Masochistic Personality Disorder: Symptoms, Causes, and Treatment

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

We are not talking about someone generous who does us a favor, but someone who literally He dedicates himself to meeting the needs of others even without their asking or considering it necessary. People who deny all kinds 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 they live people with a masochistic or self-destructive personality disorder.

• Related article: "Sadistic personality disorder: symptoms and characteristics"

Masochistic or self-destructive personality disorder

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

People with this type of personality are characterized by presenting self-deprecating behavior and seeking pain and suffering, visible in the search for environments that tend to lead to the presence of frustration or even to the search for abuse or humiliation (it is not uncommon for them to tend to consider boring people who are attracted to them and are attracted to sadistic personalities), denial of their own needs and avoidance of seeking pleasure and fun. There tends to be a rejection of those people who treat you well, and deny the possibility of being helped.

It is likely that after positive experiences they actively seek aversive or depressed experiences. These are people who show excessively selfless and generous behavior towards others, often sacrificing themselves despite not being necessary or required. Besides that, tends to fail in meeting their own goals. They tend to accumulate situations of frustration and self-harm.

People with this type of personality tend to see others either as beings in need of help or as beings competitive and cruel, while viewing themselves as despicable, pain-deserving, or simply useless. They tend to seek routine and consider that their achievements are due more to luck or external intervention.

These 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 in benefiting others. They tend to remain in the background and allow abuse towards them, having a distressed profile and giving an appearance of simplicity. They often have cognitive distortions, consider themselves inferior and believe that they have a duty to help others and never prioritize. Also, helping others makes them see themselves as necessary.

It is necessary to bear in mind that this disorder does not derive solely from the experience or fear of living some type of abuse, nor does it occur exclusively during the presence of an episode of depression higher.

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Affectation at the vital level

Obviously, the previous 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 frustration, something that in turn feeds back their beliefs of being unworthy.

In their relationships they have a tendency to receive abuse and mistreatment, being frequent behaviors of absolute submission. This is also reflected in other relationships: many people can take advantage of them, while many others will tend to distance themselves from them due to their excessive generosity and submission. Those people who treat them well or tend to want to help them may encounter rejection from these people.

And not only in the social, but also in the workplace, problems can be found: it is likely that they carry out long hours of work with the purpose of benefiting others. It can also lower your own productivity. Your lack of confidence can limit your chances of improvement in all areas, as well as your behavioral passivity when it comes to seeking your own well-being.

Possible causes

The reason for the causes of this type of personality is unknown, actually having a multi-causal origin. Although the causes are not entirely clear, some of the hypotheses in this regard reveal 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 appearance of this personality disorder is the confusion and integration in the same subject of the experience of punishment, pain and suffering together with the feeling 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 cause self-devaluation as a mechanism to achieve said affected).

The presence of deficient parental models (parents absent and cold, 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 talked about is the lack of ability to integrate positive elements, coming to feel safe feeling despised and miserable.

Treatment of this personality disorder. Treating a personality disorder (be it this or another) is somewhat complex. At the end of the day, we are facing a way of proceeding and seeing the world that has been shaped throughout a person's life. Despite this, it is not impossible.

In the case at hand and based on Millon's model, the treatment would seek to reverse the pleasure-pain polarity (a person with this personality disorder tends to have some 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 beliefs and devaluations towards oneself and the need to consent to constant and excessive abuse and self-sacrifice. It would seek to modify the belief that they deserve to suffer or that their life has no value on its own and it only has value if it helps others, as well as the rest of the cognitive distortions that usually introduce.

Would also try that they will stop seeing others as needing help or hostile entities and generate behavioral modifications in such a way that they stop looking for dependency relationships. Also alter the way of relating to others and the world, as well as promoting a more active and less querulous vital position. Improving self-esteem and reducing the level of vital inhibition are also elements that can help these people to adopt a more adaptive way of seeing the world.

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

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Current status of the diagnostic label

As with sadistic personality disorder, masochistic personality disorder was contemplated 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 withdrawn in later editions, becoming part of the classification of unspecified personality disorder. Talking about Millon, whose biopsychosocial model is one of the most recognized when it comes to personality disorders, this continues to be maintained as a personality disorder in MCMI-III.

Bibliographic references:

• American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders. 3rd revised edition (DSM-III-R). Washington, D.C.
• Horse, V. (2001). An Introduction to Personality Disorders in the 21st Century. Behavioral Psychology, 9 (3); 455-469.
• Horse, V.E. (2015). Handbook of personality disorders. Description, evaluation and treatment. Editorial Synthesis.
• Millon, T., Davis, R., Millon, C., Escovar, L., & Meagher, S. (2001). Personality disorders in the modern life. Barcelona: Masson.
• Millon, T., Grossman, S., Davis, R. and PhD, and Millon, C. (2012). MCMI-III, MILLON Multiaxial Clinical Inventory. Ed: Pearson, New York.