What is Passive Aggressive Personality Disorder?
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. They often appear to be confident, tout everything is okay, and make false promises that are inconsistently kept. Acting out is frequent in terms of verbal assaults and then rationalized away that it was out of humor or “just a joke.” In reality the intent was clear harm and possible humiliation of another party.These individuals have extreme difficulty with confrontation, and do not no do well with their behavior being pointed out. This cycle is repetitive and part of this reason is due to the fact they find someone to fill their need for sympathy. 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.
What are the causes of Passive Aggressive Personality Disorder?
This disorder is clearly harbored in early and middle childhood; observing very dysfunctional parents, learning the behavior, and learning unhealthy coping mechanisms.
What is the 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.