The DAD dependent spectrum and the SPH histrionic spectrum personalities stand out from other personality patterns due to their strong need for social approval and affection. They tend to prioritize the desires of others and adapt their behavior accordingly. These personalities have their “centers of gravity” in others, rather than in themselves. They constantly seek support and affection, and may deny their own thoughts and feelings that could potentially displease others. They avoid prioritizing their own needs for fear of being seen as undesirable by others. When alone, they may feel empty or lost, and require repeated reassurances that they will not be abandoned. They are highly sensitive to disapproval and may be deeply distressed by any form of disinterest or criticism.
However, there are notable differences between DAD spectrum dependents and SPH histrionics. DAD personalities tend to adopt a passive stance, relying on others to guide their lives, and encouraging them to take the initiative in arranging their life circumstances and providing nurturing and protection. DAD spectrum personalities, regardless of whether they exhibit mild, moderate, or severe traits, often require others to manage their lives.
On the other hand, SPH spectrum histrionics are active and take the initiative in arranging and modifying the ecological circumstances of their lives. Their primary focus is on eliciting attention and approval from others through their own behavior. They do not passively wait for others to shape their lives as seen in DAD spectrum dependents. Unlike DAD spectrum personalities, SPH histrionics do not cling or seek nurturance, but rather actively work towards securing attention and approval to avoid disinterest and abandonment. Despite initial appearances, SPH histrionics possess the will and ability to take charge of their lives.
However, despite their active approach, SPH histrionics often struggle with deep-seated insecurity and uncertainty about their desirability and true sense of being loved, in contrast to DAD spectrum dependents. (Millon 2011 288)
The DAD and SPH are particularly worth comparing as both are characterized by an imbalance between a high other and low self polarity. Both see others as the primary source of good in their lives, but they vary in whether they pursue (SPH) or wish for (DAD) the desired relationships.
DAD personalities generally tend to have a tendency to denigrate themselves and their accomplishments. Their self-esteem largely relies on the support and encouragement of others, as they are unable to draw on themselves as a major source of comfort and gratification. They passively arrange their lives to ensure a constant supply of nurturance and guidance from their environment. However, this exclusive reliance on external sources for support leaves them vulnerable to the whims and moods of others, and losing the affection and protection of those they lean on can leave them feeling exposed and empty. To protect themselves, DAD personalities quickly submit and comply with the wishes of others, or make themselves overly agreeable and cooperative to avoid abandonment.
The label “deferential” is revealing and a more fitting name for the entire spectrum may be “compliant”, as the central feature is the abdication of oneself to others.
Epidemiological studies show varying results, with meta-analyses suggesting inpatient prevalence ranging from 15% to 25%, while outpatient data indicates a lower percentage of around 10% (Klein, 2003; Oldham & Morris, 1990). Gender differences are modest, with a ratio of 2 to 1 favoring females (Bornstein, 1997). (Millon 2011 289)
The Evolutionary Polarity model provides an interpretation of the dependent personality spectrum, with major motivational elements outlined in Figure 6.1 below. Unlike some other personality spectra such as the schizoid, avoidant, and melancholic depressive spectra, the enhancement (pleasure) and preservation (pain) polarities play only a modest role in the DAD dependent personality spectrum. Instead, primary attention may be found in the other (nurturant) and passive (accommodating) polarities.
DAD dependents share with SPH histrionic personalities a major ecological commitment to seeking support, attention, and protection from others. However, there is a difference in adaptive style between the two. Dependent personalities also have a need for guidance and support from others, seeking not only nurturance and protection, but also guidance on how and when to achieve security goals. This contrasts with the active ecological style of histrionic personalities, who take action to arrange their life circumstances and make things happen. Histrionics may need others for attention and approval but are unwilling to accept the possibility of not receiving it, so they actively arrange and manipulate events. On the other hand, DAD dependents tend to entrust everything to others, being passive, loyal, trustworthy, and dependable, but lacking in initiative and competence. (294)
Figure 6.1 from Millon 2011
Table of Trait Domains of DAD Spectrum
Figure of Salience of Trait Domains in the DAD Spectrum
Expressive Emotion: Puerile: One prominent characteristic of DAD dependents is their lack of adult confidence, which is evident in their posture, voice, and mannerisms. They tend to be overly cooperative and acquiescent, preferring to yield and placate rather than assert themselves. They often avoid large social groups and noisy events, and downplay their attractiveness and achievements to avoid attention. They are often seen by others as generous and thoughtful, but at times also excessively apologetic and obsequious. Neighbors may be impressed by their humility, cordiality, and graciousness, as well as their gentle behavior.
