Avoidant personality disorder

Written by Emily Whitton
Emily Whitton
Counselling Directory Content Team

Last updated 21st February 2024 | Next update due 20th February 2027

Many of us can feel shy in certain situations but for around 2% of the population, extreme shyness and fear of rejection make forming relationships near impossible. This is known as avoidant personality disorder.

On this page, we explore the signs and causes of avoidant personality disorder, and how treatments like counselling can help. 

Disclaimer

We recognise that the system of personality disorder diagnosis can be considered controversial. It is completely your choice which term, if any, you want to use, knowing that your doctor or care team may use another. 

The terms used on Counselling Directory are those that are generally used in the UK, currently. We refer to these terms throughout, with the hope of reaching and supporting as many people as possible.


What is avoidant personality disorder?

The medical community has described personality disorders as "long-lived patterns of behaviour that cause problems with work and relationships". People with personality disorders tend to think, feel and behave outside of what is considered to be the cultural ‘norm.’ Those with avoidant personality disorder (AVPD) tend to avoid social situations, due to extreme feelings of inadequacy and sensitivity to rejection. It is known as a ‘cluster C’ personality disorder, which are those characterised by anxiety and fear.

These feelings tend to lead to social isolation, avoidance of work and any activity that may require social interaction. Someone with avoidant personality disorder may also feel very anxious about the possibility of receiving criticism and their reaction (such as crying or blushing).

Unlike typical shyness, those with avoidant personality disorder encounter significant problems that affect day-to-day life and make it very difficult to make and maintain relationships. Often, those with the condition will choose to isolate themselves rather than risk the perceived dangers of connecting with others.

What’s the difference between AVPD and social anxiety? 

People with social anxiety disorder and avoidant personality disorder share similar traits but they are considered to be different conditions. The key difference is that people with AVPD typically avoid all social interaction, whereas, those with social anxiety tend to avoid specific situations, such as giving a speech or going out with friends.


Signs of avoidant personality disorder

The nature of personality disorders means that they aren’t usually diagnosed until adulthood, however, they will typically manifest by early adulthood. A psychiatrist or psychologist will need to diagnose the condition. A doctor will likely refer you to them for confirmation and treatment. To diagnose avoidant personality disorder, they will ask about your history and see if you show any of the following common signs:

  • Avoids activities that involve other people due to fear of rejection and criticism.
  • Unwilling to develop relationships with people unless they are certain they’ll be liked.
  • Shows restraint when in an intimate relationship because they fear being shamed.
  • Very inhibited when in social situations because they fear they are inadequate.
  • Considers themselves ‘socially inept’ and inferior to others.
  • Unusually reluctant to take personal risks or try new activities for fear of embarrassment.

In most personality disorder cases, those with the condition will experience a decrease in intensity as they grow older. This means those with avoidant personality disorder may experience very few of the extreme symptoms when they reach their 40s and 50s.

Therapists who can help with avoidant personality disorder

Causes of avoidant personality disorder

As with most mental health conditions, the cause of avoidant personality disorder is largely unknown but it's believed to involve a combination of factors. These factors may include genetics, psychological and environmental factors. It is likely to be the combination of specific factors and the way they intertwine that leads to the development of the condition.


The impact of avoidant personality disorder

Perhaps the biggest impact of avoidant personality disorder is on social functioning. The condition can cause very low self-esteem and confidence. As the person with the condition will usually be hypersensitive to criticism and rejection, they will try to avoid it at all costs - and this often means staying socially isolated.

As humans, connection and social support are incredibly important for our happiness and well-being. Our social connections help us feel loved and provide us with a support system when navigating life. When we don’t have this, we can feel lonely, isolated and less emotionally resilient.

In some cases, this lack of social contact can cause the person in question to fantasise and idealise relationships with others. Because, while they may isolate themselves, this does not mean that they want to be isolated. It just feels more emotionally safe to do this than risk rejection or criticism.

Avoidant personality disorder and other conditions

Some people may experience other mental health conditions alongside avoidant personality disorder. Some conditions that commonly occur alongside include:

If you have other conditions alongside avoidant personality disorder, you will be offered appropriate treatment to help with these.


Treatment options

While symptoms typically decrease in intensity with age, this doesn’t mean you should avoid treatment. Support from a mental health professional can help ease symptoms earlier and help you build meaningful connections.

A combined approach of talking therapy, known as psychotherapy, and medication (often used for depression and/or anxiety) can be ideal for those with avoidant personality disorder. Talking therapies allow you to understand your condition more and how it affects you. This alone can be incredibly helpful.

Although a range of interventions exist, including DBT, CBT, IPT and Gestalt work, alongside Schema therapy and psychotherapy, it is my belief that regardless of intervention, it is the strength of the therapeutic relationship that is key to recovery.

- Psychotherapist Counsellor Amanda Perl (MSC BACP Accred CBT Practitioner)

Below are some of the most commonly used therapies for avoidant personality disorder.

Cognitive behavioural therapy

Cognitive and behavioural therapies can help you build up your ability to relate with others, lessening the associated anxiety. CBT in particular helps you recognise unhelpful thoughts and behaviours that may be causing problems in your day-to-day life and reframe them.

Psychodynamic therapy

Psychodynamic therapies believe that our unconscious thoughts and perceptions are developed in childhood. Therefore, this approach can help people with avoidant personality disorder bring deep-rooted feelings to the surface and help them better understand how their past experiences may have influenced their current thought processes. 

Schema therapy

Schema therapy combines elements from a mixture of other therapeutic approaches and aims to change beliefs that people have had for a long time. These patterns are known as schemas which are reinforced by coping styles (such as avoiding social interactions). Schema therapy helps people identify healthier coping mechanisms and may be useful for those who haven’t had the desired outcome from CBT. 


Often those with avoidant personality disorder will avoid seeking help until they are experiencing a severe hindrance to their lives. Please remember that you do not have to wait until crisis point to reach out for help. Support is always available and can help ease anxiety and allow you to make more connections.

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