the level of severity of dependency, dependent individuals may also be confused about their own identity and who they are unless they find themselves through their relationships. To escape this feeling of confusion about their identity, they may 'lose themselves in relationships' in order to attain a sense of self. While this helps them gain a more coherent sense of self, the identity they adopt is not their own but a reflection of those they are in relationships with.
Over time, they may experience this as relinquishing their identity, which could evoke feelings of engulfment and having their freedom taken away, as well as a sense of being controlled by others.
This means that, over time, what initially caused them to lose themselves in others, in the attempt to gain a sense of self, may become a threat to their individuality and evoke them to rebel against it.
It is because of this internal conflict that those with dependent personalities will often find themselves in a perpetual loop of clinging and distancing in relationships. They will try to strike a balance between just enough engulfment to retain a sense of individuality and just enough freedom to not feel abandoned and alone.
Unfortunately, it is often only in psychotherapy that they may learn that the notion of finding the right balance is a fantasy itself. The way out of this conflict lies in resolving the underlying dependency, so they can ultimately sustain their individuality in close relationships without losing themselves. They will also have the capacity to be alone without feeling abandoned and rejected.
Intertwining Between Relationships and Identity
Because dependent individuals rely on their relationships to attain a sense of self, an experience of attachment in relationships makes them feel good about themselves, gives them a sense of stability and grounding, favourably influences their self-esteem and a sense of self-worth, and provides them with an experience of security, safety, and continuity in their life.
However, once a relationship is threatened or ruptured, the underlying negative feelings about themselves may emerge, along with depression, feelings of confusion, abandonment, aloneness and loneliness, despair and hopelessness, meaninglessness and purposelessness, or feeling lost.
Origins of Dependency
Dependency is associated with overprotective and authoritarian parenting styles (Bornstein, 2005), whereby the child is infantilised and treated as incompetent and incapable, which in turn means that parents tend to apply more control and protection. This evokes feelings of inadequacy, incompetence, and anxiety about the adult world and adult responsibilities.
Dependency is also, similar to parentification, associated with reversed roles and reversal in parent-child need fulfillment. This means that the parent imposes their own needs over the child and expects the child to meet their needs rather than the parent meeting the child's inherent developmental needs. Because of this process, the child becomes dependent on pleasing the parent and meeting their needs, while disregarding their own. This leaves the child without a proper environment to develop their identity and individuality. The child is, conversely, stimulated and motivated to remain infantile forever and is not encouraged to separate and individuate.
We often see individuals who had parents that battled chronic illness, disability, alcohol or substance abuse, or mental health issues develop dependent personalities as their need fulfilment is diverted away from themselves and focused on their parent.
Dependency is also strongly associated with childhood trauma and childhood abuse (Bornstein, 2015; Hill et al., 2000), resulting in re-enactments of abuse in the form of partner and child abuse (both for perpetrators and victims) in adulthood (Bornstein, 2012, 2019).
Other Co-Morbid Mental Health Issues
Dependency is often accompanied by numerous mental health disorders and issues, such as higher rates of suicidality (Bornstein, 2012), eating disorders (Bornstein, 2001), physical illness (Bornstein, 1994), anxiety, depression, and self-harm. It is also an underlying personality feature in personality disorders (Bornstein, 1998) and is especially prevalent in borderline personality disorder (BPD) (Bornstein et al., 2019) and certain types of narcissistic personality disorder (NPD).
Excessive Independence or Excessive Self-Reliance
Excessive independence is a form of dependency where the dependent individual denies any dependency needs they may have for others and actually attributes (projects) those needs to others. They may perceive others as needy and dependent whilst considering themselves completely self-sufficient and not needing anyone.
Such individuals usually form codependent relationships where they provide care for overtly dependent individuals while their own needs remain unmet. They may end up in professions based on caring for others or commit their life to taking care of needy family members.
These individuals may resent the neediness they see in others; however, they won't be conscious of their own dependency, which motivates them to engage in relationships where they are needed, safeguarding them against being abandoned.
Dependent Personality Disorder (DPD)
Dependent personality disorder (DPD) is a type of personality disorder characterised by strong dependency. The main characteristics of DPD are:
Fear of separation and experiences of abandonment in failed or ruptured relationships.
