Recognizing Avoidant Personality Disorder Symptoms and Getting Help
If you experience extreme fear of social situations, you may believe that you have social anxiety disorder. However, in some cases, the roots of your fear go beyond social anxiety and are actually the result of avoidant personality disorder. By exploring avoidant personality disorder symptoms and understanding their origin, you can come to better understand your struggles and identify the underlying causes of your distress. While this condition is often highly debilitating, it is also important to know that it is treatable and finding the right treatment program can create true transformation.
Most people struggle with feelings of anxiety in social situations at some point in their lives. In some cases, these experiences are so prevalent and disruptive that they surpass “normal” levels of anxiety and become part of the realm of mental illness in the form of social anxiety disorder. Today, this disorder is gaining more recognition than ever before, thanks in part to the internet and social media postings exploring the reality of the illness.
This growing interest in social anxiety disorder is likely caused in part by the fact that its symptoms are so relatable even to people who do not experience the disorder, creating important points of connection. After all, who among us has not felt nervous in a social context? However, as social anxiety disorder becomes part of the public discourse on mental health disorders, there is another, similar condition that too often goes unrecognized, in part because it is so often mistaken for social anxiety disorder. That condition is avoidant personality disorder, a debilitating illness that deeply shapes your experience of yourself and your relationship with the world around you.
Avoidant personality disorder is not interchangeable with social anxiety disorder, although their symptoms overlap at a number of critical points. If you are struggling with this painful condition, it is essential that the nature of your distress is correctly identified in order to recognize the origin of your symptomatology and begin the healing process. By exploring avoidant personality symptoms, you can begin to better understand your thoughts, feelings, and behaviors and move toward the help you need for recovery.
Understanding Avoidant Personality Disorder Symptoms
The symptoms of avoidant personality disorder encompass a specific set of beliefs that drive disordered behavior. These include:
- Extremely low self-esteem
- Believing oneself to be inferior or unappealing to others
- Highly sensitive to criticism or perceived rejection
- Reluctance to enter social situations or form relationships
- An absence of friendships
- Avoidance of recreational or professional activities that require social contact
- Extreme shyness that arises out of fear of doing something wrong
- Unwillingness to try new things for fear of humiliation or embarrassment
While avoidant personality disorder symptoms include anxiety within social contexts, they also differ sharply from social anxiety in the underlying beliefs and sense of self that drive such anxiety. Fear of social interaction arises from a deeply held sense of insecurity, inferiority, and ineptness. In contrast, many people with social anxiety disorder have healthy self-esteem and do not believe themselves to be inferior to others; social anxiety is not rooted in a particular self-image.
Living with avoidant personality disorder can be extraordinarily limiting, as fear and rumination over your perceived shortcomings transform even the most benign activities into potential emotional minefields. “A trip to the grocery store, for example, might be terrifying [for] someone with avoidant personality disorder because they will be imagining scenarios where they might embarrass themselves or run into someone who tries to talk to them,” writes Shahida Arabi. “This hyper-anxiety seeps into their everyday life and prevents them from not only trying new things, but also engaging in behavior that even highly anxious and sensitive people might not have any issues with.”
It is also important to note that people with this condition do not lack a desire for social contact; in fact, most people with the disorder deeply want to form close relationships and be able to engage in social interactions, but are so restrained by their disruptive thoughts and distorted self-image that they are unable to participate in such activities. If you do have social relationships, they are likely with people you consider to be low-risk in terms of rejection, humiliation, or judgment, severely restricting your social options.
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The Origin of Avoidant Personality Disorder
The exact causes of avoidant personality disorder are unknown, but it is believed to arise from complex interactions between biological and environmental factors. According to one study on twins, for example, “genetic factors account for half the variance in avoidant personality disorder. [However], no biological markers have yet been found to account for the mechanisms behind this vulnerability.” In the absence of discrete biological markers, most believe that “the biological factors in personality probably do not determine whether individuals become disorders, but they set limits on the category of disorder that can develop.” As such, while some may have a genetic predisposition to developing avoidant personality disorder, the underlying vulnerability may require activation of some kind; it may be that some form of environmental trigger is necessary for the condition to come into being.
For many, that trigger appears to be childhood trauma, particularly physical, emotional, or sexual abuse at the hands of their parents, compromising the ability to form healthy attachments and a secure self-image. “Many individuals with the disorder have endured painful childhood experiences involving brutal parental criticism and rejection,” explains Samantha Gluck, a journalist specializing in mental health.
