Living with avoidant personality disorder can mean striving to feel recognized for who you truly are.
You might worry about forging connections with others. You may fear it’ll give them the chance to notice your inadequacies and judge you, if not reject you outright.
Sometimes, when people offer friendship, you might feel skeptical, even fearful, of their intentions.
Unable to safely pursue the closeness you desire, you keep to yourself and hold back in social situations. In time, you might end up feeling invisible, unseen, and alone.
This isolation can feel overwhelming and deeply distressing.
Unsure about reaching out for support because doing so requires trusting another person with your feelings?
Feeling this way is not uncommon, but therapy can make a difference.
A qualified therapist understands you didn’t choose your condition. They won’t judge you. Instead, they will offer compassion and kindness as they help you explore symptoms and build new coping skills.
Therapy can’t cure avoidant personality disorder, so symptoms of the condition won’t disappear completely.
As with other personality disorders, the goal of treatment for avoidant personality disorder involves learning more helpful ways to manage and decrease your distress.
When you live with avoidant personality disorder, opening up to others may never feel entirely natural, even with support from a therapist. Yet this support can help you feel more comfortable trusting both yourself and others.
Eventually, you might find it easier to have everyday interactions and form lasting friendships or relationships without fixating on fears of criticism or rejection.
Therapy for avoidant personality disorder offers you a safe, judgment-free environment where you can:
- explore and rebuild a negative or undefined sense of self
- learn techniques to challenge and reframe unwanted thoughts
- learn and practice skills to cope with distress more productively
- explore potential causes of rejection fears and feelings of inadequacy
- get support for anxiety, depression, and other mental health conditions
Before you start working on these goals, you’ll share any symptoms you’ve noticed with your therapist or psychologist. They might also ask questions about how those concerns affect your daily life.
There’s no test for avoidant personality disorder, so a mental health professional will diagnose the condition based on these experiences.
Working with a professional who specializes in treating personality disorders can help you get the right diagnosis and most effective treatment.
It may feel uncomfortable, even frightening, to share personal experiences at first, but remember: Your therapist is there to help. They want to offer support as you work to connect with others, and they won’t reject you.
You should feel comfortable with your therapist, but don’t worry if it takes a little time to develop a strong therapeutic relationship — that’s fairly common.
Both long- and short-term options for avoidant personality disorder treatment exist.
Some approaches to treatment, such as cognitive behavioral therapy, involve a set number of sessions. Other types of therapy may last a year or longer.
You might work with a therapist just long enough to see relief from specific symptoms, such as depression or stress. It can feel tempting to leave therapy as soon as these symptoms ease, but it’s usually worth sticking it out a little longer.
Making the time and effort to explore symptoms and their causes in more depth could lead to more significant and longer-lasting improvement.
Some avoidant personality disorder symptoms can get worse when left untreated.
Avoiding others may continue to seem like the only safe way to cope with intensifying fears of rejection and disapproval.
Even work and everyday errands might become so overwhelming that you end up isolating yourself completely.
Only a few studies have explored treatment for avoidant personality disorder to date, so evidence supporting specific therapy approaches remains limited.
The “best” treatment can depend on your unique needs, but you do have a few options to consider.
The following types of therapy
Therapists practicing this newer approach to treatment use a combination of therapeutic techniques to help you identify and heal early childhood schemas. Schemas are beliefs and coping mechanisms that contribute to pain and distress.
According to schema therapy theory, unhelpful schemas develop in childhood when parents and primary caregivers fail to provide love, care, and other emotional support.
A few of the schemas that often characterize avoidant personality disorder include:
- Lonely Child mode, or a sense of unworthiness and loneliness
- Detached Protector mode, or a tendency to avoid emotions and emotional needs
- The Avoidant Protector, which involves avoidance of stressful or unpleasant situations
- The Punitive Parent, or the belief that you deserve criticism and punishment
A schema therapist can support you in working through these modes and replacing them with more helpful coping methods through a technique called limited reparenting.
One 2014 study looked at 323 people receiving schema therapy, clarification-oriented therapy, or treatment as usual for various personality disorders, including avoidant personality disorder
Those who participated in schema therapy tended to stay in treatment longer. They also reported fewer symptoms of depression and better social and overall function at follow-up.
Cognitive behavioral therapy (CBT)
One of the most widely used approaches to mental health treatment, CBT helps you learn to identify and challenge fixed thought patterns and beliefs that cause emotional distress and lead to avoidance.
Your therapist will teach specific skills to address these thoughts as they come up.
Let’s say you often think, “No one likes me.”
Your therapist might ask for three pieces of evidence that support that belief and three that counter it.
Or they might encourage you to try reframing:
- Original thought: “I’m so boring and awkward. I can’t imagine anyone wanting to spend time with me.”
- Reframed thought: “I have a hard time thinking of things to talk about because I don’t want to say the wrong thing. Connecting with people who share my interests might make it easier to open up.”
