ANDt is widely known that expression of Saint Augustine of Hippo (IV century) that says: “Love and do what you want.” It has been cited countless times and in various contexts. However, it is rarely taken into account that in Augustinian thought love is the highest manifestation of a lucid consciousness and free self-determination. Applying these concepts to the particular field of human relationships, we could say that if there is ignorance, deception or self-deception that prevents reality from being recognized—as objectively as possible—and/or if there is some type of dependency, coercion or fear that prevents self-determination free, it is not really about ‘love’. The truth is that ‘love’ is sometimes called various individual and interpersonal experiences based on very unhealthy and addictive dysfunctional relational patterns, in which, in addition, objectivity and self-determination are considerably compromised. Such is the case of emotional dependence.
Emotional dependence is a problem that many people currently have, to the point that it is becoming a topic of increasing relevance in the field of psychotherapy in the last two decades. It is a complex problem in which much of the disturbance and suffering of those who suffer from it revolves around the issue of love, specifically in the area of the couple’s bond (Castelló-Blasco, 2005).
The emotional dependent’s peculiar focus on receiving affection, attention and appreciation from his or her partner allows this disorder to be distinguished from the DSM-V dependent personality disorder, which describes a type of dependence that we could consider instrumental in nature, according to which What the dependent person demands from the other is not only affection, but also help in concrete and material terms, guidance in making decisions, and protection in a broad sense.
On the other hand, within emotional dependence two different profiles have been recognized, namely, the demander and the giver/helper/savior.
In short, we can say that there are three main types of dependence on people:
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- Instrumental dependent: needy role; It demands care, guidance and protection.
- Affective dependent: needy role; It demands affection, attention, appreciation.
- Codependent: role of giver, helper, savior; It generates dependence on the other, becoming essential for him, to ensure his permanence.
Leaving aside for the moment instrumental dependence ─about which there is abundant literature─, on this occasion we will present some central concepts in relation to emotional dependence, a topic of increasing relevance today. We ask ourselves: what is emotional dependence? Can it be considered an addiction? What are the objectives of the psychological treatment of this problem?
Although there is no ‘official’ definition of this disorder to date, combining conceptualizations of renowned authors who have been working on the subject for several years, we can say that emotional dependence consists of a pattern of beliefs, emotions and behaviors characterized by subjective experience of an intense and always unsatisfied need for affection, together with an exaggerated and persistent demand for attention and appreciation, directed at a significant other, who is usually the partner of the emotionally dependent person (Castelló-Blasco, 2005; Sánchez-García, 2010 ; Lemos-Hoyos, 2007).
Some authors consider that, since this pattern is inflexible, generalized and chronic – long-standing in the subject’s life, having begun approximately in adolescence – and is associated with significant discomfort in the personal and relational area, emotional dependence It should be considered a personality disorder (Castelló-Blasco, 2005), although it has not yet been included as a specific disorder in the diagnostic manuals of mental pathologies, DSM-V and ICD-11.
As we said, the current DSM-V considers the diagnostic criteria for dependent personality disorder, whose indicators focus on a type of dependence that could be considered instrumental, that is, an excessive demand for care, guidance and protection; in which the dependent feels helpless, with few abilities and limited autonomy, has excessive submissive behavior, an excessive fear of abandonment, and experiences an exaggerated need to be cared for, guided and protected. While emotional dependence, although it shares the general characteristics of instrumental dependence ─feeling of being helpless without the other, exaggerated fear of abandonment, limited autonomy, submission─, differs from instrumental dependence in that the demand is exclusive of affection, attention and assessment, and is directed exclusively at the dependent’s partner (Castelló-Blasco, 2005). The emotional dependent is characterized by a marked deficit in self-esteem, a poor self-concept and devaluation; the belief that one is not worth enough, that the significant other is better and more reliable, which is why one tends to idealize him/her and look for worth, support and security in him/her; intense separation anxiety and fear of being alone; and pathological submission—which goes to the extreme of accepting contempt, humiliation, and mistreatment to avoid being abandoned. Furthermore, several studies have found that this disorder, in both women and men, depending on the severity of the case, is frequently associated with various symptoms and pathologies, such as reactive depression – especially related to a poor quality of the relationship, separation or divorce-; pathological jealousy and controlling behaviors; exaggerated histrionics and difficulties in controlling impulses—dramatic scenes, crying attacks, verbal and/or physical violence; substance abuse; risk behaviors, self-harm and suicide attempts (Lemos-Hoyos et al., 2007; Izquierdo-Martínez & Gómez-Acosta, 2013).
