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DEPENDENT PERSONALITY DISORDER
The central characteristic of the dependent personality disorder involves allowing others to make the major decisions, to initiate the important actions, and to assume responsibility for significant areas of one's life. People with this disorder often defer to spouse, parent, or friend regarding where they should live, the kind of job they should have, and who their friends should be. They subordinate their own needs to the needs of the people upon whom they are dependent, feeling that any assertion of their own needs may jeopardize the relationship. Such people will often tolerate enormous physical and/or psychological abuse for fear that they will be abandoned. Correspondingly, when they are alone even for brief periods of time, they may experience intense discomfort and helplessness. Thus, they often seek companionship at great cost. They lack self-confidence and self-esteem, and they often refer to themselves as stupid or helpless. The dependent personality disorder occurs more frequently among women than among men (Kass, Spitzer, and Williams). The mother of two small children, Joyce was brought to the emergency room with multiple facial abrasions and a fractured jaw. She was no stranger to the hospital staff. Eight months earlier, she had been treated for two broken ribs and assorted bruises. Joyce was reluctant to give the details of her injuries. But the neighbor who brought her to the hospital reported that Joyce had been physically assaulted by her husband. According to the neighbor, Joyce's husband frequently abused her verbally and "slapped her around" on a number of occasions. Although Joyce feared for her own safety and that of her children, she was unresponsive to suggestions that she move out and separate from her husband. The middle child of three, Joyce was given neither great responsibility nor great attention during her childhood. Her father was a man of strong opinions and made all the decisions in the family. He believed adamantly that women belonged at home, and joked often and coarsely about "buns in the oven and bums in bed." He controlled the family finances, and delegated no responsibility in that area. Apart from a course in typing, Joyce learned no vocational skills in high school, and dropped out to get married. Indeed, other than baby-sitting and summer jobs as a mother's helper, Joyce had no work experience at all. During the five years of her marriage, Joyce left all decisions to her husband, even to the point of agreeing to the purchase of a sofa that she really disliked. Her husband was intensely jealous of her friendships, and she therefore abandoned all of them. Indeed, except for visits to her mother who lived in the neighborhood, she went nowhere without her husband. This disorder is common, especially in women. It impairs occupational functioning if the nature of the job requires independent decision making. And social relations may be restricted to the few people upon whom the person is dependent.

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