Inability to make decisions without seeking advice or reassurance from others.
Avoidance of responsibility and transferring life decisions onto others.
Fear of conflict due to fear of rejection.
Difficulties committing to projects, hobbies, academic or professional engagements, and romantic relationships.
Excessive need for approval and support from others, which may lead the person to engage in unwanted activities solely for others' benefit.
Inability to be alone and feeling incapable of self-care.
Immediately engaging in another relationship after one ends, especially romantic relationships but also other close relationships.
Excessive fears of ending up alone.
Ales Zivkovic, MSc (TA Psych), CTA(P), PTSTA(P), Psychotherapist, Counsellor, Supervisor
Ales Zivkovic is a psychotherapist, counsellor, and clinical supervisor. He holds an MSc in Transactional Analysis Psychotherapy awarded by Middlesex University in London. He is also a Provisional Teaching and Supervising Transactional Analyst (PTSTA-P) and a Certified Transactional Analyst in the field of Psychotherapy (CTA-P). Ales gained extensive experience during his work with individuals and groups in the UK National Health Service (NHS) and his private psychotherapy, counselling, and clinical supervision practice in central London, UK. He was also a member of the United Kingdom Council for Psychotherapy (UKCP). Ales works with individuals, couples, and groups. In clinical setting, he especially focuses on the treatment of issues of childhood trauma, personality disorders, and relationship issues. A large proportion of his practice involves online psychotherapy as he works with clients from all over the world. Ales developed a distinct psychotherapeutic approach called interpretive dynamic transactional analysis psychotherapy (IDTAP). More about Ales, as well as how to reach him, can be found here.
References:
Bornstein, R. F. (1994). ADAPTIVE AND MALADAPTIVE ASPECTS OF DEPENDENCY: An Integrative Review. American Journal of Orthopsychiatry, 64(4), 622–635. https://doi.org/10.1037/h0079563
Bornstein, R. F. (1998). Dependency in the personality disorders: Intensity, insight, expression, and defense. Journal of Clinical Psychology, 54(2), 175–189. https://doi.org/10.1002/(SICI)1097-4679(199802)54:2<175::AID-JCLP7>3.0.CO;2-R
Bornstein, R. F. (2001). A Meta-Analysis of the Dependency-Eating-Disorders Relationship: Strength, Specificity, and Temporal Stability. Journal of Psychopathology and Behavioral Assessment, 23(3), 151-. https://doi.org/10.1023/A:1010913203679
Bornstein, R. F. (2005). The Dependent Patient: Diagnosis, Assessment, and Treatment. Professional Psychology, Research and Practice, 36(1), 82–89. https://doi.org/10.1037/0735-7028.36.1.82
Bornstein, R. F. (2012). Illuminating a Neglected Clinical Issue: Societal Costs of Interpersonal Dependency and Dependent Personality Disorder. Journal of Clinical Psychology, 68(7), 766–781. https://doi.org/10.1002/jclp.21870
Bornstein, R. F. (2019). Synergistic Dependencies in Partner and Elder Abuse. The American Psychologist, 74(6), 713–724. https://doi.org/10.1037/amp0000456
Bornstein, R. F., Becker-Matero, N., Winarick, D. J., & Reichman, A. L. (2010). Interpersonal dependency in Borderline Personality Disorder: Clinical context and empirical evidence. Journal of Personality Disorders, 24(1), 109–127. https://doi.org/10.1521/pedi.2010.24.1.109
Hill, E. L., Gold, S. N., & Bornstein, R. F. (2000). Interpersonal Dependency Among Adult Survivors of Childhood Sexual Abuse in Therapy. Journal of Child Sexual Abuse, 9(2), 71–86. https://doi.org/10.1300/J070v09n02_05
Loas, G., Cormier, J., & Perez-Diaz, F. (2011). Dependent personality disorder and physical abuse. Psychiatry Research, 185(1), 167–170. https://doi.org/10.1016/j.psychres.2009.06.011
Zivkovic, A. (2023). Dependent Personality and Interpersonal Dependency: At the Intersection of Developmental, Identity and Interpersonal Aspects. British Journal of Psychotherapy, 39(1), 212–231. https://doi.org/10.1111/bjp.12802
Related Posts
