Hi, I'm Dr. Tracey Marks, a psychiatrist, and I make mental health education videos. Today I'm talking about
avoidant personality disorder, and this is based on a question from Dee, and here's excerpt of his question. "Would you be willing to talk "about avoidant
personality in more detail? "I'd like to hear more
coping skills for it "and what kinds of
treatment and self-work, "things I can do myself,
to help with this. "It certainly has had a marked
impact on my relationships, "including both friends and family." Thanks, Dee, for your question. First, let me define the disorder, and this is based on the
"Diagnostic and Statistical Manual of Mental
Disorders: Fifth Edition." An essential feature of
avoidant personality disorder is a pattern of being socially inhibited, feeling inadequate and
hypersensitive to rejection or criticism starting by early adulthood. This pattern occurs pervasively, which means that it spreads
across all areas of your life, so it's not something that you only notice after being in a bad
relationship with someone who sucked your soul and
tore you down emotionally. After a relationship like that, you will have some battle wounds that can look like feeling inadequate. Most of the personality
disorders, including this one, really start to manifest around late adolescence and early adulthood, and with avoidant personality disorder, you can get hints of social
awkwardness and insecurity that seem excessive that the child just doesn't seem to grow out of. Here's a criteria, you need
four or more of the seven. Number one, avoids occupational activities that involve significant
interpersonal contact because of fears of criticism,
disapproval or rejection. This would be more than
saying, "I'll pass," whenever you're asked to do something. Your fear of criticism is so strong, that you risk being demoted or
getting negative evaluations because you're not
following through on things that you're expected to do. So let's say you have a monthly activity that involves working closely with people. You don't outwardly say,
"No, I'm not doing it "because it makes me uncomfortable." Instead, you miss meetings under the guise of being sick, or late, or
tied up with something else. You find a way to get out of it without looking like you're being defiant, so you may not get in
trouble for your absence, but it still has negative
consequences for you because you're missing in action. Number two, is unwilling
to get involved with people unless you're certain of being liked. With this, you hang on
the fringe of society. You're around, but you
won't step into the circle and go beyond the superficial with people. Since you're trying to get reassurance that the person likes you first, you end up relying on vibes and intangible body language cues to know whether or not
the person likes you. In this thought process
of making assumptions about what someone thinks is important because it ties in to how to
overcome these assumptions. Number three, shows restrain
within intimate relationships because of fear of being
shamed or ridiculed. In relationships, you keep people at an arm's distance emotionally, and this can look like being afraid to talk about deep
things, so you just don't. But a more subtle way you can do this is working all the time,
or staying too busy, and this isn't entirely conscious, meaning you don't set this up as a strategy to avoid intimacy, because at a deeper
level you want intimacy, but it's uncomfortable because
of these fears you have so you gravitate towards
work and staying busy because that's where
you're most comfortable. You tell yourself, and the person that you have the relationship with, that you can't control your business. Number four, is preoccupied
with being criticized or rejected in social situations. Usually your fixation on this is enough to keep you out of social situations, but if you do go out,
you're very uncomfortable because of worrying about
what others think of you. This is how avoidant personality disorder can look like social anxiety. I talk about social anxiety in this video, and I'll have a link to this
video in the Description. Number five, is inhibited in
new interpersonal situations because of feelings of inadequacy. This can look like shyness, you don't speak much around people, or you feel uptight and can't loosen up, and to make things easier on yourself, you just avoid dealing
with unfamiliar people if you can help it. But if you can't help, you're inhibitions may make you look awkward. You may stutter, or not
really say what you mean because you're overthinking how you say it or how the person's gonna take it. And this is just an example
of how this can look. Number six, views self as socially inept, personally unappealing,
or inferior to others. You can get to this point if you try and push through your
fears and inhibitions and force the social interactions. In other words, you can
mount your own evidence to prove this point by reflecting
back on your experience. So for example, some people get so anxious that they sweat or choke up
when they talk to people. Or let's say you're in a small group, and because you're worrying
about what people think, you draw blanks during a conversation and don't know what to say, or say the wrong thing that
doesn't make any sense. Can you then see how you could draw your own conclusion that
you're socially inept? Number seven, is unusually
