The Essential Guide to Overcoming Avoidant Personality Disorder

DIFFERENTIATING AVPD FROM BORDERLINE PERSONALITY DISORDER

The full, fundamental and frequent alternate merging and emerging of borderline personality disorder has to be differentiated from Types Ila and Ilb avoidant partial, infrequent, and mostly defensive shifting between closeness and distancing. As the DSM-IV says, the borderline process is notable for a “pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.” ¹⁴ This ambivalence about forming and maintaining interpersonal relationships leads borderlines to alternately love too well and hate too intensely: to develop close ties then drop people impulsively, seducing then abandoning them suddenly and without provocation or warning. We see a pattern where the borderline closes in and distances (merges and emerges) along the lines of Freud’s quaint simile of porcupines, who, seeking warmth, approach each other because they are cold but who then, pricking each other with their quills, move farther apart to relieve the discomfort, only to feel cold again and move closer together once more. One day, borderline individuals feel lonely, hunger for contact, and call and come over constantly, and the next day, they remain aloof, refusing invitations to visit or be visited, not even returning phone calls. Now they are relentless seekers of love and affection, and now, however much they unconsciously fear loneliness and abandonment, they disrupt potentially workable relationships offered or already in progress. When they are involved in relationships, they dream of how wonderful it was to be alone and grouse vocally that relationships invade their space and feel too close for comfort. Then, when they arrange to be alone, they dream of how wonderful it was to be involved in relationships and complain that others do not get close enough quickly enough. But when they are once again involved in relationships, they provoke others to provide the match that lights the fuse that explodes the tumescent bomb of their long-simmering avoidant fantasy—so that they can blow up over things that people concerned with relationship maintenance would at least try to forgive and forget: not replacing ice cubes after using them; not covering the unused portion of the cat food thus allowing the food to dry out; or putting feet up on the sofa, even when the sofa is old and the feet are clean.

Too, unlike the avoidant, who distances as a way to handle fear associated with being close, the borderline merges and emerges as a way to gratify need. Borderlines first merge after overestimating others as all good, assigning individuals the qualities of savior wise and true, and actively courting them out of a need to relieve intense loneliness and achieve a sense of comfort and satiation. Only then, brought up short in disappointment, they come to underestimate others as all bad and actively dump them out of a need for vengeance, seeing only others’ real, perceived, or delusionally perceived minor flaws so that they can award them the qualities of villain, fool, and cheat, in turn so that they can now avoid embracing them and instead consign them to complete oblivion.

Some Case Examples

My team and I saw a patient without an appointment as an emergency for a two-hour visit, then offered follow-up care the next day with both me and a psychologist. At first, the patient felt, “You people are wonderful—look how much time you spend with me.” Then, in short order, she changed her mind to say, “You people are dreadful— you are trying to overwhelm me, get too close, and press me to open up and tell you my problems before I am ready. Besides, you are only doing this for the money.”

This patient had, in the emerging phase, confined herself to activities that had little inherent interpersonal context—dull, lonely things like watching television supine on the couch, or self-destructive lonely things like excessive drinking and/or taking drugs. In contrast, in the merging phase, she had met and married a man after knowing him for only a few days, then, shifting once again after another few days, claimed that she and he were incompatible and filed for divorce.

A patient, after breaking up a relationship with a lover over his wearing a designer belt (as part of an attack skillfully geared to put the blame on him for his pseudosophistication instead of on her for her unrelatedness), thought twice and called the lover constantly, begged him to give her one more chance, and added, as often as she could, “I really like designer belts and, most of all, the people who wear them.” Her life ultimately deteriorated into shifting from the two-bedroom apartment with unloving roommates to the lonely studio apartment with the loving cat, then back again; placing personals ads on the Internet but constructing them in a way that assured they were geared to get few to no responses because they were too noncommittal to be consonant with their stated purpose; and frantically cruising singles bars, functions, and resorts, but drinking heavily to the point that she got too drunk to function effectively, then, after sobering up and staying home alone for months on end, starting to think, “I miss my social life,” and returning to her old ways of heavy drinking and frantically seeking “Mr. Right, right now.”

A patient told me of how a borderline man alternately seduced and abandoned her, keeping her involved in his charade by taking advantage of how her loving neediness rendered her too helpless emotionally to deal effectively and definitively with his alternate merging and emerging:

Here is a cross section of my conversations with Oscar:

Oscar avoided me through his not matching his action to his words and lofty promises. Our conversations went something like this:

O: I can’t live without you. This life here in Paris holds nothing for me. It is a life where [sobbing] no one even caresses me.

F: If you can’t live without me, how come you ditched me when I went to Paris to see you?

O: Because I don’t mean I need you for a week or two weeks, I need you for all of my life and forever.

F: A person that loves that much would have at least helped me when I telephoned, confused and panicked about what train to take to make my appointment with you—but you, working in your office at the train station, said you didn’t know, and had to hang up.

O: Well, if that is how you feel, I respect your feelings. I never try to force anyone to think differently than they do, that would be disrespectful and everyone is a sacred creature of God.

F: I don’t know which part of you to believe, the one who cries because he loves and wants to be with me, or the one who is never there and seems to have no urgency at all to see me.

O: Oscar is not a liar [he often referred to himself in the third person]. He is not a liar because when he was five years old his grandmother gave him a lesson he never forgot. When he tried to steal a candy when they were out shopping she slapped his hand, humiliating him, and made him bring it back. He has never lied again since.

Also, his emotions were phony. When he would cry, it would be with intense drama, but only for about five seconds, and then he would laugh or start a different conversation. It was more an obligatory wailing with a time limit.

Also, I am still not over the fact that he would never return my grandmother’s tablecloth. My grandmother had made it by hand (she used to do cut work when she came to this country). He inherited an apartment from his mother and said it was to be for us. I had brought the tablecloth and 12 napkins over for what was to be our place together, but we never got there because he told me the workmen were fixing it up and he was allergic to dust so we shouldn’t go. The next time I went to France, he told me he had rented the apartment out because I wasn’t clear enough about when I would move in with him. So I asked him for the tablecloth back. He said he still had it and treasured it because he treasured everything I gave him, but he would give it back to me, but he never did, although it meant a lot to me and nothing to him. Once I got really upset and he told me he had sent it and it was on its way. When I opened the envelope he sent me (yes he actually sent me an envelope!) there was one thin, worn cloth napkin (not my grandmother’s) with a hole in the middle. I asked if this was supposed to be a joke, and he started crying, saying he couldn’t do anything right, and please forgive him, God made him imperfectly.

Also, every time we got together, after passionate e-mail exchanges in the year in between, saying how when we met we were going to plan our future together—he would find a way to hedge. Here were some of his excuses about not making plans:

• I wasn’t prepared to talk about this. You take me off guard. You jumped in too strongly and didn’t wait for me to bring up the subject.

• My son Sacha is still under 18. I need to protect him from my wife, Josette, who is crazy, and I’m afraid of what she might do to him.

• My brother-in-law is gay so if I leave my son now, he may have too much of an influence on him.

