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Personality

7 Signs of Avoidant Personality Disorder

Needing to be liked but sure that they won't be.

Key points

  • Avoidant personality disorder (AVPD) manifests in high levels of social inhibition and fear of being judged as inadequate.
  • About 2.5 percent of the population may be living with AVPD.
  • Unlike many personality disorders, people with AVPD are aware that they need therapeutic support to overcome its symptoms.

Avoidant personality disorder (AVPD) can be a socially and relationally crippling disorder. It is estimated that approximately 2.5% of adults live with it (Lampe & Malhi, 2018) and gender does not seem to be a predicting factor.

The symptoms begin to manifest in childhood, but the disorder is not typically diagnosed until adulthood when relationships in all venues, from social to occupational, become too challenging to pursue. Childhood indicators that the disorder might develop include a lack of positive and healthy relationships with adults as well as an inability to develop friendships with peers. Extreme shyness and reluctance to participate in normal casual social interaction might also be signs of later AVPD development. It’s thought that AVPD is a result of a combination of influences from nature and nurture, in that there may be an inborn tendency for extreme shyness, but one's environment and early child-adult relationships likely play a role in the actual development of the disorder.

How AVPD Feels

Individuals who exhibit the symptoms of AVPD are seldom content with their condition. They recognize that they are isolated and have a longing for participation in healthy, mutually engaged relationships with others. Humans crave social interaction and social bonds have been shown to be predictive of health, longevity, and subjective well-being over the lifespan. Unfortunately, individuals diagnosed with AVPD feel incapable of developing healthy relationships and their sense of inadequacy and fear of rejection create barriers to most attempts to establish new relationships. Loneliness, and the feeling of not fitting in with others, can compromise emotional and physical health.

Sorensen et al. (2020) noted that individuals diagnosed with AVPD may ascribe their behaviors to early childhood relational experiences. Whether they were parented by inadequately prepared or damaging parents or experienced teasing and bullying at school, there is an awareness of feelings of being judged, dismissed, or treated differently even as young children. By the time a diagnosis of AVPD is made in adulthood, the frame of reference and cognitive patterns of negative self-appraisal are deeply entrenched and can be difficult to undo.

Career Disruption

The isolating facets of AVPD limit one's career choices. Finding a career in which there is limited risk of social engagement is often the most important factor. The increased emphasis on belonging, teamwork, and collaboration in today's workplaces creates a paradox for individuals with AVPD; while they crave these conditions, their fear of rejection and judgment rule out employment in this sort of environment. Job interviews or “meet-and-greet” events can loom as terrifyingly risky for individuals who fear saying the wrong thing, wearing the wrong outfit, or making other missteps. The effect can be paralyzing and they may sacrifice opportunities for advancement in order to avoid the threat of being judged as inadequate.

Relationship Risks

Not surprisingly, individuals with AVPD may also experience dependent personality disorder. This disorder reflects an unhealthy dependency on another to the extent that one’s own sense of self is suffocated in the need to ensure they are accepted and valued by that person. Once an individual with AVPD forms a mutual attachment with another, their fear of rejection may catapult them into a role of subservient devotion. Thus, their fear of rejection keeps them tied to one person and diminishes motivation to reach out to other potential new friends or significant others.

Unfortunately, individuals with AVPD can misread social cues as well as others’ emotions. They are keen observers of others and so hypervigilant to the behavior of those around them that others in their presence notice their discomfort, tension, and “apartness." This turns their worst fears into self-fulfilling prophecies; thus, they create an environment in which their certainty of others’ rejection is borne out due to their inability to be comfortable and engaged in social settings.

7 Symptoms of Avoidant Personality Disorder

Someone who is clinically diagnosable with AVPD will display at least four of the following seven symptoms (APA, 2013):

  1. Does not engage in occupational activities that would require a good amount of interpersonal contact due to their fears of being criticized or rejected.
  2. Refuses to engage with others unless they feel confident that the others will like them.
  3. Is driven by the fear of shame and ridicule in even their intimate relationships which limits their ability to be fully present and engaged.
  4. Cannot relax in social settings due to the persistent fear of rejection or disapproval.
  5. Feelings of being inadequate or less than others keep them from being fully themselves in new social settings.
  6. Possesses a strongly negative perception of their social skills, personality, and adequacy.
  7. Experiences a fear of embarrassment and humiliation so strong that they are highly reluctant to take personal risks or try out new activities.

Getting Help for Avoidant Personality Disorder

With many personality disorders, those who meet the criteria for diagnosis may not realize that they even have a problem. Narcissists have no problem putting themselves ahead of others and are wholly convinced of their “specialness”; individuals who hoard possessions don’t recognize the dangers that their cluttered homes present; histrionic individuals believe they deserve the attention that their behaviors are designed to attract. Many people diagnosed with avoidant personality disorder, however, do recognize that they are missing out on the pleasures of social connection and bonding that others easily enjoy.

Mitigation of symptoms can occur through appropriate therapeutic interventions. Centonze et al. (2021) found that creating a strong alliance between clinician and client can be an effective beginning. In addition, techniques such as guided imagery and re-scripting can be useful in reducing the negative self-appraisal tendencies of individuals as well as helping them reframe and more accurately interpret the emotions and behaviors of others. The proper treatment will support individuals' efforts to develop more effective social skills, to more accurately read others' emotions, and to become more willing to engage in the creation of new relationships.

To find a therapist, visit the Psychology Today Therapy Directory.

Facebook image: fizkes/Shutterstock

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Centonze, A., Popolo, R., MacBeth, A., & Dimaggio, G. (2021). Building the alliance and using experiential techniques in the early phases of psychotherapy for avoidant personality disorder. J Clin Psychol., 77, 1219– 1232. https://doi.org/10.1002/jclp.23143

Lampe L, & Malhi GS. (2018). Avoidant personality disorder: current insights. Psychol Res Behav Manag., 11, 55-66. https://doi.org/10.2147/PRBM.S121073

Sorenson, K. D., Wilberg, T., Berthelsen, E., & Rabu, M. (2020). Subjective experience of the origin and development of avoidant personality disorder. Journal of Clinical Psychology, 76, 2232-2248.

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