reluctant to take personal risks or to engage in any new activities because they may prove embarrassing. This may look like the 38-year-old person who wants so much to find
a partner and get married, but can't bring himself
to ask out this woman who's sending obvious signals
that she's interested. It's the lowest hanging
fruit that he'll ever have, and he just can't reach for it. He already knows it will
turn into a disaster that he won't be able to
recover from emotionally. There is a lot of overlap
between social anxiety disorder and avoidant personality disorder. However, with social
anxiety, the fear and anxiety is limited to social interactions and you realize that your fears are unreasonable at some level, but you're still anxious about it and you can still have close,
personal relationships. But with avoidant personality, there's a deep belief that
there's something wrong with you, and because of that, you
hyperfocus on sublet cues that people are rejecting
or criticizing of you. The threshold for seeing
something as critical is very low, meaning it doesn't take much for you to feel insulted or hurt
by someone's remarks. Your reaction to this is just to stay away and avoid dealing with people
in any way that you can. Now, rejection-sensitivity is not unique to avoidant personality disorder. There are other types of
people and personalities that are sensitive to criticism. For example, a person
with a more aggressive personality style may respond
to perceived criticism by attacking others first, stick it to other people
before they stick it to you. That person is not avoiding interactions, they stay in the game and they
just fight their way through. But you see the difference there? I just use that example to illustrate that no one likes criticism, and not everyone who is sensitive
to criticism or rejection responds to it in an avoidant way. With avoidant personality,
the avoidance is about avoiding relationships and closeness because of feeling inadequate
and fearing rejection or criticism in some form. The treatment for this
is cognitive therapy. There may be some behavioral exercises that a therapist can help set up for you, but generally the approach is addressing your distorted beliefs about yourself. I talk about cognitive
distortions in this video. I think it would be hard
to adequately address this from a self-help approach
because you need someone to help you identify some
of your distorted thoughts. But you may get by talking
through some of your thoughts with a trusted friend. So let's summarize some
of the common beliefs that you can have with
avoidant personality disorder. You are inadequate. People disapprove of your
and want to criticize you. If someone gets to know
you, they won't like you, so you can't expose yourself to them. Your feelings aren't safe around others because they will mock you. These are a starting place for you. If you can identify with
these, then write them down. Then, to add more of your own thoughts, think about situations that
have caused problems for you, like the examples that I gave with work, and needing to interact with small groups, and things like that. Have you had trouble at work
because of your assumptions about what people are thinking? Take an inventory of your relationships. Do you have close friends? Do you have a romantic partner? Most people with avoidant
personality disorder are deeply lonely, but
they lack the desire to do the things that it
takes to get close to someone because of how uncomfortable
it makes them feel. So part of getting past
that is being resolved to deal with the discomfort
to get to the end goal. That means you should expect
the process to be hard, and you'll have to keep going at it. But I will say, in looking for a partner, you'll probably be more suited for someone who's more emotionally
hands off like you are. You won't do well with a person
who's more emotionally needy and wants a lot of your attention. You can improve in this area of being more revealing of yourself, but you can only go so far with it. So you don't need someone
who's pressing you all the time to talk and share your feelings. Identifying what's behind your behavior is an important step
and gives you insight, but then you need to
challenge your beliefs, and that's the part that may not be so easy to do on your own. In this video I give you one way to challenge your distorted beliefs. There are other ways to challenge beliefs, but with avoidant personality disorder, I think you need someone to
help you navigate through it. Another thing that can help with avoidant personality
disorder is skills training. This would be getting help
with having conversations or how to carry yourself in public. You could also get help on
how to nurture a relationship. For example, asking people questions and following up on their answers. This shows that you're interested in them. And you can learn how to
reveal things about yourself so people can feel close to you. Also with skills training
you can get feedback on what are appropriate
things to share with people. So there's a lot here and I do think that, even if you don't have a therapist, understanding what holds you back can still help you make some changes to improve your relationships. Thanks again, Dee, for the question. See you next time.
When your family is the one who gave you this disorder they aren't going to care sadly.