• Your being upset with me made me too upset to talk with you about a plan.

Sometimes when I was with him I felt only hope that we would be together forever. Sometimes instead I felt only despair that we would always be apart. Just as I couldn’t live without him, I couldn’t live with him. As far as he was concerned, it seems as if he could, and did, live very well either way: one minute with, and the next minute without, me.

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CHAPTER 7

omor

bidity

Comorbidity with other personality disorders distorts the “pure” clinical picture of avoidant personality disorder (AvPD). For example, Millon describes an “avoidant-passive-aggressive mixed personality,”¹ which adds a dimension of annoyance with, to the anxious withdrawal from, others.

Comorbidity alters the treatment approach to AvPD, and it does so in at least two ways. First, the therapist must treat all the disorders that constitute the final picture. Thus, while nonparanoid avoidants need to focus on, expose themselves to, and immerse themselves in relationships so that they can connect with others without becoming unduly anxious, paranoid avoidants need to start not with exposing themselves to relationships in the real world, but with rethinking their suspicious ideas about the real world to which they will hopefully soon be exposing themselves. Second, comorbidity determines the nature of and increases the number of resistances that crop up to impede therapeutic progress. Thus avoidants who also, in paranoid fashion, wonder, “What did he mean by that?” tend to be reluctant to think and act less avoidant just on the therapist’s say-so. Avoidants who are also depressed tend to resist therapy because they view the therapist’s exhortations to do something as a criticism that they didn’t already do it. Avoidants who are also masochistic tend to resist therapy because they respond to getting better by feeling worse. Avoidants who are also obsessive-compulsive tend to resist therapy because as stubborn individuals, they respond to therapeutic exhortations by taking one step backward—to “rethink,” really undo, every step they just took forward.

COMORBID AVPD AND PARANOIA

Here the classic AvPD fire of sensitivity to the possibility of criticism, humiliation, and rejection is fueled by suspicion of what others might be thinking and up to. Such suspicion originates in large measure in a lack of basic trust resulting from projection, where “I dislike myself ” becomes “you feel antagonistic toward me and so must be out to get me.” These avoidants primarily withdraw because they become wrongly convinced that others dislike or even hate them, as they view a cancellation of a date due to sudden illness as a personal rejection; an ogling look from a stranger not as a come-on, but as a hostile stare; an offer of friendship or love as sexual harassment; an attempt to matchmake as trying to humiliate them for being so desperate that they need to be fixed up; and the best-intentioned advice, including that from a concerned therapist, as criticism for prior wrongdoing and/or as an attempt to control them for the personal gain of the advisor.

Projection also leads avoidants to unfairly blame others for their own need to withdraw. They weave the threads of their pathological fantasy, cognitive error, and the prophetic but unrecognized self-fulfilling consequences of their own provocative behavior into the cloth of external “stress,” then, coming to view their inner anxiety as external fear, attribute their isolation and loneliness entirely to the machinations of the world around them. Illustrative is the familiar example of singles blaming their loneliness entirely on the absence of suitable partners where they live, when such a conclusion is in fact an illusion, created mainly out of their own problematic concept of “suitability” and a false distor-tive environmental assessment based on externalization of self-hatred to become “others hate and avoid me.” Beck’s method of cognitive treatment, as revealed in taped interviews of sessions with a patient he calls Audrey, devotes itself in some measure to correcting paranoid blaming of others for having it “in for me,” as Beck shows Audrey how her withdrawal from others is in large measure a response to her belief that others are distancing themselves from her.²

Ultimately, paranoid avoidants even come to welcome their perceived “stress,” “bad luck,” or the nebulous “incompatibility” of everyone they meet, for it provides them with the excuse they are looking for to keep to themselves—the rationale they are seeking to distance themselves from others so that they can break free of them, exactly as they wanted to do all along.

COMORBID AVPD AND DEPRESSION

While nondepressed avoidants fear not being loved, depressed avoidants become convinced that they can never be lovable. Their cry is, “What’s the use of trying to relate to anyone, no one will want me.” Now they become apathetic, give up, accept the hopelessness of things exactly as they imagine them to be, inure themselves to the rejections they feel are inevitable, and steel themselves to the predictable loneliness they are convinced is bound to be their fate and as such will plague them throughout their lives.

As self-demeaning individuals, depressed avoidants become like the depressed hardware store salesman who told self-deprecating jokes on his first date: how when handing out a flier for his sale merchandise, he said, “Read this only if you are having difficulty sleeping at night.” As guilty individuals, they feel that to err is inhuman, to forgive themselves unallowable. They view themselves as sinners unworthy of loving themselves or being loved by others—partly based on a hypersensitivity to criticism that leads them to misinterpret a neutral question or positive remark as a personal devaluation, take a little joke as being seriously at their expense, and even interpret noncritical idiomatic expressions in a concrete, defamatory manner. To illustrate, I stopped using the expression “in case you haven’t heard” to convey something positive (“everybody has heard it, so I am sure you have, too”) because several of my avoidant friends thought that I was being critical of them, as if I were saying that the reason they didn’t hear of something was that they were completely, hopelessly, and stupidly deaf to the world.

Some Case Examples

A shy, depressed avoidant customer struggled to ask a salesperson in an upscale food store a question regarding the merchandise. The salesperson patiently explained his wares to her and then said, meaning it as a compliment, for he actually liked and took to this person, “I have never spent so much time with a customer before.” The customer, being depressed as well as avoidant, thought he was criticizing her for taking up his whole afternoon. As a result, she complained to management that he had sassed her, then refused to return to the store ever again.

A depressed avoidant emergency ward patient severely castigated members of the Department of Psychiatry for referring to her as a “walk-in,” a status she had convinced herself was somehow inferior to that possessed by “those who have an appointment.” In our interview, in the course of trying to assess the quality of her social life, I merely asked her, “Do you have many friends?” To this she replied that I was putting her down by criticizing her for being a loner and was even implying that “you are the sort of person that nobody could ever want.”

While nondepressed avoidants tend to confine their somatic complaints to those related to their anxiety, such as hyperventilation or tremor of the hands, depressed avoidants tend to develop a variety of off-putting messenger somatic complaints like the familiar “not tonight, dear” headache, Epstein-Barr “leave me be” chronic fatigue, or the physical weakness and need to “retreat in order to rest” of hypoglycemia, all of which are their way to proclaim, “I am withholding and withdrawing for physical reasons.” A hypochondriacal fear of catching an illness often leads depressed avoidants to become remote due to worrying about contamination, especially from sexually transmitted diseases, another isolating curtain they draw around themselves, having come to feel that “closeness is beyond emotionally precarious; it’s physically dangerous.”

For nondepressed avoidants, every new potential relationship promising a rosy future is a fresh sign of hope. For depressed avoidants, every new potential relationship recalling a dismal past is a new reason for despair.