Jorge Castelló-Blasco (2005) proposes the following provisional diagnostic criteria for what he calls “Emotional Needs Personality Disorder”:
It consists of a persistent tendency towards couple relationships characterized by imbalance between both members, clearly excessive emotional need towards the other person and inappropriate submission towards them, which begins at the beginning of adulthood and occurs in various contexts, such as This is indicated by five (or more) of the following items:
- Continuous search for relationships, always considering life next to someone.
- Excessive neediness of the partner, which results in very frequent and sometimes inappropriate contact (e.g., continuous telephone calls while the partner is in a work meeting), and which is not due to daily difficulties, decision making or assumption of responsibilities.
- Frequent choice of selfish, presumptuous and hostile partners, who are idealized with constant overvaluations of their qualities or their person in general.
- Subordination to the partner as a means of ingratiating oneself with them, which facilitates the imbalance between both members of the relationship.
- Priority of the couple’s relationship over anything else, which can cause prolonged neglect of important aspects of the subject such as their family, their work or their own needs.
- Excruciating fear of the couple breaking up even if the relationship is disastrous, with frantic attempts to resume it if it finally breaks.
- Very low self-esteem, with disregard for personal qualities or global undervaluation of the subject as a person.
- Fear and intolerance of loneliness.
- Excessive need to please people, with continuous worries about one’s own physical appearance or the impression one has made on them.
It should be noted that from the therapeutic work with the emotionally dependent, two different profiles have been observed among them, as we said. On the one hand, the ‘typical’ emotional dependent, the one we described above; and on the other hand, the emotional dependent who, even having low self-esteem like the typical dependent, unlike the latter ─paradoxically─ has a high self-concept ─“I am good, generous, and indispensable”─, presenting a characteristic altruistic pattern, according to the who assumes the role of giver, helper or savior more than needy or demanding, and makes a great effort to become completely indispensable to the significant other, thus ensuring their permanence at their side – usually the couple, although the role of giver can eventually extend to other significant people in their daily relational circle, of whom codependents ‘take charge’─. To distinguish the two types of emotional dependents, various authors adopted the term affective dependent to refer to the typical emotional dependent ─demanding/needy─, and the term codependent to refer to the second type described –giver/helper/savior─.
Both types or styles of emotional dependents have the following characteristics in common:
- Great motivation to please the needs, demands, expectations and desires of others.
- Strongly influenced by the will and judgment of the other.
- Strong dysphoric feelings – anxiety, fear and discomfort – in the face of the recurring idea of abandonment, and great anxiety in situations where they are alone.
- Great idealization of the loving partner or couple, to whom they submit and at the same time try to manipulate to avoid abandonment.
- Minimization of conflict and denial of negative events in the relationship, to the point of frequently enduring humiliation and abuse.
- The codependent, in particular, makes frequent self-sacrifices, self-postponements in order to please the other, and great self-demand, along with a high feeling of guilt for never doing enough.
Characteristic of dependent emotions is the strong desire to be with the significant other, usually the partner; desire which they experience as an uncontrollable need for the presence, closeness, attention, etc., of the other, when they are absent. Such desire for the other has been compared to the craving that substance addicts experience during the withdrawal phase. That is the reason why there are those who consider emotional dependence as a type of addiction, specifically an addiction to people (Rodríguez de Medina Quevedo, 2013).
The therapeutic treatment of emotionally dependent people will depend on the perspective adopted. If emotional dependence is considered a type of addiction, the therapeutic objective will be the recovery – and not the cure – of the emotional dependent, and the treatment will be similar to that of substance addictions, in which a stage must necessarily be included. of isolation, abstinence and detoxification with respect to the object of dependency. Additionally,…