A woman receives an invitation to a colleague’s birthday gathering. She reads the message several times. Part of her wants very much to go, because she likes these people and has spent months wishing she knew them better. Another part starts building a case against attending. She will not know what to say; someone will notice she is awkward; a silence will fall; she will be responsible for it; and afterward, the others will quietly agree she doesn’t fit in. By the evening before the event, the case has grown so convincing that she sends an apology citing a headache. She feels relief for about an hour, and then a familiar heaviness settles in, made of loneliness, shame, and the suspicion that she has done the same thing too many times to count.
This pattern, repeated across decades and across nearly every area of life, is the core of avoidant personality disorder. People with the condition are often described as shy, and that description isn’t wrong, but it is far too small. The difficulty is not a mild preference for quiet or a slow warming up to strangers. It is a pervasive and long-lasting pattern of social inhibition, feelings of inadequacy, and extreme sensitivity to criticism and rejection, so strong that it shapes where a person works, whom they befriend, whether they love, and how they see themselves. Crucially, it is not a lack of desire for connection. Most people with avoidant personality disorder long for closeness, and that longing is exactly what makes the condition so painful. They are held back not by indifference but by a conviction that closeness is dangerous because it will expose them as defective and lead to humiliation.
Avoidant personality disorder is relatively common, yet it is among the least recognized of the personality disorders. Community surveys suggest that it affects somewhere between one and three percent of adults, and it is found in a much larger share of people seeking treatment for anxiety and depression. Because the people who have it tend to hide, minimize their needs, and avoid drawing attention, they seldom come to the notice of services unless another problem forces the issue, and the underlying pattern is often missed. Many spend years or decades believing that they are simply inferior, boring, or unlovable, never learning that a name and an effective treatment exist for what they experience.
This article offers a detailed, evidence-based account of avoidant personality disorder. It explains what the diagnosis means and how it is defined, describes how it looks from the inside, and examines how it differs from shyness, introversion, and social anxiety disorder, with which it overlaps considerably. It reviews the cognitive and emotional mechanisms that keep the pattern going, the developmental and biological factors that contribute to it, and the conditions that commonly accompany it. It outlines the best-supported treatments, including cognitive behavioral therapy, schema therapy, and psychodynamic approaches, and offers practical guidance for people with the disorder and those who love them. The central message is that avoidance feels like protection but functions as a prison, and that people can learn, gradually and with support, to open the door.
What Avoidant Personality Disorder Is
Avoidant personality disorder, abbreviated AvPD, belongs to the group of conditions called personality disorders, which are defined as enduring patterns of inner experience and behavior that deviate markedly from cultural expectations, are inflexible and pervasive, begin by adolescence or early adulthood, remain stable over time, and cause distress or impairment. Within the classification used by the American Psychiatric Association, it is grouped with the Cluster C, or anxious and fearful, personality disorders, together with dependent personality disorder and obsessive-compulsive personality disorder. The word personality here does not imply a flaw of character. It refers to the habitual ways of feeling, thinking, and relating that make up a person’s style of dealing with the world, which in this condition have become a source of considerable suffering.
The Diagnostic Criteria
According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the diagnosis requires 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 at least four of seven features.
- 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 in intimate relationships because of fear of shame or ridicule.
- 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.
Each of these items describes a different expression of the same underlying fear. The person scans every situation for the possibility of being judged and found wanting, and organizes life to avoid that outcome. Notice the second criterion in particular: unwillingness to get involved unless certain of being liked. Since certainty of being liked is almost never available at the start of a relationship, the condition effectively rules out the beginnings of most connections.
Why the Word Avoidant
The name comes from the central behavior. Avoidance in this disorder extends well beyond the avoidance of parties or public speaking. It includes avoiding intimacy, avoiding disagreement, avoiding the expression of needs and opinions, avoiding career advancement that would bring visibility, avoiding new hobbies in which one might be a beginner, and even avoiding thoughts and feelings that touch on the sense of inadequacy. The behavior is driven by anticipated emotional pain, not by a lack of interest, and it brings immediate relief at the cost of long-term isolation.
Alternative Ways of Understanding the Diagnosis
Diagnostic thinking about personality disorders is changing. The alternative model in the appendix of the fifth edition describes avoidant personality disorder through impairments in identity and self-direction, such as low self-esteem and excessive shame, and in empathy and intimacy, such as avoidance of close relationships, together with the pathological personality traits of anxiousness, withdrawal, and anhedonia, a reduced capacity to experience pleasure. The eleventh edition of the International Classification of Diseases has moved away from separate categories altogether, asking clinicians to rate the severity of personality difficulties and to specify prominent trait domains, among which negative affectivity and detachment are the most relevant to avoidant presentations. These approaches reflect evidence that personality pathology lies on a continuum, and they help to explain why avoidant personality disorder overlaps so heavily with social anxiety disorder.
How Common It Is
Estimates of prevalence vary by method. Large community surveys have produced figures between about one and just over two percent, and some have found higher rates. Among people attending outpatient mental health services, the proportion is considerably higher, with studies suggesting that between about ten and twenty percent of people treated for anxiety disorders also meet criteria for avoidant personality disorder, and a still larger proportion of those with generalized social anxiety. Men and women appear to be affected about equally in community samples, although clinical samples sometimes show more women. The disorder usually becomes evident in adolescence or early adulthood, often growing out of a childhood marked by shyness and fearfulness, although the full pattern may take years to consolidate.
Craving Connection, Fearing Rejection: The Central Paradox
The feature that most distinguishes avoidant personality disorder in the minds of clinicians, and the one that people with the condition find hardest to explain to others, is the conflict between a strong need for closeness and an equally strong fear of it. This conflict is sometimes described as an approach-avoidance dilemma. The person is pulled toward others by a deep desire to belong and pushed away by the expectation of pain, and the pushing usually wins in the short term, so that the desire is never satisfied.
The Hidden Longing
It is a mistake to assume that a person who avoids others does not want them. Interviews and questionnaires consistently show that people with avoidant personality disorder desire close relationships and feel their absence acutely. They often have a rich fantasy life centered on being understood and accepted, they may be devoted to a small number of safe people, and many form intense attachments to partners, friends, or even online companions who feel less threatening. Their loneliness is not the contented solitude of a person who prefers their own company. It is a painful, unwanted state, and it often feeds the very feelings of defectiveness that drive avoidance, since the person reads the absence of friends as proof of being unlikable.