COMORBID AVPD AND GRIEF

Grievers pull back into themselves and avoid others because they feel pain so unbearable that it fully preoccupies them and saps their life energy. They also pull back out of a need to uninterruptedly chastise themselves about the bad things they guiltily believe they did to the lost loved one. Additionally, they pull back for more positive reasons: so that they may think of the person they lost full time and recreate the lost relationship inside of themselves, in their fantasies. Then they stay remote because coming to overvalue the lost object, they feel that no one new can ever match up to that person and take his or her place.

COMORBID AVPD AND OBSESSIVE-COMPULSIVE PERSONALITY DISORDER

These avoidants tend to withdraw less out of fear than out of a need to maintain relational correctness, honor, and propriety. As perfectionists, they discard relationships because of others’ minor flaws, doing so just because the other person has merely made a single, insignificant social blunder such as “you passed me on the crowded beach without even saying hello.” They also remain remote because they fear making relational mistakes. As one individual describing her excessive perfectionism put it, “My record stands for itself: in my whole life I never made a slip of the tongue, because I rarely speak so that I can avoid saying the wrong thing. For me slips of the tongue are like wrong numbers. If you dial one you didn’t get a wrong number; you dialed the number wrong.”

As worriers over nothing, they hurt relationships by subjecting them to constant evaluative questioning, always asking, “Can he or she be the only right one for me?” then answering the question as “maybe, or maybe not,” then remaining aloof due to “not knowing the correct answer.” Uncertain as to whether they do or do not want to relate to others and to a given person, they tease, then disappoint, blowing hot and cold as they alternate between interest and detachment, playing Berne’s game of “Kiss Off,”³ as they beckon others to come, only to change their minds at the last moment and push them away should they actually arrive.

A Case Example

One such man entered multiple chat rooms then did not reply to the people who replied to him or told them that he was busy now and couldn’t take the time to get back—“but I will contact you, if only you will be patient.” In singles bars, he dressed to look alluring, stood in sexy poses, and gave others seductive looks. Then, at the first sign of interest on the part of others, he became aloof and disdainful and removed himself, even though he was the one who had first extended the invitation. In his relationships, he said, “We must get together sometime,” but never made a date, or, making one, broke it, reassuring the other person that this was the very last time that it would happen, just so that he could make it happen again. When having sex, premature withdrawal was the order of his day—not to prevent conception, but to first tempt and excite, then to frustrate by stopping short of fulfillment. Ultimately, he married to get away from home, but, feeling unfaithful to his mother, divorced his wife so that he could go home again, only to complain about the singles life, about his inability to tolerate living with his mother, and about the difficulty older men have in meeting someone suitable and getting remarried. Eventually, he met someone he felt strongly attracted to, only to then take a job that required him to work every weekend and on holidays so that the few days he could take off were on nonholiday weekdays—which, not surprisingly, was the very time his new partner couldn’t be at home with him.

Nonobsessive avoidants are detached, distanced, and disinvolved partly because they have difficulty expressing their positive feelings. Obsessive avoidants can and do express their positive feelings, but only in situations where they can take them back; when they can express them paradoxically, that is, when others, having given up, no longer anticipate or are open to anything positive from them; or when they can express them indirectly, for example, to a person other than to the one who is the actual recipient of those feelings.

Some Case Examples

One obsessive avoidant man gave negative responses to acquaintances’ positive gestures, reserving his positive responses for when the gestures had been withdrawn—because the other person no longer cared and had chosen to move on. For many years, he had saved money by only having one date, never to repeat the experience because he became intensely angry when she ordered the most expensive item on the dinner menu. Then, later in life, after he saved a nice nest egg, he thought, “It’s time,” and permitted himself to fall in love. Only now he found himself making bad investments in the stock market, thinking, “Better to lose it honestly than to have it taken away from you by some gold digger.”

Speaking of a new, suitable man she had been seeing regularly for weeks, a patient said, “He’s handsome, funny, very presentable, and I love how he deals with me, especially how he listens and remembers what I have to say. But it’s really confusing. I see him one time I like him, I see him the next time I don’t like him. He really wants me. I gave him my card and he called me right back. But I just cannot commit to him. I hear my mother’s voice going around in my head, saying, ‘What are you holding out for, someone who will treat you like a piece of crap?’ It’s the old story: you want the ones who don’t want you, you don’t want the ones who do. Anyway, my intense feelings for him completely disappeared when I discovered that his body type was all wrong for me. He doesn’t have any body hair, and his legs are too short, a shock when you see him naked for the first time. So I started telling him negative things about myself: how after all I am not perfect and that right now I’m not going to object if he pushes for a relationship, but I’m not going to encourage one either.” The final choice for this woman: a man who regularly criticized her for being a cheapskate for saving money by using in-store coupons, “something we just don’t do in my family, and where I come from.”

Additionally, obsessive avoidants are stubborn, controlling individuals. They may express this stubbornness in minor ways, for example, by sending “belated birthday cards” (with the additional element of a narcissistic shift in focus from “your birthday” to “my having forgotten your birthday”), or in major ways, as when they make an appointment then cancel at the last minute. Caught up in control issues, they don’t so much turn away out of fear as they run away out of need. They look for what others want in a relationship just so that they can refuse to give it to them so that now they can gratify their need to be the one to call all the shots.

Obsessive avoidants characteristically struggle with harsh matters of morality. They resolve their good versus evil struggles interpersonally by deeming others immoral so that they may now avoid them. While nonobsessive avoidants stay away out of a need to maintain safety, obsessive avoidants stay away out of a need to more closely approximate sainthood.

COMORBID AVPD AND HYSTERICAL (HISTRIONIC) PERSONALITY DISORDER

Histrionic avoidants exaggerate the dangers associated with closeness, intimacy, and commitment. In the milder cases, a cancelled dinner date becomes a signal that a given relationship, and every relationship to come, is troubled and doomed. In the more severe cases, closeness becomes commitment, commitment becomes entrapment, and entrapment becomes fatal smothering to the extent that we hear, “Freedom is completely out of the question within the bounds of a close, loving relationship; and complete freedom is what I want out of life, for I want to be me, and I need to be free.” Because of such fears, histrionic avoidants love unwisely so that they do not have to love too well. They typically display that characteristic fear of closeness by avoiding suitable men in favor of attaching themselves to men about whom they have mixed feelings. Typically, they ignore a potentially workable relationship in favor of relationships that are likely to sputter or fail. Not only do they react negatively in positive situations, but they also react positively in negative situations, forming strong attractions where the possibility of fulfillment is weak, and vice versa, as they get turned off by those who are warm, yielding, permissive, and available, and turned on by those who are distant, unfeeling, forbidden, and unavailable. In their pursuit of negative situations and unavailable people, they sometimes become enamored of movie stars to the point of stalking them. Basically, they favor oedipal triangular situations, pursuing people who are already involved with and committed to someone else, particularly “almost divorced” lovers who promise to leave their wives and marry them, but never actually do. All told, they suffer from what amounts to a fear of success, where they do attempt to relate—but only in those situations where they are virtually guaranteed to fail to do so.

