Avoidant Personality Disorder

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The Authentic Recovery Center is a dual diagnosis treatment center located in Los Angeles, California. We specialize in the treatment of substance abuse and co-occurring disorders. We offer multiple levels of care, including inpatient and outpatient rehabilitation options. If you would like to speak with us about our rehab programs call 1 877 415 4673 now.

Learning More

This section of the website will provide a broad overview of Personality Disorders. Since disorders of this nature are diagnostically broken down into several categories, the following will focus on a single sub-category, Avoidant Personality Disorder (APD), outlining the basic information that is pertinent to this specific classification. Discussion will include a general summary of Personality Disorders, followed by a brief overview of the diagnostic criteria for Avoidant Personality Disorder, its symptoms, and finally treatment methods.

Personality Disorders – Definition, Overview, Discussion

Personality Disorders are a variety of personality types, distinguished by specific sets of behaviors that deviate from what are considered to be spectrums of normal functioning. Disorders of this kind are marked by severe and chronic disturbances in the overall development of the personality, with increasingly dysfunctional cognition and behavioral tendencies. Invariably these disturbances manifest as perpetual disruptions in personal relationships and come to affect virtually every aspect of an individual’s life.

One of the distinctive features of Personality Disorders is the intractability of the individual’s perceptions and responses. The individual’s patterns of behavior do not vary from situation to situation, but remain constant, and typically only make sense to the person. Overtime this develops into a set of traits that are completely maladaptive and which generate constant conflict, depression, or anxiety. One of the hallmarks of Personality Disorders is an inability to sustain personal relationships on any level, attended by the presence of constant upheaval in the personal histories of the sufferer. It is assumed that the emergence of these behaviors has their origins in childhood development, and is often traced back to the quality and kind of relationship the person experienced with a primary care-giver. The rigidity of the behaviors, reactions, and characteristics is striking, and applies to all varieties of the disorder.

Avoidant Personality Disorder

What is Avoidant Personality Disorder (APD)?

Avoidant Personality Disorder (APD) is a mental health condition characterized by chronic patterns of social inhibition. The distinguishing features of the disorder are a vulnerability to the criticism of others and a crippling fear that they will be negatively assessed by family, friends, strangers or peers. Because the feelings of inadequacy are so pervasive, behavioral patterns emerge that over time adversely impact every area of the person’s life.

One of the most common features of the disorder is to experience extreme doubt regarding one’s ability to communicate or connect with others, which occurs along with a chronic expectation that they will be the victim of ridicule or humiliation. The conviction that they are inadequate, or that they do not measure up to the standards of others is so overwhelming that virtually every aspect of the person’s existence is affected, leading to evasion of any situations in which they will need to interact or socialize. In time, avoidance of these threatening scenarios becomes the primary, operative impulse, leading to extreme isolation and feelings of disconnection.  At its most extreme, the entire spectrum of normal social experiences becomes curtailed and one is impaired occupationally, socially, and academically.

Symptoms of Avoidant Personality Disorder

Individuals who suffer from Avoidant Personality Disorder are morbidly engrossed with their own deficiencies. Typically, they only form relationships and bond with people they believe will not reject them or throw them away. Accordingly, the experience of loss and rejection are so intense that when faced with the option of trying to connect or remaining isolated, they will opt for isolation, regardless of the adverse impact it may have on employment or socialization.

Like all personality disorders, a diagnosis cannot be made until the individual has reached the age of 18. However, despite the diagnostic criteria, the condition typically manifests symptomatically long before the age of 18 and long before the actual cause has been determined. The most common features of Avoidance Personality Disorder are as follows:

  • Extreme anxiety regarding to rejection.
  • Chronic isolating.
  • Extreme stress in social situations, even when the desire for friendship is present.
  • Avoiding physical contact.
  • Associating physical contact with negative experiences.
  • Evading personal relationships.
  • Intense feelings of inadequacy.
  • Crippling sense of low self-esteem.
  • Fostering self-loathing.
  • Paranoia regarding the motives of others.
  • Anxiety regarding issues of intimacy.
  • Preoccupied with self.
  • Hyper-sensitivity regarding criticism.
  • Inability to relate to others
  • Recurring problems regarding occupational consistency.
  • Intense loneliness, to the extent that it defines their self-image.
  • Feeling inferior to others.
  • Crippled by an inability to try new activities or to take risks.

Treatment for Avoidant Personality Disorder

The treatment of Avoidant Personality Disorder includes such therapeutic tools Cognitive Therapy, Cognitive Behavioral Therapy, Group Therapy, what is referred to as Social Skills Training, and various medications. Because one of the chief characteristics of APD is a chronic mistrust of others establishing a trusting relationship with the person suffering is pivotal to successful treatment. Despite the differences of these various modalities, what is consistent is the need to help the sufferer deconstruct the belief-system which keeps them ill.

One of the key differences between Avoidant Personality Disorder and other personality disorders is that APD clients are usually able to perform some kind of reality testing, and thereby circumvent the minimizing, denial, and externalization that so characterizes disorders like Borderline or Narcissism. It is surmised that individuals with APD suffer such intense psychic pain that in certain circumstances they actively seek out treatment and are therefore more amenable to the demands treatment makes.

