Avoidant Personality Disorder

Avoidant Personality Disorder

Recently I had an opportunity to interview a young man who has been diagnosed with avoidant personality disorder (AvPD). AvPD is a personality disorder where the person suffers from high social anxiety and fear of intimacy despite also desiring social interaction and intimacy in most cases.

The person often feel as if they are being judged or ridiculed by others and feel unattractive, uncomfortable, or inept in social interactions.  They are usually extremely sensitive to the opinions of others and fear rejection and being judge negatively. To cope they usually withdraw from social interactions as much as possible which while it may help them successfully avoid the things they fear, it also often leaves them feeling more socially inept, lonely, anxious and depressed.

Avoidant personality disorder often results when a child has been rejected by one or both parents or his or her peer group, but it can also be caused by other factors such as a history of abuse and/or neglect.

People with avoidant personality disorder often only socialize with others they feel assured will not reject them. A very small number of people (often only one or two) will usually have gained their trust enough for them to feel confident and secure in their relationship with them.

They often look down upon themselves, minimizing their positive traits while inflating whatever flaws they perceive themselves as having. The person I interviewed is a serial “ghoster”. He would attempt to make friends and do so successfully, just to end up ghosting them. He told me that the fear of pain of what he saw was the inevitable (his friends rejection or abandoning him), was so strong that he would reject them before they had a chance to reject him. He isolated himself. He doesn’t have any current friends, but he does have a longtime girlfriend who is the one person he is closes to. He purposely chose a job where he works from home and has to deal with other people rarely. He has tried in the past to be more social. He went to college, but dropped out because the stress of having to interact with others was unbearable. He eventually went back and completed an online program. He has also often thought about suicide because he often fells anxious, lonely and undesirable and reports that it is a constant battle. He is in ongoing therapy to help keep him grounded.

Is Social Anxiety and Avoidant Personality Disorder the Same?

Avoidant personality disorder shares some of the same characteristics of social anxiety, but is less common. People with AvPD tend to have more severe symptoms of anxiety and depression than people with social anxiety. Also, people with social anxiety tend to fear the social circumstances (i.e., being at a party with a bunch of people judging how they look, act, etc.) while AvPD is more an aversion to intimacy in relationships.

How is Avoidant Personality Disorder Diagnosed?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association has a diagnostic code for avoidant personality disorder diagnosis (301.82) and describes it as a widespread pattern of inhibition around people, feeling inadequate and being very sensitive to negative evaluation. Symptoms begin by early adulthood and occur in a range of situations.

Four of the following seven symptoms have to be present to make a diagnosis of AvPD.

  • Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
  • is unwilling to get involved with people unless certain of being liked
  • shows restraint within intimate relationships because of the fear of being shamed or ridiculed
  • is preoccupied with being criticized or rejected in social situations
  • is inhibited in new interpersonal situations because of feelings of inadequacy
  • views self as socially inept, personally unappealing, or inferior to others
  • is unusually reluctant to take personal risk or to engage in any new activities because they may prove embarrassing

Treatments

Some of the treatments for avoidant personality disorder include cognitive therapy, social kills training, group therapy and drug treatments. As I said earlier, this particular young man is actively in therapy with a psychotherapist. He still prefers to isolate himself even making it a point to let me know that the only reason he felt comfortable opening up to me about his experience with AvPD was because he knew he would never talk to me again.

Five Ways To Combat Worrying

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“Worry is the direct descendant of the need to be in control. We cannot see everything. We do not know everything. It’s impossible for us to control everything…” –Iyanla Vanzant

Worrying is a natural part of life. Occasional worrying is actually a good coping skill that helps us plan ahead. However, worrying too much can become counterproductive, distracting and damaging to our mental and physical state.

Most of the things we worry about aren’t likely to happen in the first place, yet we waste vast amounts of emotional energy on them.

1 out of 10 people worry excessively. Extreme worrying can be a symptom of a mental health issue such as depression or generalized anxiety disorder. Some people who worry constantly and their worrying derails their lives may have a chemical imbalance and need medication, therapy or both.

For many of us, we worry because we want to control a situation, person or outcome that we usually don’t have that much control over. Worrying a lot usually means that you are trying really hard to control something, yet worrying usually doesn’t do anything to help or change the situation, it just causes us more emotional anguish.

Here are five tips to help combat worrying:

  1. Allow yourself to worry in small increments: I’ve told clients who worry a lot to designate one part of their day as their worry time, that way their worrying doesn’t build up nor do they worry throughout the entire day.
  2. Try to problem solve: Worrying is a poor attempt to solve a problem. It simply doesn’t work. Instead of wasting the energy on worrying, try to think of solutions to the problem you are worrying about.
  3. Learn to deal with uncertainty: Uncertainty is just a part of life, sometimes random things just happen, but many of us are unwilling to except that. We have to know and/or be in control of things that we simply can’t be. The faster we learn to deal with uncertainty, the easier it will be to stop worrying and the easier it will be to actually deal with the unexpected.
  4. Stay in the present: When we worry, we aren’t actually enjoying what’s going on around us now. We are so far into the “what ifs” of the future, that we are missing out on the great possibilities of right now. You can acknowledge your worries, but that doesn’t mean you have to allow them to pull you in. Meditation and mindfulness activities can help ease some of the stress from worrying and bring you back to the present.
  5. Get out of your head: You may find that putting what you’re worrying about down on paper helps release some of its power over you. Some people keep a worry journal next to their bed so that if their worries keep them up at night they can just jot them down on paper and “release” them. Guatemalan worry dolls, for example, are dolls based on a legend where children in Guatemala make dolls to tell their worries to and the doll “takes” their worry away.

“I have spent most of my life worrying about things that have never happened.” -Mark Twain