COMORBID AVPD AND DISSOCIATIVE PERSONALITY DISORDER

Avoidants who dissociate undergo flight—not only from the possibility or actuality of rejection, but also from the possibility or actuality of acceptance. When acceptance looms, they flee to the distant, remote, unfamiliar, foreign, strange terra incognito where what they perceive to be the discomforts, harassments, and fears of the old world of relationships, or of a specific relationship, no longer pertain. If others approach them, they, in essence, tell them, “Corner me and I will retreat,” then pull the curtains around “me,” exclude “you,” and disappear out of what they perceive to be danger. They laugh off a serious approach or seduction that comes their way so that any work they have done until now to promote a relationship evaporates and the relationship comes to naught. Some, speaking of needing to take a break from an actual relationship, call for a hiatus early on. Others make it as far as the marriage ceremony, then, at the last minute, get cold feet, leaving their groom or bride at the altar. Some even have minifugues consisting of detached, trancelike, and confused states in which they might view a potentially satisfactory relationship virtually as a terrorist attack. At times, they develop a chronic and persistent aloofness to others that is the product of their constant detaching themselves from feelings they perceive to be dangerous or forbidden by the expedient of removing themselves from other people who elicit those feelings. They also become aloof to themselves—not allowing themselves to feel through creating a protective remoteness inside that, in essence, says not, “I am afraid you find me uninteresting and will reject me,” but “I find you uninteresting and reject you.”

Ultimately, they calm down and once again become rational, as they become painfully aware of opportunity missed. Now we hear recriminations about how they utterly ruined their lives and the lives of those who loved them. Unfortunately, however, their past regrets usually do not readily translate into improved future performance.

Developmentally speaking, these avoidants often describe a past marred by constant parental warnings of the dangers of relating overall and of those associated with forming certain relationships specifically. For one little girl, the danger consisted of the loss of family, and for one little boy, the danger consisted of a symbolic castration as the father told his son that “all marriage is a ball and chain around your ankle, just like the one with which your mother ties me down and ruins my life.”

Some Case Examples

A gay man who routinely dissociated when the big moment arrived—not registering it or, registering it, denying it—still remembers an incident 40 years ago, when a handsome sailor made it clear that he wanted him, but instead of replying in kind, he ignored him, sloughed him off, to use his words, “laughed off the approach like a silly girl.” He doesn’t know why he did it, but he suspects it was because he became anxious. Forty years later, he was still bothered by his tactical error, still had fantasies of making it with the sailor, and still brooded, “Was the pleasure dangerous—the pain desirable? Did I perceive danger though there was none, see risk in the absence of a reason for concern?” His only consolation, which he ceaselessly repeated to himself for reassurance, was that had he gone with this sailor, he wouldn’t have gone with the other man he met that night, and that was the man through whom he ultimately met his lifetime lover.

A wistful patient announced his future plans to live his life by himself, camped alone under the stars in an adobe in the Arizona desert, on a farm with only the animals for companions, or on an island off the coast of Maine. The following two dreams regularly recurred during his childhood:

He was running down a long corridor in order to escape an unknown danger. At the end of the corridor, an object variously described as the tassels of a riding crop, the straws of the head of a broom, and the feathered tail of a rooster appeared through the wall and shook at him, tracing an up and down trajectory. The sight of this terrified him, although he did not know why. He remained terrified until he progressed further along the corridor, when he saw a sign that read, “Safe to the left, danger to the right,” whereupon he ran to the left and into the “arms of safety.” In the dream’s aftermath, he wet his bed and awoke. In association to his dream, he recalled how one day, after his grandmother caught him playing doctor with a childhood sweetheart, she whipped him, then took him aside and showed him a picture from a Bible: a harp whose pillar was carved in the shape of a nude body of a man, genitals absent. The grandmother suggested that he would become that man if he continued to play such dirty little games.

The shaking tassels/straws/rooster tail both represented his being whipped and the whip itself, and so both his threatened emasculation and the symbolic reassurance that his phallus was still there and intact. His running in the dream was both a running away from being whipped and emasculated and a running to a place of safety.

In a second dream, there was a park “over there” with skyscrapers arising intact from an excavation pit. His childhood sweetheart in reality lived on a street bordering the park. In the dream, he wanted to go there but was afraid and couldn’t find his way. And at any rate, he felt he didn’t deserve to be there because he hadn’t the right clothes. Ultimately he arrived, only to discover her home had been bulldozed and in its place another, taller structure, a skyscraper, had been erected.

In his associations to this dream, he described himself as a distant and lonely avoidant preoccupied with futile searching for new people whom he would like better and for new places where he would be happier. In later life, he actually fled from city to city looking for a relationship in a new place, even when many satisfactory relationships were available to him in the old one. On one occasion, he moved for no better reason than that in the new city, the skyscrapers were taller than in the old. The old city without tall skyscrapers referred to being devalued, punished, and emasculated for his sexuality now, just as he felt his grandmother had threatened to do to him when he was a kid. Fleeing to the new city, the “park with big skyscrapers, and one big one in particular” represented a restitutive attempt to avoid/undo emasculation and become physically intact once again. Fleeing also represented heading to a place characterized by safety in numbers because a bigger city was “more anonymous, a place where no one would know who I am, and hurt and abuse me for what I do.”

For successophobic avoidants, dissociation is particularly “suitable” for “acceptance emergencies,” when by chance, bad luck, or in a moment of weakness, they find themselves in a potentially happy relationship they were unable to foresee and so avoid.

In an unfortunate turn of events, the avoidant “vanishing act” often comes across to others as rejecting, even though it is not, for the dissociating avoidant is not being rejecting of, only protecting the self from rejection by, others.

Too often, these avoidants’ protective aloofness filters down from personal to impersonal pursuits with distortive results that affect choice of profession or choice of job within that profession. As a general principle, with plenty of individual exceptions, serious avoidants tend to become physicists even when they really want to become doctors, and within the medical profession, anesthesiologists even when they really want to become psychiatrists.

COMORBID AVPD AND POSTTRAUMATIC STRESS DISORDER

Some avoidants pull back in the here and now to steel themselves from a potential or actual current relationship that reminds them of a traumatic relationship from the past. They confound new people they might love or who might love them with old people whom they loved once, only to discover that in reply, they hurt them badly and irrevocably. Unable to discriminate between bad past and good present relationships, they instead continue to generalize from old bad experiences to new, unrelated, good, and potentially satisfying involvements.

A Case Example

As a child, an avoidant was raised in the same bedroom as a delusional grandmother who regularly and, because of her age and status, with some authority, announced that through the window, she could see “kidnappers, and I worry that they will whisk you away.” Later in life, he stayed away from all involvements with people who were overly intense like her. Instead, he preferred people who were bland, unemotional, and uninvolved, which unfortunately, and predictably, meant that they were also remote.

