I think that submissive symmetry would be the most difficult to change, even though I do not think it is the most damaging pattern. When people are submissive by nature, it is often difficult to get them to change. Their personality may not lend itself to assertiveness. I think it is easier to teach assertive people to use some self control, although it may be frustrating for them. It seems pretty common in our society to teach self-control, such as not interrupting others, taking turns, and sharing, but I think it is very hard to teach passive people to become more dominant. Also, it is probably hard to get people to acknowledge that there is a problem (as opposed to an abusive relationship where one person is dominant and the other is submissive).
I think the most damaging to a relationship would be competitive symmetry, at least from a day to day perspective. There would be constant conflict and competition. This would likely lead to arguments and anger. In the long run, I think rigid complementary might be worse, such as in abusive relationships where the husband physically and mentally dominates the wife. I think these rigid complementary relationships would be most damaging to self-esteem. The submissive partner always gives in and does not have a role in the relationship to provide self-esteem. I think this is worse for a submissive stay at home parent who may judge her self worth based on the family and relationship. A submissive person who works may build self-esteem outside the house and may be willing to play a secondary role at home.
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