1/ Depressive Personality
"Despite its omission from the DSM, depressive personality is the most common personality syndrome seen in clinical practice. It is a personality syndrome in every sense of the term: an enduring pattern of psychological functioning evident by adolescence
"Despite its omission from the DSM, depressive personality is the most common personality syndrome seen in clinical practice. It is a personality syndrome in every sense of the term: an enduring pattern of psychological functioning evident by adolescence
2/ and encompassing the full spectrum of personality processes.
People with depressive personalities are chronically vulnerable to painful affect, especially feelings of inadequacy, sadness, guilt, and shame. They have difficulty recognizing their needs, and when they do
People with depressive personalities are chronically vulnerable to painful affect, especially feelings of inadequacy, sadness, guilt, and shame. They have difficulty recognizing their needs, and when they do
3/ recognize them, they have difficulty expressing them. They are often conflicted about allowing themselves pleasure. They may seem driven by an unconscious wish to punish themselves, either by getting into situations destined to cause pain or depriving themselves of
4/ opportunities for enjoyment. A psychologically insightful observer might describe the person as their own worst enemy.
Where there is an enemy, there is often anger & aggression. One underlying psychological theme in depressive personality is internal attacks against the
Where there is an enemy, there is often anger & aggression. One underlying psychological theme in depressive personality is internal attacks against the
5/ self. The person is angry, defends against experiencing anger, and instead directs it at themselves in the form of self-criticism, self-deprivation, and self punitiveness. The relevant SWAP item is, 'Has trouble acknowledging or expressing anger toward others and instead
6/ becomes depressed, self-critical, self-punitive, etc.' In short, the person treats themselves like someone they despise.
Clinicians can easily miss the patient’s anger & aggression because people with depressive personalities tend to be overtly agreeable & put others’ needs
Clinicians can easily miss the patient’s anger & aggression because people with depressive personalities tend to be overtly agreeable & put others’ needs
7/ first, including the clinician’s needs. If psychotherapy is to bring about meaningful psychological change, anger must be recognized, experienced, and explored in the therapy relationship.
A second psychological theme involves separation, rejection, and loss. The person may
A second psychological theme involves separation, rejection, and loss. The person may
8/ be preoccupied with and painfully vulnerable to disruptions in interpersonal relationships. They fear being abandoned and left unprotected and uncared for. As a result, they avoid interpersonal conflict and have difficulty asserting themselves.
9/ Undue people-pleasing and helpfulness protect against disapproval or rejection. In psychotherapy, they suppress legitimate criticisms and dissatisfactions for fear of hurting the clinician’s feelings or damaging the therapy relationship. Instead of communicating their
needs
needs
10/ and wants, they accept what is offered and make do. This can lead to a relationship dynamic in which the clinician thinks things are going swimmingly and the patient does without, thereby recreating the patient’s dysfunctional relationship pattern in the therapy relationship.
11/ This pattern may have roots in relational disruption or insufficient emotional availability of a caretaker in early development, leaving the person feeling emotionally empty and incomplete, and believing their deprivation was caused by their own badness. Some patients have
12/ a pervasive sense that someone or something essential to their well-being has been lost and can never be recovered. These feelings can crystalize around, and be amplified by, subsequent experiences of loss. Rewards and pleasures that are realistically available may be
13/ experienced as a pale shadow of what was lost or could have been. Such patients may need the clinician’s help to mourn what has been lost before they can invest emotionally in what life can offer now.
For some patients with depressive personalities, themes of unconscious
For some patients with depressive personalities, themes of unconscious
14/ anger and self-attack predominate. For others, themes of separation and loss predominate. These themes have been discussed in the clinical and research literature in terms of introjective (self-critical) and anaclitic (dependent) depression. Both themes may be present in
15/ any blend.
Depressive personality is the most common personality style among people drawn to the mental health professions. Clinical practitioners have endless opportunity to care for others instead of themselves, be unduly helpful, and fault themselves for falling short of
Depressive personality is the most common personality style among people drawn to the mental health professions. Clinical practitioners have endless opportunity to care for others instead of themselves, be unduly helpful, and fault themselves for falling short of
16/ unrealistic, self-imposed standards." (p. 6-7)
—Shedler (2021) The Personality Syndromes
pdf available here:
jonathanshedler.com
—Shedler (2021) The Personality Syndromes
pdf available here:
jonathanshedler.com
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