Avoidant personality disorder, often referred to as avoidant personality, is one of the personality disorders defined in the fields of psychiatry and psychology.
Most people avoid from time to time when they want to dismiss difficult choices or situations. Avoidant personality disorder is characterized by an established pattern of avoidance in the areas of behavior, emotions and thoughts. People affected by avoidant personality disorder often experience severe anxiety and insecurity in social situations. They tend to avoid situations in which they might be judged or rejected by others. This leads to social isolation and difficulty forming close relationships.
Nonetheless, there are effective therapeutic methods that can help sufferers of this disorder cope with their symptoms. In the following sections of this article, you will learn about the symptoms, causes and treatment of avoidant personality disorder
What is avoidant personality
Avoidant personality disorder, also known as avoidant personality, is one of many personality disorders described in the DSM-5, the diagnostic classification used by mental health professionals. It is characterized by a complex pattern of behaviors, thoughts and emotions that affect the way an individual functions and interacts with other people.
Avoidant personality disorder(APD) is a type of personality disorder that is characterized by a strong fear of negative evaluation and rejection from others. People with this disorder have low self-esteem, a strong sense of shame and a tendency to be self-critical. Low self-esteem causes patients to avoid social, professional and intimate situations that could cause them anxiety or discomfort. They often feel lonely, isolated and unhappy.
Avoidant personality – criteria and diagnosis
The diagnostic criteria for avoidant personality disorder is defined by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).
- Criterion A: A general pattern of avoidance of social interaction for fear of rejection or criticism. A person avoids professional, social or other interpersonal relationship activities for fear of rejection, criticism or disapproval.
- Criterion B: Generalized lack of self-confidence and extremely sensitive to negative evaluations. The person exhibits excessive feelings of incompetence, lack of worth, or is overly critical of themselves.
- Criterion C: Avoidance of new relationships due to fear of rejection. The person avoids engaging in new interpersonal relationships for fear of rejection.
- Criterion D: Inhibition in interpersonal relationships for fear of exposing oneself to criticism or rejection. The person avoids intimacy or shows great reluctance to share intimate thoughts and feelings for fear of negative judgments from others.
- Criterion E: Periodic lack of confidence in social situations. In social situations, the person shows excessive shyness or fears that others will judge him or her negatively.
- Criterion F: Impact on daily functioning. The pattern of avoidance, lack of self-confidence and fear of proximity are persistent and affect daily functioning.
- Criterion G: Exclusion of other disorders. These behaviors are not due to other disorders, such as depression.
The diagnosis should be established by a qualified professional, such as a psychologist , psychotherapist or psychiatrist, after a thorough evaluation and verification of functioning.
Personality disorder – differential diagnosis. Avoidant personality
Avoidant personality disorder is often confused with social anxiety disorder(SAD), which also involves fear of social situations. However, there are some differences between the two disorders. People with social phobia are mainly concerned about feeling anxious and showing signs of nervousness in the presence of other people. People with avoidant personality disorder mainly fear being judged negatively and rejected by other people. In addition, social anxiety is mainly concerned with certain social situations, such as speaking in public, eating in a restaurant or talking on the phone. Avoidant personality disorder affects a wide range of life situations, such as work, school, family and relationships.
Avoidant personality – causes
There is no single specific cause of avoidant personality disorder. It is believed to be the result of the interaction of genetic, biological and environmental factors. Some of the possible causes are:
- Heredity. Avoidant personality disorder may be partly genetic. Studies have shown that people with the disorder are more likely to have relatives with similar problems in their family. For example, a study of monozygotic and dizygotic twins showed that there is significant genetic concordance in the occurrence of avoidant personality disorder. As another example, a study found that people with avoidant personality disorder are more likely to have a variant of the serotonin transporter gene (5-HTTLPR), which is associated with greater susceptibility to stress.
- Temperament. Avoidant personality disorder can also be associated with temperament traits such as hypersensitivity, shyness or cautiousness. People with the disorder often exhibit these traits from childhood. For example, a study of infants found that those who were more tearful, shy and timid in the presence of strangers had a higher risk of developing avoidant personality disorder in adulthood. As another example, a study found that people with avoidant personality disorder have lower levels of dopamine in the brain, which is associated with less motivation and pleasure.