Beneath their warmth and affability, there may be a plaintive and solemn quality, as they constantly seek assurances of acceptance and approval from others. This need for reassurance may be particularly evident during times of stress, when dependents may exhibit overt signs of helplessness and clinging behaviors. They may actively seek attention and encouragement from others, and their mood may be colored by a depressive tone. They may become wistful or mournful, and overly conciliatory and self-sacrificing in their relationships, displaying a maudlin and sentimental disposition.
Interpersonal Conduct: Submissive: DAD dependent individuals often use interpersonal behaviors to manipulate their environment and achieve their aims. They may feel inadequate and believe that they lack the skills necessary to meet their needs on their own. As a result, they may abdicate self-responsibility and place their fate in the hands of others, seeing others as better equipped to navigate the complexities of life and attain rewards.
To achieve their goals, dependent personalities learn to attach themselves to others and submerge their individuality. They may deny points of difference, avoid expressions of power, and ask for little other than acceptance and support. They may assume an attitude of helplessness, submission, and compliance, acting weak and expressing self-doubt. By displaying a need for assurance and a willingness to comply and submit, dependents may elicit the nurturance and protection they seek from others.
Dependent individuals may also avoid expressing their own opinions, preferences, or desires in order to maintain harmony and avoid conflict. They may go along with others’ decisions and opinions, even if they disagree internally, to maintain the support and approval of those they depend on. They may also excessively praise and flatter others, and seek constant reassurance and validation from them.
In relationships, dependents may be overly reliant on others for decision-making, problem-solving, and emotional support. They may avoid taking independent actions or making decisions on their own, seeking constant guidance and approval from others. They may also use guilt, passive-aggressive behaviors, or manipulation to gain attention, care, and protection from others.
Overall, DAD dependent individuals use a variety of interpersonal behaviors, such as helplessness, submission, compliance, and seeking reassurance, to manipulate their environment and arrange their relationships in a way that fulfills their need for support and nurturance.
Cognitive Style: Naïve: Dependent individuals tend to limit their awareness of self and others to a narrow sphere, staying within comfortable boundaries. They may constrict their world and avoid introspection, being naïve, unperceptive, and uncritical in their view of themselves and the world around them. They may have a Pollyanna-like approach, seeing only the “good” in things and focusing on the pleasant side of troubling events.
Dependents may avoid confronting or acknowledging difficulties or challenges that arise in their lives. They may have a tendency to minimize or dismiss problems, and may not fully recognize or address negative aspects of their own behavior or relationships. This lack of introspection and self-awareness may contribute to their ongoing dependence on others for support and decision-making.
Dependent individuals may also have a positive bias, focusing primarily on the positive aspects of people and situations, while ignoring or downplaying negative aspects. This can result in a tendency to idealize others and view them as capable and trustworthy, even if they may not be. This naivety and uncritical view of others may make them more susceptible to manipulation or exploitation by others.
Overall, dependent individuals may limit their awareness of self and others, staying within comfortable boundaries and avoiding introspection. They may have a tendency to be naive, unperceptive, and uncritical, focusing on the positive aspects of people and situations, which can contribute to their ongoing dependency on others.
Self-Image: Inept: Dependent individuals tend to view themselves as weak, inadequate, and fragile when feeling alone or abandoned. They often see themselves as incapable of doing things on their own without the support or guidance of others. They lack self-confidence and tend to belittle their own competencies, beliefs, and achievements. They may prefer to portray themselves as of limited value to others because it results in fewer demands being placed on them, allowing them to solicit the support and protection they desire.
