This Is What It Feels Like to Live With Avoidant Personality Disorder
EVERYONE IS SENSITIVE to criticism sometimes and wants to be accepted and liked by others. When you become so hypersensitive that you worry you’re constantly being judged and have chronic feelings of inadequacy that make you avoid most social interactions, it could be a sign of avoidant personality disorder (AVPD).
Avoidant personality disorder is one of a group of personality disorders. It’s characterized by being hypersensitive to rejection and criticism, needing uncritical acceptance, withdrawing from social settings despite wanting acceptance and affection, and having low self-esteem, according to the American Psychological Association (APA).
It’s a long-standing pattern of behaviors that are so severe that they cause distress and sometimes hinder someone’s ability to work and have relationships, according to the APA.
“Personality disorders are about the construct of how a person makes their way in the world and relates to the world around them, including relationships and their mentality about the world,” says Erin Rayburn, LMFT, mental health treatment strategist, and owner of Evergreen Therapy.
“Avoidant personality disorder is someone who tends to have a fear of emotional intimacy and social intimacy with people, tends to fear criticism and rejection, and is very sensitive to how people perceive them,” she says.
These feelings manifest as social anxiety and avoiding social situations and relationships unless they feel “safe,” Rayburn explains, “meaning someone feels accepted and secure.”
In a 2019 study published in the Journal of Clinical Psychology, researchers asked people to describe what it’s like to live with AVPD. The overarching theme to emerge from the interviews was the participants’ struggle to be a person.
“They felt safe when alone, yet lost in their aloneness,” the researchers said. They “longed to connect with others yet feared to get close.” In the researchers’ opinion, the participants’ profound difficulties with their “core self” and in their dealings with others correspond to “a personality disorder diagnosis.”
What Is Avoidant Personality Disorder?
AVPD is a diagnosable personality disorder that features a continuing pattern of behavior related to feelings of inadequacy, social inhibition, and sensitivity to rejection, says Amira Johnson, LMSW at Berman Psychotherapy.
“Those with this disorder may show shyness or sensitivity to criticism from others,” she says. “It can be associated with anxiety disorders, mainly social anxiety.”
Symptoms of AVPD, according to Cleveland Clinic, include:
Needing to be liked by others
Feeling anxiety in social situations
Avoiding conflict
Feeling extreme self-consciousness
Being oversensitive and easily hurt by criticism or disapproval
Having few close friends (or none at all)
Being reluctant to become involved with others out of fear of being liked
Being shy, awkward, and self-conscious in social situations
Exaggerating problems
Not trying new things or making changes
Having a poor self-image
Like other personality disorders, experts aren’t sure of the exact cause of AVPD. It’s believed that it could be genetic, according to the Cleveland Clinic. Environmental factors, like past experiences of rejection by parents or peers, could also play a role.
Avoidant Personality Disorder Isn’t The Same As Imposter Syndrome
People often confuse AVPD and imposter syndrome, but Rayburn and Johnson say the two aren’t the same.
Imposter syndrome, which isn’t a diagnosable condition, is a phenomenon where someone feels intellectual self-doubt and may even feel like a fraud, and it may be accompanied by anxiety and depression, according to APA.
Both AVPD and imposter syndrome bring feelings of inadequacy, but imposter syndrome comes with a fear of being discovered as false. Someone might think they don’t deserve their success and doubt their abilities or skills, Johnson says.
“However, anxiety seems to be the main stressor for those with AVPD, as they do not doubt themselves or their capabilities but rather may struggle in social situations, or may be so focused on what people think it can cloud their judgment of themselves,” she explains. “Versus imposter syndrome, where the person themselves creates the fear all on their own.”
What It’s Like To Live With Avoidant Personality Disorder
According to the 2019 research on AVPD, researchers revealed two main themes for people living with the disorder: “fear and longing” and “a doubting self.”
Fear and longing
“Fear and longing” included participants’ descriptions of having to put on a mask when socializing and their difficulty feeling normal. This constant performance means they feel other people never really know them.
Another difficulty that was mentioned repeatedly was the dread of getting close to others. Coping measures included only interacting through email or text message, and when in physical company, avoiding eye contact.
Participants also said the solitude that brings them comfort and safety was also suffocating. They were “feeling sad, almost grieving when they were alone," the researchers said. To cope, the participants said they keep busy playing computer games, listening to music, playing sports, and enjoying hobbies. But, the relief evaporated as soon as thoughts of being evaluated crept into the mind.
It’s a misconception that people with AVPD want to keep their distance from others—instead, they often feel lonely and generally long for connection, Johnson says. “They do actually want to be close to people, but fear what will happen if they get too close.”
Self-doubt
Researchers revealed that people living with AVPD feel chronic insecurity and a fleeting sense of self. Participants perceive that other people breeze through life and have no trouble being themselves—while, the participants constantly struggle to make sense of their own persistent insecurities.
Many participants said they fear they’ve forgotten who they truly are. On the positive side, they found time in nature was therapeutic, especially when immersed in a physical challenge.
They also lack feelings of belonging, attachment, and intimacy. Their suspicion of others and the burden of keeping up appearances “caused the participants to retreat from and miss social experiences that might have provided more trustworthy and comforting answers to questions related to the inner mental lives of themselves or others.”
People with AVPD often believe that they’re disliked by others. “They might be second-guessing people, trying to figure out their true intentions,” Johnson says. “When they walk into the room, they may feel immediately judged, and in turn, feel lonely.”
What Are Relationships Like for People With Avoidant Personality Disorder?
Struggling with interpersonal relationships is a hallmark of personality disorders, Rayburn says. If you’re in a relationship with someone with AVPD, it might feel like your partner stays busy or distracted to avoid having too much physical and emotional contact with you.
“So, somebody who's on the receiving end of this might feel like they’re literally avoiding you or they don’t want to engage, or you're being blown off or ghosted,” she says.
Many people with AVPD avoid relationships out of fear of ridicule and because of poor self-confidence, even if they want a relationship, Johnson says. People with AVPD may show emotional unavailability and avoid conflict. And, if someone with the disorder gets hurt, they may distance themselves from the relationship.
“AVPD can be a life-changing condition, and it can bring sorrow and struggle to the lives of those who are dealing with it on a daily basis,” she says.
How Is Avoidant Personality Disorder Treated?
The therapeutic alliance (a warm, trusting relationship between therapist and client)—always important—will be even more critical for clients with avoidant personality disorder, according to the 2019 study. “The therapeutic relationship provides an opportunity for persons diagnosed with AVPD to experience being met with acceptance and understanding,” the researchers said.
Cognitive behavioral therapy (CBT) is one of the most common treatments for AVPD. “It teaches the patient ways to change their thinking and behavioral patterns,” Johnson says. “The goal is to help people to recognize those self-destructive thought patterns that might contribute to their anxiety and social interactions.”
Psychodynamic or psychoanalytic therapy may help those with AVPD, by helping them address where the feelings of inadequacy and low self-esteem come from, she adds.
People with AVPD often have a tough time seeking therapy because the nature of therapy is to talk about your feelings, Rayburn says. People seek treatment for anxiety or depression first.
“Then, once the patient becomes more comfortable with the therapeutic relationship and starts making traction with anxiety and depression symptoms, they may become dependent on the therapist because that's a relationship they feel comfortable in,” she says. “So, working on expanding social connectivity is a big part of the treatment process with avoidant personality disorder.”
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