How to Overcome Your Fear of Rejection and Humiliation - Treatment of Avoidant Personality Disorder
According to the Diagnostics and Statistical Manual-IV-TR, an individual exhibiting marked avoidance of close relationships and social situations due to an excessive fear of rejection, suffers from avoidant personality disorder.
These individuals have low self-esteem and suffer from feelings of inadequacy. This is why the main aim of any treatment approach is to improve the self-esteem and confidence of the patient. Here is a brief look at the different treatments available for fear of rejection and avoidant personality disorder.
The initial aim of psychotherapeutic approaches is to establish a trusting relationship with the patient. Once trust is established, the patient is encouraged to discuss details about his issues. The therapist helps the patient in making connections between the shame felt by him and the resultant avoidant behavior.
There are three main psychotherapeutic treatment approaches used with avoidant personalities and these are cognitive behavioral therapy, group therapy and behavior modifications therapy.
Cognitive Behavioral Therapy or CBT
CBT is considered to be the most effective psychotherapeutic approach for the treatment of avoidant personality disorder. It considers faulty thinking as the underlying cause of the problem. By identifying distorted thinking patterns and questioning their validity, CBT aims at showing the individual that there are people who indeed value his company and that he has had valuable and enjoyable social interactions in the past.
This process is known as cognitive restructuring and it helps remove the insecurities of the individual and expose the irrationality of his/her fears vis-à-vis his relationships and social situations.
Patients may be initially reluctant to join a group therapy session. However, an empathetic and supportive setting can help the individual overcome these social anxieties and the fear of rejection. Often, the best option is to begin with individual therapy. As the patient's confidence and self-esteem improves, group therapy may be introduced to provide a safe environment for social interactions.
Excessive fear of rejection, social withdrawal, shyness, and distrust of others are some of the common characteristics present in avoidant personalities. Behavior modification techniques such as desensitization can be quite helpful in overcoming these symptoms.
Desensitization involves taking the patient from the therapist's office to a social setting that is generally avoided by him/her. It may take around three to four months of therapy for the individual to be ready for this trip. With the therapist by his side to support and guide him, the patient may find the situation less stressful than originally perceived.
Medications can make it easier to manage the symptoms of avoidant personality disorder. Monoamine oxidase inhibitors or MAOIs help control social uneasiness. Anti-anxiety agents may prove to be useful in controlling the anxiety experienced by an individual in a particular social setting. This can be especially helpful while using the above mentioned desensitization technique.
However, as with all other personality disorders, overuse of these drugs may in fact interfere with effective psychotherapeutic treatment.
Since these individuals often avoid attending group sessions due to a fear of rejection, self-help groups and communities are not usually very effective. While antidepressants and anti-anxiety agents may help in controlling symptoms associated with social interaction, they will not be effective if not combined with psychotherapy.
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