Dependent individuals may also see themselves as considerate, thoughtful, and cooperative, but may have marked feelings of personal inadequacy and insecurity upon closer examination. They tend to downgrade themselves, claiming to lack abilities, virtues, and attractiveness. They may magnify their failures and defects, and minimize their accomplishments and attributes when comparing themselves with others. They may assume personal blame for problems they feel they have brought on others.
This pattern of self-deprecation may serve as a strategy for dependent individuals to elicit reassurance and validation from others. By portraying themselves as unworthy and unlovable, they may seek praise and commendation from others to alleviate their feelings of inadequacy and insecurity. This behavior may be a way for dependents to gain external validation and assurance of their worthiness, and to maintain the support and protection of others in their environment.
Intrapsychic Content: Immature: The inner world of dependent individuals’ representations of significant others is often characterized as childlike or even infantile. Their intrapsychic world is composed of unsophisticated ideas, incomplete recollections, and rudimentary aspirations. They tend to see others as they may have been years before, such as how their parents were when they were children. Unlike other personality types who hold mixed images of the past, with subsequent experiences giving them a sense of completeness, dependents tend to have a fixation on the past, with prominence given to more youthful impressions.
Dependent individuals feel the need to be more than just childlike in order to secure and retain their hold on others. They strive to be admiring, loving, and willing to give their all. By internalizing the role of the totally submissive and loyal, they seek to evoke consistent care and affection from others. Most dependents have learned through parental models how to behave affectionately and admiringly, and they possess an ingrained capacity for expressing tenderness and consideration, which are essential elements in holding on to their protectors.
Dependent individuals have also learned the “inferior” role well, and they are able to provide their “superior” partners with a sense of being useful, sympathetic, stronger, and competent – precisely the behaviors that they seek in their mates. They have learned interpersonal strategies that succeed in achieving the goals they seek, drawing from various sources to maintain their dependent position and evoke the care and support they desire from others.
Intrapsychic Architecture: Inchoate: The dependent personality type often relies on others to handle life’s challenges and responsibilities. This reliance on external sources leads to underdeveloped coping abilities and a lack of diverse regulatory controls within their intrapsychic world. They may borrow competencies through introjection or have rudimentary coping abilities that are not well-differentiated.
While dependents may function adequately when closely connected to others who can “function” for them, they are often ineffective when coping on their own. They may engage in behaviors that convey weakness and inferiority to avoid assuming responsibilities they feel burdened by. Self-deprecation may be used as a strategy to evoke sympathy and attention from others, which can temporarily alleviate their guilt. Dependents may deny or rationalize their inadequacies, attributing them to external circumstances or physical illness, and may restrain assertive impulses to prevent criticism and rejection.
Dependents are often socially affable and good-natured, which helps them avoid social deprecation and maintain a positive image of themselves. They may indulge in a gentle and tolerant attitude towards themselves, covering up their self-condemnation with a Pollyanna-like tolerance of their own failures, similar to how they dilute the shortcomings of others with a saccharine attitude. They strive to maintain a balance between moderate and severe self-deprecation to preserve their sense of equilibrium.
Mood/Temperament: Pacific: Dependents tend to exhibit warm, tender, and noncompetitive behavior when things are going well in their lives. They may shy away from social tensions and interpersonal conflicts, possibly due to high oxytocin levels in their brains, which are associated with social bonding and positive emotions. However, when they face rejection or abandonment, they may seek counseling or therapy.
Underneath their initial veneer of positivity, these troubled dependents may no longer experience joy in life. Once they let their guard down, they may report deep feelings of insecurity, pessimism, discouragement, and dejection. They may no longer be able to hide their suffering and may express their underlying insecurities through gloomy emotions and tears. Previously, they may have felt the need to appear pleased and content with life, but when faced with adversity, their true emotions may come to the surface.
