Possible Etiologies for Dependency

   
Psychodynamic Perspective
    According to  classical psychoanalytic theory, dependency results from fixation in the oral stage of development.  Infants who were either frustrated or overindulged in this stage may later develop dependency behaviors.  According to Bornstein (1993), two new theoretical models of dependency resulted from the more classic psychodynamic perspective; object relations theory and attachment theory.  In object relations theory, the exchange both biologically and socially between mother and child becomes internalized.  The child becomes dependent on both aspects and the nature of these interactions become part of the self concept of the individual (pp. 4-5).  If the mother is overly indulgent, children come to the overly optimistic belief that all people will cater to them in a similar matter.  Conversely, if the mother is absent in her nurturance of the child, they will come to demand excessively of others to meet their unfulfilled needs (p.3).  Attachment theory views the infant as becoming increasingly attached as they mature rather than being nurtured in developing independence.  This in turn effects the evolution of the individual's personality as well as the expectations they will have in future relationships (pp.5-6). 
   
    In addition, Millon and Davis (2000) note two defense mechanisms common for the dependent personality within the psychodynamic framework.  Namely; introjection and idealization.  In introjection, the individual sees themselves as weak and powerless; inadequate.  To combat this, they seek to bond with a stronger figure and adopt their identity as their own.  Dependents commonly idealize their partners, seeing them as flawless and strong.  The individual takes great stock in being loved by someone so much better than they, hence the devastation when relationships end (pp.216-217).
The Interpersonal Perspective

    Millon and Davis (2000) characterize the dependent personality as one that is desperately seeking love and approval in interpersonal relationships.  The formulation of this desire stems from the nature of interpersonal interactions in the formative stages of life.  Obviously, all newborns are dependent upon their caregiver(s) for nearly every biological and emotional need.  Most children as they grow and mature slowly seek independence.  Some parents do not allow this natural maturation; rather, they cater to every whim and emotion of their child, keeping them from developing competently.  In essence, children learn to trust to an extreme, they believe that every facet of their well-being is dependent upon someone else's care (pp.218-219).
   
    Benjamin (1993) carries the interpersonal perspective further into development.  She conceptualizes the DPD sufferer as someone who was "mocked by peers for incompetence" (p.227).  The individual internalizes these concepts, reinforcing their belief that others are needed to make decisions and substitute their judgment for the inadequacy of that their own.  Benjamin defines the "crucial dimension" as parental control.  The dependent child grew up believing that submission to a stronger more competent parent is the only option for success interpersonally.  This parent role becomes unwittingly adopted by the later attachment figure of the individual who looks to them to be the leader of their life (p.227-228).
The Cognitive Perspective
    This perspective takes its lead from overbearing early caretakers as do the previous two theories, however, the thought processes developed as a result of those interactions is the focus of the cognitive perspective.  Children who grow to develop dependent personality disorder are conceptualized to have an internalized fear of trusting oneself based on a lack of trust from their caregiver(s).  At an essential level, they believe they are helpless and in constant need of a strong and competent figure.  This dichotomous thinking, "either I have someone to take care of me or I will die" leads to "catastrophizing, especially with regard to relationships" (Millon and Davis, 2000, pp. 220-222).  Dependents view the end of a relationship as the end of their world, solidifying their belief that they are worthless. 
   
    The self image of the dependent personality is not all negative, "[they]see themselves as considerate, thoughtful, cooperative...humble and self-effacing" (Millon and Davis, p.220).  These positive beliefs coupled with the negative dependent beliefs make the person seem naive and in need of assistance.  Bornstein (1998) notes that the way these dependency needs are expressed are based on the ways caregivers responded to early strivings.  For example, if a child was rewarded with extra attention and help when they complained of physical discomfort or sickness, they learn to exhibit "medical help seeking tendencies" as an adult in various situations where the individual feels particularly helpless. Bornstein sees dependency needs as manifesting in either passive or active attention seeking behaviors  (p. 177).  Since less is asked of those who seem incompetent; they continue to get help, thus reinforcing their belief they are helpless and holds them from developing more than the most basic coping strategies.  "Cognitively, the dependent needs simplicity" (Millon and Davis, p.223).
The Genetic Perspective
    The field of genetic research is very young, consequently, the amount of information relating personality disorders to genetics is small.  However, Nigg and Goldsmith (1994) provide some possible insight.  They see the manifestation of personality disorders as a "blend of genetically influenced temperament and experientially developed character" (p.346).  They further note that theoretically dependent personality disorder should "reflect...particularly the facets of altruism, compliance, and modesty" (p.368).  MZ twin studies show a .53 correlation in altruism and a .25 correlation in DZ twins, with dependent personality disorder; suggesting a genetic piece in the formation of potentially maladaptive traits (p.368). 
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