Negativistic (Passive-Aggressive) Personality Disorder

Some people are perennial pessimists and have "negative energy" and negativistic attitudes ("good things don't last", "it doesn't pay to be good", "the future is behind me").

The Negativistic (Passive-Aggressive) Personality Disorder is not yet recognized by the DSM Committee. It makes its appearances in Appendix B of the Diagnostic and Statistical Manual, titled "Criteria Sets and Axes Provided for Further Study."Some people are perennial pessimists and have "negative energy" and negativistic attitudes ("good things don't last", "it doesn't pay to be good", "the future is behind me"). Not only do they disparage the efforts of others, but they make it a point to resist demands to perform in workplace and social settings and to frustrate people's expectations and requests, however reasonable and minimal they may be. Such persons regard every requirement and assigned task as impositions, reject authority, resent authority figures (boss, teacher, parent-like spouse), feel shackled and enslaved by commitment, and oppose relationships that bind them in any manner.

Passive-aggressiveness wears a multitudes of guises: procrastination, malingering, perfectionism, forgetfulness, neglect, truancy, intentional inefficiency, stubbornness, and outright sabotage. This repeated and advertent misconduct has far reaching effects. Consider the Negativist in the workplace: he or she invests time and efforts in obstructing their own chores and in undermining relationships. But, these self-destructive and self-defeating behaviors wreak havoc throughout the workshop or the office. People diagnosed with the Negativistic (Passive-Aggressive) Personality Disorder resemble narcissists in some important respects. Despite the obstructive role they play, passive-aggressives feel unappreciated, underpaid, cheated, and misunderstood. They chronically complain, whine, carp, and criticize. They blame their failures and defeats on others, posing as martyrs and victims of a corrupt, inefficient, and heartless system (in other words, they have alloplastic defenses and an external locus of control). Passive-aggressives sulk and give the "silent treatment" in reaction to real or imagined slights. They suffer from ideas of reference (believe that they are the butt of derision, contempt, and condemnation) and are mildly paranoid (the world is out to get them, which explains their personal misfortune). In the words of the DSM: "They may be sullen, irritable, impatient, argumentative, cynical, skeptical and contrary." They are also hostile, explosive, lack impulse control, and, sometimes, reckless. Inevitably, passive-aggressives are envious of the fortunate, the successful, the famous, their superiors, those in favor, and the happy. They vent this venomous jealousy openly and defiantly whenever given the opportunity. But, deep at heart, passive-aggressives are craven. When reprimanded, they immediately revert to begging forgiveness, kowtowing, maudlin protestations, turning on their charm, and promising to behave and perform better in the future.

Also read these:Anger - The Source of Personality Disorders - click HERE!The Intermittent Explosive Narcissist - click HERE!

Therapy and Treatment of Personality Disorders

Disillusioned, most therapists now adhere to one or more of three modern methods: Brief Therapies, the Common Factors approach, and Eclectic techniques.

The dogmatic schools of psychotherapy (such as psychoanalysis, psychodynamic therapies, and behaviorism) more or less failed in ameliorating, let alone curing or healing personality disorders. Disillusioned, most therapists now adhere to one or more of three modern methods: Brief Therapies, the Common Factors approach, and Eclectic techniques.

Conventionally, brief therapies, as their name implies, are short-term but effective. They involve a few rigidly structured sessions, directed by the therapist. The patient is expected to be active and responsive. Both parties sign a therapeutic contract (or alliance) in which they define the goals of the therapy and, consequently, its themes. As opposed to earlier treatment modalities, brief therapies actually encourage anxiety because they believe that it has a catalytic and cathartic effect on the patient. Supporters of the Common Factors approach point out that all psychotherapies are more or less equally efficient (or rather similarly inefficient) in treating personality disorders. As Garfield noted in 1957, the first step perforce involves a voluntary action: the subject seeks help because he or she experiences intolerable discomfort, ego-dystony, dysphoria, and dysfunction. This act is the first and indispensable factor associated with all therapeutic encounters, regardless of their origins.

Another common factor is the fact that all talk therapies revolve around disclosure and confidences. The patient confesses his or her problems, burdens, worries, anxieties, fears, wishes, intrusive thoughts, compulsions, difficulties, failures, delusions, and, generally invites the therapist into the recesses of his or her innermost mental landscape. The therapist leverages this torrent of data and elaborates on it through a series of attentive comments and probing, thought-provoking queries and insights. This pattern of give and take should, in time, yield a relationship between patient and healer, based on mutual trust and respect. To many patients this may well be the first healthy relationship they experience and a model to build on in the future.

Good therapy empowers the client and enhances her ability to properly gauge reality (her reality test). It amount to a comprehensive rethink of oneself and one's life. With perspective comes a stable sense of self-worth, well-being, and competence (self-confidence). In 1961, a scholar, Frank made a list of the important elements in all psychotherapies regardless of their intellectual provenance and technique:

1. The therapist should be trustworthy, competent, and caring.

2. The therapist should facilitate behavioral modification in the patient by fostering hope and "stimulating emotional arousal" (as Millon puts it). In other words, the patient should be re-introduced to his repressed or stunted emotions and thereby undergo a "corrective emotional experience."

3. The therapist should help the patient develop insight about herself - a new way of looking at herself and her world and of understanding who she is.

4. All therapies must weather the inevitable crises and demoralization that accompany the process of confronting oneself and one's shortcomings. Loss of self-esteem and devastating feelings of inadequacy, helplessness, hopelessness, alienation, and even despair are an integral, productive, and important part of the sessions if handled properly and competently.

Learn more about psychoanalysis - click HERE!

Read more about treatment modalities and therapies - click HERE!