He also had a hypochondriacal father who worried constantly that he might get polio and even kept him at home for months in quarantine so that he would not come into contact with the polio virus. “To ice the cake,” as the patient said, “he dressed me up in high shoes, like the ones actual polio victims wore, and forced me to wear knickers that had gone out of style and were made out of wool that, because of my allergy to lanolin, itched me so intensely that I could hardly function in social situations unless I wore shortie pajamas underneath to act as a lining—only to be regularly humiliated when, as predictably happened, my pajamas spontaneously fell down and stuck out from below.” Not surprisingly, later in life, the boy developed a pervasive shyness that in effect said, “I am too ashamed of myself to get close to anyone, for if I stay away from people, I won’t be dangerously on display and mocked as a result.”

COMORBID AVPD AND PARAPHILIA

Paraphiliac avoidants are disabled in loving because they limit their attraction to the (paraphiliac) object or situation—one that, by definition, represents only part of normative patterns of arousal and activity. An example is an overfondness for a particular body part such as a foot. For paraphiliac avoidants, the attraction to the part is an aspect of the process of distancing themselves from the whole. Part of the process is that paraphiliac avoidants find themselves compulsively attracted to relationships that are dysfunctional because they are nonreciprocal. Thus a subway marauder experienced a decrease in sexual arousal when a partner promised (threatened) to get close. So he rubbed women in the subway because with such strangers, a full personal and sexual relationship was completely out of the question.

COMORBID AVPD AND NARCISSISM

Narcissistic avoidants tend to avoid less out of fear and more out of a preoccupation with their own needs, one that can be selfish in the extreme. Thus a single man at the beginning of the evening complained to his blind date, “I had to interview 90 women just to get you,” and at the end of the evening, “I’ve dated women with small breasts, and I’ve dated women with large breasts, but no matter how hard I try, I can’t seem to find a woman whose breasts are exactly the right size.”

Narcissistic avoidants don’t get close to, and maintain a solid relationship with, others because they jealously guard an identity of which they are inordinately fond. They have difficulty giving up “being me” in order to become “us.” They feel that “who I am” (my masculinity, my identity as an independent man, my emancipated status as a woman) is more important than “who I am with.” They are entirely too willing to stand on principle, even though that means standing alone.

COMORBID AVPD AND PASSIVE-AGGRESSION

Passive-aggressive avoidants antagonize others in subtle ways. Their goal is to provoke others to withdraw from them in a way that allows them to deny that they are the ones orchestrating the withdrawal from others.

COMORBID AVPD AND AGGRESSIVE PERSONALITY DISORDER

The same avoidant individual can be, and often is, both afraid of criticism and highly judgmental and critical of others.

A Case Example

One aggressive avoidant had few friends/lovers because, as she herself complained, she couldn’t keep from criticizing everyone she knew both for things beyond their control, like their looks, financial status, and emotional problems, and for things within their control, but essentially unimportant, like wearing yesterday’s clothes or recommending and taking her to all the “wrong” places. For example, she was very close to a colleague for many years, until that colleague got slightly depressed and needed someone to talk to, at which time she told her, “I am not interested in doing therapy with my friends” and refused ever to see her again. She also often criticized people for things that were her own fault. For example, “utterly shattered” over having missed a bus stop (though the next stop was only a few blocks away), she found herself severely castigating the bus driver for not reminding her to get off—even though, assuming (incorrectly) he knew her from earlier trips, she had not bothered to tell him the location of her stop. She often attacked innocent people just because they were around and available to be savaged. Sometimes it was the messenger, sometimes it was the next person to come along after the last person who troubled her, and sometimes it was the repairman who was trying to fix the problem. For example, she excoriated the bus driver of the bus that came (for there being so few busses) because she was angry at the driver of the bus that did not come. She excoriated an airline ticket agent when her luggage was lost, although it was the person who handled the luggage, not the ticket agent, who, if any abuse were deserved, was the one who merited it. Finally, she

often went back in time to tease out one thread from the skein of life’s normal give-and-take, stretch the simple unremarkable strand, and weave it into a tapestry horrific enough to give her the reason she needed to act out negative feelings about potentially positive relationships. Thus, after 43 years of not seeing a childhood companion, she was reintroduced to him at a large party she gave, whereupon she spontaneously announced, loudly and unforgivingly, and to all present, “Here’s the boy who, when we were both two years old, threw dirt in my carriage.”

COMORBID AVPD AND PASSIVE-DEPENDENT PERSONALITY DISORDER

Some Type IIc passive-dependent avoidants “actively” surround themselves with a protective shell to effectively hide out from a world they perceive to be threatening and rejecting They do this by forming a (possibly unhealthy) dependent relationship with one to avoid having healthy relationships with many. They might become overly close to a parent to avoid having a lover (or to avoid having to go to work) or form an overly close codependent relationship with a single partner to avoid other outside relationships. Some seek safety by becoming dependent on groups of like-minded avoidants. On the positive side, these groups enhance self-esteem through imparting a sense of belonging that makes all concerned feel wanted and involved. On the negative side, by becoming overly possessive, they enhance pathological intragroup attachments that isolate the group members from the outside world.

Other passive-dependent avoidants are simply too inactive to actively relate to others, for that means doing the work required to meet someone like Mr. or Ms. Right. I advised one patient from northern New Jersey desperate for, but unable to meet, a partner to go to New York and try hanging around a special place where bachelors go to meet women. In response, he could do no better than complain, “Too far. Too hard to get there.”

In still other cases, the passivity is not the cause but, rather, the result of the primary avoidant problem. One avoidant, afraid that being active could lead to being rejected, refused to follow her friends’ advice to be more forward with men. For example, when a man she liked said good-bye to her, ignoring her friends’ advice to say, “I won’t let you get away until I get your phone number,” she merely said goodbye back and let it go at that. In her case, it was guilt and shame about her humanity that led her to hold back, for she believed that simply acting interested in a man meant that she was proposing to have an illicit liaison with him.

When passive avoidants like her find themselves in a troubled relationship, they tend to both welcome the troubles and make little or no active attempt to fix them. Typically, they ask or allow others to take full responsibility for the outcome of their lives—deputizing virtual strangers into telling them what to do. Rather than looking for problems and coming up with solutions on their own, they write letters to newspaper columnists, or to me, asking, “What do you think I should do?” or they find therapists who tell them whether to stay or go. Predictably, they select that columnist or therapist they know, intuitively, by reputation, or from past experience, will encourage them to leave. Then they lead them on by only giving them information that would seem to suggest they should go and censoring information that might suggest they should stay.

On a more favorable note, passive-dependents are nonavoidant when they suppress their hostility in order to maintain their dependency. They act kind when we would expect them to be unkind, say “it doesn’t matter” when they should be setting limits, say yes when they should be saying no, suppress their sexuality should they deem it somehow troublesome to others, and generally behave in a selfsacrificial fashion—all in order to avoid offending others in a way that might lead others to retaliate by rejecting and dismissing them.

COMORBID AVPD AND MASOCHISM

Nonmasochistic avoidants want to relate well in order to avoid personal distress. In contrast, masochistic avoidants want to relate poorly in order to induce personal suffering. Some, looking to relate to people who cannot or will not relate to them, deliberately extend themselves only to those who are unlikely to accept them. Disinterested in people who overlook their flaws or see them as virtues, and wanting most of all to get approval from someone who already disapproves of them, they become unaccountably attracted to and actively seek out critical, humiliating, and rejecting persons, or at the very least choose those who are too different from them to be sufficiently compatible to make suitable companions and partners.

