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Old March 22nd, 2006, 10:09 AM
James Pretzer James Pretzer is offline
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Join Date: Jun 2004
Posts: 283
Default Passive-aggressive behavior in an adolescent

With passive-aggressive behavior in general, the problem is that the individual expresses anger indirectly or in disguised ways. When this is the case, I'd generally want to start by developing an understanding of the individual's expectations regarding the likely consequences of dealing with anger and conflict more directly and actively. If they have unrealistic fears about the consequences of dealing directly with anger and conflict, then it can be important to challenge these expectations (possibly through behavioral experiments). It also can be important to help them find adaptive ways of dealing with anger and conflict (perhaps appropriate assertion), to help them recognize the drawbacks of their old ways of dealing with anger, and to address dysfunctional cognitions that result in unnecessary anger.

With passive-aggressive personality disorder, all of these interventions apply but it is also important to identify sources of chronic anger and to address them. If the individual has been trying to suppress all anger, this can easily result in chronic resentment and occasional angry outbursts. If the individual has strong convictions about how they "should" be treated by others, chronic anger can result when these expectations are not met. Likewise, if the individual operates on the basis of a unilateral contract "I've done ________, therefore they should _____________.", this also can easily result in chronic anger.

In an adolescent, all of these interventions can be useful but it can be important to pay much more attention to the family context:
  1. What messages about anger has the child grown up with?
  2. What examples has the child grown up with regarding how to deal with anger and conflict?
  3. What are the parents' beliefs regarding how children should handle anger?
  4. How will the family respond if the child tries dealing with anger more directly or if the child tries being appropriately assertive?
  5. Is the child being treated in ways that result in chronic anger?
  6. etc.

It can be very difficult, if not impossible, to deal effectively with passive-aggressive behavior if it is not possible to engage the family in treatment as well. In particular, if the family environment played an important role in the development and maintainence of the behavior, it will be quite difficult to change the behavior unless it is possible to make some lasting changes in the environment.
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