The Expectation of Humiliation
The fear that blocks the way is not a vague unease but a specific prediction: that if others see me as I really am, they will find me lacking, and they will show it. This expectation may involve open ridicule, but more often it involves subtle signs of disapproval, such as a pause, a raised eyebrow, a failure to reply, or a polite coolness. The person is exquisitely alert to such signals and tends to interpret ambiguous ones negatively. Research on rejection sensitivity, a tendency to anxiously expect, readily perceive, and intensely react to rejection, has shown that it is elevated in avoidant personality disorder, and that it predicts both withdrawal and the use of protective strategies in relationships.
Shame at the Core
If one emotion defines the disorder, it is shame. Shame differs from guilt. Guilt says that I did something bad, and it motivates repair. Shame says that I am bad, and it motivates hiding. People with avoidant personality disorder carry a chronic, background sense of being fundamentally defective, inferior, or unacceptable, which is activated by social exposure and relieved by concealment. Studies using measures of shame proneness have found it to be a strong correlate of avoidant traits, and clinicians increasingly regard it as the engine of the condition. Because shame is itself shameful, people rarely speak of it, and they may hide the extent of their suffering even from therapists, which makes the disorder hard to detect.
Safe People and Narrow Worlds
Many people with the disorder do have a few close relationships, typically with a partner, a family member, or one or two longstanding friends, and these relationships are protected fiercely because they feel safe. Within them, the person may function warmly and even playfully. The limitation is that the circle is small, and the person depends heavily on it. Loss of a safe person, through death, illness, or a move, can be devastating, since there are few others to turn to and the person lacks practice in building new connections. Over time, the life of a person with the disorder can become very narrow, organized around routines that minimize exposure to evaluation, with work, hobbies, and social contact all chosen for their safety.
The Disorder From the Inside
The diagnostic criteria describe behavior. To understand the condition, it helps to consider what it feels like and how it appears in daily life. The following sections describe common experiences, noting that each person is different and that these descriptions are not a means of self-diagnosis, which is best left to a qualified clinician.
Constant Self-Monitoring
In company, a person with the disorder is often engaged in a constant internal commentary about how they are coming across. Am I talking too much or too little? Did that sound stupid? Why did she look away? This self-monitoring consumes mental resources, so that the person has less attention for the conversation, performs less fluently, and may indeed appear distant or awkward, which seems to confirm the fear. The pattern is similar to that described in social anxiety disorder, in which self-focused attention and a distorted internal image of one’s appearance maintain anxiety.
Mind Reading and Negative Interpretation
People with avoidant personality disorder commonly assume that they know what others are thinking, and the assumption is usually negative. A friend who is quiet is presumed to be irritated, a colleague who does not reply immediately is assumed to have lost interest, and a compliment is taken to be politeness covering real disdain. Cognitive therapists describe these as cognitive distortions, including mind reading, emotional reasoning, and discounting the positive. Because the interpretations feel like observations, and because the person usually avoids checking them, they are rarely corrected.
Perfectionism and the Fear of Mistakes
Many people with the disorder hold very high standards for their own social performance, and treat any imperfection as evidence of inadequacy. They may rehearse conversations in advance, rewrite messages many times, and replay interactions afterward, searching for errors, a pattern called post-event processing. They may also avoid beginning activities in which they would be a novice, since being seen as unskilled feels intolerable. This reluctance to take personal risks is one of the diagnostic criteria, and it can prevent learning of every kind, from a new language to a new job.
Emotional Numbing and Hidden Feelings
Alongside intense social fear, people with the disorder often manage their feelings by suppressing them. They may describe themselves as unemotional, keep their opinions to themselves, and avoid expressing needs or disagreement, for fear that doing so will invite criticism. This restraint can make intimate relationships feel one-sided, and the partner may feel shut out. Some people also experience a muted capacity for pleasure, and a tendency to daydream or to retreat into fantasy as a substitute for real engagement.
Work, Study, and Money
The disorder frequently interferes with education and work. People may choose jobs well below their abilities that involve little contact, decline promotions that would require leading others or being visible, avoid meetings, and struggle in interviews. Some work remotely or alone by design, and some do well in roles that suit their conscientiousness and attention to detail. The cost is often underemployment and lower income, and a lingering sense of unrealized potential. Studies have found that avoidant personality disorder is associated with notable impairment in occupational functioning, comparable to that of other serious mental disorders.
Intimate Relationships
Romantic life is often the most painful domain. The wish for a partner may be intense, but the process of meeting, dating, and becoming known is full of exposure. Some people never date. Others form relationships only with people who make the first move and who seem unlikely to reject them, and they may stay in relationships that are unsatisfying because leaving feels too risky. Within a relationship, the person may find it difficult to be open about needs, vulnerabilities, or disagreements, and may hold back affection or sexual intimacy for fear of being judged. Partners sometimes misinterpret the reserve as indifference, and the resulting distance reinforces the fear.
A Composite Example
The following account is a composite and does not describe a real person. A man in his late thirties, whom we shall call Daniel, works as a data analyst, a job he chose because it involves little contact with others. He was a quiet child who was teased about his stutter, and he learned early that speaking up invited ridicule. He is intelligent and well liked by the few colleagues who know him, but he eats lunch alone, has turned down two promotions that would have required him to manage a team, and has not had a romantic relationship in eight years. He says that he would love to have a partner, but that he cannot imagine anyone being interested in him once they knew him. Recently a woman at a climbing club began talking to him, and he felt happy for a week. Then, convinced that she was merely being polite, he stopped attending the club. He describes his life as safe and unbearably empty. In therapy, he learns that his assumption about her thoughts was a prediction, not a fact, that his avoidance had cost him every opportunity to test it, and that the shame he carried from childhood had been steering his adult decisions. After two years of treatment, he leads a small project team, attends a weekly club, and has begun to date. He still feels nervous, but the nervousness no longer decides what he does.
Avoidant Personality Disorder, Shyness, Introversion, and Social Anxiety
Because the disorder looks so much like several more familiar conditions, it is important to separate them. The differences affect both how a person understands their own experience and what kind of help is likely to be useful.
Shyness and Introversion
Shyness is a common tendency to feel tense and inhibited in new social situations, and it usually eases with familiarity. Introversion is a personality trait describing a preference for quieter settings and a tendency to find prolonged social stimulation tiring. Neither is a disorder, and neither involves a pervasive sense of inadequacy or a fear of rejection that governs life choices. An introvert may be entirely at ease with people and simply choose solitude, whereas a person with avoidant personality disorder wants more connection than they allow themselves to have and is distressed by the gap. A shy person may grow more confident over time, while the disorder tends to persist unless treated. The distinguishing questions are whether avoidance reflects a free preference or a fear, and how much of life it has taken over.
