Social situations can be scary for a lot of people, but for those who suffer from Avoidant Personality Disorder (AvPD), they can be downright terrifying. People suffering from AvPD suffer from severe anxiety and a fear of embarrassment to the point of avoiding social situations altogether, unless they’re positive they’ll be liked and not be rejected. Often considering themselves socially unappealing, many suffer from a feeling of inadequacy and inferiority when it comes to being around others. This fear of rejection can affect every aspect of the patient’s life, from avoiding work functions to avoiding interpersonal or romantic relationships due to this fear. People who have this disorder are often described as shy or isolated. According to studies, this disorder affects 2.4% of the population and affects both men and women equally. It’s also commonly diagnosed with other personality disorders, particularly Borderline personality disorder and cluster A personality disorders.
To be formally diagnosed with AvPD, the patient must display four or more of the following symptoms.
1. Avoids occupational activities that involve significant interpersonal contact due to fears of disapproval, criticism, or rejections.
2. Unwilling to get involved with people unless they’re certain they’ll be liked.
3. Shows restrain in intimate relationships due to fear of being ridiculed or shamed.
4. Preoccupied with being rejected or criticized in social situations.
5. Inhibited in new interpersonal situations due to feels of inadequacy.
6. Views self as socially inept, inferior, or unappealing.
7. Unusually reluctant to take personal risks or engage in new activities in case they prove embarrassing.
While the exact cause of AvPD is unknown, studies have shown that there appears to be a mixture of genetic, social, and psychological factors involved. Studies have shown people who suffer from AvPD often have anxiety disorders in early childhood, sometimes perpetuated by being naturally shy and withdrawn in new situations. This shy temperament can cause the person to draw away from social situations in fear of embarrassing themselves, an action that can start off innocent enough but may eventually lead to completely avoiding social situations for fear of social rejection. Emotional neglect in early childhood as well as rejection from others their age can also lead to the development of AvPD, especially when coupled with a highly sensitive personality.
Due to their fear of social situations, many people with AvPD struggle when it comes to therapy as finding a therapist they trust can be extremely difficult. Fostering trust in this doctor-patient relationship is the most important for a therapist while treating AvPD. By building this trusting relationship, not only with therapy start to feel like a safe place that the patient doesn’t have to avoid, but it will also make moving forward in treatment easier. While medication can be used to treat some of the symptoms of AvPD such as anxiety, the main forms of therapy involve social skills training, cognitive therapy, and exposure therapy to slowly get the patient more used to being in social situations. As part of exposure therapy, some therapists may suggest group therapy so the patient can practice social skills in a safe and controlled environment. If both the therapist and the patient put in the effort to continue the treatment, then significant improvements can be made. Symptoms may never completely disappear, but they can become more manageable and allow the patient to live a mostly normal life.
