Do you know someone who seems rather shy and awkward socially? Do they avoid situations where they have to be close to people? Do they have chronically low self-esteem and a tendency to focus intently on their own shortcomings – as well as a huge fear of embarrassing or shaming themselves.
These traits in themselves don’t automatically mean the person has an avoidant personality disorder. It’s only if these behaviours are intense, extreme, ongoing – and are significantly affecting the person’s functioning in everyday life – that there may be in issue.
Like all psychiatric conditions, a personality disorder needs to be diagnosed by a psychiatrist according to behaviours and symptoms listed in the DSM-5 diagnostic manual. The criteria for avoidant personality disorder include significant impairments in personality functioning shown through impairments in self functioning and interpersonal functioning.
Self-functioning impairments can include:
- Identity: This involves feelings of low self-esteem and believing themselves to be socially inept, personally unappealing, or feeling inferior to others. They may also experience excessive feelings of shame or inadequacy.
- Self-direction: They may have unrealistic standards for behaviour related to their reluctance to pursue goals, take personal risks, or engage in new activities involving interpersonal contact.
Impairments in interpersonal functioning can include:
- Empathy: They can become preoccupied with, and sensitive to, criticism or rejection, and they normally infer other people’s perspectives of them to be negative.
- Intimacy: They can be reluctant to become involved with people unless they’re certain of being liked. They find intimate relationships incredibly difficult because of their fear of being shamed or ridiculed.
Avoidant Personality Disorder diagnosis
To be diagnosed with avoidant personality disorder, the following pathological personality traits need to be present:
- Detachment, characterised by:
- Withdrawal, including reticence in social situations, avoiding social contact and activity, and lack of initiating social contact.
- Avoiding intimacy in close or romantic relationships, interpersonal attachments, and intimate sexual relationships.
- Anhedonia, which is a lack of enjoyment from, engagement in, or energy for life’s experiences; there’s an inability to feel pleasure or take interest in things.
- Negative affectivity, characterised by anxiousness: intense feelings of nervousness, tenseness, or panic, often in reaction to social situations; worrying about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful, apprehensive, or threatened by uncertainty; and fears of embarrassment.
- Detachment, characterised by:
To be diagnosed, the impairments in personality functioning and personality traits have to be relatively stable across time and consistent across situations; they are not ‘normal’ for the person’s life developmental stage or environment; and they’re not due to the effects of a substance or medication.
To support someone with avoidant personality disorder, it may help to understand what the symptoms are and to know that the person may have developed these behaviours and traits to help them survive a childhood where their needs weren’t met. Be sensitive to their fear of criticism and don’t expose them to social situations that could potentially be scary and shaming, but instead let them decide for themselves if they want to come along. Also, don’t take their behaviour personally if they come across as awkward or rejecting. You may want to encourage them to seek support, such as seeing their GP, if their life is becoming unmanageable – or talking to a therapist.
If you or someone you know feels ready to seek support for avoidant behaviour, or if they have avoidant traits that are making life difficult, then get in touch with us at The Awareness Centre. We have a team of counsellors, psychotherapists and psychologists offering sessions seven days a week from our centres in Clapham and Tooting. Email us on [email protected] or call 020 8673 4545.
2 Comments. Leave new
Hmmm… I wonder if treatment is always possible. I think it’s a matter of whether the condition is caused by the persons misinterpreting the words and actions of their peers… or if there’s something inherent in the person that actually DOES cause them to be ostracized. In the latter case, it’s a defense mechanism. And perhaps one that’s important for their survival.
True… by keeping people at arms length they’re missing out on the occasional possitive that might come from an interpersonal relationship… but people are cruel, and to continue to subject yourself to legitimate ridicule is just plain stupid.
Example: I grew up a well-adjusted child of a divorced couple, and in the custody of my grandparents. But when I was 8 years old, my grandmother died only a few months before a certain incident made national headlines only a few miles from where I lived. That is, Lorena Bobbitt cut off John Bobbitt’s penis.
Unfortunatly… my name is, also, John Bobbitt. Before 8th grade is come home with something like 17 broken bones, I had zero friends that lasted longer than 3 days (theyd be bullied until they’d come to me in tears and say they couldn’t be around me anymore), I had ONE girlfriend growing up and since then all attempts at dating went well… until they either learned my full name or that I was a Virgin (last week a girl threw a plate of food at me and broke my nose on our second date when she found out I was a Virgin), I wasn’t allowed to walk with my graduating class because the admin feared it might cause a “disturbance” When my name was called, I’ve actually been arrested several time for for “supplying False Information” and “hindering an Investigation” because I refused to answer if I was “the guy who got his d*** chopped off” when cops asked (charges dropped, but home was burglarised and I was left homeless during the week I was incarcerated).
On and on and on. Just this morning I opened my front door and found a butcher knife stuck in it. Lorena put out a new movie recently… so this is the fallout. I’ll just toss it in the box with the others.
Avoidant personality disorder keeps me alive; and while it’s very lonely, and I beg god for the courage to take my own life… i see no other option. Even psychiatrists…I’ve had two follow me around for a few days to experience my daily life. One refered me elsewhere, and went home in tears, saying only “I’m so sorry…”. And the other recommended that I change my name before any treatment was attempted (I’ve tried twice and was denied both times- to the tune of $600 each time)… but commented that it may be too little too late as far as my personality was concerned. After all, no women will date a 36 year old virgin. Period. It’s an established fact, I’m sorry to say (people argue the point, but in the end, I’ve got the record to prove it- and the scars).
My point is… not always is it treatable, short of changing the mentality of the population and it’s treatment of each other. That, we can’t control. And god knows…. people are very cruel.
Hello John. Thanks for letting us have your comments on our avoidant personality post. There can be many factors that lead a person to receive this diagnosis. We agree that we can’t change what other people say and do. The only thing we can change is how we respond to them. You mention that you have seen psychiatrists. We wonder if you have considered entering therapy to explore and process the many things that have happened to you?