Self-defeating personality disorder (also known as masochistic personality disorder) is a personality disorder that was never formally admitted into the Diagnostic and Statistical Manual of Mental Disorders (DSM). It was discussed in an appendix of the manual’s revised third edition (DSM-III-R). As an alternative, the diagnosis Personality disorder not otherwise specified may be used instead. Some researchers and theorists continue to use its criteria. It has an official code number, 301.90.
Diagnosis
Proposed DSM III-R
Self-defeating personality disorder is:
A) A pervasive pattern of self-defeating behavior, beginning by early adulthood and present in a variety of contexts. The person may often avoid or undermine pleasurable experiences, be drawn to situations or relationships in which he or she will suffer, and prevent others from helping him, as indicated by at least five of the following:
- chooses people and situations that lead to disappointment, failure, or mistreatment even when better options are clearly available
- rejects or renders ineffective the attempts of others to help him or her
- following positive personal events (e.g., new achievement), responds with depression, guilt, or a behavior that produces pain (e.g., an accident)
- incites angry or rejecting responses from others and then feels hurt, defeated, or humiliated (e.g., makes fun of spouse in public, provoking an angry retort, then feels devastated)
- rejects opportunities for pleasure, or is reluctant to acknowledge enjoying himself or herself (despite having adequate social skills and the capacity for pleasure)
- fails to accomplish tasks crucial to his or her personal objectives despite demonstrated ability to do so, e.g., helps fellow students write papers, but is unable to write his or her own
- is uninterested in or rejects people who consistently treat him or her well, e.g., is unattracted to caring sexual partners
- engages in excessive self-sacrifice that is unsolicited by the intended recipients of the sacrifice
B) The behaviors in A do not occur exclusively in response to, or in anticipation of, being physically, sexually, or psychologically abused.
C) The behaviors in A do not occur only when the person is depressed.
Exclusion from DSM-IV
Historically, masochism has been associated with feminine submissiveness. This disorder became politically awkward when associated with domestic violence which is mostly caused by males. However a number of studies suggest that the disorder is common. In spite of its exclusion from DSM-IV, it continues to enjoy widespread currency amongst clinicians as a construct that explains a great many facets of human behaviour.
Sexual masochism that “causes clinically significant distress or impairment in social, occupational, or other important areas of functioning” is still in DSM-IV.
Millon’s subtypes
Theodore Millon identified four subtypes of masochist. Any individual masochist may exhibit none or one of the following:
- self-undoing masochist – including avoidant features
- possessive masochist – including negativistic (passive-aggressive) features
- oppressed masochist – including depressive features
- virtuous masochist – including histrionic features.