ANXIETY AND THE NEED FOR DEPENDENCE

As children we are all dependent upon our parents for our physical survival. So a pattern of accepting dependence is ingrained into us at an early stage.

Although we grow up into relatively independent adults, a need for some degree of dependence persists with us all. This is more obvious in the character of a woman, and has the biological function of allowing her to accept dependence when it is necessary for her during her childbearing period. On the other hand, the idea of being dependent on others may conflict with the aggressive and self-assertive aspects of a man’s personality. Such men want to be independent of their parents or their wife, but at the same time they feel the need for dependency. They are caught in the dilemma of unconsciously wanting dependence and at the same time not wanting it. As a result they feel a tension for which they can see no reason.

Another cause of tension concerns the need to have others dependent on us. It is not uncommon for an emotionally mature woman to marry a man less mature than herself. He comes to rely on her, and to be dependent upon her. She in turn enjoys giving this support from the fullness of her maturity. However, it often happens when the couple have their first baby, that the wife switches, and gives her dependence to her child. The husband becomes tense; he is not quite sure what has happened. Those around him may see that his anxiety is due to the loss of his wife’s emotional support, while he himself unconsciously saves face by not recognizing this cause of his tension.

On the other hand, a man who is a little immature may have fought hard to become independent of his parents in spite of his deep-seated wish to remain dependent. He succeeds, and has the feeling of well-being because his independence satisfies his masculinity. However, if such a man marries a mature, motherly type of woman, as he is often unconsciously driven to do, he may become tense again, because she, without knowing it, tries to develop a dependent relationship with him, which he unconsciously wants but at the same time strives to avoid.

In considering these different types of dependent relationships, it is well to remember that the mature person of either sex has a capacity both to give dependence to others and to accept some degree of dependence for himself. The man who would stand alone sees himself as the true picture of strength and maturity; but in reality he is a person who is not sufficiently secure to allow himself normal human interdependent relationships with his fellows.

A fifty-nine-year-old man who came to see me had always been extremely introverted and afraid of making a fool of himself in public. He had married a woman eight years younger than himself. She was a complete extrovert, and he saw in her all that he wished for himself. He developed a dependent relationship, but was unable to come close to her emotionally and was physically a poor lover. He covered up his feelings of inferiority with a good deal of aggression toward her. His wife eventually took a lover. He was shattered by the sudden loss of dependence, and he completely went to pieces, breaking down with acute anxiety symptoms.

The only thing in the world he wanted was to get her back. He worked conscientiously at the relaxing exercises. When his wife saw him more relaxed and without his former aggression, she abandoned her lover; and the story ends happily with the pair lovingly reunited.

They jointly sent a Christmas card with the note, “Christmas for us started on . . .” and then gave the date of their reunion.

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WHAT ARE THE PROS AND CONS OF USING ST JOHN’S WORT VERSUS THE SSRIS SUCH AS PROZAC AND LUSTRAL?

It is important to remember that there have been no head-to-head trials comparing St John’s Wort with the SSRIs in the treatment of depression. All reports of comparisons between the herbal and synthetic anti-depressants are therefore anecdotal. Nevertheless, there are lessons to be learned from anecdotes and one conclusion I have reached, based on many stories that there are certain people who do better on St John’s Wort than on the SSRIs. When both types of antidepressants are used in their conventional dosages, St John’s Wort appears to be superior to the SSRIs with respect to side-effects. Particularly, it appears to cause fewer sexual side-effects, less weight gain and fewer feelings of dullness in thinking or feeling. When used in their conventional dosages it is possible that the SSRIs may be more potent and I have encountered cases where they have reversed depressive symptoms that did not respond to St John’s Wort alone. In the currently planned multi-centre research study sponsored by the US National Institute of Mental Health, St John’s Wort and the SSRI Lustral are to be compared for the first time; It will be fascinating to see how they stack up against each other. In the meanwhile each depressed person will have to choose the type of anti-depressant – herbal or synthetic -best suited to his or her needs based on the information available and his or her own personal preferences.

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