- Life experiences. Avoidant personality disorder can also be caused by negative life experiences, such as rejection, criticism, abuse or neglect from parents such as a toxic mother, peers or teachers. People with this disorder often have a history of trauma or abuse, parentification. For example, a study of college students found that people with avoidant personality disorder were more likely to have experienced parental rejection and criticism as children. As another example, a study found that people with avoidant personality disorder were more likely to be victims of bullying at school.
As you can see, avoidant personality disorder can have different sources and affect different aspects of a person’s life. It is worth noting that each person is unique and the causes of avoidant personality disorder can vary. Moreover, it is often the result of the interaction of many factors.
Avoidant personality – test
There is no single simple test for avoidant personality disorder. In order to make a diagnosis of this disorder, it is necessary to consult a doctor or psychologist who will conduct a clinical interview and assessment. However, there are some diagnostic criteria that can help diagnose this problem. According to the DSM-5 classification, avoidant personality disorder is characterized by the presence of at least four of the following symptoms:
- Avoidance of professional activities that require significant contact with people, due to fear of criticism, disapproval or rejection.
- Reluctance to establish relationships with people unless one is confident of being accepted.
- Restraint in intimate situations due to fear of embarrassment or ridicule.
- Engaging in social or interpersonal situations only with great anxiety.
- A sense of inferiority to other people and an exaggerated tendency to compare oneself with them.
- Excessive preoccupation with the possibility of being criticized or rejected in social situations.
- Discouragement to take on new activities, self-sabotage or risky situations due to fear of making a mistake or being shown in a bad light.
If you notice that certain criteria are present, then get help – online psychotherapy. Remember that it is not your fault and that you can change.
Anxious personality vs. avoidant personality
Avoidant personality is one of the types of personality disorders described in the DSM-5. People with this disorder are characterized by a chronic sense of low self-worth, fear of rejection and difficulty establishing and maintaining interpersonal relationships.
Anxious personality, often referred to as avoidant personality, is not officially classified as a separate personality disorder in the DSM-5. In clinical practice, the term“anxious personality” can be used to describe individuals who exhibit anxious traits in their personality, but do not meet the criteria for avoidant personality disorder.
Avoidant personality in a relationship. Do I need to avoid intimacy?
Avoidant personality disorder can have a big impact on your love life. People with this disorder often have difficulty establishing and maintaining close relationships. They may avoid getting involved in a relationship for fear of rejection, abandonment or hurt. Or they may be in a relationship but keep their partner at a distance, not expressing their feelings, needs or desires. They may also sabotage their relationship by looking for flaws in their partner, comparing them to other people or withdrawing from interpersonal contact.
People with avoidant personality disorder are often attracted to partners who have their own emotional problems or personality disorders. For example, they may be in a relationship with a narcissist who takes advantage of their weakness and subordinates them to her will. Or they may be in a relationship with an anxious person who is also afraid of rejection and abandonment and needs constant reassurance of love. Such relationships are often full of conflict, tension and suffering.
To improve the quality of their love life, people with avoidant personality disorder must face their fears and learn to build trust and intimacy with their partner. They also need to work on their self-esteem and self-acceptance. Some ways to do this are:
- Becoming aware of their negative beliefs about themselves, their partner and relationships. For example: “I am not worthy of love,” “My partner will leave me,” “Relationships are dangerous.”
- Trying to change these beliefs to more realistic and positive ones. For example: “I am worthy of love”, “My partner loves me”, “Relationships are valuable”.
- Learning to communicate with your partner in an open, honest and assertive way. Expressing your feelings, needs and desires, as well as listening to and respecting those of your partner. Resolving conflicts in a constructive and consensual manner.
- Finding time for activities together that give you pleasure and bring you closer together. This can be a walk, a movie, dinner, a massage or sex. It is important to show your partner your love and gratitude for their presence and support.
- Seek professional help if avoidant personality disorder is hindering you in your relationship or making you very uncomfortable. Individual or couples therapy can help you understand and change your behaviors, thoughts and emotions that are affecting your relationship. It can also help you improve your self-esteem and self-acceptance.
