Self-sacrifice and self-sacrifice in order to help others are aspects that are valued positively by society when they start from a willingness to help someone at a particular time. However, there are people who always put the needs of others before their own and even go so far as to deny their own or the possibility of experiencing pleasure or joy for themselves and for themselves .

We are not talking about someone generous who does us a favor, but someone who literally devotes himself to meeting the needs of others even without their asking or considering it necessary. People who deny any kind 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 a 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 causes them great suffering. We are talking about what people with a masochistic or self-destructive personality disorder experience .

Masochistic or self-destructive personality disorder

A self-destructive or masochistic personality disorder is a personality type characterized by the presence of a relatively stable pattern of behavior and worldview over time and through situations in which elements of self-destruction and self-denial constantly appear .

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

It is likely that after positive experiences they will actively seek out aversive or depressing experiences. These are people who manifest an excessively self-sacrificing and generous behavior towards others, often self-sacrificing despite not being necessary or required. In addition, they tend to fail in the fulfilment of their own objectives . They tend to accumulate situations of frustration and self-harm.

.

People with this type of personality often see others either as beings in need of help or as competitive and cruel beings, while they see themselves as despicable, deserving of pain or simply useless. They tend to look for routine and consider their achievements to be due more to luck or outside intervention.

These are people with a high vulnerability to humiliation, a 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 abuses against them, having an afflicted profile and giving the appearance of simplicity. They often present cognitive distortions, consider themselves inferior and believe that they have a duty to help others and never prioritize themselves. Likewise, the fact of helping others makes them see themselves as necessary.

It is necessary to take into account that this disorder does not derive only from the experience or fear of living some kind of abuse, nor does it occur exclusively during the presence of a major depression episode.

Affect at a vital level

Evidently, the above-mentioned characteristics generate that these people present a series of important difficulties in their day-to-day life, which can take place with a high level of suffering. It is not uncommon for them to experience high levels of frustration , which in turn feeds back into their beliefs of being unworthy.

In their relationships they tend to be abused and mistreated, and it is common for them to behave in a completely submissive manner. This is also reflected in other relationships: many people can take advantage of them , while many others will tend to move away from them due to their excessive generosity and submission. Those who treat them well or who usually want to help them may find themselves rejected by these people.

And not only socially, but also at work, problems can be found: they are likely to work long hours in order to benefit others. This can also reduce their own productivity. Their lack of confidence may limit their possibilities of improvement in all areas, as well as behavioural passivity in seeking their own well-being.

Possible causes

The reason for the causes of this type of personality is unknown, having in fact a multi-causal origin. Although the causes are not entirely clear, some of the hypotheses in this respect show the influence of childhood experiences and lifelong learning.

The main hypotheses in this respect are mainly based on a psychoanalytical 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 him to self-evaluate as a mechanism to achieve such affection).

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

Treatment of this personality disorder
Treating a personality disorder (whether it is this or another one) is somewhat complex. After all, we are dealing with a way of proceeding and seeing the world that has been shaped throughout a person’s life. Nevertheless, it is not impossible.

In the case at hand and based on the Millon model, treatment would seek to reverse the pleasure-pain polarity (a person with this personality disorder tends to have some discordance getting 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 and devaluing beliefs 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 in itself and only has value if they help others, as well as the rest of the cognitive distortions that they usually present.

It would also try to stop them from seeing others as needing help or hostile entities and to generate behavioural modifications in such a way that they stop looking for dependency relationships. Also to alter the way of relating to others and to the world, as well as to encourage a more active and less querulous vital positioning. Improving self-esteem and decreasing the level of vital inhibition are also elements that can help these people to adopt a more adaptive way of seeing the world.

The use of techniques such as cognitive restructuring, behavioural experiments, the use of expressive techniques or psychodrama would be useful for this purpose. Training in social skills can also be useful in learning to relate positively. The use of animal-assisted therapy may also be useful, as well as assertiveness training. Likewise, behavioral activation may be very necessary to help them become more vitally active

Current status of the diagnostic label

As with sadistic personality disorder, masochistic personality disorder was covered 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 removed in later editions, becoming part of the classification of unspecified personality disorder. As for Million, whose biopsychosocial model is one of the most recognized in terms of personality disorders , it 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.
  • Caballo, V. (2001). An introduction to personality disorders in the 21st century. Behavioral psychology, 9(3);455-469.
  • Caballo, V.E. (2015). Manual of Personality Disorders. Description, evaluation and treatment. Editorial Sintesis.
  • Millon, T., Davis, R., Millon, C., Escovar, L., & Meagher, S. (2001). Personality disorders in 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.