What is avoidant personality disorder?
Avoidant personality disorder (AVPD) is a persistent behavioral pattern that is related to social inhibition, feelings of inadequacy, and sensitivity to rejection, which can cause problems in the work environment and interpersonal relationships.
This disorder is characterized by extreme shyness and sensitivity to criticism from others, and is called type C personality disorder or a personality disorder involving anxiety and fear.
AVPD is usually associated with other mental health conditions, such as anxiety disorders, especially social anxiety disorders. People with this disease show an avoidance pattern for fear of rejection or disapproval, and they feel very distressed. The disease affects approximately 2.5% of the population, and roughly equal numbers of men and women are affected.
The following is a list of common symptoms associated with avoidant personality disorder:
- Need to be liked
- Anhedonia (lack of activity fun)
- Worry about saying the wrong thing or doing the wrong thing
- Anxiety in social situations
- Avoid conflict (becoming a “lovable person”)
- Avoid interaction in the work environment or refuse promotion
- Avoiding intimacy or sharing intimacy
- Avoid making decisions
- Avoid situations caused by fear of rejection
- Avoid social occasions or events
- Vulnerable to criticism or disapproval
- Extreme self-awareness
- Failed to initiate social contact
- An air of fear and tension
- Feeling of inadequacy
- Allergic to negative reviews
- lack of confidence
- Lack of trust in others
- Misunderstanding the neutral situation as negative
- No close friends/lack of social networks
- Social inhibition
- Unwilling to take risks or try new things
- Think of yourself as socially incompetent or inferior
- Watch out for signs of disapproval or rejection
Avoidant personality disorder can only be based on well-trained mental health experts Manual of Diagnosis and Statistics of Mental Disorders (DSM-5). Although the family doctor can be the first contact for diagnosis, your doctor should refer you to a psychologist, psychiatrist, or other mental health professional for diagnosis.
Avoidant personality disorder is usually diagnosed in adults because the child’s personality is still developing. Behaviors such as shyness may be a normal experience in childhood, but then grow up.
According to DSM-5, a person must have a consistent pattern of avoiding social contact, being overly sensitive to rejection and criticism, and feeling inadequate, as shown in at least four of the following criteria:
- Avoid professional activities that involve a lot of social contact because of fear of criticism, disapproval or rejection
- Unwilling to associate with others unless you are sure they will like you
- Withdraw from an intimate relationship for fear of being laughed at or humiliated
- Focus on criticism or rejection in social situations
- Inhibition of new social occasions due to feeling inadequate
- Feeling socially incompetent, unattractive, or inferior to others
- Being afraid of embarrassment, afraid to take risks or try new things
The cause of avoidant personality disorder is believed to involve genetic, environmental, social and psychological factors. If there are other factors, emotional abuse, criticism, ridicule, or lack of care or upbringing by parents or caregivers during childhood may lead to the development of this personality disorder. Rejection by peers may also be a risk factor.
Usually, people with this disease are very shy when they are children, and will not get rid of this shyness as they grow older.
Social anxiety disorder and avoidant personality disorder have similar symptoms and genetics, and AVPD is a more serious form of the disease.
Avoidant personality disorder may occur and overlap with a variety of other diseases, including:
Most people with avoidant personality disorder do not seek treatment.When they do, it is usually because of specific life problems or other types of symptoms they are experiencing, such as depression and anxiety. If the problem is resolved, they usually stop treatment.
Avoidant personality disorder may be difficult to treat like other personality disorders because it is a long-lasting behavior pattern, and people with this disorder may have difficulty realizing that psychotherapy is needed and may be beneficial.
Unfortunately, people with avoidant personality disorder who do not seek treatment have a rather bleak outlook-usually they become self-isolated and use avoidance as their only coping strategy.
On the other hand, when the treatment is successfully applied, it can help reduce symptoms and increase the range of coping strategies that patients can use to control anxiety. People with avoidant personality disorder may always be a little shy, but avoidance does not dominate their thinking.
Talking therapy for avoidant personality disorder may include cognitive behavioral therapy (CBT), psychodynamic therapy and schema therapy.Group therapy and social skills training may also help.
CBT helps to learn how to change unhelpful thinking patterns, while psychodynamic therapy aims to understand how past experiences, pain, and conflict may lead to current symptoms.
The schema treatment of avoidant personality disorder is a comprehensive method based on CBT and many other treatment techniques. It focuses on the therapeutic relationship between the therapist and the client, with the goal of improving daily functions and gaining insights into change based on understanding and redesigning early life experiences.
A key feature of schema therapy is “limited re-nurture”, in which the client expresses childhood needs and learns to develop and internalize healthy parental voices.
The main concepts of schema therapy
In schema therapy, the client understands four main concepts:
- The pattern of maladaptation is a pattern of how it is repeated throughout a lifetime.These patterns are divided into five areas: disconnection and rejection, impaired autonomy and performance, impaired restriction, excessive responsibility and standards, excessive vigilance and inhibition.
- When I was young, I learned what coping styles (for example, evasion, counterattack).
- Which patterns are being used to deal with and how they are unhelpful (for example, avoidance, detachment, obedience, punishment).
- How to develop a healthy adult coping model and meet core emotional needs.
Although there are currently no drugs specifically approved for the treatment of avoidant personality disorder, if a person suffers from other related diseases, such as depression or anxiety, drugs may be prescribed to help relieve these symptoms.
For example, antidepressants can help improve mood and anhedonia, reduce anxiety symptoms, and can also reduce sensitivity to rejection.
The first step in improving the quality of life of patients with avoidant personality disorder is to identify symptoms. By understanding your specific symptoms, you will be better able to work with your therapist to find solutions to these problems.
Consider involving friends and family in your treatment, so they can better understand what you are going through and how to help.
Self-care is also important, including finding healthy coping skills to prevent you from turning to drugs or alcohol, smoking, overeating, or self-harm when you encounter difficulties.
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If you think someone you know or love may have symptoms of avoidant personality disorder, be sure to encourage that person to seek help. Without professional treatments such as talk therapy, symptoms and their related effects on interpersonal relationships are unlikely to improve.