When these relationships fail to hurt and punish them as hoped and expected, they arrange to hurt and punish themselves through these relationships. After seeking them out, they stick with unfulfilling people and make a concerted effort to convert their harshest and most disdainful critics, the harsher and more critical the better, from negative to positive. They willingly (though resentfully) become submissive and do almost anything, even things that are not in their best interests, just to make these relationships work. They even gladly excuse the most outrageous behavior in their partners just so that the relationship can continue, as did the masochistic woman who excused her husband for cursing and reviling her in the foulest of terms on the basis of “anyone who hurts another person like that must be in pain himself.” And should their relationships “threaten” to work, they imagine negativity in a neutral or positive situation. A man might call and leave a message for someone on Friday and, “forgetting” about the weekend, think he was being rejected because the call was not returned until Monday. They look for, and find, flaws in others because now they can make a cause célèbre out of the deficits, deliberately marring a relationship that works so that they can give themselves the excuse they are already seeking not to make repairs, but instead, to give up and leave.

Some Case Examples

A masochistic bisexual avoidant avoided people who treated him with respect in favor of relating to people who were unpleasant, hurtful, or abusive to him. He shrank from people he sensed would accept and love him by placing ads on the Internet and then not replying to responders who seemed interested in him. He also turned down promising introductions from friends and family who wanted to fix him up when he sensed that the fix might work out. Instead, he felt most strongly attracted to remote women, prostitutes, in particular. In an attraction to heterosexual prostitutes, the money transfer was avoidant because it convinced him, “I don’t love, I buy.” In a sideline attraction to transgender prostitutes, he knowingly involved himself in a situation where “confusion precluded closeness.” (For the prostitutes, the avoidant attraction often was, “I do it with many people, not one, and not for love, but for money,” which both precluded closeness and provided them with an opportunity for expression of hostility toward people who can’t “get it” but have to “buy it.”)

A masochistic single woman came to me complaining of a burgeoning successophobia typified in a recurrent dream “that my driving phobia”—a symptom of which she long complained in reality—had “lifted enough for me to be able to drive, but when I tried to park the car, I would swing it widely, and into traffic, bumping, hitting, and destroying other cars in the process.”

When speaking of her relationships, she complained, “I have searched the world and there is no one in it for me.” I suggested she ask her relatives, who knew many eligible bachelors, to fix her up with blind dates. They did, and the dates were not bad. But to defeat herself, her relatives, and me, she announced, “Blind dates never work out,” and refused to accept ever being fixed up again. For her, blind dates got an undeservedly bad reputation because as a masochistic avoidant, she needed to be certain that no relationship would ever develop. To that end, she saw to it that her self-destructive behavior continued into the blind date itself.

Drawing additional inspiration from a successophobic belief that what was bad for her was good for her, and the reverse, she made a masochistic choice in her final selection of the man who was to be her husband. As she put it, looking back, “I avoided all the attractive men I met. Instead, I married the man who was unattractive, impotent, thin, reserved, self-preoccupied, and mother-fixated.” Later, after meeting her goal of getting married to a man she found unattractive, she was actually surprised, as if she were learning it for the first time, that they had nothing in common, or that, as she put it in more specific, sexual terms, “His penis doesn’t fit my vagina.” After some years of couple treatment, she decided to try to get along with him. “He is really not a bad guy,” she finally admitted. But then a new symptom arose— her “seven-year itch.” Unlike nonmasochistic avoidants, in whom the seven-year itch is a longing for variety originating partly in a sense of boredom that can be reality based, her seven-year itch appeared precisely in order to disrupt a relationship that was finally going well: her husband had begun to respond to her positively, surprising her by becoming loving, just the way she once thought she had always wanted him to be, but which now “turned her off completely.”

Many avoidants act out as masochistically with place as they do with person. In a self-destructive geographical maneuver, they choose to live in a place where they sense they are not wanted and can never be happy. They have a civil right to be there, but more important, because they do not fit in, they get stuck in what is for them a hopelessly deaffirming culture, where they aren’t nearly as happy as they might be in another location, one where they had both a right and a reason to be.

In therapy, masochistic avoidants tend to be especially resistant to improvement. They find ways to keep their avoidance in order to continue their suffering. They call their loneliness preferential and attempt to convince their therapists of the same thing. They claim to value their privacy and independence over all else. They say that “marriage isn’t right for everyone and it’s not right for me.” They note that having regular sex is not all it is cracked up to be. In the words of one such avoidant, “The best things in life are only for the isolate.” Should therapy appear to be working, they find a way to defeat it by having a masochistic triumph that consists of cutting off their noses to spite their therapist’s face. This was the motivation of an unmarried woman who allowed her goal of meeting people to become secondary to her goal of proving to everyone trying to help her—family, friends, and me—that “No matter what I do, I still can’t find Mr. Right, and no matter what you do, you still can’t help me catch him.”

Not surprisingly, in couple therapy, masochistic avoidants respond negatively when a partner improves. In their headlong rush to a painful divorce, they deliberately, if unconsciously, continue to view a mate who has newly become interesting as still boring, who has learned to be nice as still insufficiently positive for their taste, and who has changed from remote to close as a newly developing threat to their valued freedom, independence, and identity.

COMORBID AVPD AND ADDICTION

Avoidants who are also addicts gamble or take drugs as a substitute for having relationships. For example, they gamble not to be involved with, but to retreat from, the world and the people in it via entering the substitutive fantasy arena of the casino, their figurative opium den. A man gambled in Las Vegas to get away from his wife. He thought of himself as a “guest of the owner” of his favorite casino, as if the owner wanted not his money, but him personally. He viewed the casino as the perfect home with the perfect people in it, in contrast to “my own shabby surroundings and impossible home life.” As anyone who has tried to make eye contact with a serious gambler in a casino can attest, he, like many gamblers, hardly noticed anyone around him. He was blocking out the possibility that someone might be interested in him personally or sexually—as if the gambling (as intended) made human relationships, at least for the moment, entirely beside the point.

COMORBID AVPD AND BISEXUALITY

Bisexual avoidants indulge in Types IIa and IIb avoidant behavior when they behave homosexually to avoid heterosexuality, and the other way around.

A Case Example

A patient was at first a heterosexually oriented child. But, as he recalled, because he threw a baseball underhanded, his peers humiliated him to the point that his self-esteem fell precipitously. So as an adult, he “became bisexual to protect myself from rejection and the consequent loss of self-esteem by surrounding myself with two different kinds of people and fleeing protectively from one to another whenever I felt criticized and humiliated.”

