The Self-Preservation Subtype

Dependency Disorder

In addition to features of paranoid disorder, the Self-Preservation 6 presents aspects common to the typical picture of two disorders included in DSM IV: avoidant personality disorder and dependent personality disorder.

Dependent personality disorder (DPD) more closely resembles the Enneatype Nine, but in some traits, we can recognize the phobic subtype. A generalized and excessive need to be cared for results in submissive and dependent behavior, with fear of separation and a search for warm contact.

The pathological dependent person finds it difficult to make daily decisions without receiving advice and reassuring words, needing others to assume responsibility in most areas of their life. They have difficulty expressing disagreement, for fear of losing support or approval, and struggle to initiate projects or carry things forward with autonomy.

They feel uncomfortable or helpless when alone, due to an exaggerated fear of being unable to take care of themselves. When a close relationship ends, they urgently seek another source of care and support. Self-Preservation 6 constantly seeks the protection of figures to whom it attributes authority and strength, in order to establish a dependency relationship with them.

The concept of dependency disorder as a nosographic entity is recent, although Kraepelin had already described an "incapable" personality, receptive to external influences. Schneider spoke of weak will. Abraham and Fenichel, from a psychoanalytic perspective, described these subjects with "oral personality" as poorly determined, prone to external influences, and in constant search of figures capable of recreating the safe environment provided by the mother during lactation. All of them highlighted the excessive demand for help and security. Millon points out that in these patients, there is great avoidance, characterized by docility, lack of assertiveness, the need for care, and the avoidance of adult responsibilities, leading to submission in interpersonal relationships and a self-image of naivety, with feelings of inadequacy and ineptitude.

Birtchell considers dependency in adults the equivalent of attachment in children, pointing out how dependency is normal in certain situations such as disabling illnesses or childhood, while the pathological dependent is incapable of establishing their own identity, separate from reference figures.

Dependence can be considered an ethologically appropriate attitude of adaptation in some contexts, driving the search for protection by someone considered stronger. However, in some clinical situations, it can result in a serious deficit in personal and social functioning. The phobic symptoms also serve to minimize separation.

According to Stone, the constant demand for reassurance, the inability to express disagreement, and the willingness to perform unpleasant tasks are behaviors aimed at maintaining dependence on significant figures.

Avoidant Disorder

Some features of Self-Preservation 6 are also recognized in DSM avoidant personality disorder (AvPD). We find generalized social inhibition, feelings of inadequacy, and hypersensitivity to criticism in various contexts: work, when it involves significant interpersonal contact; with people the individual is uncertain about liking in intimate relationships (fearing humiliation or ridicule); social situations where they fear rejection; and new interpersonal situations.

The individual considers themselves socially inept, with little personal attractiveness, or inferior to others. They are reluctant to take risks or engage in new activities because they fear potential failure. The typical shyness of Self-Preservation 6 is understood as constant avoidance of involvement and situations in which their value could be questioned, without the guarantee of an acceptable outcome.

On the threshold of contact with others, the pathological avoidant feels inadequate and inhibits themselves with typically phobic anxiety and shame. They develop a sense of estrangement in two-way relationships, as well as exclusion in groups, and do not achieve a fully satisfying feeling of belonging and sharing with others.

AvPD could be defined as an intimacy disorder, where the desire to establish close relationships is strong but accompanied by a feeling of exclusion. Avoidants link their sense of inadequacy to the expectation of rejection or negative judgment, which leads to avoidance. The desire for affection is coupled with a constant fear of rejection, which drives the individual to seek refuge in loneliness, often tinged with sadness.

This disorder was first defined as a diagnostic entity by Millon, who differentiated it from schizoid personality disorder: the former is painfully inhibited in social contact, while the latter is detached. The avoidant desires social involvement and is highly sensitive to others, while the schizoid prefers solitude and is indifferent to acceptance or rejection. According to Millon, avoidance is an active choice in which the individual defends themselves from an environment perceived as rejecting. With avoidance, they close themselves off socially, except within the family, which may be experienced as conflictual but always remains a source of support.

