What Causes Avoidant Personality Disorder and How is it Treated?
Every person is endowed with his/her own personality that is unique and absolutely different from the other. However, there are people, who have personalities which are considered as a disorder as they do not suit the social norms. The Avoidant Personality Disorder or AvPD is one such disorder that is seen to occur in 1.8-6.4% in the normal population. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has listed Avoidant Personality Disorder or AvPD as a "Cluster C" which encompasses fearful or anxious disorders. If not diagnosed on time, Avoidant Personality Disorder or AvPD can lead to severe conditions in which the person's day-to-day interactions with others and maintaining relationships with them will be affected.
Definition of Avoidant Personality Disorder:
Avoidant Personality Disorder or AvPD is a mental condition that is characterized by feelings of inadequacy, extreme shyness and sensitivity to rejection, along with an inferiority complex. The condition is diagnosed only when such behaviours become long-term and persistent and are very distressing or disabling.
Signs and Symptoms of Avoidant Personality Disorder:
The general sign of Avoidant Personality Disorder or AvPD is associated with feeling extremely shy and also being concerned about and be over-sensitive to what others think of the person. A sense of inadequacy and inferiority makes the person suffering from Avoidant Personality Disorder or AvPD feel socially inept. Due to such recurrent feelings that cannot be changed easily with familial support, the Avoidant Personality Disorder patient gradually starts to avoid work, school and other social interactions. Usually troubled with extreme self-doubts and no amount of self-confidence, they are quite vulnerable to criticism and often react to criticism with crying.
What makes the situation even worse for people suffering from Avoidant Personality Disorder or AvPD is that due to their lack of self confidence, hypersensitivity to rejection and low self-esteem, they gradually become relatively isolated. As a result, to avert such isolated circumstances and crisis situations, Avoidant Personality Disorder patients do not have any social support network. In personal grounds, their desire and need for acceptance and affection leads them to fantasize about ideal relationships that practically do not exist; and in work field, they try to avoid any and every kind of social situations in which they might have to meet people in order to cater to job needs.
The general symptoms are associated with the following personality traits that are seen in almost every single person suffering from Avoidant Personality Disorder.
- Due to fear of criticism, rejection and disapproval, a person suffering from Avoidant Personality Disorder or AvPD avoids significant interpersonal contact and occupational activities
- Avoidant Personality Disorder person is preoccupied with the thought of being rejected, even before facing the situation
- With the fear of being disliked and unwilling to be involved with others, Avoidant Personality Disorder sufferers get associated with only those, with whom they feel comfortable or are not afraid to be rejected
- People suffering from Avoidant Personality Disorder would have a persistent feeling of inferiority to others, unappealing to others and socially inept
- Even in intimate relationships, shows restraint
- Reluctant to take any personal risks
- Catastrophising or always considering the possibility of a "worst" situation to occur
- Giving importance to the source of the occurrence of a bad situation or blame the reason, rather than finding a solution
Types of Avoidant Personality Disorder:
Each and every person with the Avoidant Personality Disorder consists of a range of personality or characteristic traits that do not necessarily match with the other. Hence, depending on the symptoms and the major prominence of the traits, they can be divided into four subtypes and they are:
- Phobic Type of Avoidant Personality Disorder: In this condition, the general apprehensiveness is usually displaced and instead repugnancy, qualms and disquietude, dreadful situations, avoidable tangible precipitant takes its place.
- Conflicted Type of Avoidant Personality Disorder: Usually the person suffers from an internal discord and fears any sort of dependency. Hesitation, confusion, angst and unreconciled within the self and severe torment overpowers the person.
- Hypersensitive Type of Avoidant Personality Disorder: extremely panicky, terrified and hyper-suspicious regarding anything and everything. This gradually leads to terror; a sense of being wary and timorous overpowers the condition. It most often even leads to become thin-skinned, feeling prickly and petulant.
- Self Deserting Type of Avoidant Personality Disorder: A deep sense of self awareness leads to discarding all the images and memories that are painful and gradually suicidal tendencies overpower.