Social Anxiety Disorder
The closest relative is social anxiety disorder, particularly its generalized form, in which a person fears most social situations. The overlap is so great that many researchers consider the two conditions to be points on a single spectrum, with avoidant personality disorder representing the more severe, early-onset, and pervasive end. Studies find that the great majority of people with avoidant personality disorder also meet criteria for generalized social anxiety disorder, and that the two cannot be reliably distinguished on the basis of symptoms alone. Some differences have been proposed. Avoidant personality disorder is thought to involve a more global and entrenched sense of inadequacy, greater shame, more difficulty with intimacy, a longer history reaching back to childhood, and more impairment in identity and relationships. Social anxiety disorder is more focused on the fear of negative evaluation in particular situations and may be more episodic. In practice, the choice of label matters less than recognizing the severity and tailoring treatment accordingly.
Schizoid Personality Disorder
Schizoid personality disorder also involves social withdrawal, but its motivation is entirely different. A person with the schizoid pattern is genuinely indifferent to relationships, derives little pleasure from closeness, and shows restricted emotional expression, without an underlying fear of rejection. A person with avoidant personality disorder wants closeness and fears it. This distinction is often summarized by saying that the schizoid person does not want connection, and the avoidant person wants it but cannot allow it.
Dependent Personality Disorder
Dependent personality disorder, another anxious-cluster condition, features a pervasive need to be taken care of, submissive and clinging behavior, and fear of separation. Like avoidant personality disorder, it involves feelings of inadequacy and a fear of criticism, and the two frequently co-occur. The difference lies in the response: the dependent person seeks out relationships and clings to them for security, while the avoidant person withdraws from them to prevent injury. Some people show a mixture, drawing close to a single safe person with great dependence while avoiding everyone else.
Autism Spectrum Conditions
Autistic people may also appear withdrawn, avoid social situations, and be anxious, and the two conditions are sometimes confused, particularly in adults whose autism has not been recognized. The causes differ. In autism, social difficulties arise from differences in social communication, sensory processing, and the interpretation of social cues, and the person may not share the fear of negative evaluation and the deep sense of defectiveness that are central to avoidant personality disorder. However, autistic people frequently develop social anxiety and avoidant behavior after repeated experiences of misunderstanding or rejection, and the two conditions can coexist. Careful developmental history is needed, because treatments must then be adapted to the person’s needs.
Depression and Other Conditions
Depression involves social withdrawal as a result of low mood and loss of interest, and it can be difficult to distinguish from avoidant personality disorder, particularly since the two often coexist. In depression, the withdrawal tends to come with a loss of desire for activities and relationships, while in avoidant personality disorder the desire remains, and the pattern has been lifelong. Body dysmorphic disorder, post-traumatic stress disorder, and borderline personality disorder can also involve avoidance and fear of rejection. Borderline personality disorder is marked by intense, unstable relationships and fear of abandonment that leads to clinging and angry outbursts, whereas avoidant personality disorder is marked by stable inhibition and withdrawal. A skilled clinician considers the whole pattern.
What Keeps Avoidance Going
A personality disorder is by definition a stable pattern, and understanding why it is stable is the key to changing it. Cognitive and behavioral research has identified several processes that form a self-sustaining cycle, in which the very strategies that protect the person from pain also prevent the discovery that the feared outcome is less likely than predicted.
The Core Beliefs
The cognitive model of personality disorders developed by Aaron Beck and colleagues proposes that each disorder is characterized by a set of deeply held core beliefs and associated strategies. In avoidant personality disorder, the typical core beliefs concern the self, such as “I am socially inept,” “I am unlovable,” “I am inferior,” or “I am defective,” and concern others, such as “People are critical and rejecting,” and “If people get to know me, they will not like me.” Conditional beliefs link these to behavior, such as “If I get close, I will be hurt,” and “If I do not take risks, I cannot be humiliated.” The strategies that follow are avoidance, withdrawal, and concealment of the self, in an attempt to prevent the feared outcome. These beliefs are often formed in childhood and feel like simple facts, so that the person does not question them.
Avoidance as Negative Reinforcement
The behavioral mechanism is the same as in other anxiety conditions. Avoiding a feared situation reduces anxiety immediately, and that relief rewards and strengthens the avoidance. Each time the woman in the opening example declined the invitation, she felt relief, which taught her brain that declining was the right way to cope. At the same time, she lost the chance to discover that the party would probably have been tolerable and that the feared rejection might not have occurred. Avoidance thus prevents disconfirmation. It also has a compounding effect: the more a person avoids, the less practice they have in social skills, the more awkward they may feel in the few situations they do enter, and the more their avoidance seems justified.
Safety Behaviors
When avoidance is not possible, people use subtler protective strategies. These include rehearsing what to say, speaking little, avoiding self-disclosure, agreeing with others to prevent conflict, keeping conversations on safe topics, focusing on others to deflect attention, using alcohol or substances to relax, and leaving early. The cognitive model described by David Clark and Adrian Wells for social anxiety applies closely. Safety behaviors may make the feared outcome more likely, since a person who avoids revealing anything about themselves can appear distant, and they prevent learning, since any good outcome is attributed to the safety behavior and not to the harmlessness of the situation.
Selective Attention and Memory
The mind of a person with the disorder is tuned to detect threat. Attention is drawn to signs of disapproval, such as a frown or a delayed reply, and away from signs of acceptance, such as a smile or a friendly comment. Ambiguous events are interpreted negatively, and memories of social events are biased toward the negative. Research on attentional bias in social anxiety and related conditions has repeatedly found this pattern. The effect is a filter that lets in confirmation of the fear and keeps out disconfirmation, so that the person’s experience seems to prove what they already believe.
Anticipation and Post-Event Processing
The cycle extends before and after an event. Beforehand, the person imagines the worst, rehearses failure, and may build such dread that they cancel. Afterward, they replay the event in detail, focusing on moments that seemed awkward and concluding that they were judged. This review is selective and increases the negative memory of the event, which fuels anticipatory dread the next time. The combined effect is that a brief social encounter may occupy the mind for days, making avoidance appear to be the economical choice.
Experiential Avoidance and the Avoidance of Feeling
Researchers in the tradition of acceptance and commitment therapy emphasize that the avoidance in this disorder extends beyond situations to inner experience. The person avoids thoughts, feelings, memories, and bodily sensations associated with shame and fear, through distraction, suppression, daydreaming, or substance use. This experiential avoidance, though it brings short-term relief, maintains the problem, since feelings that are avoided do not lose their power and the person never learns that they can be tolerated. Studies have found that experiential avoidance is higher in avoidant personality disorder and is associated with greater impairment.
