Avoidant personality disorder in relationships

Author: Samir Kadri Medical Reviewer: Morgan Blair Last updated:

A person diagnosed with Avoidant personality disorder (AVPD) can find forming and maintaining relationships challenging.

Experiencing strong feelings of inadequacy, struggling with criticism, and harboring an entrenched fear of rejection are some aspects of AVPD that can lead to a person avoiding or struggling with social interaction.

Sharing opinions, expressing emotions and generally being your authentic true self can feel difficult, and naturally this makes forming the bond required for a relationship difficult.

Whilst AVPD can be tricky to cope with, there are steps you can take to overcome obstacles and develop secure relationships.

What is avoidant personality disorder?

Avoidant personality disorder (AVPD) is characterized by intense feelings of inadequacy, which can lead to those affected avoiding any scenario where they feel they may be criticized [1].

According to the Diagnostic and Statistical Manual of Mental Health Disorders (5th Edition), a diagnosis of AVPD requires 4 or more of the following list to have been identified by early adulthood [2]:

  • Avoidance of occupational activities that require interpersonal contact because they fear they may be rejected, criticized or general disapproval.
  • Reluctance to interact with other people unless they are certain they will be liked.
  • Holds back in relationships because they fear ridicule or shame
  • Is fixated on being rejected or criticized in social situations
  • Withdrawn in new social situations because they feel inadequate
  • Sees themselves as socially inept, unappealing and inferior to others
  • Unusually averse to taking personal risks or participating in new activities for fear of being embarrassed.

Avoidant personality disorder should not be confused with social anxiety, which has similar symptoms, but is a lot more common. Unlike AVPD, people with social anxiety don’t have overriding feelings of inadequacy or inferiority.

How does avoidant personality disorder affect interpersonal relationships?

Lack of emotional availability – a person diagnosed with AVPD can struggle to display vulnerability, express their emotions readily and have commitment issues. Typically, they are comfortable looking out for themselves and may find outward displays of care and affection towards a partner draining.

Avoidance of new activities and social relationships – a reluctance to engage in new activities, or meet new people, for fear of ridicule and scorn from others [3]. This makes it challenging to connect with other people and form social relationships. Many sufferers tend to have only a few close friends due to their reluctance to emotionally connect with others [3].

Hypersensitivity – their innate sense of inadequacy means someone with AVPD is hypersensitive to any signs of criticism. This can lead to them incorrectly surmising that their friend or partner disapproves of them in any given situation, which can cause a strain on the relationship.

Low self-esteem – marred by a pervasive feeling of inadequacy, people with AVPD struggle with self-image. They are quick to criticize themselves and believe they are inferior to others.

As they don’t believe they are adequate, people with AVPD can believe others will eventually recognize they are too, so they keep their distance.

As they are prone to thinking themselves inadequate, people with AVPD are often scared that others will recognize they are too. As a result, they are more likely to keep an emotional distance between others generally to prevent this fear being realized.

How are partners affected by a loved one’s AVPD?

Below are the ways that the discussed aspects of a loved one’s AVPD can affect their partners:

Lack of emotional availability – If your partner has AVPD, it can feel like they are being aloof no matter how loving you act toward them. This can be disconcerting as we all want to feel cared for and valued by our partner.

It is important to recognize that showing emotion can feel exhausting and unintuitive for someone with AVPD. The very act of regularly spending time with you, and feeling comfortable in your presence, may be a way of them showing affection.

Avoidance of new activities and social relationships – It can feel frustrating when your partner refuses to try new activities or meet new people. It can feel like your social life is deteriorating and lead to you feeling unfulfilled, bored and afraid to confront the issue for fear of your partner perceiving it as criticism.

Try to be supportive and not shame them for the way they feel; recognize that many social situations you find comfortable can feel extremely overwhelming for someone with AVPD.

Hyper-sensitivity – Dealing with your partner wrongly accusing you of criticizing them can feel exasperating and infuriating. You may feel you have to constantly present a façade to reassure them that you approve of their behavior, which can feel exhausting.

Low self-esteem – Dating someone with chronic low self-esteem can feel challenging. As your partner has an unfairly negative self-image, they may worry that you will start seeing it too.  This can lead to them emotionally withdrawing from you as they fear rejection.

Naturally, this strikes at the heart of the relationship, as emotional intimacy is a key component. It is important to try and not take this personally, recognize this is a challenging aspect of life for them, and offer help and support.