Children naturally want to bond with their parents, but due to the constant parental rejection and ridicule, it’s virtually impossible to form a healthy bond. This leaves these children hungry for close relationship, yet lacking the skills to form and maintain them. They begin to develop a protective psychological shell that shields them from further parental ridicule and rejection. The resulting social awkwardness may cause peers to tease and ridicule them as well, contributing to the intense fear of social interactions
Indeed, studies have found that people with avoidant personality disorder report high rates of childhood abuse along with poor social interactions in adolescence, suggesting that the condition arises early in life and may be a maladaptive response to trauma. Additionally, researchers have observed that avoidant personality disorder is specifically associated with “the lack of a reported good relationship with a non-caretaking adult.” Interestingly, avoidant personality disorder often co-occurs with dependent personality disorder, suggesting that the two share common roots.
Overcoming the Challenges of Treatment
Avoidant personality disorder is a chronic, lifelong condition that will continue to disrupt emotions, thoughts, and behaviors unless treatment is sought. Today, there is a wide variety of interventions that can be used to both alleviate acute symptoms and break through the disordered beliefs that underlie those symptoms. These include psychopharmacological and psychotherapeutic treatment options. Of particular note is cognitive behavioral therapy, which aims to replace damaging patterns of thought and behavior with healthier, reality-based alternatives as well as desensitize patients to those situations that act as triggers for symptoms. Additionally, trauma-focused therapies may help you explore the roots of your disorder and create strategies for processing the pain of traumatic childhood experiences while giving you a framework for creating secure attachments. Due to the intensity of the disorder and its profound impact on functionality, long-term residential treatment is often the best treatment milieu, offering the ability to participate in a broad range of therapies to overcome distress.
However, if you are living with avoidant personality disorder, the condition itself can present unique barriers to treatment. Many people with this condition are highly reluctant to enter into mental health treatment due to the social contact inherent to such care. As such, finding the right treatment environment that will encourage participation and foster feelings of safety is paramount. The following features may help to make treatment less intimidating and more productive:
- Experienced and compassionate clinicians: It is critical that the treatment program you choose is staffed by clinicians who have the experience and compassion necessary to effectively address avoidant personality disorder symptomatology. This includes a deep understanding of your individual challenges and how to form strong therapeutic alliances that will allow you to feel safe and comfortable throughout the treatment process. It is also important that these clinicians create a general milieu of warmth and acceptance amongst all clients and set a standard of respectful and supportive interaction to help you benefit from the therapeutic opportunities presented by the social environment.
- Appropriate therapies: While CBT is often particularly helpful for people struggling with avoidant personality disorder, many are initially reluctant to participate in verbally-based therapies that require direct social interactions. As such, the availability of non-verbal therapies, such as holistic, creative, and experiential modalities, can help you feel more comfortable in exploring yourself. These therapies can help bolster your confidence and give voice to your struggles in a supportive and nonjudgmental environment, enhancing your ability to participate in verbal therapies as time goes on.
- Gradual independence: Healing from avoidant personality disorder doesn’t happen overnight and overcoming the functional limitations caused by the disorder can take time. Providing you with the support you need at each stage of healing will be crucial to ensuring that you are met where you are at and are not overwhelmed by responsibilities for which you are not ready. This includes support not only with emotional wellbeing, but with concrete skill-building to increase independence, resilience, and self-reliance. For people with avoidant personality disorder, breaking through isolation, building and maintaining social relationships, and fostering the ability to fulfill educational and professional goals will be of particular importance.
With appropriate care delivered in an environment of love, you can come to uncover your own strengths and purpose and harness your inner resources for healing. The guidance of clinicians will be paramount to this process, but so too will the support of your peers, who can help you learn and practice new social skills and reframe your understanding of yourself as a competent social actor. Most importantly, you will be empowered to develop a strong sense of self-worth, helping you remove the current of self-devaluation that underlies avoidant personality disorder, releasing you from fear and opening up infinite possibilities for your future.
Hanbleceya offers comprehensive treatment for people struggling with mental health disorders as well as co-occurring substance use disorders and process addictions. Contact us to learn more about our renowned San Diego-based program and how we can help you or your loved one start the journey toward recovery.