CBT can also involve exposure therapy. In exposure therapy, situations that prompt feelings of anxiety or fear are slowly introduced.
You might begin by greeting a co-worker on a regular basis, move on to volunteering your opinion in a meeting, and eventually invite someone out for drinks after work.
As part of this process, your therapist might encourage you to predict what you think will happen and then compare that prediction with your actual experience.
In psychodynamic therapy, your therapist will help you explore past experiences that factor into current mental health symptoms and other emotional distress.
This approach can help you get more insight into how your attachment style and early relationships contribute to your present sense of self, personality, and behavior.
As part of psychodynamic therapy, you’ll usually:
- explore your emotions, including those you have trouble expressing or managing
- talk about early familial relationships
- share goals, dreams, and hopes for the future
- explore your fears and the effects they have on your life
The therapy process can help you begin to understand and work through fears of rejection and feelings of inferiority, and explore potential solutions for your difficulties interacting with others.
Psychodynamic therapy can empower you to take steps toward pursuing the relationships you desire with others. It can also help you better understand and strengthen your relationship with yourself.
Social skills training
Your therapist might also recommend interpersonal and social skills practice as part of treatment.
Social skills training can take place in individual sessions, group sessions, or both. It usually involves learning and practicing interpersonal and communication skills, including:
- maintaining eye contact and other body language
- starting and ending conversations
- talking about yourself and asking questions
- asking questions
- extending invitations and making plans
Results from a few small studies suggest a few other potentially helpful treatment approaches, including:
No medication can directly address rejection fears and other personality traits specific to avoidant personality disorder, but some psychiatric medications can offer relief from other symptoms.
It’s not uncommon to experience feelings of anxiety or depression when living with avoidant personality disorder.
Severe symptoms can quickly get overwhelming, to the point where you find it hard to concentrate on your daily responsibilities or take care of basic needs.
Anxiety and depression can also drain your energy and make it tough to work toward change.
If you struggle to manage these symptoms on your own, your mental healthcare team might recommend medication along with therapy.
Both antidepressants and anti-anxiety medications, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs),
Just keep in mind that medication can’t treat underlying causes of these symptoms. That’s why mental health professionals generally recommend medication in addition to therapy, not as an alternate approach.
Seeking support from a trained, compassionate therapist is usually key to improvement in symptoms.
The strategies below can also have a positive impact on your day-to-day experience.
Remember physical well-being matters, too
If you’ve ever heard of the
Good physical health can’t “cure” mental health symptoms. Still, feeling physically well can help boost resilience, optimism, and energy, all of which can help improve your outlook and motivation to create change.
These tips can improve physical wellness:
- Eat balanced meals and snacks for energy. Try these nutritious, mood-boosting foods.
- Aim for
7 to 9 hoursof quality sleep each night. Regularly getting less sleep than you need can negatively affect mental and physical health.
- Make time for your favorite physical activity. Regular exercise can offer
plenty of benefits, including improved health, better sleep, and relief from stress and other mental health symptoms.
- Find your calm with music, a warm bath, or relaxation techniques.
Make time for your interests
Getting involved in hobbies and activities you enjoy doesn’t just help you make the most of everyday life. It also offers a great opportunity to meet people who share similar interests.
Knowing you share common ground can help boost your confidence and make it easier to open up.
Not sure where your interests lie? Exploring new hobbies can help you learn more about what you like and don’t like.
Trying new things might feel a little scary and uncomfortable, but keep in mind you might meet others taking the same risk.
Practice expressing yourself
Journaling and art are great ways to get in the habit of expressing your emotions before you feel ready to share them with others.
A journal can give you space to set out distressing feelings, in words or pictures.
When you write things out, you may notice they weigh on you less heavily. Journaling can also make it easier to identify and explore unwanted emotions and keep track of any patterns.
If you feel uncertain about who you truly are, you can also use a journal to explore your values, likes and dislikes, and dreams for the future.
Remind yourself it’s OK to go slow
You probably won’t feel able to trust others immediately or jump right into a relationship or friendship. That’s OK.
Moving slowly but steadily can be the key to lasting progress.
If you push yourself to overcome your fears all at once, you might feel so overwhelmed that you decide connection isn’t worth the effort.
It can help to start by listing small ways to interact with others and try to do one of these things each day. For example:
- Ask your librarian for a book recommendation.
- Comment on your co-worker’s photo on Facebook.
- Tell a stranger you like their outfit.
- Say hi to a neighbor when you go out for a walk.
Then, try to do one of these things each day.
While avoidant personality disorder symptoms may fade or become less intense as you age, you may always have some lingering feelings of inadequacy or fears of rejection.
Therapy won’t completely change these elements of your personality. That said, support from a trained therapist can help you learn to respond to this distress with self-compassion and take steps toward building fulfilling friendships and relationships.
Learn more about getting support for avoidant personality disorder here: