Is Couple Therapy Indicated for Patients with Dependent Personality Disorder?

The value of couple therapy for individuals with severe personality disorders (PDs) is only beginning to be recognized, although clinicians have long observed the healing aspects of intimate relationships. For patients with dependent personality disorder in intimate relationships, couple interventions may prove to be effective. The authors' clinical experience is used to describe two dimensions of dependency that might determine whether patients will benefit from couple therapy. The first dimension focuses on interpersonal dependency resulting from insecure attachment. In the first case example, the couple failed to benefit from couple therapy because of their enmeshed relationship. The second dimension relates to the lack of self-confidence and assertiveness that leads to an interpersonal crisis. A second case example is used to demonstrate that patients with this pattern of dependency may do well in couple therapy. By assessing which aspect of dependency predominates, the therapist can determine the appropriateness of couple therapy. This paper hopes to increase awareness of couple therapy for patients with PDs and to encourage further research into its applications with these patients.