Their stories often show dependence on compact and closed family units. The child might be subjected to continuous jokes and humiliation, but the family is viewed as the main source of support, the only safe place in a world of rejecting people.

The depressed mood leads them to seek care. The tendency to withdraw and isolate increases vulnerability to depression. Depressive phases reflect the failure of the coping strategies typically used, and the space created by social avoidance becomes intolerable. Collapses of self-esteem are frequent, which intensifies the anxiety surrounding relationships.

A central emotion in avoidant disorder is shame. Individuals with AvPD may feel ashamed of many aspects of themselves. Social situations should be avoided because they expose their inadequacies for all to see.

Anxiety Due to Loss of Affective Bond

Anxiety due to the loss of an affective bond emerges when reconstructing the histories of many Self-Preservation 6 individuals starting therapy. On a superficial level of consciousness, the mother figure is seen as present and attentive, but a detailed review reveals her discontinuity and ambivalence, which exposed the child to great separation anxiety. Attacks on the internalized object lead to the dynamics of self-accusation, typical of depression, which becomes a central point in the psychodynamics of E6.

Only in 1926, at the age of seventy, did Freud systematically study separation anxiety, a topic he had only briefly addressed in 1905 (in "Three Essays on the Theory of Sexuality") and in 1917 (in the "Introduction to Psychoanalysis"). It was the publication of O. Rank's book, The Trauma of Birth, that prompted him to re-examine the problem of anxiety:

"Only very few cases of the child's manifestation of anxiety are understandable to us. We will have to stick to them. There are three in total: when the child is alone, when he is in the dark, and when he finds a strange person in the place of the familiar one (the mother). These three situations boil down to one condition: noticing the absence of the loved and yearned-for person. Anxiety thus arises as a reaction to noticing the absence of the object [...] The situation of dissatisfaction is, for the infant, analogous to the experience of birth [...] The danger now is the absence of the mother, and as soon as the child notices this, he signals distress before the feared situation can be established."

Freud concluded that anxiety functions as an "alarm signal" experienced by the ego to announce danger. Among these, the loss of the object occupies a primary place. Anxiety becomes a reaction to the potential loss of the object, suffering as a reaction to that loss,

and defensive processes protect the ego from instinctive demands that may arise in the absence of the object.

Anna Freud studied separation anxiety during World War II while working with infants and children in boarding nurseries. In a joint essay with Dorothy Burlingham, she noted:

"During this phase of life, the child's reactions to separation are especially violent [...] His new ability to love is deprived of the objects on which he usually relied, leading to unsatisfied affective needs. The longing for the mother becomes intolerable and leaves the child in a state of despair [...] To alleviate the feeling of guilt, the child exaggerates all the affection they have felt for their parents."

D. W. Winnicott links the baby's anxiety to insecurity caused by deficiencies in the maternal response to their needs, i.e., a lack of support. What is observed in depressed adults is a set of defenses organized from an original depression. C. Geets argues:

"For Winnicott, the fear of collapse is caused by early experiences where the individual, during the first stages of development, faced the inconstancy of their environment. The immaturity of the infantile ego was such that the child could not integrate these experiences into a sense of personal omnipotence. As a result, this primitive agony could not be fully noticed at the time it occurred and persists as a 'torment' projected into the future."

The collapse may be the only way to experience the past, inaccessible to conscious memory, because at the time, the subject had not yet been formed as an integrated person. Consequently, they could not find their psychic space. And since emptiness creates despondency, the patient defends themselves by organizing a "controlled emptiness," clinically expressed as fear of death.

84.A. Freud, Child Psychoanalysis and the Clinic, Paidós, Buenos Aires, 1977. 85.C. Geets, Winnicott, Armando, Rome, 1983. [Vers. Cast: Donald Winnicott. Pediatrics, Games, and Psychoanalysis, Almagest, Buenos Aires, 1993.]