Perhaps you\u2019ve encountered individuals who seem to really struggle in social situations.\u00a0 They lack confidence in themselves, feel inadequate in social situations, and rarely risk getting close to anyone unless they\u2019re certain of being liked.\u00a0 They avoid social situations and any type of interaction that they believe will be uncomfortable or risky. People like that may be suffering from a psychiatric condition appropriately named \u201cAvoidant Personality Disorder\u201d. Personality disorders are complex and challenging in that they are deeply ingrained, lifelong conditions that start to develop early in life.\u00a0 This type of disorder deeply impacts the way a person thinks about, perceives, and relates to himself and the world around him.\u00a0 These disorders are difficult to treat effectively because of their pervasive and inflexible nature, and the fact that those suffering from there are resistant to change. Avoidant Personality Disorder, as with all personality disorders, leads to a lifelong pattern of unhealthy behaviors.\u00a0 This pattern, along with a very negative self-perception, causes problems not only for those who have the disorder, but also for those around them.\u00a0 In fact, when personality disordered individuals end up in treatment, it\u2019s often because someone else \u2013 such as an exasperated or frustrated significant other, family member, or employer \u2013 who suggested or insisted that they get help.\u00a0 Sadly, though, treatment is often a futile endeavor.\u00a0 That\u2019s not to say there are never exceptions \u2013 but they tend to be few and far between. As you can imagine, constantly avoiding situations that may feel uncomfortable or risky can create significant problems in just about every area of a person\u2019s life \u2013 work, school, relationships, and family life.\u00a0 Careers never get off the ground, while jobs are lost because the person can\u2019t face her boss, attend important meetings, or handle uncomfortable situations with coworkers.\u00a0 Dating relationships are negatively impacted or ruined by the constant need for reassurance, and marriages are strained when the avoidant spouse never wants to engage in social activities or neglects important responsibilities that require interacting with others. The avoidant patterns can even negatively impact a person\u2019s health, if he or she fails to get necessary checkups and medical care as part of the avoidant pattern.\r\nThe Clinical Picture\r\nThe avoidant pattern of behavior for those with Avoidant PD is rooted in intense feelings of inferiority or inadequacy, as well as their hypersensitivity to anything that vaguely resembles (even if it\u2019s just imagined on their part) a negativity response from or scrutiny by others.\u00a0 These individuals are usually the classic wallflower \u2013 the person who\u2019s painfully shy, very quiet around others, and always holds back in any type of social situation or encounter. The avoidant behavior serves as a means of protection \u2013 isolating themselves from others, refusing to risk making new friends or shying away getting involved in any type of intimate relationship, and going to great lengths to avoid any social situation that could be awkward or uncomfortable \u2013 each of these things reduces their risk of being judged, getting hurt, or feeling uncomfortable.\u00a0 Those behaviors also protect them from facing the depth of their feelings of inadequacy and lack of social skills. People with Avoidant PD are also very reluctant to take personal risks or be adventurous and try new things.\u00a0 They\u2019d much prefer to stay in their very small comfort zone \u2013 where it\u2019s safe and predictable. Individuals suffering from this particular personality disorders have a very negative self-perception.\u00a0 They see themselves as undesirable and socially awkward.\u00a0 They feel inadequate and ill-equipped to handle normal social interactions. The payoff is that they don\u2019t have to face:\r\n\r\n \tDisapproval\r\n \tCriticism\r\n \tHumiliation \/ embarrassment\r\n \tShame\r\n \tRejection\r\n \tRidicule\r\n \tJudgment\r\n\r\nThat payoff reinforces the avoidant behavior again and again and again.\u00a0 And it continues throughout their entire life. Individuals with this disorder aren\u2019t necessarily complete loners.\u00a0 But in order for them to feel safe or comfortable with someone, they need frequent reassurance.\u00a0 In fact, they typically won\u2019t even venture into a relationship with first knowing for sure that the other person genuinely likes them and will truly accept them.\u00a0 Needless to say, this is often off-putting to others, and can kill a potential relationship \u2013 friendship or romantic - before it ever gets off the ground.