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Avoidance

Avoidant Personality Disorder (AvPD) – Symptoms, Causes, & Treatment

People with avoidant personality disorder struggle with chronic feelings of inadequacy and are highly sensitive to being rejected by others.

This fear causes them to avoid social interactions and even live a very lonely and depressing lifestyle.

This article will help you gain more understanding of avoidant personality disorder, its diagnostic criteria, its causes, and common treatment.

Ready? Let’s get started!

What Is A Personality Disorder?

An individual’s personality is influenced by genetic characteristics along with environmental factors (surroundings, life situations).

Personality disorders are estimated to affect about 10 percent of people. Although personality disorders differ from mental disorders, like bipolar disorder or depression, they can cause significant impairment.

A personality disorder is defined as a way of thinking, feeling, and behaving that differs significantly from what is expected by the culture.

Personality disorders must affect at least two of the following areas:

  • Way of thinking about oneself and others
  • Way of responding emotionally
  • Way of relating to other people
  • Way of controlling one’s behavior

What is Avoidant Personality Disorder?

The American Psychiatric Association’s official manual of mental disorders DSM-5 defines avoidant personality disorder (AvPD) as “a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.”

Diagnostic criteria for AvPD defined by the DSM-5 include:

1. Avoidance of occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.

2. Unwillingness to get involved with people unless they are certain they’re going to be liked and accepted without criticism.

3. Showing restrain within intimate relationships because of the fear of being shamed or ridiculed.

4. Preoccupation with being criticized or rejected in social situations.

5. Feeling inhibited in new interpersonal situations because of feelings of inadequacy.

6. Viewing one’s self as socially inept, personally unappealing, or inferior to others.

7. Reluctance to take personal risks or to engage in any new activities because they may prove embarrassing.

Avoidant personality disorder vs. social anxiety disorder

Avoidant personality disorder AvPD may resemble social anxiety disorder, especially given its frequent onset in childhood and its persistence into and through adulthood. However, avoidance patterns in AvPD are more pervasive than those present in social anxiety.

Another difference is that people with social anxiety disorder often realize that their fears are irrational, while people with avoidant personality disorder believe that they are inferior to others and therefore rejection and humiliation are inevitable.

Related: 10 Signs of Social Withdrawal

Subtypes of Avoidant Personality Disorder

Psychologist Theodore Millon identified four subtypes of avoidant personality disorder: phobic, conflicted, hypersensitivity, and self-deserting.

1. Phobic

Phobia is the fear of someone or something. The object of the phobia could even be a situation or an idea.

The basis of the phobic subtype of Avoidant Personality Disorder is their extreme fear of people, of how other people respond to them, of public places, of crowds, etc.

People with AvPD believe that person or situation is actually harmful, which then leads to avoidance.

This avoidance will then feed into their fear and negative self-image.

Related: Agoraphobia Natural Treatment: 9 Steps to Overcome Panic Attacks

2. Conflicted

Conflicted people are indecisive when it comes to actions they should make and assume their outcomes. The rejection and humiliation they think will occur if they make the wrong choice, make them live in a constant mental war with themselves.

As a result, they assume that the wrong choice, in any situation, would be to act at all.

3. Hypersensitive

People who are hypersensitive tend to overreact or express an extreme reaction to how people respond to them.

What may seem like a silly remark may seriously impact someone who is hypersensitive and cause him to feel rejection on a more severe level.

This will then lead to increased stress, anxiety, and even depression. This can also feed their avoidance.

Related: How to Defeat Social Anxiety and Build Confidence?

4. Self-Deserting

Self-deserting subtypes will withdraw from reality and spend more time living a fantasy in their minds.

They may also take on an alternative personality or identify in an attempt to avoid self-awareness while seeing themselves as even less because of how they measure up to the fantasy persona.

This alternative personality allows them to be “someone else”, create a distance between them and their underlying issues, and enable them to downplay the severity of what is actually occurring in their psyche, which further worsens their negative self-image.

What Causes Avoidant Personality Disorder?

There are multiple theories on what causes AvPD.

The disorder can evolve from genetic predispositions for anxiety and depression-based issues. Environmental factors, such as childhood abuse, neglect, and trauma can also contribute to the development of the disorder.

When a child is exposed to constant humiliation, rejection, and neglect by their caregivers, they will come to expect the same reaction from everyone else. This, naturally, leads to withdrawal and avoidance, which enhances the previous fears and beliefs. The cycle continues and enhances the severity of the disorder.

Many people with AvPD have had painful early experiences of chronic parental and/or peer-group criticism or rejection. This makes the person with AvPD gradually develop a defensive shell of self-protection against repeated criticisms.

Common Therapy Treatments for AvPD

Cognitive Therapy

A therapist can assist someone with AvPD in changing their negative outlook and learning how to build social skills and deal with rejection and humiliation.

This will help the patient overcome their fears and build resilience.

Pro Tip: Choose your support system wisely. Consider online therapy and choose from thousands of licensed therapists and mental health counselors. Connect wherever and whenever it’s convenient for you by phone, texts, or video sessions. Check out Online-therapy now and get 20% off with this link >>

Exposure Therapy

Exposure therapy involves facing one’s fears in small doses that are increased gradually over a period of time.

This could involve asking a store clerk for assistance or going to a public, but not frequented, space and then gradually increasing the degree of exposure, depending on the severity of the disorder.

The idea is for the person to face their fears intolerable amounts in order to see that situation they’re afraid of is indeed safe.

Manage Your Anxiety Worksheets (1)

Group Therapy

Group therapy can be a form of exposure therapy.

The fact that group therapy involves other people can be a source of fear for someone with AvPD, but if the patient can get past the group setting, then being able to relate to others can be a great help in alleviating their fears.

Online Support Groups

Having people who suffer from similar or the same conditions and/or understand what one is going through can be a huge help.

This also can give people with AvPD the opportunity to help someone else with similar issues.

Medication

While medication is not a quick cure-all solution, it can help increase tolerance of pain, anxiety, and depression.

A mental health professional can determine what would be the most beneficial treatment.

Related: Beating Generalized Anxiety Disorder Without Drugs: 10 Practical CBT Exercises to Stop Intrusive & Anxious Thoughts

overcome avoidance worksheets

Avoidant Personality Disorder Resources

Befrienders International: a website on topics related to depression, loneliness, Isolation and suicide.

Online support groups

Pro Tip: Get the support you need whenever and wherever you want with 7Cupsoftea. It’s an on-demand emotional health service that connects you to caring listeners for free.

Counselling Resources

Online-therapy.com offers support based on the evidence-based practice of Cognitive-behavioral Therapy (CBT). Get the support you need whenever and wherever you want with weekly live sessions by phone or video and unlimited messaging.

For persons struggling with anxious thoughts, depressed moods, low self-esteem, low motivation, or loneliness, check out Online-therapy.com here.

If you are looking for a specialist near you, use the Psychology Today therapist directory here. Many of the practitioners accept insurance. 

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avoidant personality disorder treatment

References

  • Portions of this article were adapted from the book Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), © 2013 by American Psychiatric Association. All rights reserved.
  • Portions of this article were adapted from the book Avoidant Personality Disorder: the Ultimate Guide to Symptoms, Treatment, and Prevention, © 2015 by Clayton Geoffreys. All rights reserved.
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