How to Spot High Functioning Avoidant Personality Disorder

There is not one known reason why someone would develop AVPD, but it is thought that genetics and environmental factors can play a role.

Genetic causes

It could be that if someone has an immediate family member with AVPD, such as a parent, they may be more likely also to develop the disorder.

A trait called behavioral inhibition may be a causal factor for someone developing AVPD. This is where somebody is shy, avoids new experiences, avoids strangers, and has increased sensitivity and anxious reactions.

This is thought of as a temperament that is genetic. It would make sense to think that someone who is behaviourally inhibited is likely to develop AVPD compared to someone who is not shy and is open to new experiences.

That being said, not every shy child will go on to develop AVPD, in the same way that not every shy adult has the disorder.

Environmental causes

Those with AVPD often report past experiences of parental or peer rejection, which can impact a person’s self-esteem and sense of worth.

Early childhood neglect, emotional abuse, and trauma can be large factors in the development of AVPD.

Negative childhood factors which could influence the development of AVPD include:

• A low amount of love expressed by parents

• A low amount of pride expressed by parents

• Increased amounts of intolerance by parents

• Parents who try to shame or guilt a child

A person who experienced these types of parenting as a child can feel that they are unworthy of being loved and are less likely to see others as safe or supportive.

Additionally, social and cultural factors such as a lack of social support or cultural norms that emphasize perfectionism and self-criticism may also play a role. Being socially isolated may also be a risk factor for developing AVPD.

Because of this, they are more likely to develop feelings of mistrust towards others, even when other people do not give them a reason to mistrust them.

The mistrust can come across as arrogant or rude, making other people not want to interact with that person, which can cause further isolation.

The increased isolation leads back to a lower level of trust. Thus, there is a cycle that starts with abuse and neglect and carries on into adolescence and adulthood.

However, it is important to note that not everyone with AVPD was abused or neglected as a child. In the same way, not everyone who was abused or neglected as a child will go on to develop AVPD.

How can AVPD be Managed?

Treating personality disorders can be difficult since people with these disorders can have deep-rooted patterns of thinking and behavior which may have existed for many years.

A lot of people with AVPD do not seek treatment, and when they do, it is often for a specific life problem or other types of symptoms such as depression and anxiety.

It is important to note that treatment for AVPD will not change someone’s personality. Likely, someone naturally shy will always have some difficulty with social interactions, so it is useful to have realistic outcomes in mind when seeking treatment.

Treatment should aim at improving the symptoms of those with AVPD and can help them to develop the ability to relate to others.

Therapy

Psychotherapy is a possible treatment for AVPD.

Together in therapy, the client and therapist can practice challenging negative beliefs and explore the small but significant steps that can be taken to build solid friendships, be more engaged at work, and develop intimate relationships with others.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a type of psychotherapy that focuses on identifying unhelpful thought patterns and behaviors and finding ways to make them more realistic and helpful.

Clients of CBT can learn to be more aware of when they are falling into unhelpful thinking patterns and can challenge themselves with the therapist to adjust this.

This can involve building social skills and graded exposure to situations that would otherwise be avoided for fear of criticism or rejection.

Psychodynamic therapy

Psychodynamic therapy often focuses on childhood experiences which may be useful for people with AVPD who experienced neglect or abuse in early life.

This type of psychotherapy is aimed at being aware of how past experiences, pain, and conflict may be contributing to current symptoms.

Schema therapy

Schema therapy is an integrative approach that builds on CBT and many other therapeutic techniques.

It has the goal of improving daily functioning and gaining insight for change based on understanding and restructuring early life experiences.

A key feature is ‘limited reparenting’ in which the client expresses childhood needs and learns to develop and internalize a healthy parent voice.  The main concepts of schema therapy are:

• Understanding how maladaptive schemas are patterns that are repeated throughout life.

• Understanding what coping styles were learned as a child.

• Identifying what schema modes are being used to cope and how they are unhelpful.

• Learning how to develop healthy adult modes of coping and getting core emotional needs met.

Group and family therapy

Often, group therapy is used to help people with AVPD who have similar challenges. This helps to create a safe space to build solid relationships with others.

Family therapy can also prove useful s that family members understand the condition and can provide a supportive home environment that promotes growth and healthy risk-taking.

Treatment for people with AVPD is most effective when family members are involved and supportive.

Medications

There is very limited research demonstrating that medication is effective in treating AVPD.

Often, medications can be used to treat some of the symptoms of AVPD or symptoms associated with comorbid conditions such as anxiety and depression.

These medications can include antidepressants and anti-anxiety medications. For the best results, it is often recommended that medication is taken in combination with therapy.