Why It’s Important to Address Avoidant Personality (and How to Treat It)

Avoidant personality disorder (AVPD) is a mental health condition characterized by long-term, persistent social restraint, usually due to feelings of:

• Social ineptitude or awkwardness
• Inadequacy or low self-esteem
• Extreme fear of the possibility of humiliation, rejection, negative criticism, or disapproval from other people

People living with this condition often tend to struggle in personal and professional social situations, which can make it difficult to succeed in certain careers or intimate relationships. Even friendships can be affected. Many people with avoidant personalities may become isolated, and this can significantly impact emotional wellness.

Professional support can help people with AVPD cope with these difficult feelings and the social challenges they spark. But as the condition shares some similarities with other mental health concerns, it’s important to arrive at the correct diagnosis before developing a treatment plan. Therapy may not have the same benefit when it doesn’t address the specific challenges of avoidant personality.

Avoidant Personality: What Makes It Different?

Diagnosing AVPD may prove challenging, as this condition can involve traits and symptoms that resemble those of other personality disorders, including dependent and schizoid personality disorders. When these conditions co-occur, one may be missed in diagnosis.

Personality disorders involve deeply entrenched patterns of thought and behavior, characteristics that become part of personality over time.

People with dependent personality disorder (DPD) are also likely to feel inadequate, have greater sensitivity to criticism, and need frequent reassurance from loved ones. This condition can occur along with avoidant personality. Experts suggest this may happen because people living with AVPD tend to develop strong attachments when they become close to someone and may eventually become dependent on those loved ones. DPD is characterized by an extreme need to be taken care of, however, which sets it apart from AVPD.

Schizoid personality disorder may also involve avoidance of social and interpersonal relationships, but people living with this personality disorder tend not to seek out social contact because they don’t desire the company of others. People with AVPD, on the other hand, do want to interact with others and develop relationships. They simply fear rejection, so they avoid doing so until they feel certain they’ll be accepted.

Social anxiety (social phobia) also shares many symptoms with AVPD, so these conditions may be misdiagnosed as each other. They also sometimes co-occur, which can make distinguishing between them even more difficult.

AVPD and social anxiety differ in one important way. Personality disorders involve deeply entrenched patterns of thought and behavior, characteristics that become part of personality over time. The feelings and emotions that occur with personality disorders seem very real to the person experiencing them, even if they don’t represent the truth. For example, a person with AVPD may truly believe in their own inadequacy and doubt any other outcome than their inevitable rejection.

Social anxiety, on the other hand, is a type of anxiety. Feelings of insecurity, worry, and fear may not be any less intense than those experienced by people with a personality disorder, but people with anxiety are far more likely to recognize their feelings as an anxiety response. In other words, people living with social anxiety may realize their fear of social rejection isn’t grounded in reality, and they may have an easier time challenging these anxious thoughts.

A 2015 study looking at 91 adults who had either social anxiety or AVPD found evidence to suggest childhood neglect could increase risk for AVPD. This factor could help explain some key differences between the two conditions.

Avoidant Personality Treatment Options

Personality disorders can improve with treatment. Support from a compassionate therapist can help people with avoidant personality disorder explore any issues causing distress or having a negative impact on their lives and learn how to cope with these challenges.

Possible approaches that may help soothe symptoms of AVPD include:

Therapy

Therapy is the recommended treatment for any personality disorder. Different approaches may have more benefit than others for specific personality disorders. When it comes to AVPD, helpful approaches include:

• Psychodynamic therapy
• Schema therapy
• Emotion-focused therapy

While therapists may use these approaches less frequently than standard therapies such as cognitive behavioral therapy (CBT), research suggests they can often lead to greater improvement of personality disorder symptoms.

Complementary treatments

Many people living with personality disorders such as AVPD find alternative approaches helpful.

These might include:

• Biofeedback
• Acupuncture
• Art therapy
• Yoga therapy
• Meditation

These approaches may have benefit for some but may not work well for everyone. Research generally supports them as possibly helpful and not harmful in most cases.

Avoidant Personality and Self-Care

People living with AVPD may want to take steps on their own, outside of therapy, to try and improve symptoms or find relief from emotional distress. It’s common for people struggling with personality disorders, or any mental health issue, to fall back on coping methods that don’t help and might even cause harm.

These coping strategies, such as drinking, drugs, impulsive or reckless behavior, or self-harm, might feel safe, even easy, and they may help manage or relieve pain in the moment. But choosing positive, helpful coping strategies can do more than relieve pain for a short time. These techniques can promote long-term healing and growth.

• Live healthfully. It may not seem like it, but eating nutritious meals, getting enough physical activity, and sleeping well can all promote mental wellness. Spending time in nature and getting some sun can also help improve emotional wellness.
• Develop social skills. People struggling with social interaction might find classes helpful. Therapists and counselors, university wellness centers, and similar organizations can offer more information about these and related classes. These classes may have the most benefit after a few sessions of therapy.
• Don’t force it. When trying to improve emotional health, it’s important to sit with difficult feelings and confront challenges that arise. In terms of AVPD, this can involve increasing interactions with other people in order to recognize that rejection is not the inevitable outcome. But it can take time to feel ready to do this. Working with a therapist to develop a plan of action that seems both realistic and feasible can help make success more likely.
• Seek out enjoyable hobbies. Combining social interaction with a favorite activity can make the social interaction easier and help increase the chances of meeting like-minded people. It’s usually easier to naturally fall into conversation with people who share interests, and these new connections may seem less challenging or stressful as a result.

If a person diagnosed with avoidant personality does not receive treatment, they may continue to experience difficulty forming close relationships with others, leading to isolation and deep feelings of loneliness.

Whether or not you have received a formal diagnosis, therapy can help if you feel you may have symptoms of AVPD. A licensed mental health professional can screen you for AVPD and other similar conditions in order to create the best treatment strategy for you. Find a therapist near me.

References:

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington, VA: American Psychiatric Association.
2. Avoidant personality disorder. (n.d.). Retrieved from https://www.bridgestorecovery.com/avoidant-personality-disorder
3. Eikenaes, I., Egeland, J., Hummelen, B., &; Wilberg, T. (2015, March 27). Avoidant personality disorder versus social phobia: The significance of childhood neglect. PloS One, 10(3). doi: 10.1371/journal.pone.0122846
4. Guina, J. (2018, April 30). The talking cure of avoidant personality disorder: Remission through earned-secure attachment. The American Journal of Psychotherapy, 70(3), 233-342. Retrieved from https://psychotherapy.psychiatryonline.org/doi/full/10.1176/appi.psychotherapy.2016.70.3.233
5. Kvarnstrom, E. (2016, April 6). Avoidant personality disorder goes beyond social anxiety. Retrieved from https://www.bridgestorecovery.com/blog/avoidant-personality-disorder-goes-beyond-social-anxiety
6. Lampe, L., & Malhi, G. S. (2018, March 8). Avoidant personality disorder: Current insights. Psychology Research and Behavior Management, 11, 55-66. Retrieved from doi: 10.2147/PRBM.S121073
7. Lampe, L., & Sunderland, M. (2015). Social phobia and avoidant personality disorder: Similar but different? Journal of Personality Disorders, 29(1), 115-130. doi: 10.1521/pedi_2013_27_079
8. Pos, A. E. (2014). Emotion focused therapy for avoidant personality disorder: Pragmatic considerations for working with experientially avoidant clients. Journal of Contemporary Psychotherapy: On the Cutting Edge of Modern Developments in Psychotherapy, 44(2), 127-139. Retrieved from https://psycnet.apa.org/record/2013-41393-001

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