The Self-perpetuating Cycle of Avoidant Personality Disorder

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Avoidants have limited contact with others when they use avoidance to protect themselves from being rejected. People notice the withdrawing behavior of the avoidant individual which leads either to a reciprocal avoidance by the observer or ridicule of the avoidant by those observing his hermit-like behavior. As Millon and Everly point out, often people who appear weak or timid attract the attention of those who enjoy belittling others. A cycle of withdrawal, ridicule or rejection, further withdrawal and so on, perpetuates the avoidant personality disorder.

The avoidant is painfully alert to the minutest signals of rejection from others. Unfortunately, being hypersensitive to rejection often lowers avoidants’ ability to correctly perceive what is and what is not rejection. They may imagine rejection where none exists or view a minor and partial rejection as one that is major and complete. They feel that every rejection follows from a thoughtful evaluation of their real worth when they know that people who reject others sometimes do so because they have problems of their own (act reflexively and transferentially rather than thoughtfully and realistically) (Kantor). The strategy they have adopted to protect themselves backfires and the fears associated with the negative view of themselves seems to be confirmed. As the pattern repeats itself and the problem magnifies, the avoidant finds him or herself in a world of self-fulfilling prophecy.

Furthermore, as avoidants withdraw more and more from social situations, they are left with an increasing amount of time to reflect upon their sorrowful state. Like an unrequited love affair, avoidants’ desire for interpersonal relationships peaks and most often the conclusion they reach is that they are not only incapable of improving their attractiveness or likeability to others, but that they do not even deserve acceptance. This fosters more avoidance and alienation (Millon and Everly).

Finally, we cannot overlook the importance of operant conditioning in the perpetuation of avoidant personality disorder. The avoidant desires social affiliation yet is fearful of rejection and humiliation. The pattern of avoidant, seclusive, aloof and hypersensitive behavior that characterizes the disorder is negatively reinforcing to the individual. That is, through avoidant behaviors, these individuals can reduce the probability that they will be rejected or humiliated. Thus the behavior is reinforced and the disorder is made more severe (Millon and Everly).

Treatment

Avoidance reduction is typically an action-oriented approach to handling the causes, complications and consequences of Avoidant Personality Disorder. It borrows from the active techniques found in other psychotherapies. For example, “total push”, from behavior therapy, forces avoidants to face social interactions for longer periods of time; supportive therapy gives encouragement (“you can do it”), positive feedback (“you are good enough to succeed”) and reassurance (“you can handle the anxiety”); family therapy tries to convince the smothering family to stop infantilizing the individual; and pharmacological therapy advises administering anti-depressant medication to help alleviate the avoidant’s anxiety. Generally, avoidants are encouraged to “do” rather than contemplate, to engage themselves in fearful situations as a means of overcoming their fear.

next: Symptoms, Causes, Risk Factors for APD

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Reviewed: 04/2006