\r\nCause\r\nNo one knows exactly why someone develops a personality disorder.\u00a0 There may be genetic and biological factors that make some individuals more vulnerable than others.\u00a0 But many experts believe that the person\u2019s early environment plays a significant role.\u00a0 The personality deficits develop largely due to the failure to learn appropriate coping skills while growing up.\u00a0 Avoidant individuals fail to learn how to navigate social challenges in a way that benefits them as well as those they are interacting with.\u00a0 As a result, they continually rely on unhealthy coping mechanisms learned early in life.\r\nTreatment\r\nAs mentioned earlier, personality disorders \u2013 by their very nature \u2013 are very hard to treat.\u00a0 If progress is made in treatment, it is usually miniscule at best.\u00a0 Avoidant individuals very rarely seek treatment because therapy is 1) essentially a \u201csocial\u201d interaction, and 2) as requires a fair degree of vulnerability in order to be effective. And vulnerability is the very thing avoidant individuals want to avoid like the plague!\u00a0 \u201cTalk to therapist about deeply private and personal things?\u00a0 Are you kidding me?\u00a0 No thanks\u201d!, is likely pretty close to what an avoidant individual would say to themselves at the mere thought of getting into therapy.\u00a0 That\u2019s certainly not their cup of tea! When it comes to treating Avoidant PD, psychotherapy is the best approach.\u00a0 However, the caveat with that is that the therapist really should be someone with a lot of experience working with individuals who have personality disorders.\u00a0 Otherwise, both the therapist and the client will most likely end up frustrated and therapy ends before any progress is made, as this is a tedious and lengthy process. One of the key aspects of psychotherapy, that is particularly beneficial for someone with Avoidant PD, is establishing trust and developing a solid therapeutic relationship (i.e. the relationship between the therapist and the client).\u00a0 If this initial objective can be achieved, then the therapy process will be greatly enhanced.\u00a0 Without these two things, however, therapy with an avoidant individual is doomed.\u00a0 Remember, the avoidant person as to feel emotionally safe and comfortable in order to let anyone get close. With Avoidant PD, one of the goals of therapy is to help individuals gain insight into what drives their maladaptive behavior \u2013 and how it negatively impacts them as well as other people in their lives.\u00a0 Therapy can then begin to help them learn more effective social skills and behaviors \u2013 ones that will allow them to get their needs met in a healthier, more appropriate manner. Medication is not usually part of the treatment for individuals with Avoidant PD, unless it is prescribed to treat symptoms of anxiety, depression, or another co-occurring disorder.\u00a0 Otherwise, its effectiveness \u2013 if any \u2013 will be extremely limited.\r\nCo-Occurring and Similar Disorders\r\nIt\u2019s not at all uncommon for individuals with Avoidant Personality Disorder to have a co-occurring psychiatric disorder.\u00a0 This is true with the other personality disorders as well.\u00a0 Mood disorders, such as major depressive disorder or dysthymia, as well as anxiety disorders co-occur frequently with Avoidant PD.\u00a0 Other personality disorders, such as Dependent, Borderline, Schizoid, Schizotypal, and Paranoid, may also co-occur. Social Phobia (also known as Social Anxiety Disorder) and Avoidant Personality Disorder have a substantial amount of overlap in terms of the overall clinical picture.\u00a0 This is especially true for \u201cgeneralized\u201d Social Phobia, in which the fear involves most social situations rather than specific ones.\u00a0 As a result, many experts look at these two disorders as essentially two sides of the same coin \u2013 in other words, a slightly different conceptualization of the same underlying disorder.\u00a0 That being said, individuals with Social Phobia whose anxiety is limited to just one or very few social situations would not meet the criteria for a diagnosis of Avoidant PD. Although treatment for Avoidant Personality Disorder often has limited effectiveness, this doesn\u2019t mean it shouldn\u2019t be sought.\u00a0 Some people do make progress in therapy \u2013 enough to enable them to make changes in their life that clearly benefit them \u2013 and those around them.\u00a0 If you (or someone you love) is suffering from Avoidant Personality Disorder (or suspect that you might be), don\u2019t hesitate to reach out for help.