The Social Consequences That Confirm the Fear
Finally, the social world responds to the person’s behavior in ways that often reinforce the belief. A person who rarely initiates contact, speaks little, and does not share personal information may be perceived as aloof or uninterested, and others may stop trying. The person then concludes that they were right about being unlikable. This interpersonal feedback loop, in which avoidance produces the rejection that it was meant to prevent, is a major reason why the pattern persists across a lifetime, and why it can feel to the person like objective evidence of their defect.
Where Avoidant Personality Disorder Comes From
As with other personality disorders, the causes are multiple. The best-supported account involves an interaction between an inherited temperamental vulnerability and early experiences that teach the child that closeness and self-expression are dangerous.
Temperament: The Inhibited Child
The strongest predictor is early temperament. The developmental psychologist Jerome Kagan and colleagues showed that a proportion of infants, roughly fifteen to twenty percent in the samples studied, react to novelty with vigorous distress, and that these children are more likely to become behaviorally inhibited, cautious, and shy in later childhood. Longitudinal studies have found that behavioral inhibition in early life increases the risk of social anxiety disorder in adolescence and, in some studies, of avoidant personality traits in adulthood. Twin studies suggest that avoidant personality disorder is moderately heritable, with estimates generally ranging from about thirty to over fifty percent, and that it shares much of its genetic basis with social anxiety and with the broad trait of negative emotionality, which includes proneness to anxiety, shame, and sadness. No single gene is responsible, and genetic vulnerability is a predisposition and not a destiny.
Parenting and Family Environment
Family experience influences whether an inhibited temperament develops into the disorder. Retrospective studies of adults with avoidant personality disorder report higher rates of parental criticism, rejection, emotional coldness, and overprotection, as well as a family atmosphere that emphasized shame, appearances, and the opinions of others. Some parents are critical and humiliating, teaching the child that their self-expression will be ridiculed. Others are overprotective, rescuing the child from every uncomfortable situation and conveying, without intending to, that the world is dangerous and that the child cannot cope. Some are themselves socially avoidant, modeling withdrawal. It is important to stress that these are risk factors, not verdicts. An inhibited child can draw out protective behavior from loving parents, and many parents who do their best find that the usual approaches do not work for a very sensitive child.
Peer Rejection, Bullying, and Humiliation
Experiences outside the family matter greatly. Studies have found that bullying, teasing, social exclusion, and humiliation in childhood and adolescence are strongly associated with later avoidant personality features. A child who is mocked for a stutter, a physical feature, an accent, or a difference in interests learns that exposure brings pain, and a sensitive child may generalize this lesson to all social situations. Many adults with the disorder can recall specific incidents of public humiliation that seemed to crystallize their belief about themselves. In these cases, the fear is not irrational in its origins, but it persists after the danger has passed.
Emotional Neglect and Attachment
Attachment research offers another perspective. Children whose emotional needs are met inconsistently or dismissively may learn to suppress their needs and to rely on themselves, developing what is called an avoidant or, in more disturbed cases, a fearful-avoidant attachment style. Adults with avoidant personality disorder show high rates of insecure attachment, particularly the fearful style, characterized by a desire for closeness combined with a fear of being hurt. This corresponds closely to the central paradox of the disorder. Emotional neglect, in which a child’s feelings go unnoticed or are treated as unimportant, is increasingly recognized as a significant contributor, even in the absence of overt abuse.
Cultural and Social Context
Culture shapes how avoidant traits are expressed and judged. In societies that value modesty, restraint, and deference, social inhibition may be more acceptable and less impairing, while in societies that prize extraversion and self-promotion, it may be more disabling. A related cultural syndrome, taijin kyofusho, found in Japan and Korea, involves fear of offending others through one’s appearance or behavior. The modern environment may also play a role. Social media increases the sense of being constantly observed and compared, and heavy reliance on online contact may reduce practice in face-to-face interaction. The isolation of the pandemic years limited social experience for many young people. The evidence on these influences is still developing, but it suggests that environments that limit social practice can worsen existing vulnerability.
The Brain and Stress Systems
Research on the biology of avoidant personality disorder is limited compared with other conditions, but studies of social anxiety and of behavioral inhibition point to an overactive threat-detection system. Neuroimaging studies find heightened activity in the amygdala and insula in response to critical or angry faces and to the anticipation of evaluation, and reduced regulatory activity in regions of the prefrontal cortex. Differences in serotonin and dopamine functioning have been proposed. Research has also shown that social rejection activates brain regions involved in the processing of physical pain, including the anterior cingulate cortex, which helps to explain why rejection feels so painful and why avoiding it can seem a matter of survival. As with other conditions, these patterns appear to change after successful treatment, which supports the view that they reflect modifiable functioning.
What Often Comes With It
Avoidant personality disorder rarely occurs alone. The majority of people who meet criteria also have at least one other mental health condition, and the combinations complicate both diagnosis and treatment.
Depression
Depression is very common, and often develops as a consequence of the loneliness, lost opportunities, and chronic self-criticism that the disorder brings. People with the disorder show high rates of persistent depressive symptoms, and studies suggest that having both conditions leads to greater impairment than either alone. Because depression can also sap the energy needed for therapy, it is usually addressed in treatment. Suicidal thoughts occur more often in people with avoidant personality disorder than in the general population, particularly when depression and isolation are present, and anyone experiencing them should seek help from a professional or an emergency service without delay.
Anxiety Disorders
Generalized social anxiety disorder is the most frequent companion, and generalized anxiety, panic disorder, and agoraphobia are also common. Some people develop panic attacks in social situations, which add to the fear of exposure. Treatment often addresses these conditions together, since the same principles of graded exposure and cognitive work apply.
Substance Use
Alcohol and other substances are sometimes used to ease social anxiety and to make interaction possible. This is understandable, but it carries the risk of dependence and prevents the person from learning that they can cope without it. People with avoidant personality disorder have higher rates of alcohol and cannabis use problems than the general population, and integrated treatment is recommended where both are present.
Eating Disorders and Body Image Problems
Eating disorders, particularly anorexia nervosa and bulimia, have been linked to avoidant personality traits, with perfectionism, shame, and fear of negative evaluation as shared features. Body dysmorphic disorder, a preoccupation with perceived defects in appearance, also commonly occurs alongside avoidant traits and can intensify the wish to hide.