Causes and Risk Factors of Avoidant Personality Disorder:
There has not yet been any discovery of the specific cause of the Avoidant Personality Disorder to occur. However, scientists often associate the gene factors as well as environmental and social conditions of the person as the cause of Avoidant Personality Disorder. To highlight the social conditions, the scientists have highlighted and focussed on the factors such as how a person in his early developmental stage has learned to interact with friends and family. However, on the other hand, to deal with the psychological factors, the person's ability to cope with a situation, to deal with stress and how the environment plays a role over temperament and personality of the individual, are mostly considered and given importance to.
Those, who have had a condition of repeated rejections in the past and have been severely criticised during a tender mental condition, might develop Avoidant Personality Disorder gradually. If it persists, it will become a personality and changing a personality that has already been established is quite difficult. The occurrence of Avoidant Personality Disorder is limited and can be seen only in 2.36% in the American general population, according to the National Epidemiologic Survey on Alcohol and Related Conditions, 2001-02. It has been seen that those, who have been extremely shy as children are more likely to develop Avoidant Personality Disorder, but it is not necessary that all the shy children will have AvPD.
Diagnosis of Avoidant Personality Disorder:
Diagnosis of Avoidant Personality Disorder or AvPD is very important as it is the only way through which the exact difficulty and the problems that the person is suffering from or is troubled with, can be determined and gradually catered to. However, Avoidant Personality Disorder is a mental health condition that cannot be diagnosed with any kind of blood tests or lab test and can only be diagnosed by a trained and well equipped mental health professional, such as a psychiatrist or a psychologist.
The diagnosis of Avoidant Personality Disorder is made by the professional, depending on the symptoms and the characteristic traits that one possesses. Standardised questionnaires are administered to diagnose Avoidant Personality Disorder. If at least few of those conditions match with your personality, you will be considered to have Avoidant Personality Disorder or AvPD considering the in-detailed patient history. The questionnaire focuses on whether you have:
- Fear of criticism, disapproval, or rejection.
- Unwilling to get involved with unknown people
- Avoid intimate relation with the fear of rejection and humiliation
- A deep sense of inferiority
- Unlikely to participate in new activities
- Worried to take personal risks
- Afraid of embarrassment
Depending upon whether your conditions meet these criteria or not, the mental health professional will determine if you have Avoidant Personality Disorder or not.
Treatment of Avoidant Personality Disorder:
The maximum difficulty with a person suffering from Avoidant Personality Disorder or AvPD is that he or she does not agree to proceed to a therapy or treatment. Additional to their fear of meeting people, they also develop a sense of rejected and distressed and feel that their family and friend are trying to get rid of them and send them to an even more difficult situation. However, with the treatment therapies for Avoidant Personality Disorder, they are usually given a better life, they are helped with identifying the trouble and helped with coping with those difficulties.
The therapies do not 'treat' the problem, as there is no disease to treat as such, but they are assisted with tools and equipment that can help them to overcome their fear and cope with them easily. The personality characteristics that they possess would not be completely changed with these therapies; that is to say, a shy person would not become bold, but the extent of shyness from everything, the fear of meeting unknown people and the fear or rejection will be controlled.
The therapies that are used in this process of treating Avoidant Personality Disorder are:
Psychodynamic Psychotherapy for Avoidant Personality Disorder
By having a talk or chat with the patient, the mental health professional discovers which past situations have influenced in the current behaviour. The professional assists in eliminating that thought and overcoming the situation by resolving those emotional conflicts.
Cognitive Behavioural Therapy for Treating Avoidant Personality Disorder
This is also a form of talk therapy in which the patient is helped with replacing the unhealthy beliefs and thought processes with healthier ones. The therapist will assist you on how to overcome difficulties and negative thoughts, feelings and actions with the positive ones.
Alternative Therapies That Can Help Treat Avoidant Personality Disorder
Once the patient suffering from Avoidant Personality Disorder has developed a considerable control over their negative emotions, with proper advice from the mental health professional, they can also start taking sessions for alternative therapies. Relaxation therapy is one such kind which is often used to calm down Avoidant Personality Disorder sufferers and help them to stabilize. Other alternative therapies include, yoga, meditation, music and drama therapy, dance movement therapy etc.
Sometimes, antidepressant medication is also given to reduce the sense of rejection aongh Avoidant Personality Disorder sufferers. If you have this mental health condition, seeking expert professional help will help you to overcome your fears and worries and sense of rejection or criticism.