Intrapsychic Dynamics: Introjection/Denial: Dependent individuals may struggle with feelings of inadequacy and fear of being alone. To cope with these fears, they may engage in introjection, which is a process of internalizing the beliefs and values of another person, often imagining themselves to be one with, or an integral part of, a more powerful and supportive figure. By aligning themselves with the competencies of their partners, they can avoid the anxieties triggered by their own perceived lack of abilities. This process allows them to feel uplifted by illusions of shared competence and find solace in the belief that the attachments they have formed are strong and inseparable through incorporation.
They also often rely on denial mechanisms as part of their defensive style. This can be seen in their tendency to adopt a Pollyanna-like mindset, where they try to downplay or ignore interpersonal strain or discomfort. They may use excessively sweet or accommodating speech to avoid conflict and may go to great lengths to cover up or smooth over any troublesome events. They are particularly sensitive to their own hostile impulses and quickly push them away, as they fear that such feelings may jeopardize their security and acceptance. They may respond to any perceived transgressions with a burst of contrition and self-debasement to seek forgiveness and maintain their relationships. (297-298)
Variants on the DAD Spectrum
The individuals who fall under the DAD spectrum have been found historically in various traditional cultures. These individuals are expected to play subordinate roles, act in a self-abnegating manner, and publicly exhibit low self-esteem. Even in Western culture in the early 21st century, there are settings where women are still expected to play inferior and subjugated roles.
With the advent of the feminist movement, women have made important strides in rejecting the status of second-class citizens and advocating for gender equality. However, there are still many parts of the world, particularly in undeveloped regions, where the cultural norm is to deferentially minister to the wishes of men. This pervasive cultural style of subordination and dependence remains prevalent in certain societies despite progress in other areas. It highlights the complex and varied ways in which cultural norms and gender roles continue to impact individuals with DAD traits in different parts of the world. (299)
Altruistically Deferential Personality: The first personality variant on the DAD spectrum is characterized by individuals who primarily seek to be attractive and pleasing to others in order to become close to significant others. They aim to be captivating and appealing through well-intentioned behaviors, striving to be congenial, faithful, comely, and fetching with the hope of being needed and desired by others. They are highly attentive to how others react to them, seeking abundant reciprocal appeal and affection.
The altruistic intent of these individuals is genuine, as they genuinely want to do useful and good things for others, and provide helpful services to enhance their existence. Generosity and charity are central to their sense of self and everyday aspirations. They extend themselves to others in the hope that their magnanimity and unselfishness will be returned. They focus on the positive attributes in others, preferring to ignore their deficits and unattractive traits, hoping that others will do the same for them. This may stem from their early family relationships where they learned to be nurturing and altruistic as a way to gain acceptance and security from supportive parental figures.
Many of these individuals have deeply embedded reservoirs of affection and goodwill, leading to a generalized attitude of philanthropy and helpfulness towards others. They readily attune to the needs and welfare of others, express empathic compassion, and are willing to be considerate and charitable to those who are suffering. They are accepting and non-judgmental, seeking ways to encourage others to be the best version of themselves. Many of them may become benevolent and compassionate social leaders, using their warmth and generosity to inspire and motivate others to actualize their potentials.
