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Avoidant Personality Disorder


Neurotic Solution: Avoidant Type
Sensitive Personality Type
Values of the Sensitive Type New!



Perspectives q.v.





The Disease Perspective

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association, 1994, pp. 664-665) describes Avoidant Personality Disorder as a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
  • avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection;

  • is unwilling to get involved with people unless certain of being liked;

  • shows restraint within intimate relationships because of the fear of being shamed or ridiculed;

  • is preoccupied with being criticized or rejected in social situations;

  • is inhibited in new interpersonal situations because of feelings of inadequacy;

  • views self as socially inept, personally unappealing, or inferior to others;

  • is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.




The Dimensional Perspective

Here is a hypothetical profile, in terms of the five-factor model of personality, for Avoidant Personality Disorder (speculatively constructed from McCrae, 1994, pg. 306):



High Neuroticism
Chronic negative affects, including anxiety, fearfulness, tension, irritability, anger, dejection, hopelessness, guilt, shame; difficulty in inhibiting impulses: for example, to eat, drink, or spend money; irrational beliefs: for example, unrealistic expectations, perfectionistic demands on self, unwarranted pessimism; unfounded somatic concerns; helplessness and dependence on others for emotional support and decision making.

Low Extraversion
Social isolation, interpersonal detachment, and lack of support networks; flattened affect; lack of joy and zest for life; reluctance to assert self or assume leadership roles, even when qualified; social inhibition and shyness.

High Openness
Preoccupation with fantasy and daydreaming; lack of practicality; eccentric thinking (e.g., belief in ghosts, reincarnation, UFOs); diffuse identity and changing goals: for example, joining religious cult; susceptibility to nightmares and states of altered consciousness; social rebelliousness and nonconformity that can interfere with social or vocational advancement.

High Agreeableness
Gullibility: indiscriminate trust of others; excessive candor and generosity, to detriment of self-interest; inability to stand up to others and fight back; easily taken advantage of.

High Conscientiousness
Overachievement: workaholic absorption in job or cause to the exclusion of family, social, and personal interests; compulsiveness, including excessive cleanliness, tidiness, and attention to detail; rigid self-discipline and an inability to set tasks aside and relax; lack of spontaneity; overscrupulousness in moral behavior.





Too Sensitive


The Sensitive Personality Type, missing the mark in excess of its strengths and virtues, equals Avoidant Personality Disorder:

Indesluttedhed (inclosing reserve).



Character Weaknesses and Vices*

  • no close friends*
  • hypersensitivity to criticism
  • avoids people, out of fear
  • reticence
  • overly self-conscious
  • avoids tasks with social demands
  • exaggerates "difficulties"


Know Your Major Weaknesses


* Derived from Michael Stone's (pg. 23) list of the "personality traits" of DSM-III-R Avoidant Personality Disorder. Descriptors marked with an asterisk, he says, are not true personality traits.





The Behavior Perspective





The Life Story Perspective



Childhood

 

Universal Character Disorder   Paranoid


Stoic explanation

Avoidant personality disorder is a typological representation of bad character, of a vicious disposition formed by habitual passion. Passions are, or are the results of, erroneous value-judgments. The objects of passion listed below (derived mostly from Beck, Freeman, and associates, 1990, pp. 43-44) are external, indifferent things that the Avoidant personality incorrectly judges to be good or bad. (Evolutionary Psychology and Behavior Genetics provide adequate scientific explanations of the origins of these impulses.) The cure of Avoidant personality disorder will require correcting these habitual, erroneous value-judgments by making proper use of impressions.


Niebuhrian / Horneyan explanation

Avoidant character disorder is a type of "solution" to the problem of anxiety; that is, it is a strategy to alleviate anxiety. The objects of desire and pleasure listed below (derived mostly from Beck, Freeman, and associates, 1990, pp. 43-44) are limited goods pridefully turned to for security when we fail to trust God. They are analogous to Karen Horney's "neurotic needs."

Karen Horney: Intrapsychic Strategies of Defense

The Resignation Solution

"Even when we deeply value ourselves, the anxiety built into finitude will tempt us to find our source of security in some strategy rather than a trust in God" (Cooper, pg. 163).


