Conceptions of Dependency
    The DSM-IV-TR defines the essential feature of Dependent Personality Disorder as a "pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation.  This pattern begins by early adulthood and is present in a variety of contexts.  The dependent and submissive behaviors are designed to elicit caregiving and arise from a self-perception of being unable to function adequately without the help of others" (APA, 2000, p. 721). 
   
    This definition begs some questions such as; what is dependency? and how can we determine what constitutes a pathological level of dependency?  The answers to these questions are not easy or definitive.  Hirschfeld et al. noted in 1976 that the concept of dependency has origins in a variety of theories including psychoanalytic, social, and ethological (as cited in Hirschfeld, Shea, and Weise in Livesley, 1995, p.239).  Due to the varied background used in understanding this construct; there is no "universally accepted operational definition for dependency" (Bornstein, 1993, p.18).  Currently, there are two major frameworks which are useful for conceptualization.  The first, a four-tiered definition of what makes up dependency comes from Bornstein (1993):
  1. Motivational: a marked need for guidance, approval, and support from others.
  2. Cognitive:  a perception of the self as relatively powerless and ineffectual, along with the belief that others are powerful and can control the outcome of situations.
  3. Affective:  a tendency to become anxious and fearful when required to function independently, especially when the product of one's efforts are to be evaluated by others.
  4. Behavioral:  a tendency to seek help, support, approval, guidance, and reassurance from others and to yield to others in interpersonal transactions (p.19). 
  Secondly; Livesley et al. developed five dimensions of attachment and five dimensions of dependency to contribute to the broader understanding of this larger construct (as cited in Hirschfeld et al. in Livesley, 1995).  Livesley conceptualized dependency as being made up of both attachment needs and dependency needs.  These feelings and behaviors are understood to occur on a continuum of adaptivity. 
Attachment
  1. Fear of loss of an attachment figure.
  2. Need for affection.
  3. Need for proximity to the attachment figure.
  4. Feelings of security based on physical presence of attachment figure.
  5. Strong protest at separation from attachment figure.
Dependency
  1. Low self-esteem.
  2. Need for advice and reassurance.
  3. Need for constant reassurance and approval.
  4. Need for care and support.
  5. Submissiveness (p.244).
   Pathological Dependency

     Many of these traits and behaviors can be present in an individual and be within the normal range culturally and socially, and perhaps even be adaptive.  Millon and Davis (2000) describe characteristics of a dependent style that are healthy and desirable such as genuine empathy, grace, agreeableness, humility, and an ability to love unconditionally.  It is when an individual becomes subsumed into the identity of others, leading to the loss of self both during and after relationships end that these traits become maladaptive (p.208).  Further, pathologically dependent individuals do not simply consult or ask for advice to process themselves, rather they forfeit responsibility to others for their own lives, down to the most mundane decisions.
  
    Pincus and Wilson (2001) conceptualized dependency as reflecting a "core motivation to obtain and maintain nurturant and supportive relationships" based on psychometric analyzes of various self-report tests (p.228).  This motivation is doubtlessly shared by the vast majority of healthy individuals, it is the manner in which persons express this desire cognitively and behaviorally that can connote a pathological level of dependence.  Unhealthy expression of this motivation can be seen in  Bornstein's (1998) conception that dependent personality disorder is an overt expression of dependency desires with little to no strategy for self reliance.  Although individuals may have some insight into their behaviors, the belief that they are weak and helpless prevents any striving for change (pp.180-181).   So where does this pathological level of dependency come from?