How to improve your relationship with your partner

Being with someone with AVPD can feel difficult at times, but there are steps you can take to having a better relationship with your partner. Here are some steps you can take to improving your relationship if your partner has AVPD:

Study up

Learning about AVPD and how it affects sufferers will help you to empathize with your partner, strengthening your relationship and enabling you to practice patience and kindness.

Offer support

Establish signals or signs your partner can use when they feel uncomfortable at a social gathering. You can establish ways to deal with this discomfort together or opt to excuse yourself. Having rituals like this reinforces the idea that the two of you are a team.

Be patient

Manage your frustration and demonstrate to your partner how willing you are to be patient with their behavior. If they don’t feel they need to act a certain way to meet your approval, they may feel more comfortable with trying new experiences or interacting with new people. In any case, you will make your partner feel more at ease.

Find a compromise between their needs and your own

Just because your partner struggles with social activities, doesn’t mean you are obligated to. Have an open, frank discussion with each other about what you require from your social lives and come to a solution that benefits both parties. If one person’s needs in a relationship are always being prioritized, that’s a recipe for disaster.

Attend couple’s counseling

Going to couple’s counseling together can be beneficial for your relationship. Having a neutral space where both of you can discuss your feelings, concerns, and ways you can improve your relationship will help you to understand each other and make it easier to find workable solutions to your problems.

How to manage AVPD

If you are struggling with AVPD, professional help could be your best course of action. Therapy is the vanguard treatment, and studies shown that many people who get treatment learn to successfully manage their symptoms [4]. There are numerous options to choose from and it’s essential for people to choose a therapist with an approach that suits them.

Below are some therapy options used to manage AVPD:

  • Cognitive behavioral therapy (CBT) – talking therapy that is characterized by identifying harmful, negative thought patterns and behaviors and replacing them with desired ones.
  • Exposure therapy – placing patients in situations that trigger their AVPD, clients are encouraged to address their triggers in manufactured scenarios. This can enable them to develop new ways to emotionally process, habituate and generally cope better with the scenarios they fear [5].
  • Couples therapy – whilst any couple can reap the rewards of this form of therapy, couples where one or both members have AVPD may find it especially useful [5]. The therapist can encourage healthier communication, heightened awareness of avoidant behaviors and help in the formulation of a management plan to cope going forwards.
  • Interpersonal or psychodynamic therapy – personality disorders often stem from adverse childhood experiences or trauma, and therefore a therapeutic approach that touches on the past can help you to understand and manage your disorder.
References
  1. Zimmerman, M. (2022, December 14). Avoidant Personality Disorder (AVPD). MSD Manual Professional Edition. https://www.msdmanuals.com/professional/psychiatric-disorders/personality-disorders/avoidant-personality-disorder-avpd
  2. Fariba KA, Sapra A. Avoidant Personality Disorder. [Updated 2022 Jun 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559325/
  3. RETTEW, D. C., ZANARINI, M. C., YEN, S., GRILO, C. M., SKODOL, A. E., SHEA, M. T., MCGLASHAN, T. H., MOREY, L. C., CULHANE, M. A., & GUNDERSON, J. G. (2003). Childhood Antecedents of Avoidant Personality Disorder: A Retrospective Study. Journal of the American Academy of Child &Amp; Adolescent Psychiatry, 42(9), 1122–1130. https://doi.org/10.1097/01.chi.0000070250.24125.5f
  4. Weinbrecht, A., Schulze, L., Boettcher, J., & Renneberg, B. (2016). Avoidant Personality Disorder: a Current Review. Current Psychiatry Reports, 18(3). https://doi.org/10.1007/s11920-016-0665-6
  5. Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: an inhibitory learning approach. Behaviour research and therapy, 58, 10–23. https://doi.org/10.1016/j.brat.2014.04.006
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Author Samir Kadri Writer

Samir Kadri is a medical writer with a non-profit sector background, committed to raising awareness about mental health.

Published: Mar 28th 2023, Last edited: Sep 22nd 2023

Morgan Blair
Medical Reviewer Morgan Blair MA, LPCC

Morgan Blair is a licensed therapist, writer and medical reviewer, holding a master’s degree in clinical mental health counseling from Northwestern University.

Content reviewed by a medical professional. Last reviewed: Mar 28th 2023