How to cope with Avoidant Personality Disorder?
Avoidant personality disorder (AvPD) is a difficult personality disorder to live with, because of the preoccupation with rejection, fear of criticism and inadequacy, insecurity about one’s physical appearance, and sometimes feelings of inferiority. It is these fears and insecurities that make coping with avoidant personality disorder such a struggle, and not only for the person with AvPD: friends, relatives, and romantic partners often suffer as well. For instance before or during social situations as these are often very stressful and likely to be avoided by the person with AvPD.
This page discusses the avoidant personality disorder symptoms, strategies and exercises to reduce these symptoms, and makes sure that coping with avoidant personality disorder becomes easier for those suffering from AvPD.
This page does not directly focus on the difficulty people with AvPD have with making decisions, because the other exercises will already help someone with AvPD to become more confident of their own skills, thoughts, and appearance. It is easier for someone with AvPD to make decisions when their confidence levels increase.
At Barends Psychology Practice, we offer (online) therapy for avoidant personality disorder. Contact us to schedule a first, free of charge, online session. (Depending on your health insurance, treatment may be reimbursed).
Coping with avoidant personality disorder – Symptom A4
Symptom A4 is all about the preoccupation with being criticized or rejected in social situations. This can cause someone with avoidant personality disorder to be more withdrawn in social situations, which could lead to less social interaction and feelings of not fitting in.
Being criticized or rejected in social situations does not equal being rejected as a person. Criticism and rejection are always subjective and context related. For instance, in a group of religious people an atheist may be criticized or rejected. It is very likely that this atheist is being criticized or rejected for his view on religion, but not for anything else. This same atheist will not be rejected or criticized for his view on religion in a group of atheists. In other words, always use the right context and realize that the criticism comes from an individual and is, therefore, subjective.
What can you do about this fear of criticism and social rejection?
People criticize behaviour, reject an opinion or disapprove of someones motives, but they do not criticize, reject or disapprove of a person. Apart from the fact that these negative evaluations are only opinions, they are also temporary and changeable. They don’t mean much and if you take all the other features about you in regard, then it is clear how insignificant their criticism, disapproval or rejection is. A good way to look at the situation:
EXERCISE 1 – putting things in perspective
- Get a pen and paper.
- Write down 20 random things about yourself: eye color, favorite music, how you like your coffee/tea best, things you (dis)like about others, and so on. This is a pretty long list.
- Categorize these things about yourself in four categories according to how important they are to you.
- Take the thickest book you can find.
- Observe the amount of chapters, paragraphs, sentences, words, and letters.
- Take your categorized list and count the things in the least important category. Each of them represents 1 letter in the book. The second category represents a word, the third a sentence, the fourth (the most important category) a paragraph.
- Imagine that this book is you and that each letter in the book says something about you. Each word, each sentence, each paragraph, and so on… Now use your list and count the amount of letter, words, sentences, and paragraphs and mark them in your book. Do you see how much of the book is still not marked?
- Do you realize how small (in comparison to the whole book) your list now is?
This exercise can also be done with criticism and insecurities about yourself: write down a list of 20 insecurities about yourself and follow the rest of the instructions.
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Coping with avoidant personality disorder – symptom A2
This symptom focuses more on rejection. Someone with AvPD does not want to get involved with people unless he or she is certain of being liked. Possible rejection causes a lot of fear and stress in people with AvPD, which makes attending social situations very difficult if not impossible. People with AvPD are preoccupied with the fear of rejection. This fear of possible rejection makes people with AvPD pay extra attention to signs of rejection in the behaviours of others , which is called attentional bias. The attentional bias makes it more difficult for people with AvPD to focus on other information (information that contradicts their fear of rejection). This leads to the false belief that people, indeed, show signs of rejection, which increases the avoidant personality disorder symptoms. In the image to the right or above you can see what happens with Brett’s thoughts; he has several thoughts during a conversation with someone, but only the negative thought catches his attention. For people without AvPD this thought is simply one of many and not alarming. For the person with AvPD, however, this is a very alarming thought and will produce feelings of insecurity and inadequacy. These negative feelings will likely negatively affect the conversation (Brett does not know what to say or how to keep the conversation going, he may stutter or blush, and eventually the conversation comes to an end, which confirms Brett’s fear of rejection).
What can you do about it?
Reducing the fear of rejection makes coping with avoidant personality disorder a lot easier. There are a couple of exercises that can reduce this fear, depending on the amount of practice and the severity of the fear of rejection:
EXERCISE 2 – Counting the signs
This exercise is only meant for those people who have mild/moderate Avoidant Personality Disorder.
- During an encounter with someone, count all the positive, neutral, and negative signs someone sends out.
- Right after the encounter, write them down on paper or create a note in your phone.
- Categorize them according to your interpretation: positive, neutral, negative.
- Discuss this list with your friend, partner, relative or therapist and ask them whether or not they agree with your list.
- Discuss the social encounter with the friend, partner, relative or therapist to see if you missed some signs or need to interpret them differently.
- Merge the positive and neutral signs list.
- Count the signs in the positive/neutral category and compare them with the amount of signs in the negative category.
- It will be clear that there are more neutral/positive signs someone sends out compared to negative signs.
- Ask yourself the question: do I reject someone over one or two things I dislike about the other person, even if there are a lot more neutral to positive things about that person? The answer to this question is most likely: No. Do you think someone else would reject another person over one or two things they dislike about that person, even if there are a lot more neutral to positive things about that person?
Exercise 2 helps people to focus more on the neutral to positive signs. By putting more emphasis on the neutral to positive signs, it is likely that the attentional bias towards social rejection will become less strong.
The following exercise focuses more on the power the negative signs has and tries to reduce their significance.
EXERCISE 3 – Testing the old hypothesis
- Write down what the worst fear is regarding social rejection (for instance: people find me boring/unappealing).
- Write down what the worst consequence is if this worst fear comes true (for instance: people will avoid talking to me).
- During a social situation, engage in one or more conversations and remember the people you spoke to.
- During a new social situation, test the hypothesis that people find you boring/unappealing by checking if your worst fear (people will avoid talking to me) comes true.
- If people do not avoid you in an obvious way and still talk to you (it doesn’t matter if you start the conversation or not), then your hypothesis is incorrect.
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NOTE: getting to the core of your fears can be really difficult and the help of a professional is often recommended. Most people with AvPD get stuck on the fear: people find me boring/unappealing. <-- this is difficult to test and also not your biggest fear. The biggest fear is that people do not want to talk to you. <-- this fear is much easier to test. By practicing a lot with these exercises, coping with avoidant personality disorder becomes a lot easier.
Coping with avoidant personality disorder – symptom A3
The third symptom focuses more on insecurity. The fear of being shamed or ridiculed causes someone with avoidant personality disorder to show restraint in intimate relationships. Being insecure about your physical appearance or performance in bed are among the more common insecurities. More often than not, these insecurities developed after a traumatic incident where they were shamed, ridiculed or made fun of. A common response is to avoid doing or showing what you are most insecure about.
In relationships it is important to be transparent and honest. Talk to your partner about your insecurities and set up a plan to do something about it. Sometimes this means working out or practicing more, but in most cases the partner has a completely different view of you than you have of yourself. Apply exercise 1 in your relationship as well, and ask your partner to create a small list (10 items) of things he or she likes about you. The less superficial they are, the better.
Coping with avoidant personality disorder – symptoms A1 and A7
Symptoms A1 and A7 are all about avoidance: avoiding occupational activities that involve significant interpersonal contact (symptom A1) and a reluctance to take any personal risk or to participate in new activities out of fear of embarrassment (symptom A7).
Someone with AvPD avoids interpersonal contact or new activities, because they fear criticism, disapproval, rejection or embarrassment. Giving a speech, having drinks with coworkers after work or attending a birthday party of coworkers causes someone with avoidant personality disorder a lot of stress and worry: ‘what if they don’t like me?’, ‘what if they find me boring?’. The stress and worry often becomes so severe that someone with AvPD will decline an invitation or comes up with an excuse to not have to give the speech. Unfortunately, avoiding interpersonal situations takes away a chance for someone with AvPD to experience that their fears are not true. On top of this missed chance, their fear of interpersonal situations will increase.
- If this fear of rejection, disapproval or criticism is the result of a traumatic event, then please reach out to a professional for PTSD treatment. PTSD treatment reduces the above mentioned fears significantly.
Coping with avoidant personality disorder in an effective way can only be done if the person is willing to break the vicious cycle of avoidance. Exposing yourself to interpersonal contact or new activities is scary and stressful, but also rewarding once you know what to pay attention to and how to deal with ambivalent verbal or nonverbal signs of the people around you. The exercises on this page will help you to get through these stressful situations.
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Coping with avoidant personality disorder – symptom A5
This symptom is more about feelings of inadequacy. Someone with AvPD often wrongly thinks he or she is not interesting enough. They have a feeling that their performances are not noteworthy or that their interests are not shared by others. In the above mentioned exercise 3, you already experienced that people will not avoid you and therefore do not believe you are uninteresting or unappealing. However, for the sake of the following exercise, we’ll assume your interests are limited and you may lack interesting conversing topics.
If a person does not experience enough or has enough interesting stories to tell, there is a fair chance that the conversation goes downhill pretty quickly. Fortunately, there are certain topics people are always interested in: politics (local or world), technology/gadgets, economy, culture (for the people living abroad), cooking, sports, kids, and work. Knowing about the latest gadgets or political scandals ensures that people will listen to you or that people will take your contribution into account. Here is a simple exercise to help you:
EXERCISE 4 – Reading into topics
- Pick a topic that the news covers a lot these days (for instance Global warming).
- Get familiar with the terms and definitions used.
- Search the Internet for in-dept articles from renown websites or journalists and read them.
- Search the Internet for alternative views on the same topic and read them as well.
- Adopt a popular view or a view you support the most.
- When there is a social situation and this topic comes up, you can join in.
It takes two to four weeks to get acquainted with a topic. Once you’ve sufficiently read into the topic, you can move on to a new topic. In a year from now you will be acquainted with at least 12 interesting topics. Knowing about more topics boosts your confidence levels, makes it easier to participate in conversations, and increases the chance of receiving positive feedback from others.
Coping with avoidant personality disorder – symptom A6
Symptom A6 is more about feeling unappealing, socially inept or inferior to others. These feelings often produce a preoccupation with ones appearance (physically or verbally). A preoccupation with ones own behaviour can easily lead to unnatural behaviours which can make someone feel even more socially inept, unappealing or inferior to others. Especially when the person analyses their own performance after an event, they often feel more unappealing, inept or inferior. People with avoidant personality disorder may use the confirmation bias to find evidence for their inferiority to others and social ineptness. Someone with a confirmation bias looks for evidence that supports their current belief about something. Someone who feels inferior to others will look for evidence that shows that they are indeed inferior to others, while they will ignore evidence stating the opposite. In the image above or to the right we illustrated the confirmation bias in a very simple way.
What can you do about it?
Coping with avoidant personality disorder is easier when you test the right hypothesis. Earlier, in exercise 3, we focused on testing the old hypothesis in the correct way. The old hypothesis could not be confirmed anymore and that gives us the opportunity to create a new hypothesis. Someone with a confirmation bias will look for evidence that supports his or her theory or belief and ignores evidence stating the opposite. If someone with AvPD wants to feel more appealing and socially equal to others, they have to look for evidence in that direction. In other words, coping with avoidant personality disorder becomes easier if there is a confirmation bias towards positive beliefs about oneself. Here is an exercise:
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EXERCISE 5 – Testing the right hypothesis
- Go back to exercise 3 and read the old fear and hypothesis. In our example these were: ‘people find me boring/unappealing’ and ‘people will avoid talking to me’.
- Create a new hypothesis by transforming the old one into something positive. In our example it will become: ‘people find me interesting/appealing’ and one way to test this is to see whether or not people want to talk to me.
- During social situations, remind yourself several times of the new hypothesis.
- Look for evidence that confirms this hypothesis.
NOTE: in the beginning it will be difficult to focus on positive signs, because there is a confirmation bias stating that you are unappealing/boring. However, with a lot of practice and conscious effort, you will notice that it becomes easier to focus on positive signs. At the same time, try to ignore the negative signs/thoughts by distracting yourself if they pop up. This way you can’t give these negative thoughts and signs attention and that decreases their impact on your mood.
-  Li, H., Zeigler-Hill, V., Yang, J., Jia, L., Xiao, X., Luo, J., & Zhang, Q. (2012). Low self-esteem and the neural basis of attentional bias for social rejection cues: Evidence from the N2pc ERP component. Personality and Individual Differences, 53, 947-951.