He also traced the origin of his bisexual shifting to problems in his early relationship with his parents. According to him, an overattachment to and identification with his mother fostered homosexual fantasies as he acted toward male companions in a way that reproduced his mother’s seductive behavior toward him. But heterosexual fantasies came to the fore as he fled from homosexual relationships because they made him feel too much like a woman and so much too much like his mother. Also, every time a woman was unpleasant to him, she “sent me to men” because she reminded him of his mother’s hostility toward him, while every time a woman was warm/seductive toward him, she “sent me to men” because she aroused oedipal/incestuous anxiety related to “my mother fixation.”

He also traced his bisexual shifting back to his relationship with his father. He believed that his complete disrespect for his father put a damper on his heterosexuality because he had no male figure to identify with. And a restitutive need for a good father accounted for his never-ending search for an imperfect man he could make over into an ideal male parent.

As he concluded, overall, “I use my bisexuality to reduce anxiety about getting close to any one individual, for my being bisexual means that I will never be stuck in one place, and with one person only.”

COMORBID AVPD AND MIXED PERSONALITY DISORDER

I diagnosed the following individual as a man with avoidant, including sexually avoidant, passive-aggressive, and narcissistic, personality features: ¹

I do and what I can do to change. Your book has helped me get a better understanding of who I am and I must say I do not like myself for it.

My story goes like this: I was with my wife for seven years and for the first part everything was fine. We moved in together after six months. Three months afterward, my sister moved in with us (arriving on a student visa from Greece). She interfered all the time with my relationship with my wife, and it became too tiring to deal with her as she had issues of her own (she was 30 when she arrived, she is now 36). This took a toll on my relationship with my wife. Yet I was unwilling to tell my sister she had to go home then kick her out. She would sign up for college courses in English as a second language and just not go (she needed to be enrolled in a class to keep her visa). She would go once a week to make an appearance then spend the rest of the time sleeping during the day and staying up all night watching TV or cooking. When my wife learned I was the one paying for all my sister’s expenses and she had sucked up all my savings, she asked me why I needed to support my sister like this and said she was using me. I explained it was a cultural thing and she would not understand.

Around the same time I got money from my parents to buy a new home. My wife and I found a nice loft in Center City but I insisted we get a two-bedroom to accommodate my sister. We all moved in and things got worse. The two-bedroom was an open concept with wall partitions going up 8 feet while the ceiling height was 14 feet, so you could hear every sound.

Our sex life went from very little to even more so. We were never really that sexually compatible to begin with since my wife was more the romantic type that needed the candles flickering and soft music playing in the background, while I was more spontaneous and aggressive and liked to be adventurous. As our sex life became worse I got to the point that I was more into porn than into her. I would rather just lie beside her and relieve myself than do anything, and if she tried to touch me, I would push her away, and this even when my sister was not home. I would not let her have me unless I was drunk or high and she was not into that as she said she would feel she was taking advantage of me and making me do something I did not enjoy.

My wife got sick of the situation and started to hook up with other guys on the side. She learned that with others, she could

have the sex she wanted and enjoyed, the sex that she could never get from me.

Spring last year, we decided to move to a new place with more privacy. My wife begged me to get rid of my sister, and I kept telling her that since my parents gave me the money for the place I did not want to do that, even though our parents also wanted my sister to go back home and live her life there, and my sister owns her own place back in Greece. My wife got to a point where she felt alone because she was in a ménage à trois relationship with me and my sister. My wife also complained that she put all the money she made into our home, yet every day she would come home to find the house a complete mess as my sister would do nothing around the house but cook a meal she saw on a cooking show that day.

My wife begged me to do something but I refused as I said that it is not her house as my parents gave me the money for it. I told her that this was not her home even though everything she made went toward it. She began to feel like she was working toward nothing in her future. She even started contemplating suicide.

She had enough. She had to get away, so she flew to London for a week to clear her mind and distance herself from the relationship to evaluate what she should do. She came back with as few answers as she had when she left. When she returned she connected with a guy ( John) that she thought was very nice even though he was 11 years older. They started talking and got to know each other well; they hooked up and she said that the sex was the best she ever had.

Next she decided she had had enough of being the third person in her marriage and moved out and in with John. She knew this was not the brightest of ideas but she felt like she finally met someone that she could connect with on all levels of a relationship and she was not willing to pass up the opportunity to be happy for once.

So four months ago she filed for a divorce. It was only then that I finally sent my sister packing for home and begged my wife to come back home and work out our problems. During that time, though, she fell hard for John, and they seem to have a great relationship. The exception is that John gets mad that my wife and I still have a business and work together.

My wife feels torn. While now I would like to have an exclusive relationship with her, she is unsure of what to do. I feel like after all those years of my being stuck with my sister from hell, she should give me a second chance and try to work out things with me. I know she is cheating on me, and while I am willing to forgive, I would be unwilling to open up the relationship since I go for exclusivity. On the other hand, she says her relationship with John is great, sexually things are fantastic, and it all just feels right for her without her having to try.

So reading your book made me feel like I’m behaving inadequately. I have tried to get professional help for this to get her back. The situation is driving me to the point where I do not know what to do. If you could tell me what to do, I would forever be in your debt.

CHAPTER 8

Cognitive-Behavioral Aspects

According to Burns and Epstein, emotional disorder is the product of “negative cognitions or [negative] automatic thoughts” and “stable underlying [incorrect or partially correct] assumption [s]” ¹ that distort and disrupt interpersonal relationships through the creation of irrational disjunctive beliefs about oneself, others, and the world. These irrational beliefs, developed and maintained in the face of evidence to the contrary, lead to decreased interpersonal objectivity due to flawed interpretations of interpersonal events. These flawed interpretations feed back to firm up the original distortive beliefs to the point that the latter become unwritten laws—“activat[ed] stable underlying assumption[s]”² such as “if someone doesn’t like me, then that means that I am unlikable.” These unwritten laws lead to catastrophic thinking such as “since I am unlikable, all is lost” so that the avoidant becomes unable to differentiate between real and imagined dangers, having lost realistic internal reference points by which to judge his or her own behavior and its consequences, further escalating the antagonistic interpersonal schemas.

PROJECTIVE (PARANOID) THINKING

Avoidants who think in the paranoid mode create outer stress from inner turmoil by attributing their personal negative biases and guilt feelings to others, turning their own worries, fears, and selfcondemnations into objective convictions of assault and attack. Projections largely account for suspiciousness and suspiciousness for the avoidants’ classic fear of criticism, humiliation, and rejection, reflecting an impoverishment of basic trust.

Here are three common projective assumptions avoidants make about others:

I feel unworthy and devalue myself. Projection of unworthiness and self-devaluation becomes “you devalue me.” Therefore a cancellation of a date due to sudden illness becomes a personal rejection, an offer to matchmake becomes humiliation for being so desperate that one needs to be fixed up, and the best-intentioned advice, including that from a truly concerned therapist, becomes a criticism for prior wrongdoing.

I am guilty about my sexuality. Projection of sexual guilt turns a friendly look from a stranger from a come-on or a “cruise” into a hostile stare or “sexual harassment.”

I fear being controlled. Projection of fear of being controlled becomes “you are controlling me,” turning a potential partner’s request to have a close or exclusive relationship into an assault on one’s independence. Good advice becomes the advisor’s attempt to manipulate for personal gain, and a personals ad on the Internet becomes not an offer to meet meant to attract, but a pack of lies designed to attack.

