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Dr. Saltzman,

I have an old friend who I have decided has Passive Aggressive Personality Disorder. I especially see the symptoms in connection w/his relationship with me (two guys, 'non-weird' friendship, just for clarification). The short version is that I need to know how to deal with him. I know that his life is tough right now, and the last thing he needs is abandonment. But I can't just allow someone to run over me. How do you deal with a PAPD (presuming my diagnosis is correct)?

If you want the gory details, let me know, and I'll try to explain.

Joey Martin

ask dr-robert ask psychologist todos santos ask psychologist dr robert saltzman

Hello Joey, and thanks for writing--

Although passive aggressive personality disorder once was recognized by psychologists as an official diagnosis, this is no longer the case. In other words, passive aggressive behavior no longer is considered a "disorder," but rather a "style" of relating to others, in which a person seems compliant with the desires and needs of other people, but actually passively resists them, often, but not always, becoming increasingly hostile and angry.

I think is helpful and useful to see passive-aggressive behavior as a style of relating rather than as a disorder because once someone is diagnosed with a "disorder," either by a medical person or by a well-meaning friend, that person may be set apart, particularly by less-informed people, from the rest of humanity, put in a special category--the sick person--and then will be seen as "less than."

In fact, the passive-aggressive style is simply another way of trying to maintain the integrity and strength of the fragile ego. In other words, it is a way of standing up to others which is different is style, but not in substance, from dealing with perceived threats by being aggressive ("get out of my face"), by sexualizing situations (Monica Lewinsky "standing up" to the power and superior position of Bill Clinton by means of flirtation and fellatio--dragging him down to her "level," in other words), by coming on as intellectually, athletically, or spiritually, or even racially superior, or any one of the myriad other ways that human beings try to prove themselves equal or superior to their fellows in order to try to protect the frail sense of egoic selfhood.

I do not need the "gory details," as you say. I will assume that you have rightly observed the passive-aggressive style in your friend, which you will have done by noticing some or all of the following:

ask dr-robert ask psychologist todos santos ask psychologist dr robert saltzman

Since you have compassion for your friend, and wish not to abandon him, I will suggest to you that were I to have such a person in therapy, my treatment plan would entail trying to strike a balance between fulfilling his or her demands (which would tend to support and encourage the passive-aggressive style), and refusing the demands (which would feel like a rejection). Then, while trying to maintain this delicate balance between gratifying demands and frustrating them, I would constantly, but gently, point out the probable consequences of the passive-aggressive behavior (unhappiness, loss of friendships, losing the confidence and trust of others, etc.)

I know that you cannot be a psychotherapist for your friend, but I imagine that with patience you might be able to help him by following such procedures. If you cannot make a difference yourself, I would suggest that you show this letter to your friend and urge him to get into psychotherapy for a while. With proper treatment, this style of ego-defense often can change into something more useful.

By the way, this is a very common problem. Except for questions about schizophrenia and about penis size, I receive more ask the psychologist letters on this topic than on any other.

Be well.

ask dr-robert ask psychologist todos santos ask psychologist dr robert saltzman

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