Habitual Passions

Desires/ Pleasures

 Fears/ Distresses
  • acceptance
  • being close to others
  • living up to one's intellectual and vocational potential
  • a sense of mastery from accomplishment
  • introspection
  • sensitivity
  • hyperawareness of feelings
  • low expectations
  • remaining on the fringes of groups
  • rejection
  • being hurt
  • being unsuccessful
  • getting involved
  • being socially inept
  • being incompetent in academic and work situations
  • being criticized
  • being demeaned
  • being found uninteresting
  • being worthless
  • being unlovable
  • unpleasant feelings
  • doing new things
  • unpleasant situations
  • unpleasant thoughts
  • being evaluated
  • being discovered to be a "fraud"
  • being put down
  • attracting attention
  • new responsibilities at work
  • seeking advancement
  • failure
  • reprisals



Cognitive Effects

Basic Belief: I may get hurt. [Strategy]: Avoidance (Beck, Freeman & associates, pg. 26).

The "idealized self is made up of beliefs about how we should feel, think, or act" (Tamney, pg. 32).

Compulsive beliefs and attitudes are idols, too.

In Cognitive Therapy of Personality Disorders, Aaron T. Beck, Arthur Freeman, and associates (1990) list typical beliefs associated with each specific personality disorder. According to my view, the beliefs and attitudes rationalize and reinforce the idealized image and the compulsive attachments and aversions. They are analogous to Karen Horney's "shoulds" and "neurotic claims." Here are the typical beliefs that they have listed (pp. 359-360) for Avoidant Personality Disorder:

  • I am socially inept and socially undesirable in work or social situations.
  • Other people are potentially critical, indifferent, demeaning, or rejecting.
  • I cannot tolerate unpleasant feelings.
  • If people get close to me, they will discover the "real" me and reject me.
  • Being exposed as inferior or inadequate will be intolerable.
  • I should avoid unpleasant situations at all costs.
  • If I feel or think something unpleasant, I should try to wipe it out or distract myself—for example, think of something else, have a drink, take a drug, or watch television.
  • I should avoid situations in which I attract attention, or I should be as inconspicuous as possible.
  • Unpleasant feelings will escalate and get out of control.
  • If others criticize me, they must be right.
  • It is better not to do anything than to try something that might fail.
  • If I don't think about a problem, I don't have to do anything about it.
  • Any signs of tension in a relationship indicate the relationship has gone bad; therefore, I should cut it off.
  • If I ignore a problem, it will go away.


Beck's Cognitive Therapy for Personality Disorders







American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington: Author.

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed., text revision. Washington: Author.

Beck, Aaron T. and Freeman, Arthur M. and Associates (1990). Cognitive Therapy of Personality Disorders. New York : Guilford Press.

Beck, Aaron T. and Freeman, Arthur M. and Associates (2003). Cognitive Therapy of Personality Disorders, 2nd ed. New York : Guilford Press.

Cooper, Terry D. (2003). Sin, Pride, and Self-Acceptance: The Problem of Identity in Theology and Psychology. Downers Grove, IL: InterVarsity Press.

Gunderson, John G. and Philips, Katherine A. (1995). Personality Disorders. Comprehensive Textbook of Psychiatry/VI, Vol. 2. Eds. Harold I. Kaplan and Benjamin J. Sadock. Baltimore: Williams & Wilkins.

McCrae, Robert R. (1994). "A Reformulation of Axis II: Personality and Personality-Related Problems." Costa, Paul T., Jr., Widiger, Thomas A., editors. Personality Disorders and the Five-Factor Model of Personality. Washington, D.C.: The American Psychological Association.

(1989). Personality Disorders: Avoidant Personality Disorder. Treatments of Psychiatric Disorders, Vol. 3. American Psychiatric Association. Task Force on Treatments of Psychiatric Disorders. Washington, DC : American Psychiatric Association.

Stone, Michael H. (1993). Abnormalities of personality: within and beyond the realm of treatment. New York: W.W. Norton.

Tamney, Joseph B. (2002). The Resilience of Conservative Religion. New York: Cambridge UP.



Avoidant Personality Disorder: links

 Personality Disorders





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