THE MAKING OF FALSE EQUIVALENCIES (SIMILAR = THE SAME THING)

Avoidants think negatively due to emphasizing the similarities, while overlooking the significant mitigating differences, between A and B. They perceive a little questioning of them to be a shattering critical assault upon them, see mere disinterest on the part of others as full negativity or hatred, and misinterpret advice from others (“this is what you can profitably do”) as a demand made upon them (“this is what you should do”). They see kidding as humiliation; turn constructive criticism into a put-down or a personal attack; and interpret friendliness as inappropriate sexual interest, or even sexual harassment. They believe any assertiveness on their part to be the exact equivalent of aggressiveness to others so that acceptable forwardness equates to unacceptable pushiness. They believe merely thinking about something bad equates to doing bad things; view the passivity associated with being in love as dangerous neediness, helplessness, and vulnerability; and see their minor flaws as completely disqualifying lesions. Commitment becomes entrapment; ordinary desire comes to equal desperation; cooperation with a friend or intimate comes to equal submissiveness; and submissiveness comes to equal complete loss of control and total, abject surrender. The uncertainty associated with all relationships becomes unpredictability; then unpredictability becomes certainty: that of looming, inevitable, attack, destruction, and loss.

A Case Example

One of my avoidant patients developed his characteristic sensitivity to criticism because he redefined criticism as anything short of complete acceptance so that if you didn’t love him completely, you condemned him totally. He developed low self-esteem because he viewed any slight imperfection on his part as a fatal flaw and came to believe that if he was not all good, he was no good at all. He developed a fear of losing his identity completely because he viewed closeness as merging and merging as engulfment so that any woman who liked him would, by definition, keep him from completely realizing his individuality by demanding that he submerge himself fully into her as an individual.

THINKING ACCORDING TO EXCLUSIVE (AND EXCLUSIVELY NEGATIVE) CAUSES

Avoidants who think this way become selectively blind to alternative explanations for their avoidant beliefs. Unable to think of any positive elements in, and so other explanations for, others’ presumed negativity, they explain others’ less than fully positive behavior toward them as strictly antagonistic and rejecting. Although they see the possibility of negativity in all positivity, they rarely, if ever, see the possibility of positivity in those situations that they at first perceive to be completely negative. Thus “he didn’t return my phone call yet” becomes not “he wants to get back to me but he is busy,” but “he does not like me enough to want to get back to me ever,” or “he was talking to me when his cell phone rang, and when he picked it up he turned away from me” becomes not “he had to answer that call because it was his business,” but “he prefers the person calling him to me.” Self-punitive attitudes originate along similar lines so that instead of “my anxiety is somewhat off-putting, I better be careful,” we hear a much more selfpejorative “I destroy anyone who wants to love me, and so I am not worthy of even trying to be loved.”

OVERGENERALIZING FROM ONE SPECIFIC INSTANCE TO ALL INSTANCES

Avoidants who overgeneralize slide too easily from shaky hypothesis to incontrovertible evidence to irrefutable fact. For example, a patient viewing all new relationships as if they are repeats of old, traumatic ones becomes effectively blind to alternative possibilities so that because he fell in love with someone unreliable once, no one he loves can ever be trusted again.

Very frequently, avoidants negatively parentalize what are in fact positive relationships after basing their conclusions on trivial shared characteristics of new nonparental and old parental relationships, then emphasizing the inconsequential or inaccurately perceived negatively of the new based on a tenuous similarity to the less than satisfactory old. For some avoidant women, all men remind them of an abusive father, and for some avoidant men, all women remind them of a rejecting mother.

CATASTROPHIC (ALARMIST OR WORST POSSIBLE SCENARIO) THINKING

Catastrophic thinking involves histrionic exaggeration, leading to overcautiousness or to the taking of desperate (and unnecessary) protective measures, leading to serious personal and professional misjudg-ments or even to making a suicide attempt. Avoidants who think this way typically make “mountains out of molehills” as they indulge in “all is lost” or “for want of a nail the ship was lost” or “for want of a penny the kingdom was lost” thinking. They assign absolute rather than relative meaning to minor problematic events, then overreact to these as if they constitute major negative developments. They become unable to say to themselves “so what” and “big deal,” then remain calm and unemotional about things that don’t really matter, or even about things that do matter but not that much, or, if that much, are best overlooked for the individual’s overall happiness and peace of mind.

Serious perfectionism is a kind of catastrophic thinking, where the avoidant discards a potentially or actually viable relationship because of perceived minor flaws, pulling back completely from a valid social/ sexual interaction just because the other person has merely made a single, insignificant transactional blunder.

Many avoidants make two, or more, cognitive errors simultaneously. For example, a patient’s habit of taking criticism too seriously led him to feel too frightened and devastated to relate intimately to anyone. This serious fear of criticism started with similar equals the same thing distortive thinking so that if someone merely requested that he do something, that request became an intended criticism that that thing was not done. Also, thinking catastrophically, he perceived actual minor criticism to be a rejection and the rejection a warning that the relationship was in serious trouble, and that it, and his life, were going to end badly.

Cognitive errors do not develop or thrive in a vacuum; rather, they appear, take shape, and persist within a facilitating matrix of disruptive, often traumatic, developmental events; internal conflicts inadequately resolved by normative or pathological defensiveness; negative behavioral conditioning; distortive interpersonal perceptions first formed in childhood that persist into adulthood; comorbid emotional disorder; misguided existential and socially based philosophical beliefs; and ongoing real-life stresses.

In the realm of disruptive developmental events, often adults continue to think in an avoidant manner in the here and now because as children, they identified with parents who thought the same way, or as children, they long ago jumped to the only partly true conclusion that their parents were criticizing or rejecting them. For one guilty patient, his mother’s getting even a little angry when she felt his behavior was out of line meant that she didn’t love him at all. Now he believes that anyone who sets firm limits on him is, just as she did, furiously criticizing him and rejecting him completely.

In the realm of ongoing interpersonal stresses, a shy, hypersensitive avoidant patient carrying on the “great tradition” of early parental negativity felt uncomfortable meeting new people because he failed to distinguish making a minor social blunder from ruining himself completely socially. He believed that others’ basic feelings about him could change, without warning, from positive to negative, just the same way his parents’ basic feelings did change toward him when, as a child, he did something they disapproved of. He did not believe that adult interpersonal relationships had an in-built margin of error so that most peoples’ basic feelings did not change from positive to negative over something trivial or even momentous. Instead, he saw everybody as a parental clone who would turn on him the same way his parents did when he made childish mistakes.

I could not convince him otherwise because his family actually did continue to reject him over nothing—by showing a clear preference for his brothers and sisters now, as they did then, and seamlessly, essentially from the day he was born.

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¹

recently was given your book as a gift and I must say that I find some parts of it very helpful to my situation. I have spent hundreds on counselors in the past few months and have not received any direction from them on understanding why I do the things