Psychotherapy is the treatment of choice. Various modes are used, including supportive, psychodynamic, behavioural assertiveness training, and the paradoxical approach in group or individual settings. The goal of treatment should be to help the patient escape from the vicious circle of self-defeating behaviour and develop a mature way of expressing anger and other feelings. The sessions can become a battleground and struggle for control, in which the patient opposes, criticizes, and resents the therapist on whom he or she wants to be dependent. It is very important for a therapist not to engage in a sadomasochistic power game with passive-aggressive patients; therefore humiliating and critical comments should be avoided.

Paradoxical approaches may be useful for overcoming resistance and achieving more compliance by the patients. Symptom prescription is a particularly useful strategy. Behavioural therapy techniques, such as assertiveness training or behavioural contracting, may be beneficial.

Your Perfect Right

Your Perfect Right

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