Other Personality Disorders
Avoidant personality disorder overlaps with dependent, obsessive-compulsive, schizotypal, paranoid, and borderline personality disorders. Many clinicians therefore focus on the individual’s specific pattern of difficulties, and on dimensions such as severity, anxiousness, and withdrawal, and not on categories alone.
The Cost of Avoidance
Because the disorder is quiet, its costs are often invisible, including to those who bear them. People with the condition rarely disturb others, and their suffering can go unnoticed for decades. Yet the research shows a substantial burden on quality of life, relationships, and work, comparable to that of other serious conditions.
Loneliness and Health
Chronic loneliness is one of the most consistent consequences. Large studies have linked persistent loneliness and social isolation to poorer physical and mental health, including higher risks of depression, cardiovascular disease, sleep disturbance, and early mortality. While the direction of causation is complex, the findings suggest that isolation is not a benign state. For people with avoidant personality disorder, loneliness is both a result of the disorder and a factor that maintains it, since isolation deprives them of the corrective experiences that would challenge their beliefs.
Unrealized Potential
Many people with the disorder are intelligent, sensitive, creative, and conscientious, and the greatest cost may be the gap between what they could do and what they allow themselves to do. Careers that stall, talents that go undeveloped, relationships that never begin, and travels never taken accumulate into a life that feels smaller than it should be. People often describe a sense of watching life from the sidelines.
The Cost to the Family and Partners
Partners and family members may carry heavy burdens. They may find themselves speaking for the person, arranging social life, covering for withdrawal, or feeling shut out. Children of a parent with the disorder may miss social opportunities or may absorb the avoidant pattern. At the same time, many people with the disorder are loyal, gentle, and devoted partners and parents, and treatment improves family functioning.
Treatment: What the Evidence Supports
For many years, avoidant personality disorder received little research attention, and many clinicians believed that it was difficult to treat. In the past two decades, evidence has accumulated that psychological therapies produce meaningful improvement. The research base is smaller than for social anxiety disorder or borderline personality disorder, and larger trials are needed, but the available findings are encouraging.
Cognitive Behavioral Therapy
Cognitive behavioral therapy is the best-studied approach. Trials by Ronald Rapee and colleagues, and by others, have found that cognitive behavioral treatment of avoidant personality disorder, which combines cognitive restructuring, graded exposure, and social skills practice, produces significant reductions in avoidance, anxiety, and associated symptoms. A trial by Alden in the 1980s found that graded exposure, skills training, and cognitive intervention each produced improvement in people with avoidant personality disorder, with more intensive combinations performing best, and later studies have supported these findings. Treatment tends to take longer and to be more demanding than for uncomplicated social anxiety, often lasting between twenty and fifty sessions, and gains may be partial in severe cases. Nevertheless, a substantial proportion of people no longer meet the criteria after treatment, and the improvements are generally maintained.
The therapy begins with building a trusting relationship, which is itself a significant therapeutic task, since the person may expect the therapist to judge them. The therapist then explains the cycle of avoidance and develops a shared formulation. Cognitive work examines the predictions, interpretations, and core beliefs, and tests them. Graded exposure, in which the person approaches the situations they avoid in a planned sequence from easier to harder, provides the experiences that disconfirm the fear. Behavioral experiments are used to test specific predictions: a person who believes that sharing a personal opinion will lead to rejection may share one with a safe person, and observe what happens. Skills training addresses gaps in social skills, such as starting conversations, assertiveness, and managing conflict. Throughout, safety behaviors are identified and gradually dropped.
Schema Therapy
Schema therapy, developed by Jeffrey Young, was designed for personality disorders and addresses the early maladaptive schemas believed to underlie them, such as defectiveness and shame, social isolation, emotional deprivation, failure, and vulnerability. It combines cognitive, behavioral, and experiential techniques, including imagery work in which the person revisits childhood experiences and the unmet needs within them, and a concept called limited reparenting, in which the therapist offers, within professional boundaries, some of the warmth and acceptance that was lacking. A randomized trial by Bamelis and colleagues in the Netherlands, which included people with avoidant, dependent, obsessive-compulsive, and other personality disorders, found that schema therapy produced higher rates of recovery than treatment as usual, and than clarification-oriented therapy, with good retention. Schema therapy is lengthy, typically one to three years, but it may be particularly suitable for people whose difficulties are rooted in shame and early experiences.
Psychodynamic and Interpersonal Approaches
Psychodynamic therapies focus on the unconscious conflicts, defenses, and relational patterns that maintain avoidance, using the therapeutic relationship as a means to understand and change them. For a person who fears judgment, the experience of being understood and accepted by a therapist, over time, can be corrective. A trial by Emmelkamp and colleagues in the Netherlands compared cognitive behavioral therapy with brief dynamic therapy in people with avoidant personality disorder and found that cognitive behavioral therapy produced greater improvement on several measures, though both showed benefits. Interpersonal psychotherapy and approaches that focus on the repair of relationship patterns are also used. Some clinicians combine elements of several approaches, choosing according to the person’s needs.
Acceptance and Commitment Therapy and Mindfulness-Based Approaches
Because experiential avoidance is a central feature, acceptance and commitment therapy has been adapted for avoidant personality disorder and related conditions. The approach teaches people to notice and make room for painful thoughts and feelings, such as shame and anxiety, without struggling against them, to step back from thoughts through a process called cognitive defusion, to clarify what they value, and to take committed action in line with those values even when discomfort is present. Early studies and case series are promising, though larger trials are needed. Mindfulness-based approaches, which cultivate nonjudgmental awareness, may help in reducing self-criticism and rumination.
Compassion-Focused Therapy and Self-Compassion
Because shame is so central, therapies that target self-criticism and build self-compassion are of particular interest. Compassion-focused therapy, developed by Paul Gilbert, teaches people to understand the origins of their threat responses, to develop a kind and supportive inner voice, and to approach themselves with warmth. Research on self-compassion has found that it is associated with lower social anxiety and shame, and that practices of self-compassion can reduce self-criticism and make it easier to approach feared situations. For many people with the disorder, learning to treat themselves as they would treat a friend is a turning point.
Group Therapy
Group therapy offers a unique opportunity: it places the person in a social situation that is structured, supportive, and focused on the very fears they have avoided. Group cognitive behavioral therapy and groups based on schema or psychodynamic approaches have been used successfully. Members can practice skills, receive feedback, and discover that others share their experience, which directly challenges the belief of being uniquely defective. The prospect of a group is frightening to many people with the disorder, and a period of individual therapy may be needed to prepare, but those who persist often find the group to be the setting in which they make the most progress.
