{"id":18360,"date":"2021-08-24T00:00:00","date_gmt":"2021-08-24T06:00:00","guid":{"rendered":"https:\/\/www.unk.com\/blog\/?p=18360"},"modified":"2024-05-01T07:25:20","modified_gmt":"2024-05-01T13:25:20","slug":"working-with-the-avoidant-client","status":"publish","type":"post","link":"https:\/\/www.unk.com\/blog\/working-with-the-avoidant-client\/","title":{"rendered":"Working With the Avoidant Client"},"content":{"rendered":"

“Pain in this life is not avoidable, but the pain we create avoiding pain is avoidable.<\/em>”<\/p>\n

– R.D. Laing<\/p>\n

I’m not one for labelling people. Therapy should, I feel, help clients transcend<\/em> their labels<\/a>.<\/p>\n

And yet an understanding of differing personality types<\/em><\/a> is vital for any therapist. When we understand personality diversity, we can avoid the trap of assuming other people are fundamentally the same as us in all ways. This helps us avoid being continually surprised\/shocked\/disappointed\/unduly impressed when they behave differently to us.<\/p>\n

Humanity shares some common characteristics<\/a>, certainly, but within that greater pattern certain people share commonalities with certain other people based on their personality type.<\/p>\n

There’s another important point here.<\/p>\n

No one has to fatalistically assume that personality type will unalterably determine the course of our lives.<\/p>\n

An introvert, for instance, can learn to be more outgoing. Someone naturally prone to neuroticism<\/a> can, over time, learn to be much calmer.<\/p>\n

So yes, we all tend to fall broadly into distinct personality types. Most people will have more or less stable patterns<\/em> of inner and outer experience. Perhaps they’ll be open to new experiences, or conscientious, or extroverted, or agreeable. Or perhaps not!<\/p>\n

So the idea of personality type is potentially useful as long as we don’t limit people by viewing them only through the lens of what we assume they (or we) must<\/em> be like.<\/p>\n

And so we come to the concept of personality disorders<\/em>.<\/p>\n

Dealing with disordered minds<\/h3>\n

Personality is a constellation of individual traits, experiences, and behaviours that are stable over time. A personality disorder<\/em> is a stable collection of personality traits that cause the person and the people in their lives ongoing problems. This is not at all to say (and I hope this goes without saying) that having problems means you have a personality disorder!<\/p>\n

When many people consistently find a particular person ‘difficult’, when a person consistently runs into problems, and when those problems seem to be self-manufactured (whether the person recognizes that or not), that person may<\/em> have a personality disorder. At least from a psychiatric perspective.<\/p>\n

Another way of looking at things might be that someone labelled as suffering a personality disorder might be simply not meeting their emotional needs<\/a>, or even their physical needs – as the tale of the thirsty king<\/a> so beautifully illustrates.<\/p>\n

Anyway, I think looking at some people through the frame of personality disorders can be useful, as long as we don’t fall into the trap of not seeing the unique individual behind the label.<\/p>\n

Personality disorders, of which 10 are currently recognized,1<\/sup> include borderline, antisocial, histrionic, and narcissistic personality disorders.<\/p>\n

It’s important to remember that people seldom fall into neat diagnostic boxes, and that one and the same person may glide in and out of many different diagnostic categories at different times. Comorbidity is said to be common among those with personality disorders. For example, those diagnosed with borderline personality disorder may also have traits of histrionic personality disorder, or even narcissistic personality disorder<\/a>, and so on.<\/p>\n

So with these caveats in place, in this piece I’ll focus on helping clients with so-called avoidant personality disorder (APD). I’ll describe what it is and how to recognize it, and offer a few ideas of my own that I hope will give you some fresh ways to help someone who exhibits signs of APD.<\/p>\n

But first… what is<\/em> avoidant personality disorder?<\/p>\n

Hiding away<\/h3>\n

I worked with Jane over many months. She had reached the point where she hid away from the world completely, wanting to just curl up and not be seen or judged by others anymore. She was terrified of meeting me because of how I might judge her.<\/p>\n

In our fourth session she finally told me, with some embarrassment, that she’d previously been diagnosed with avoidant personality disorder.<\/p>\n

“Does that diagnosis mean I can never change?” she asked me plaintively.<\/p>\n

I reassured her that all human personality is mutable and we can alter, sometimes radically, elements of how we feel and what we do.<\/p>\n

I suggested: “A diagnosis is perhaps a starting point, not a finishing line.”<\/p>\n

Diagnosis is not treatment, of course, but it can be a starting point for some.<\/p>\n\n

Anyway, Jane did show signs of many of the classic avoidant personality indicators<\/a>. She:<\/p>\n