Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

The Avoidant Personality

A middle aged woman who was working in production developed carpal tunnel syndrome from repetitive movements in her job. She was treated surgically with good outcome, and then there is struggle to find her work within any residual limitations, but she does not show for the interview, keeps her answering machine on and does not answer her cellphone. She lives alone, has never dated, and her parents are deceased. She lives in a very rural area, and she appears to have no friends. What do you suppose is going on with her?”

There are some individuals who seek production work to be assured of social contact without social risk. Many suffer from a psychological condition called Avoidant Personality Disorder. It is characterized by fears of criticism and disapproval. The individual mobilizes all resources to insure that they are not rejected and are preoccupied with the fears/thoughts of rejection. For some people, this spontaneously subsides when successful experiences occur. However, many valuable social experiences are avoided due to fear of rejection.

In Avoidant Personality Disorder, the individual has a lifelong pattern of feeling extremely shy, inadequate, and sensitive to rejection. Approximately 1% of the adult population has avoidant personality disorder, equally divided between males and females. The cause is unknown but is likely tied to early social experiences, rejecting events and embarrassing social situations.

People with avoidant personality disorder are preoccupied with their own shortcomings. They form relationships with others only if they believe they will not be rejected. Loss and rejection are so painful that these people will choose to be lonely rather than risk trying to connect with others.

A person with avoidant personality disorder will:

Be easily hurt by criticism or disapproval

Hold back too much in intimate relationships

Be reluctant to become involved with people

Avoid activities or occupations that involve contact with others

Be shy in social situations out of fear of doing something wrong

Exaggerate potential difficulties

Hold the view they are socially inept, inferior or unappealing to other people

When injured, they cannot mobilize against this fear of potential rejection or criticism and simply avoid all efforts to assist them.

A combination of antidepressant medications to reduce the mood and anxiety symptoms, and psychotherapy, particularly cognitive-behavioral approaches, may be key to mobilizing them. A combination of medication and psychotherapy may be more effective than either treatment alone.”

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