The Therapeutic Relationship
Whatever the approach, the relationship with the therapist matters a great deal. A person who expects criticism may be slow to trust, may withhold information, may agree with the therapist while privately doubting, and may drop out at the first sign of disapproval. Good therapists are warm, consistent, and non-judgmental, they notice and gently name avoidance within the sessions, they check regularly how the person is experiencing the therapy, and they work at a pace that allows trust to grow. For many people, the experience of revealing something shameful to the therapist and being met with acceptance rather than rejection is itself a powerful corrective experience.
Medication
No medication is approved specifically for avoidant personality disorder, and the evidence is limited. Because of its overlap with social anxiety disorder, medications used for that condition, such as selective serotonin reuptake inhibitors, may reduce anxiety and avoidance in some people, and small trials of antidepressants in avoidant personality disorder have shown some benefit. Medication may also be helpful when depression or another anxiety disorder is present. It is generally considered an adjunct to psychotherapy and not a replacement for it, since drugs do not teach the new learning that change requires. Benzodiazepines carry risks of dependence and may interfere with exposure, and are generally avoided for long-term use. Any decision should be made with a doctor, and medication should not be stopped suddenly.
Digital and Self-Help Resources
For people who find the prospect of face-to-face therapy daunting, guided self-help and online programs based on cognitive behavioral therapy for social anxiety can offer a manageable first step. Evidence shows that internet-delivered treatments are effective for social anxiety disorder, and may help those with milder avoidant features, though people with severe or long-standing patterns often need the support of a therapist. A first step using a digital program can build confidence and may lead to further help.
What to Expect From Treatment
Progress tends to be gradual. Early gains often involve a better understanding of the pattern and a reduction in self-criticism, followed by small behavioral changes, such as speaking up in a meeting or accepting an invitation. Deeper changes in the sense of self and in the capacity for intimacy usually take longer. Setbacks are expected, particularly at times of stress or after rejection, and they are not a sign of failure. Many people say that the hardest part is beginning, and that the first successful step brings a surprising sense of freedom.
Practical Strategies: Opening the Door
Professional treatment is the best option for a disorder of this severity, and the following strategies are not a substitute for it. They are drawn from the evidence-based approaches described above and may help people who are waiting for treatment, who are in therapy and wish to practice, or who have milder avoidant tendencies. People who are feeling hopeless or who have thoughts of ending their life should contact a professional or an emergency service immediately.
Notice the Pattern Without Judgment
The first step is to recognize avoidance when it occurs. A simple log can help: write down the situation, the thought that came, the feeling and its intensity, what was done, and what happened afterwards. After a week or two, patterns usually emerge. It helps to adopt a stance of curiosity and kindness, treating avoidance as a learned protection and not as a character flaw.
Treat Predictions as Hypotheses
The mind of a person with the disorder presents predictions as facts. Writing a prediction down in advance, such as “If I join the conversation, they will find me boring,” and rating how confident one is, creates distance. Afterwards, compare what happened with the prediction. Over time, the record shows how often the feared outcome fails to occur, and how much of the distress arises from anticipation and review and not from the events themselves.
Build a Ladder of Small Steps
Avoidance is reduced most effectively through graded exposure. List the situations that are avoided, from least to most frightening, and work through them one at a time. Early steps might include greeting a neighbor, asking a shop assistant a question, sending a message to a friend, sharing an opinion in a small group, or accepting an invitation for an hour. Choose a step that is challenging but manageable, repeat it until it becomes easier, and then move on. It helps to plan steps in advance, to expect anxiety to rise, and to stay in the situation until it begins to ease, when safe, instead of leaving at the peak.
Drop Safety Behaviors Gradually
Identify the protective habits that make situations bearable but prevent learning, such as rehearsing, avoiding eye contact, talking only about safe topics, or leaving early. Try dropping one at a time, noting the prediction beforehand and the result afterwards. The aim is to learn from experience that the feared outcome is less likely without the protection than expected.
Shift Attention Outward
Self-focused attention increases anxiety and impairs performance. In conversation, practice directing attention to the other person: what they are saying, how they look, what they seem to care about. When the mind drifts back to self-monitoring, gently redirect it without criticism. Asking open questions and listening carefully helps to take the focus off oneself and makes others feel valued.
Practice Small Disclosures
Intimacy grows through gradual, reciprocal self-disclosure. Rather than waiting for certainty of acceptance, which never comes, try sharing a small piece of personal information, such as an opinion, a preference, or a mildly vulnerable feeling, with a person who seems trustworthy, and observe the response. Most people respond warmly to sincere and modest openness. Over time, the level of disclosure can increase as trust is established.
Treat Shame With Compassion
Shame thrives in secrecy and self-attack. Practice speaking to yourself as you would to a friend in the same position. When a harsh thought arises, ask what you would say to someone you cared about. Research shows that self-compassion reduces shame and anxiety and does not weaken motivation. Sharing a shame-laden memory with a trusted person or a therapist, and finding that it is met with understanding, can loosen its hold.
Find Low-Pressure Ways to Be Around People
Structured, activity-based settings reduce the pressure to make conversation from nothing. Classes, clubs, volunteer groups, sports teams, and hobby circles provide a shared focus, regular contact with the same people, and built-in topics. Familiarity is a strong ally for people with avoidant tendencies, and repeated low-stakes contact can lead to friendship without the intensity of a social event. Online communities can serve as a stepping stone, provided they do not replace face-to-face contact altogether.
Look After the Body
Regular exercise, adequate sleep, balanced eating, and moderation in caffeine and alcohol reduce baseline anxiety. Slow breathing with a long exhalation can calm physical tension before and during a social situation. Avoid using alcohol as a social crutch, since it prevents learning and risks dependence.
Be Patient With Setbacks
Change is slow, and progress is rarely smooth. A painful experience after a period of progress does not erase what has been gained. Keeping a record of achievements, however small, maintains perspective. Seeking support from a trusted friend, a support group, or a therapist is itself an act of courage and a form of the exposure that the disorder resists.
Supporting Someone With Avoidant Personality Disorder
Family members, partners, and friends often feel unsure how to help a person who seems to want closeness but pulls away. The approach that works best combines patience, warmth, and gentle encouragement, and avoids both pressure and overprotection.