However, these individuals are constantly looking for signs of acceptance in their relationships, and may become frantic in their efforts to elicit favorable responses. If they are unable to receive the desired recognition and appreciation for their acts of empathy and caring, they may be hesitant to ask for what they need from others. This can lead to overextending themselves, becoming exhausted and disorganized in their efforts to please everyone. They may experience brief breakdowns and physical ailments as a result of unrequited efforts, claiming that their suffering stems from their beneficence and unselfishness. (300-301)
Accommodatingly Deferential Personality: The behavior of a accommodatingly deferential person can be best characterized by submissiveness and a reliance on others for affection, nurturance, and security. The fear of being abandoned often leads to excessive compliance and obliging behavior. Some individuals with this personality style may cope by being socially gregarious and superficially charming, seeking attention and engaging in self-dramatizing behaviors. These individuals can be compared with “Appeasing Sociables” as they are quite similar. They have a natural ability to placate and concede, exhibiting gregariousness, charm, and self-dramatization as normal variants of the histrionic personality style. Both accommodatingly deferentials and appeasing sociables are gracious, neighborly, benevolent, and eager to please, displaying obliging and agreeable behavior in their relationships with others. However, what sets them apart is the strong tendency of the accommodating personality style to be self-sacrificing and adopt a submissive role, even portraying themselves as inferior and subordinate to others. This amalgamation of the dependent and masochistic personality styles is often evident in these individuals. (301)
Deferential personalities may sometimes slip into more pathological variants. In some cultures, there are established acceptable roles for individuals at the normal Deferential level, and thus few may deteriorate to the Attached level. Even if they do, they might be tolerated as they provide a perceived useful submissive function in relation to others. (303)
Childlike Attached Personality: The concept of maturation and development is complex and varies among individuals. It is not necessarily a predetermined course that follows the same timeline for everyone. Some individuals may mature faster or slower in certain areas, and not all individuals may mature in all aspects of their functioning to the same level.
In the intellectual realm, for example, some individuals may show extraordinary talent in certain areas like mathematics or music from a very early age, while others may struggle to achieve even modest levels of accomplishment in the same areas throughout their lives. Individual differences in the level and rate of maturation are common across all domains of attributes.
Similarly, in the realm of adult characteristics and capabilities, there are individuals who may prefer and engage in childlike activities, find satisfaction in relating to children, and may seem incapable of or averse to activities that are commonly associated with adulthood. These individuals, referred to as “childlike attached personalities,” may exhibit immature, undeveloped, and inexperienced traits. They may prefer to remain oriented to the world of childhood and adolescence, finding comfort in a more tranquil existence without the demands, strivings, competition, and responsibilities of adulthood.
There could be various reasons for these preferences, such as constitutional predilections or early life experiences that reinforced a preference for a childlike existence. Some individuals may lack ambition, energy, or autonomous behaviors, making the expectations of adulthood overwhelming and frightening. Others may have overly passive and easygoing personalities, lacking confidence in assuming adult roles and responsibilities. Gender identity may also play a role, with some individuals lacking a strong gender identity and finding the assumption of adult roles distasteful or frightening.
It’s important to note that these individuals may generally be pleasant and sociable, as long as they are allowed to remain in their pre-adult preferences and activities. However, their behaviors may be seen as signs of irresponsibility and neglectfulness to others, such as troubled parents or spouses who may expect them to “mature” and assume adult responsibilities. It’s essential to approach these situations with understanding and empathy, recognizing that maturation and development can vary among individuals and may not always follow societal norms or expectations. (303-306)
Selflessly Attached Personality: Selflessly attached personalities are individuals who not only subordinate themselves to others, a characteristic shared by other dependent personalities, but go a step further by merging themselves completely with another person or institution, losing their own identity in the process. They willingly give up their sense of self as independent individuals in order to gain a sense of significance, identity, emotional stability, and purpose in life through their attachment. As this process of total identification with another becomes established, these individuals fail to develop their own distinctive potentials. Their own sense of self becomes less significant, and whatever they do is done primarily in service of extending the status and significance of the person or institution they are attached to. They may deny or dissociate from any impulses and potentials that might have existed for them as independent persons, and instead fully merge with the other, as if they have no self of their own, becoming non-beings except for their coupling with another person. Their existence is not denied, but rather becomes an extension of the person or institution they are now a part of. They may exhibit confidence and self-assurance, but only as it reflects the achievements and powers of the person or institution they are identified with. They have not lost their sense of self-worth, but rather have acquired and assumed the qualities of the person or institution they have identified with.
Many selflessly attached individuals feel fulfilled by their attachments. They willingly submit to the values and beliefs of their significant attachments, and their sense of being depends on it. The more they are fused with the idealized object, the more emotionally attached they become, and the more they feel that they exist as persons with significance in the world. For example, some mothers may live solely for their children or completely immerse themselves in the lives of their husbands. Although they may have gone to extremes in their identifications, losing too much of themselves in the process, these selfless dependents feel vitalized and valuable by giving themselves fully to others and embracing the actions and values of another, displacing their own selves for the sake of the other person.
Due to the insecurities that result from their loss of self and the vulnerable position they have placed themselves in, these dependent personalities are likely to have acquired some features of the depressive personality. Even though no actual loss may have occurred in the past, these dependents have learned to live on the edge of such possibilities. They may experience the loss and consequent hopelessness that would ensue from such an eventuality, and elements of a depressive character may have infused into their basic dependent style, interjecting expectancies and reactions that would have occurred had these losses become a reality. (306-307)
Attached personalities may regress to a pathological level, especially in cultures or ecological habitats that actively reject submissive and pacific personalities. Clinical dependency is likely to exist in environments where there have been significant personal losses or serious family complications, which can exacerbate the symptoms of dependent personality disorder.
Research has shown that certain personality types tend to overlap or coexist with dependent personality disorder. Statistical cluster studies have provided evidence to support this observation. Additionally, the pathogenic background of the various dependent personality disorder spectrum variants may also contribute to differences in patterns of occurrence and severity of symptoms. (307)
Ineffectual Dependent Personality: The ineffectual dependent personality shares similarities with the languid schizoid. Both styles exhibit a general lack of vitality, low energy level, fatigability, and a weakness in expressiveness and spontaneity. It is not uncommon to see that ineffectual dependents may reflect a mixture of both dependent and schizoid characteristics.
However, there are differences between the two. The languid schizoid type is deficient in motoric and affective expression, and their thought processes may appear unfocused, particularly in interpersonal matters. They may exhibit persistent aloofness from social interactions due to anhedonic temperament, lacking interest or pleasure in social activities.
On the other hand, ineffectual dependents do not want to be isolated from close personal relationships. They may seek closeness and care, but lack the drive and staying power to pursue solutions to problems. They may also exhibit deficiencies in adult-like skills and may be unwilling to tackle even minor problems. (307)
Disquieted Dependent Personality: The disquieted dependent is a subtype of dependent personality that may be prevalent in institutional settings where people are sustained in a dependent and parasitic state by institutional rewards and requirements. They may exhibit behavior characterized by submissive dependence, self-effacement, and noncompetitiveness. They rely on others for guidance and security, and assume a passive role in relationships.
However, unlike other dependent types, the disquieted dependent also exhibits intense apprehensiveness and fearfulness, which overlay a lack of initiative and anxious avoidance of autonomy. This subtype reflects a combination of dependent and avoidant personality styles. Some of the distinctive features of disquieted dependents may include restlessness, being easily disconcerted and fretful, experiencing a general sense of dread and foreboding, and being apprehensively vulnerable to fears of abandonment and loneliness unless they are near nurturing figures or accessible to supportive institutions.
Disquieted dependents are highly dependent, needing attention and support from others to maintain their emotional balance, and being particularly vulnerable to separation from those who provide support. They may express their tensions through outbursts of anger towards others for failing to appreciate their needs for security and nurturance, which can undo the very security they seek.
In addition to their apprehensiveness, disquieted dependents may also exhibit a pattern of withdrawing from social encounters and building a defensive armor to dampen excessive sensitivity to rejection. They may experience loneliness, isolation, and emotional dysphoria, with underlying feelings of anxiety, sadness, and guilt. Despite their efforts to be pleasant and agreeable, they may still feel tension and emotional distress. They may also have a persistent search for support and reassurance, expressing complaints of weakness and easy fatigability, which may reflect an underlying mood of depression.
Due to past experiences of rebuff and fears of isolation, the disquieted dependent may continue to exhibit clinging helplessness and struggle with simple responsibilities, feeling that life is empty but heavy, and experiencing pervasive anxiety and fatigue. (307-308)
Rather than taking a screenshot of a zoomed out PDF, I’m going to just embed the PDF in the page here. When I’m done with this part of the series, I’ll post the whole table.
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