Cognitive Behavioral Therapy (CBT)

Generally speaking, CBT is a style of therapy in which the therapist works with the client to deconstruct negative self-images that result from the client continually regarding themself in a negative light. The focus is on altering the dysfunctional thinking that has developed as a response to triggering stimuli, and requires the client to adopt modified behaviors in situations where exposure to a stressor is present.  One of the primary advantages of Cognitive Behavioral Therapy is its tendency to alleviate symptoms while simultaneously curtailing the condition itself. The central premise is to help the client develop new coping strategies in the face of impending or inevitable arousal.

Other Cognitive Behavioral styles include rational-emotive therapy, systematic desensitization, and social skills training. Frequently these modalities are employed in conjunction with exposure techniques, which are centered on the idea that having the client walkthrough their fears in the presence of a trained clinician, will provide training of sorts for navigating stressful situation elsewhere. The two distinctive forms of exposure therapy are graduated or flooding.

Cognitive Therapy

The goal cognitive therapy is to focus on dismantling the cognitive distortions that occur in regards to self-worth and self-image. The guiding principle is to have the therapist assist the person to identify negative thought patterns and discern their origin.  Important too is helping the person understand that they do not suffer alone; and that there is in fact a virtual community of individuals striving to make progress in the same arena. This is vitally important; because of the key components is the awful sense of isolation that attends ADP sufferers.

The Cognitive process includes isolating what is referred to as self-talk; a process whereby self-statements are clearly identified, defined, and neutralized. During this process clients are encouraged explain how they feel about themselves at any given time, and equally important; explore the content of the feelings and why the feelings are being generated. This is especially important when experiencing a sense of ineptness, inadequacy, or the awful, prevailing conviction that they are intrinsically unacceptable.

Group Therapy

Group therapy has been shown to be successful treating a variety of conditions. With APD sufferers, group therapy is typically recommended after a period of intensive individual therapy. The premise is that at a certain point in one’s treatment, having them navigate the feelings that arise when dealing with groups can be especially helpful. The group forum becomes a non-confrontational and highly supportive environment in which the client is assisted to walkthrough their fears and create new response-precedents they can reference in other areas of their life.

Medications

Anti-depressants are used to reduce symptoms associated with rejection, although the exact causal factors for this are as yet unknown. The anti-depressants usually prescribed for people suffering APD are referred to as SSRIs (or Selective Serotonin Re-uptake Inhibitors), and include:

  • Prozac
  • Paxil
  • Lexapro
  • Zoloft

Amongst the tranquilizers most commonly prescribed to treat symptoms of Avoidant Personality Disorder are benzodiazepines. Benzodiazepines are fast-acting sedatives that fall into the category of minor tranquilizers. Although they are highly effective for short-term treatment of anxiety symptoms, they are not without their side-effects. Tolerance, followed by dependence and withdrawal symptoms, make them appropriate for short-term use only. These considerations are vitally important when treating individuals who have been dual diagnosed or when treating people who have histories of addiction.

A Special Note Regarding Benzodiazepines and Dual Diagnosis

Dual Diagnosis refers to a condition in which an individual’s addiction occurs simultaneously with another mental health problem, each aggravating the other and both contributing to the problems of the individual.  In situations where a dual diagnosis has been made – especially where some form of anxiety disorder has been diagnosed in tandem with an addiction – the use of benzodiazepines is usually discouraged. Unlike the anti-depressants that are prescribed for anxiety disorder, benzodiazepines have a euphoric component and abuse potential that generally makes them inappropriate for treating a population with histories of addiction.

Because of these complications, most physicians specializing in treating dual diagnosed clients will only prescribe benzodiazepines in a very restrictive way, for the shortest duration possible. Given these considerations, dual diagnosed individuals have a better chance of receiving comprehensive care from treatment teams that are specifically trained to deal with individuals who suffer from co-occurring disorders.

The benzodiazepines most commonly prescribed for short-term treatment are:

Treatment Goals and Objectives for Avoidant Personality Disorder

Like other mental health disorders, no known cure for APD exists. However, with vigilance and maintenance, it is possible to manage the condition and allow for considerably better quality of life. The goal is improved management of symptoms in tandem with a reduction in the severity of the condition itself. Improvement of in functionality is key, with marked demonstrations manifesting at home or work or in social situations. Ultimately, freedom from the disorder is the intention of any intervention.

The topic of Avoidant Personlaity Disorder is large, and not easily summed up in one article. Education and awareness are the first steps to acquiring help. Take the time necessary to keep yourself informed about latest practices and current treatment options. Hopefully this article will assist giving you a foundation of knowledge that will make selecting the correct course of treatment easier to determine.

Call to Learn More about Treatment for Avoidant Personality Disorder at the Authentic Recovery Center

If you would like to learn more about the Authentic Recovery Center call 1 877 415 4673 now. We offer multiple options for the treatment of personality disorders, including inpatient and outpatient programs designed to help people who exhibit signs of avoidant personality disorder. The good news is that APD is 100% treatable. Call us today to see whether or not our program is right for you.

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