Independence

Business Logo for Psychological and Neuropsychological Issues Americans prize their independence.  Hollywood earns billions portraying characters that express their independence in an aggressive fashion.  Many Americans loath dependence and equate it with weakness.  Is dependence really equatable with weakness?

The author’s experience with nursing home and hospital patients over the last twenty years may shed some light.  The severely medically ill typically dread becoming a burden on their loved ones.  It is rare to find older adults who readily agree to live with their children.  Rarely does the avoidance stem from ill feelings, as from the aforementioned dread of becoming a burden.  The ailing older American is typically more resistive of living with their children than the children themselves.

Other cultures have less difficulty with dependence.  These patients typically experience less adjustment problems with illness and nursing home placement.  Forced dependence from medical illness is viewed as an unavoidable part of life, rather than stemming from a personal inadequacy.  Just as they may have taken care of ailing friends and relations, there is an expectation that it is a societal necessity to receive care in turn.  In such cultures, the resistance to unavoidable dependence would be taken as askew, and possibly indicative of mental illness.

These notions regarding dependence are focused on physical rather than mental illness.  Quite often long-term mental illness has a significant impact on parenting style and resources.  This impact may be resented by the children as they age; especially as they compare notes with peers whose parents did not suffer with mental illness.  Children of recurrent depressive and bipolar patients are often the least motivated to care for an incapacitated parent.  The very real physical responsibilities of providing care is even more difficult when the parent is uncooperative and apparently unappreciative.  It is nearly impossible for children to fathom the role of mental illness in parenting, as it requires a prospective obtained outside the confines of the family unit.

In regards to mental illness, there was a disorder termed Dependent Personality Disorder.  This so-called disorder is no longer a part of the diagnostic nomenclature, but its very existence is significant.  Dependent Personality Disorder was confined to the American diagnostic manual of mental disorders, and has never been a part of the international classification of mental illness.  Too much dependence was viewed as a mental illness, and psychologists and psychiatrists were given the task of drawing the line.  Dependence was not only considered a weakness, but possibly a disease that required treatment.

Anthropologists and evolutionary psychologists now consider the the role of grandparents as an advantage unique to our species.  Grandparents living within the family unit were able to confer knowledge and skills to the children that the parents were too busy to provide.  This advantage may be the reason other forms of humanoids became extinct.  Prior to World War II, it was the norm for couples to live with their parents for many years.  Married couples initially depended upon their parents, and in turn, the parents came to depend upon their children.  It may be merely an artifact of simple economics, but the children and grandparents may have benefited in ways that were not reducible to mere income potential.

Dependence is a problem if either party perceives it as a problem.  Dependence is highly influenced by cultural norms.  Dependence stemming from mental illness is often less well received than physical incapacity.  Dependence may be an evolutionary adaptation that secured our species spot at the top of the food chain.  We depend upon others for their knowledge and experience, as well as physical support.  Others depend upon us for the very same reasons.  Perhaps dependence is often perceived as a weakness by those who are afraid of the responsibility.  The responsibility is to not hate those on whom we depend.  It’s very American.

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