What Helps
Consistent, low-pressure warmth is the foundation. Showing interest without demanding a response, being reliable, and offering invitations that are easy to accept or decline without penalty communicate safety. It helps to take the person’s fear seriously, to acknowledge that the distress is real, and to avoid minimizing it. Noticing and appreciating small steps, such as attending an event or sharing an opinion, reinforces change. Offering to accompany the person to a first step, or to help find a therapist, can make a great difference. It is also useful to be patient with slow trust, since it may take a long time for the person to believe that your acceptance is genuine.
What to Avoid
Remarks such as “Just be more confident,” “Stop being so shy,” or “Nobody is judging you” are well meant but often feel dismissive, and may increase shame. Criticism, teasing, and public embarrassment are especially damaging, since they confirm the person’s deepest fear. Forcing a person into overwhelming situations can strengthen avoidance. At the other extreme, taking over, speaking for the person, making all the arrangements, or organizing family life around the avoidance maintains the problem. A balance of support and gentle encouragement toward gradual steps, ideally agreed with the person, works best.
Looking After Yourself
Supporting a person with the disorder can be draining, especially when progress is slow and the person withdraws. Keeping your own friendships, interests, and health is not selfish, and it makes it possible to continue to support. Consider seeking guidance from a therapist about how to respond, and, where appropriate, joining the person in some sessions.
Parents of Inhibited Children and Teenagers
The pattern often begins in childhood, and early help can change its course. Parents of shy, fearful children can accept the child’s temperament without shame, avoid labeling the child as shy in their hearing, and provide repeated, manageable opportunities to meet new situations, with praise for effort and not outcomes. It is important to resist the natural urge to rescue the child from every uncomfortable moment or to speak for them, since this teaches the child that they cannot cope. Where fear is severe, persistent, or interfering with school and friendships, a consultation with a child mental health professional is advisable, and cognitive behavioral therapy adapted for young people has good evidence of effectiveness. Protecting children from bullying and responding firmly to it is also essential.
Common Myths About Avoidant Personality Disorder
Several beliefs make the disorder harder to understand and to treat. The first is that people with the disorder prefer to be alone. In fact, most long for connection, and their solitude is a source of pain. The second is that it is simply extreme shyness that people must learn to live with. While related to shyness, the disorder involves a pervasive sense of inadequacy and avoidance that governs life choices, and it responds to treatment. A third is that avoidant people are arrogant or cold. Their reserve is usually misread, and it comes from fear, not from superiority.
A fourth myth is that personality disorders cannot change. Research shows that personality patterns are more flexible than once thought, and that many people with avoidant personality disorder improve substantially with treatment. A fifth is that people with the disorder should just push themselves. Unplanned, overwhelming exposure with harsh self-criticism can reinforce fear, while planned, graded, and supported exposure works. A sixth is that the disorder is the same as introversion. Introversion is a preference and not a fear, and many introverts are socially confident. A seventh is that people with the disorder are not interested in relationships and do not need them. The opposite is true, and the need for belonging is a central feature of the condition.
A Realistic and Hopeful Outlook
The outlook for people with avoidant personality disorder is more positive than was once believed. Long-term studies of personality disorders, including the Collaborative Longitudinal Personality Disorders Study, have found that many people no longer meet the criteria after several years, and that the disorder is less fixed than the term personality implies, although avoidant traits tend to remain to some degree and improvements in social functioning often lag behind improvements in symptoms. With treatment, the prospects are better still. People who complete cognitive behavioral or schema therapy frequently show lasting gains in social engagement, work, and relationships, and many report a deep change in how they see themselves.
Recovery does not mean becoming a different person. A person who has recovered may still be quiet and thoughtful, may still prefer small gatherings, and may still feel a flutter of nervousness before meeting new people. What changes is that fear no longer decides. They can accept the invitation, speak up in the meeting, reach out to a friend, and allow someone to know them, because they choose to and because they have discovered, through experience, that rejection is neither as likely nor as unbearable as they had believed. Many describe a sense of grief for the years spent avoiding, together with a sense of astonishment at how much life was waiting.
When to Seek Help
It is time to seek professional help when avoidance has lasted for months or years, when it is limiting work, friendships, or romantic life, when loneliness or shame is persistent, when depression or anxiety is present, or when the person feels that fear is running their life. A good first step is to see a general practitioner or a mental health professional for an assessment. It is reasonable to ask whether the clinician has experience in treating social anxiety and personality difficulties and which approach they use. For a person who fears judgment, making the first appointment may be among the hardest things to do, and it is also the first step of the treatment itself.
Conclusion
Avoidant personality disorder is a condition of paradox. The people who have it want closeness and flee from it, are sensitive to others and convinced that others will reject them, and protect themselves from pain by building a life in which little can happen. The pattern is sustained by shame, by distorted predictions, by safety behaviors that prevent learning, and by the social consequences of withdrawal, which seem to confirm the fear. Its roots lie in an inhibited temperament combined with experiences of criticism, neglect, or humiliation that teach that exposure is dangerous.
Understanding the disorder in this way points toward what can be done. Cognitive behavioral therapy, schema therapy, and related approaches help people to test their predictions, to face what they avoid in graded steps, to drop protective behaviors, to build skills and self-compassion, and to experience acceptance. These treatments take time and courage, and the evidence, though less extensive than for some other conditions, shows that most people who engage with them improve. Family and friends can help by offering patient warmth without pressure. Anyone who recognizes themselves in this description, who feels that fear of rejection has shrunk their life, is encouraged to speak with a doctor or mental health professional. The wish for connection that has been hidden for so long is not a weakness. It is the part of the person that knows what is worth reaching for, and with help, it can lead them out of avoidance and toward the relationships they have always wanted.
FAQ About Avoidant Personality Disorder
What is avoidant personality disorder?
Avoidant personality disorder is a long-standing pattern of social inhibition, feelings of inadequacy, and extreme sensitivity to criticism and rejection, beginning by early adulthood and present across many areas of life. People with the disorder typically avoid occupational and social activities that involve significant contact, are unwilling to get involved with others unless certain of being liked, hold back in intimate relationships for fear of being shamed, see themselves as socially inept or inferior, and are reluctant to take personal risks. A diagnosis requires at least four of seven specified features and significant distress or impairment. Unlike simple shyness, the pattern is pervasive, persistent, and disabling, and it usually coexists with a strong but hidden wish for closeness.
What is the difference between avoidant personality disorder and social anxiety disorder?
