A Psychological Aspect of Susan Smith: Dependent Personality Disorder
On October 25, 1994, Susan Smith drowned her two sons, Michael and Alex, in the John D. Long Lake in Union County, South Carolina. For nine days she lied about knowing where the boys were. On November 3, she confessed to the killings and would soon go to trial.
Susan’s defense team hired a psychiatrist to conduct a psychiatric evaluation of her. She was diagnosed as having dependent personality disorder. He described her as a person who “feels she can’t do anything on her own”. “She constantly needs affection and becomes terrified that she’ll be left alone” She was only depressed when she was alone. The psychiatrist studied her family history and concluded that based on her family history and his interviews with her, Susan had a tendency toward depression that began in her childhood. Susan’s attorney argued that his client was psychologically destabilized by a lifetime of betrayal. A father who killed himself when she was just six, a stepfather who sexually molested her as a child, a husband who cheated on her and a boyfriend who toyed with her affections (Pergament).

Her boyfriend testified that “the pleasure she got from sex was not physical pleasure, it was just in being close and being loved”. The psychiatrist testified that Susan had sex with four different men during the six-week period leading up to the murders and she had begun to drink heavily during this time (Pergament). Alcoholism is a component of dependent personality disorder.
After only four days of testimony, the defense rested its case. Susan was charged with two counts of murder and sentenced to life in prison with the chance of parole in 30 years, the year 2025.


Dependent personality disorder is an inability to function without significant reliance on a forceful or dominant person providing direction. Individuals diagnosed with dependent personality disorder are usually quiet, and needy for attention, valuation, and social contact. Lack of self-confidence and relying on others are typical. Threatened with solitude or separation, a dependent disorder person may panic with feelings of profound helplessness (Gillihan). The person may be convinced that he/she is incapable of functioning on his/her own. A dependent person seeks direction from others, even on insignificant issues. The relationships of individuals with dependent disorder are usually unbalanced. They tend to seek all-powerful helpers, or people they believe can protect them from feelings of loneliness. They may jump from relationship to relationship to avoid being alone. People with this disorder do not trust their own ability to make decisions, and feel that others have better ideas. They may be devastated by separation and loss, and they may go to great lengths, even suffering abuse, to stay in a relationship (Gillihan). An individual may be diagnosed with dependent personality disorder if they meet five or more of the following criteria established in the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV):
1) Difficulty in making everyday decisions without excessive advice and reassurance 2) Needs others to assume responsibility for major areas of his/her life 3) Difficulty expressing disagreement with others and unrealistically fears loss of support or approval if he disagrees 4) Difficulty initiating projects or doing things on his/her own, due to lack of confidence in judgment or abilities 5) Goes to excessive lengths to obtain nurturance and support, to the point of volunteering to do things that are unpleasant 6) Uncomfortable or helpless when alone due to exaggerated fears of being unable to care for him/herself 7) Urgently seeks another source of care and support when a close relationship ends 8) Unrealistically preoccupied with fears of being left to take care of him/herself. (American Psychiatric Association, 1994)
DPD is classified as a Cluster C personality disorder in the DSM-IV. Cluster C personality disorder is described as anxious or fearful. Females are more likely than males to have a Cluster C personality disorder (Joseph Rey, 1996).
Childhood illness or separation anxiety disorder of childhood may be a premorbid condition to DPD. Some experts believe that events occurring in early childhood exert a powerful influence upon behavior later in life. Others indicate that people are genetically predisposed to personality disorders. In some cases, however, environmental factors may cause a person who is already genetically vulnerable to develop a personality disorder (National Mental Health Association).
What is the link between parental over protectiveness and authoritarianism and the development of dependent personality traits in children? Parental over protectiveness and authoritarianism serve simultaneously to 1) reinforce dependent behaviors in children of both sexes and 2) prevent the child from developing independent, autonomous behaviors (since the parents do not permit the child to engage in the kinds of trial-and-error learning that are involved in developing a sense of independence and mastery during childhood). Thus, when parental over protectiveness or parental authoritarianism is characteristic of the family unit, this will tend to produce high levels of dependency in children, since both parental controls foster and encourage dependent behavior. When both parental over protectiveness and authoritarianism are present within the family unit, dependency in children is particularly likely to result (Robert Bornstein, pg. 41).

Rey (1996) suggests that because personality is shaped by experiences during childhood and adolescence, it is likely that mental disorders occurring during these years may have an influence on personality development. He found that the quality of the family environment before the age of 12 years was the “most robust development predictor of personality disorder in young adults”.
There is no specific treatment for this disorder, although psychotherapy may be useful in gradually helping people make choices that affect their own life. This is the treatment of choice for dependent personality disorder. Psychotherapy for patients with this disorder focuses on helping them see the unconscious conflicts that are contributing to or causing their symptoms. It also helps people become more flexible and is aimed at reducing the behavior patterns that interfere with everyday living (NMHA). Long term therapy is not recommended because it can reinforce a dependent relationship upon the therapist. An important component of therapy is examining the client’s faulty cognitions and related emotions such as lack of self-confidence. Assertiveness training and other behavioral approaches have proven to be most effective in treatment (Gillihan).
In conclusion, The National Mental Health Association suggests that:
There are many types of help available for different personality disorders. Treatment may include individual, group, or family psychotherapy. Medications prescribed by the patient’s physician may also be helpful in relieving some of the symptoms of personality disorders including problems with anxiety and depression.






References
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. (4th ed.). Washington, DC: Author

Bornstein, Robert F. (1993). The Dependent Personality. New York: Guilford Press

Gillihan, Lori. (n.d). Dependent Personality Disorder. Retrieved March 1, 2002, from http://cstl-coe.semo.edu

National Mental Health Association. (n.d.). Personality Disorders. Retrieved from http://www.nmha.org

Pergament, Rachel. (n.d.). Susan Smith: Child Murderer or Victim? Retrieved March 1, 2002 from http://www.crimelibrary.com

Rey, Joseph M. (1996) Antecedents of Personality Disorders in Young Adults. Psychiatric Times, 13 (2). Retrieved March 1, 2002, from http://www.mhsource.com