Avoidant personality disorder vs. love
Avoidant personality disorder doesn’t mean you can’t love or be loved. People with this disorder have the same emotional needs as any other person. They need love, acceptance, security and closeness. However, because of their fear of rejection and criticism, they often can’t show it or ask for it.
People with avoidant personality disorder often love very deeply and intensely. However, their love is often hidden under a layer of insecurity, shame and isolation. Experiencing shame, they are unable to trust their partner or themselves. They are afraid that their love is not enough, that they will be betrayed, abandoned or hurt. Therefore, they often avoid expressing their feelings or showing affection.
People with avoidant personality disorder need love that is patient, understanding and respectful. They need a partner who will give them a sense of security and stability. A partner who will accept them as they are, while encouraging them to grow and change. A partner who will show them his love not only with words, but also with actions.
Treatment of avoidant personality – psychotherapy
Avoidant personality disorder is a difficult problem to overcome, but it is not incurable. It is worth noting that the treatment of avoidant personality disorder is a long-term process that requires commitment and patience. There are various forms of treatment that can help people with this disorder improve the quality of their lives and relationships. Some of them are:
- Cognitive-behavioral therapy(CBT): This is a type of therapy focused on changing the negative thoughts and behaviors that maintain avoidant personality disorder. The therapist helps the patient identify and challenge their beliefs about themselves, other people and the world. He or she also helps the patient expose himself or herself gradually to social situations that trigger anxiety and learn to cope effectively.
- Schema therapy. This is a type of therapy focused on changing deeply ingrained patterns of thought, emotion and behavior (known as schemas) that arose as a result of unmet basic emotional needs in childhood. The therapist helps the patient understand and modify his or her schemas, the unconscious rules by which he or she functions. He also helps the patient meet his emotional needs in a healthy way and build a positive self-image.
- Dialectical behavior therapy (DBT): This is a type of therapy aimed at people with personality disorders who have difficulty regulating their emotions and impulsivity. The therapist helps the patient learn to accept himself and his situation while striving for change. He also helps the patient acquire skills in stress management, interpersonal communication, frustration tolerance and problem solving.
Pharmacotherapy
There are no specific medications for avoidant personality disorder. However, some medications may be helpful in alleviating the symptoms that accompany this disorder, such as anxiety, depression and social phobia. These medications can be prescribed by a psychiatrist and should be used under his or her supervision. Some of the medications that can be used are: antidepressants known as antidepressants, anti-anxiety medications, beta-blockers or mood stabilizers.
Avoidant personality internally torn
Avoidant personality disorder means that people struggling with it often experience an inner conflict between two opposing desires: the desire for closeness and the desire for avoidance. On the one hand, they desire to be loved, accepted and understood by other people. On the other hand, they fear rejection, criticism and embarrassment by other people. That’s why they often have trouble deciding whether to engage in or avoid contact with others.
People with avoidant personality disorder also have a complicated relationship with their partner. On the one hand, they love him and need his presence and support. On the other hand, they fear him and push him away. Therefore, they often behave in inconsistent and contradictory ways toward their partner. For example, they may be affectionate and caring once, and cool and distant once.
People with avoidant personality disorder also often have an ambivalent attitude toward themselves. On the one hand, they want to change and improve their lives. On the other hand, they are afraid of change and risk. Therefore, they often sabotage their own goals and dreams. For example, they may have a lot of intellectual or artistic potential, but do not develop it due to fear of failure or judgment. They may have many passions and interests, but fail to pursue them because of a lack of self-confidence.
Summary
Avoidant personality disorder is a serious problem that can hinder social, professional and intimate functioning, but it is treatable. There are various forms of treatment that can help gradually change one’s life.
People with avoidant personality disorder can also help themselves by taking small steps toward change. They can try to expose themselves to situations that cause anxiety, but are important or beneficial to them. They can learn to accept themselves and their imperfections. They can seek support from family, friends or support groups. They can develop their passions and interests. They can love and be loved.
Bibliography:
Beck Aaron T. Freeman Arthur Davis Denise D; Cognitive therapy for personality disorders. WUJ 2016