The two conditions overlap so much that many researchers regard them as points on a single spectrum, with avoidant personality disorder at the more severe and pervasive end. Most people with the personality disorder also meet criteria for generalized social anxiety disorder. Differences that have been proposed include a more global and entrenched sense of inadequacy and shame in avoidant personality disorder, an earlier and longer history, greater difficulty with intimate relationships, and more impairment in identity and self-esteem. Social anxiety disorder tends to focus on fear of negative evaluation in specific situations. Treatment approaches are similar, though avoidant personality disorder often requires longer therapy and more attention to core beliefs and shame.
Is avoidant personality disorder the same as being introverted or shy?
No. Introversion is a personality trait involving a preference for quiet settings and a tendency to find prolonged social stimulation tiring, and an introvert may be entirely comfortable with people. Shyness is a common tendency toward discomfort in new social situations that usually eases with familiarity. Avoidant personality disorder involves a pervasive fear of rejection, deep feelings of inadequacy, and avoidance that restricts work, friendships, and intimacy, together with a wish for connection that goes unfulfilled. A useful question is whether the avoidance reflects a free preference, which suggests introversion, or a fear that prevents the person from doing what they would like, which suggests an anxiety-based problem that may merit assessment.
Do people with avoidant personality disorder want relationships?
Yes, typically they want them very much. The central paradox of the disorder is a strong desire for closeness combined with an equally strong fear of being judged, criticized, or rejected. Many people with the condition have a rich inner life centered on being understood and accepted, form intense attachments to a few safe people, and feel their loneliness acutely. This distinguishes the disorder from schizoid personality disorder, in which the person is genuinely indifferent to relationships. In avoidant personality disorder, the avoidance protects against anticipated pain but leaves the longing unmet, which contributes to loneliness, shame, and depression.
What causes avoidant personality disorder?
No single cause has been identified. An inhibited, anxious temperament that is partly inherited is the strongest predictor, with twin studies suggesting moderate heritability. Early experiences then shape whether the temperament develops into the disorder. These include parental criticism, rejection, emotional neglect, or overprotection, as well as bullying, teasing, and humiliation by peers, and insecure attachment in which closeness is both desired and feared. Core beliefs of being defective or unlovable form and are maintained by avoidance and safety behaviors that prevent disconfirming experiences. Biological factors, including a sensitive threat-detection system in the brain, probably contribute. The disorder is best understood as arising from the interaction of temperament and experience, and not from anyone’s fault.
Can avoidant personality disorder be treated?
Yes. Although research is more limited than for some other conditions, trials show that cognitive behavioral therapy, which combines cognitive restructuring, graded exposure, and social skills practice, can reduce avoidance and anxiety, and schema therapy has produced high recovery rates in people with several personality disorders including the avoidant type. Psychodynamic, acceptance-based, and compassion-focused approaches also help some people. Treatment typically takes longer than for uncomplicated social anxiety, often many months to a few years, and it depends on building trust with the therapist. Many people achieve lasting improvement in social engagement, work, and relationships, and long-term studies suggest that personality disorders are more changeable than once believed.
Is there a medication for avoidant personality disorder?
No medication is approved specifically for the disorder, and the evidence for drugs is limited. Because of its overlap with social anxiety disorder, selective serotonin reuptake inhibitors and similar medications may reduce anxiety and avoidance in some people, and small studies have shown some benefit. Medication is also useful when depression or another anxiety disorder is present. It is generally regarded as an adjunct to psychotherapy, since drugs do not provide the new learning that change requires. Benzodiazepines are usually avoided for long-term use because of the risk of dependence and because they may interfere with exposure. Decisions about medication should be made with a doctor, and it should not be stopped suddenly.
How can I support a partner or friend with avoidant personality disorder?
Patience and consistent, low-pressure warmth are the most helpful. Show interest without demanding a response, be reliable, offer invitations that are easy to accept or decline, and take the person’s fear seriously without agreeing that the feared outcomes are likely. Notice and appreciate small steps. Avoid criticism, teasing, and remarks such as “just be more confident,” which increase shame. Equally, avoid taking over, speaking for the person, or organizing life around the avoidance, since this maintains the problem. Encourage professional help and offer practical assistance in finding it. Trust may build slowly, and it helps to look after your own wellbeing, since supporting someone with this condition can be demanding.
Can avoidant personality disorder go away on its own?
Some people improve over time, especially if life circumstances provide supportive relationships and gentle opportunities for social experience, and long-term studies show that a considerable proportion of people with personality disorders no longer meet the criteria after several years. However, without treatment, the pattern often persists, and avoidant traits frequently remain to some degree. Because avoidance prevents the corrective experiences that would change the underlying beliefs, the pattern tends to be self-maintaining. Treatment greatly improves the prospects of lasting change, and it is worth seeking at any age. Waiting in the hope that the problem will disappear can mean years of lost relationships and opportunities.
Why do I want friends but avoid people at the same time?
This conflict is the hallmark of avoidant personality disorder, and it is understandable. The wish for connection is a basic human need, while the fear of rejection and humiliation is learned, often from early experiences of criticism, teasing, or neglect. When a social opportunity arises, the desire pulls you toward it, and the anticipated pain pushes you away. Avoidance brings immediate relief, which teaches the brain that avoiding is the right strategy, and it prevents the experiences that would show that the feared rejection is less likely than predicted. The result is loneliness that feeds the belief that you are unlikable. Therapy helps to break the cycle by testing predictions through gradual steps and by reducing shame.
Recommended Books on Avoidant Personality Disorder and Social Fear
- Letting Go of Shyness: Overcoming Avoidant Personality Disorder by Yolanda Cohen
- Overcoming Social Anxiety and Shyness: A Self-Help Guide Using Cognitive Behavioral Techniques by Gillian Butler
- The Shyness and Social Anxiety Workbook: Proven, Step-by-Step Techniques for Overcoming Your Fear by Martin M. Antony and Richard P. Swinson
- Reinventing Your Life: The Breakthrough Program to End Negative Behavior and Feel Great Again by Jeffrey E. Young and Janet S. Klosko
- Cognitive Therapy of Personality Disorders by Aaron T. Beck, Denise D. Davis, and Arthur Freeman
- Dying of Embarrassment: Help for Social Anxiety and Phobia by Barbara G. Markway, Cheryl N. Carmin, C. Alec Pollard, and Teresa Flynn
- Self-Compassion: The Proven Power of Being Kind to Yourself by Kristin Neff
- The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are by Brene Brown
- Schema Therapy: A Practitioner’s Guide by Jeffrey E. Young, Janet S. Klosko, and Marjorie E. Weishaar
- Attached: The New Science of Adult Attachment and How It Can Help You Find and Keep Love by Amir Levine and Rachel Heller
