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According to the DSM IV, the essential symptoms are a continuous
pattern of negativistic attitudes and passive resistance to demands
for adequate performance in social and occupational situations.
This behavior usually begins in early adulthood. However it is also
seen in childhood. These individuals frequently resent and resist
demands to function at a level expected by others. It is commonly
seen in the workplace, but also commonly seen in marriages and other
relationships. The behavior is expressed by procrastination, forgetfulness,
stubbornness, and intentional inefficiency. It is a very common
response to a task assigned by someone in authority. When asked
to do a certain task, individuals will not do the task, or if they
do, may hide the fact it was done. They may call in sick the day
the assignment is due. These individuals consistently externalize
blame onto others. They take no responsibility for their actions.
They become very argumentative. They are very cynical and skeptical.
These individuals are envious of others, and resentful of their
peers. They have few friends, and usually seek out individuals in
their peer network that may be less fortunate than them. They are
excellent at looking for sympathy from others. They frequently apologize
and state that things will be much better in the future, and usually
beg for “another chance.” Their self-confidence is extremely
poor, despite a false presentation of assertiveness. Some of these
characteristics are also found in individuals with borderline personality
disorder, as well as antisocial and avoidant personality disorders.
As indicated above, these individuals usually have issues with
those in authority, and it is often revealed in therapy that they
have had very domineering parents, either maternal or paternal,
who have placed them in situations where they have had to avoid
tasks at hand, becoming very manipulative, and excelling at putting
things off. It is not uncommon for these individuals to wrap themselves
in a cloak of “poor me” syndrome.
Treatment of Passive Aggressive Personality Disorder
Treatment for these individuals usually requires a long process.
These patients for the most part have difficulty looking and assessing
their behavior. They may eventually see their shortcomings, however
will rationalize away their behavior, trying to justify it. One
of the goals of therapy is to try to promote self-confidence in
these individuals by helping them realize how they are impeding
their own success. If they change their behavior, they can become
more successful at their jobs, and move up the occupational ladder.
It is also important to point out to them their cynical natures.
However this should attempted in the first month or two of sessions,
as these individuals may quit therapy and run. There is some secondary
gain obtained from their behavior. Subsequently, if these individuals
can learn to get their secondary gain from other sources and in
a more healthy and productive manner, some of the passive-aggressive
behavior should dissipate over time.
As with any personality disorder, relapse is very common. In therapy,
we try to give individuals tools to work with, so they can catch
when their behavior occurs, and there is always an open door policy,
and individuals should understand that they can come back at any
time for a “tune-up,” if you will, when they do relapse.
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