This article covers dependence and attachment issues commonly found in people with Complex PTSD, trauma-related Borderline Personality Disorder, DDNOS and Dissociative Identity Disorder.



Being excessively independent means being unable to seek any form of help, for example social support from friends, this is actually a phobia (avoidant behavior) rather than healthy.

Healthy (secure) Dependency versus Insecure Dependency

Dependency is often viewed as being an undesirable quality, and in some way shameful (particularly for men), but healthy and secure dependency allows a person to ask for help or support when it is appropriate. Just as a person without a trauma history could do. Benefits in psychotherapy include co-operation, being open to suggestions but making decisions yourself, and forming a positive attachment to the therapist.

Insecure dependency involves either extreme dependence (extreme demanding behavior, helplessness, inability to accept limitations of supportive people, etc) or counterdependency (excessive independence, inability to seek help even if in crisis, unable to establish a healthy, therapeutic dependence in psychotherapy leading to little progress, criticizing and rejecting expression of neediness from others).

Dependency and Trauma

Steele, van der Hart, & Nijenhuis (2001) stated:



Studies have also consistently demonstrated that strong social support following trauma (implying some degree of dependency) is essential to prevent further difficulties with trauma-related disorders (e.g., King et al., 1998; Runtz & Schallow, 1997). However, most chronically traumatized individuals do not receive such support until the time they enter therapy. Many, if not most chronically traumatized children live within a family system that denies, minimizes, or even encourages ongoing abuse and neglect, and that does not provide the child with adequate support following traumatic events. Such a relational environment leads to insecure attachment, which involves insecure dependency (Bowlby, 1988).

Childhood Abuse and Trauma

Early trauma – particularly abuse at the hands of a care-giver – leads to distrust and difficulties in attaching securely to the care-giver. A secure attachment style can’t develop so the child forms an insecure attachment: avoidant/dismissing, ambivalent (resistant), or disorganized attachment (attachment which swings between avoidant and ambivalent). This attachment style is maintained in later life and is know to affect all major relationships.

Insecure dependency may take the form of excessive dependency or excessive independency (a counter-phobic stance toward feared or rejected dependency), as the basic trust needed for secure dependency never develops or is destroyed. Excessive dependency is present in ambivalent (resistant) attachment styles, counterdependency is present in avoidant/dismissing attachment styles, and disorganized attachment involves moving between both forms of insecure dependency.

Dependency and Complex Dissociative Disorders

Complex Dissociative Disorders (DDNOS and Dissociative Identity Disorder) are typically believed to involve both excessive dependency and counterdependency. For example, a child alter (an Emotional Part) may be clingy and excessively needy, but another alter like a protector (also an Emotional Part) may have a ‘fight’ response, eg resisting discussing feelings and showing anger at a very needy child part.

References

Steele, K., van der Hart, O., & Nijenhuis, E. R. (2001). Dependency in the treatment of complex posttraumatic stress disorder and dissociative disorders. Journal of Trauma & Dissociation, 2(4), 79-116. http://www.trauma-pages.com/a/steele-2001.php Counter-dependence: The flight from intimacy. Weinhold, J & Weinhold, B. http://weinholds.org/the-flight-from-intimacy-healing-counter-dependency/

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