For many persons with persistent self-defeating patterns—or what many have called self-defeating personality disorder (SDPD)—suffering within relationships is preferable to being alone. Formerly known as masochistic personality disorder, SDPD will likely be among several disorders to be excluded as a formally recognized diagnosis from the upcoming DSM-5. (It was considered in the DSM-III-R as a category needing further study, but it was not included in the DSM-IV.)
How does SDPD present, and how does the clinician avoid unwittingly reinforcing a very problematic behavior pattern?
Here with information to help you identify the symptoms and treat the disorder is Dr. Nancy McWilliams, Professor at Rutgers University Graduate School of Applied and Professional Psychology in Piscataway, New Jersey. Dr. McWilliams also offers brief commentary on the rationale for excluding SDPD from DSM-5.
For teaching points, please click here.