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David Baxter PhD

Late Founder
Insufferable Clinginess, or Healthy Dependence?
By BENEDICT CAREY, New York Times
March 6, 2007

The domestic scenes that would slowly suffocate the marriage were not scenes at all, in the usual sense, but silences, imagined slights, private fears that went unspoken. She would ask him to do the dishes after dinner and feel a shudder when he put off the chore, as if it were a rejection.

Or she would dress up to go out, and then struggle against a growing dread as the moments passed and he did not comment on how good she looked.

?I never once said anything, but I had this need for approval, this terrible dependence that he had no way to understand,? Ronni Weinstein, 61, a therapist living near Chicago, said about her former husband. Indeed, she added, she has since learned that her dependent urges might have been used to bind the marriage rather than undermine it.

?That?s what healthy couples learn to do,? she said, ?to voluntarily depend on one another and decide who is doing what for the relationship.?

Neediness has a familiar face: the close friend who is continually asking for reassurance, for advice, for help with the wireless connection. The accomplished adult who lurches from one relationship to another, playing geisha for each new partner. The abused spouse who is afraid to walk out.

Yet only in recent years have researchers begun to realize that while in some guises dependence can undermine mental health, in others it can provide valuable social support.

At one extreme is an ingrained, helpless need to be cared for ? a stubborn problem that psychiatrists diagnose as dependent personality disorder. In milder forms, dependency can come across as an annoying clinginess. But it can also be a protective warmth that cements romantic relationships in times of stress. It is the way people manage dependent urges, researchers are finding, that determines the effect of needy behavior on relationships.

?There are the dependent people who panic easily, who are calling a friend or spouse 15 times a day, undermining the relationship, and then there are those who have learned to modulate their impulses,? said Dr. Robert F. Bornstein, a psychologist at Adelphi University in Garden City, N.Y., and co-author, with his wife, Mary A. Languirand, of ?Healthy Dependency? (Newmarket Press, 2003).?These people may have dependency needs that are very intense,? he continued, ?but they have developed social skills, learned to make others feel good about helping them. That makes all the difference.?

A tug-of-war between headstrong independence and needy vulnerability is visible as early as infancy. In so-called attachment studies, young children or primates who are confident in their mother?s affections tend to be confident when exploring an unfamiliar room or meeting a stranger. Those who are less secure often cling to their mothers in new situations, noticeably fearful.

?This is an absolutely fundamental dynamic that underlies all of our interpersonal relations, as well as psychiatric diagnoses,? said Dr. Sydney Blatt, a professor of psychology and psychiatry at Yale University.

Researchers measure the strength of dependency traits by having people rate how highly they endorse certain beliefs, like, ?After a fight with a friend, I must make amends as soon as possible?; ?I am very sensitive to others for signs of rejection?; or ?I have a lot of trouble making decisions for myself.?

In studies, people who score highly on these tests also tend to rate their parents as either authoritarian or overly protective (or one of each). ?The message growing up is: You?re fragile, you?re weak, you need someone powerful to look after you,? Dr. Bornstein said.

That upbringing primes many people, as they grow, to seek similarly dependent pairings, with friends, colleagues and romantic partners. The pattern persists at least in part because it is frequently rewarded.

In one recent study, psychologists rated 48 men and women attending Gettysburg College in Pennsylvania on measures of dependency, and calculated their grade-point averages. After controlling for the students? SAT scores and the difficulty of their course schedules, among other factors, the researchers found, to their surprise, that those students who scored highly on measures of dependency were doing significantly better, on average, than those who were more self-sufficient.

One likely reason, the authors found, was that dependent students were much more likely to say they sought help with course work from their professors.

In another experiment, presented in January at the American Psychoanalytic Association?s annual meeting, psychologists at the University of Leuven in Belgium measured dependency traits, relationship satisfaction and levels of conflict in 266 adults in long-term relationships. The researchers found that dependent partners scored significantly higher on satisfaction than more self-sufficient ones ? but only when couples were struggling.

At least in the short run, dependent traits seemed to buffer the relationships in times of crisis, the authors suggest. Afraid of losing the relationship, ?individuals high on dependency may actually behave in a more positive way to their partner, like being more complying, being more loving,? said B?n?dicte Lowyck, the psychologist who led the study.

In the long run, Ms. Lowyck said, it is not at all clear whether such protective instincts nourish a relationship or smother it. The answer will depend on the couple, experts say, and likely on the content of a partner?s dependence: how it is expressed, whether the person is generous as well as needy, flexible as well as anxious.

To distinguish different shades, or varieties, of dependency, two psychologists, Aaron L. Pincus of Pennsylvania State and Michael B. Gurtman of the University of Wisconsin, Parkside, administered an exhaustive battery of dependency-related questionnaires to 654 psychology students. The scales rated everything from social confidence to preference for solitude to urges to please others. The psychologists? analysis of the answers suggested that there were three distinct varieties of dependent behavior patterns.

One was defined predominantly by submissiveness (?I don?t have what it takes to be a good leader? or ?I am easily downed in an argument?). Another was characterized principally by exploitability (?I am afraid of hurting people?s feelings? or ?I do things that are not in my best interest in order to please others?). And a third, which the psychologists call love dependency, was based on a longing for social connection (?Being isolated from others is bound to lead to unhappiness? or ?After a fight with a friend, I must make amends as soon as possible?).

People who struggle with an exaggerated need for the comfort of others may show flashes of all three types. ?But it is this love dependency that is the most adaptive,? Dr. Pincus said. ?These are people that form very strong attachments, who are not happy unless surrounded by friends and family? and least likely to stumble over their own anxieties.

Dr. Weinstein, the Chicago-area therapist, said that in more than 30 years of practice she had seen dozens of couples in which submission and exploitation have ended marriages. And studies now suggest that in severely troubled, abusive relationships, the aggressor, as well as the victim, often have a dependent fear of losing the relationship.

?This is the kind of couple where maybe the husband says: ?You?re going to the store by yourself? You?re going to leave me here alone? You can?t do that ? here, I?ll drive you,? ? Dr. Weinstein said.

?And this kind of trivial-sounding exchange can turn very demanding and even violent, because of this unreasonable fear of abandonment.?

Skilled therapists can help people manage such fears, but there is little research to guide treatment. In one approach, people learn to identify, and alter, some of the conversation habits that make their interactions with others so volatile.

For example, they learn to reduce the number of times they seek reassurance in a conversation ? ?You?re not just saying that, right?? ?Do you really mean that?? ? and, eventually, to shift the focus of the conversation to the other person.

The patient can also learn to defuse his or her fears of losing a relationship by taking some of the hard evidence of a partner?s commitment at face value: flowers, romantic dinners, back rubs.

The partner can help, too, at least in cases of garden-variety neediness. Psychiatrists often advise a kind of sympathetic distancing: acknowledge the person?s fears; offer some reassurance; but nudge (or push) the person to at least experiment with interests, hobbies or habits that don?t revolve around the relationship.

And then turn off the cellphone for a few hours.
 
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