Masochistic personality disorder: symptoms, causes, and treatment.

This psychological alteration is related to self-hatred.

Self-denial and self-sacrifice in order to help others are aspects that are valued positively by society when they are based on a willingness to help someone at a specific moment. However, there are people who always put the needs of others ahead of their own and even deny their own needs or the possibility of experiencing pleasure or joy for themselves and for others. experience pleasure or joy for themselves and for themselves..

We are not talking about someone generous who does us a favor, but about someone who is literally dedicated to supplying the needs of others even without them asking for it or deeming it necessary. People who deny any kind of recognition, but at the same time feel deeply offended if their effort is ignored. People with a constantly dysphoric emotionality, with thoughts of not deserving anything positive and great insecurity and fear.

We are talking about people with a dysfunctional personality, which does not allow them to adapt correctly to the environment and generates great suffering. We are talking about what people with people with a disorder of the masochistic or self-destructive personality..

The masochistic or self-destructive personality disorder

It is considered self-destructive or masochistic personality disorder to that type of personality characterized by the presence of a pattern of behavior and vision of the world relatively stable in the time and across the situations in which they appear of constant way elements of self-destructiveness and self-denial..

People with this type of personality are characterized by the following characteristics a self-devaluative and pain- and suffering-seeking behaviorvisible in the search for environments that tend to lead to the presence of frustration or even to the search for mistreatment or humiliation (it is not uncommon that they tend to consider boring those people who are attracted to them and feel attraction for sadistic personalities), the denial of their own needs and avoidance of seeking pleasure and amusement. There tends to be a rejection of those who treat them well, and denial of the possibility of being helped.

It is likely that after positive experiences they actively seek to live aversive experiences or become depressed. These are people who manifest an excessively self-sacrificing and generous behavior towards others, often self-sacrificing even though it is neither necessary nor required. In addition to this, they tend to fail to achieve their own goals.. They tend to accumulate situations of frustration and self-prejudice.

People with this type of personality tend to see others as either needing help or as competitive and cruel, while they see themselves as worthless, deserving of Pain or simply useless. They tend to seek routine and consider that their achievements are due to luck or external intervention.

They are people with high vulnerability to humiliation, great insecurity and fear of abandonment.. They do not usually ask for favors or make great efforts to achieve their own goals, having a rather passive attitude and seeking gratification in self-denial and benefiting others. They tend to remain in the background and allow abuses towards them, having a distressed profile and giving the appearance of simplicity. They often present cognitive distortions, consider themselves inferior and believe they have a duty to help others and never prioritize themselves. Likewise, the fact of helping others makes them see themselves as necessary.

It is necessary to keep in mind that this disorder does not derive solely from the experience or fear of experiencing some type of abuse, nor does it occur exclusively during the presence of a major depressive episode.

Affect on a vital level.

Evidently, the above characteristics generate that these people present a series of important difficulties in their day-to-day life, which can lead to a high level of suffering. It is not uncommon for them to experience high levels of frustrationwhich in turn feeds back into their beliefs of being unworthy.

In their relationships with their partners, they tend to be abused and mistreated, with behaviors of absolute submission being frequent. This is also reflected in other relationships: many people may take advantage of themMany others will tend to distance themselves from them because of their excessive generosity and submissiveness. Those people who treat them well or tend to want to help them may find themselves rejected by these people.

And not only socially, but also at work they may encounter problems: they are likely to work long hours for the purpose of benefiting others. This may also reduce their own productivity. Their lack of confidence may limit their possibilities for improvement in all areas, as well as behavioral passivity when it comes to seeking their own well-being.

Possible causes

The causes of this personality type are unknown, having in fact a multicausal origin. Although the causes are not entirely clear, some of the hypotheses in this regard suggest the influence of childhood experiences and lifelong learning.

The main hypotheses in this regard are mainly based on a psychoanalytic perspective. Among the different factors that seem to influence the onset of this personality disorder are the confusion and integration in the same subject of the experience of punishments, pain and suffering and the sensation of protection and security. It is also possible that it has been learned that the only way to achieve affection is in moments of personal suffering (something that in the future will lead to self-devaluation as a mechanism to achieve such affection).

The presence of deficit parental models (absent and cold parents, irritated and with a high level of vital frustration) that the child will later replicate as a way of functioning and seeing the world is also proposed as a hypothesis. Another element that is discussed is the lack of capacity to integrate positive elements, becoming secure while feeling despised and miserable.

Treatment of this personality disorder The treatment of a personality disorder (whether this or another) is somewhat complex. After all, we are dealing with a way of proceeding and seeing the world that has been configured throughout a person's life. Nevertheless, it is not impossible.

In the case at hand and based on Millon's model, the treatment would seek to invert the pleasure-pain polarity (a person with this personality disorder tends to have a certain discordance obtaining pleasure from pain and vice versa) and strengthen the search for gratification in themselves (decreasing dependence on others). It would also seek to generate a change in beliefs towards oneself and modify negative and devaluing beliefs towards oneself and the need to consent to constant and excessive abuses and self-sacrifices. The aim would be to modify the belief that they deserve to suffer or that their life has no value in itself and only has value if they help others, as well as the rest of the cognitive distortions that they usually present.

We would also try to to stop seeing others as needing help or as hostile entities, and to generate behavioral and to generate behavioral modifications so that they stop looking for dependent relationships. Also alter the way they relate to others and to the world, as well as encourage a more active and less querulant vital positioning. Improving self-esteem and reducing the level of vital inhibition are also elements that can help people to adopt a more adaptive way of seeing the world.

For this purpose, the use of techniques such as cognitive restructuring, behavioral experiments, the use of expressive techniques or psychodrama would be useful. Social skills training can also be useful in learning to relate positively. The use of animal-assisted therapy may also be helpful, as well as assertiveness training. Likewise, behavioral activation may be very necessary to help them acquire a more active vital position.

Current status of diagnostic labeling

As with sadistic personality disorder, masochistic personality disorder was included in the revision of the third edition of the Diagnostic and Statistical Manual of Mental Disorders or DSM-III-R.

However, both diagnostic labels were removed in later editions, becoming part of the unspecified personality disorder classification. With regard to Millon, whose biopsychosocial model is one of the most recognized with regard to personality disorders, still maintains it as a personality disorder.Millon, whose biopsychosocial model is one of the most recognized in terms of personality disorders, still maintains it as a personality disorder in the MCMI-III.