AVOIDANT PERSONALITY DISORDER

Symptoms

Avoidant people have a high level of anxiety and low self-esteem. Low self-esteem causes fear of contact with others, and the lack of such contact further lowers self-respect. The patient suffers because they feel a strong need for contact with other people and for closeness, but because of the anxiety caused by interpersonal relationships, they are unable to meet these needs. A person with avoidant personality disorder withdraws from various kinds of social activities and avoids contact with other people, does not take on challenges in life, prefers not to show up, does not write back, and would rather not call than risk failure. Such a person feels of little worth and not attractive enough; in their view, they are not interesting company for anyone, nor do they deserve praise or respect. They expect acceptance from others, but only unconditional acceptance can satisfy them. The same applies in close, friendly, and intimate relationships. A person with an avoidant personality usually hesitates for a long time before taking the first step or responding to someone else’s invitation to make contact. This often results in turning away from the people around them, because others may interpret this hesitation as resentment or excessive distrust. Avoidant personality is also characterized by inhibition in expressing emotions and feelings and frequent episodes of depressed mood. People with this type of personality constantly feel tension and shyness in situations involving contact with others, are sensitive to criticism, continually analyze and control their own behavior, are very restrained in showing feelings, isolate themselves socially, are cautious and rather reserved, and tend to give up on dreams and escape into a world of fantasy. They may even develop social phobia, which effectively hinders or even prevents interpersonal relationships.

Causes

Psychologists see the causes of an avoidant personality in a specific set of traits related to a particular person’s temperament and character. These determine how a child, and later an adolescent, responds to stimuli from the outside world and how they cope with stressful situations. Psychologists include the following character traits as conducive to the development of an avoidant personality: introversion, shyness, sensitivity (often hypersensitivity), and a tendency toward negative interpretation of events. When these characteristics are confronted with sometimes difficult life experiences, they can lead to the development of a set of personality disorders known as avoidant personality disorder.

The reason for the development of an avoidant personality may also be a lack of acceptance, understanding, and love within the family, as well as problems in relationships with peers resulting from the child’s difference or family situation. However, not every child who experiences such difficulties will develop an avoidant personality, which is why the theory linking social, biological, and psychological factors appears to be correct.

Diagnosis

To classify a personality as an avoidant personality type, four or more criteria must be met:

• Avoidance of professional activities that require significant interpersonal contact, due to fear of criticism, disapproval, or rejection,
• Unwillingness to form relationships with other people, except with some people they like,
• Restraint in intimate relationships caused by fear of being embarrassed or ridiculed by others,
• Preoccupation with criticism or rejection in social situations,
• Refraining from entering into new interpersonal relationships because of a sense of inadequacy,
• Seeing oneself as socially incompetent, unattractive, or inferior to others,
• Extreme reluctance to take personal risks or undertake new activities, since these may be embarrassing.

Treatment

Treatment mainly consists of psychotherapy, aimed among other things at improving self-image. In the initial period of treatment, these people find it difficult to participate in group psychotherapy, which is why individual psychotherapy is preferred. Group sessions may become possible at a later stage of treatment. Pharmacotherapy may include the administration of certain medications belonging to the group of antidepressants. If problems such as depression, social phobia, or agoraphobia coexist or occur together, appropriate treatment should be provided.