My name is Sam Vaknin. I am the author of Malignant Self-Love, Narcissism Revisited.

People suffering from avoidant personality disorder feel inadequate, unworthy, inferior, they lack self-confidence.

As a result, they are shy and socially inhibited.

Aware of their real and often imagined shortcomings, avoidance are constantly on the lookout, they are hypervigilant and hypersensitive.

Even the slightest, most constructive and well-meant or helpful criticism of disagreement are perceived by avoidance as complete rejection, ridicule and shaming.

In this sense, people with avoidant personality disorder are exactly like narcissists, they endure narcissistic injuries continuously.

Consequently, avoidance go to great lengths to avoid situations that require interpersonal contact, such as attending school, making new friends, accepting a promotion or teamwork activities.

Inevitably, avoidance find it difficult to establish intimate relationships. They test the potential friend, mate or spouse, to see whether they accept them uncritically and unconditionally.

Avoidants continuously demand verbal reassurances that they are really wanted, really desired, loved or cared about. When asked to describe avoidance, people often use terms such as shy, timid, lonely, isolated, invisible, quiet, reticent, unfriendly, tense, asocial, risk-averse, resistant to change, reluctant, restricted, hysterical and inhibited.

Not a very palatable range of adjectives.

Avoidance is a self-perpetuating vicious cycle.

The avoidance’s stilted mannerisms, fears for her personal safety and security, and stifled conduct elicit the very ridicule and derision that he or she fears.

Even when confronted with incontrovertible evidence to the contrary, avoidance doubt that they are socially competent or personally appealing.

Rather than let go of their much cherished self-image, defective self-image, deformed, unrealistic, delusional, they sometimes develop persecutory delusions.

For instance, certain avoidance may regard honest praise as flattery and a form of attempted manipulation.

People with avoidant personality disorder ceaselessly fantasize about ideal relationships and how they would outshine everyone else in social interactions, but they are unable to do anything to realize their wall-to-meeting fantasies.

In public settings, avoidance tends to keep themselves to themselves, and they are very reticent. When pressed, they self-deprecate. They act overtly and overly modest. They minimize the value of their skills and contributions, as it borders on the narcissist’s false modesty.

By doing so, they are trying to preempt what they believe to be inevitable forthcoming criticism by colleagues, spouses, family members and friends.

The disorder affects 0.5 to 1% of the general population. Up to 10% of outpatients seen in mental clinics also suffer from avoidant personality disorder. It is often co-orbit diagnosed together with certain mood and anxiety disorders, with dependent and borderline personality disorders, and with cluster A personality disorders, paranoid, schizoid and schizotypal.

Now meet Gladys. Gladys is a woman diagnosed with avoidant personality disorder, and we will go through a simulated therapy session with her.

As I said, Gladys is female, she is 26, and she is diagnosed with avoidant personality disorder, and she says, I would like to be normal, says Gladys, and blushes.

In which sense is she abnormal, I ask?

Well, she says that she prefers reading books and watching movies with her elderly mother to going out with her colleagues to the occasional office party.

Maybe she doesn’t feel close to them, I suggest. How long has she been working with these people?

Well, eight years, says Gladys, in the same firm. And she adds, not one raise in salary, she blurts out, evidently hurts. Her boss bullies her publicly, and the searing shame of it all prevents her from socializing with peers, suppliers and clients.

Does she have a boyfriend? I must be mocking her, she responds. Who would date an ugly duckling, plain secretary like her?

I disagree wholeheartedly and in details with her self-assessment. I think that she is very intelligent. She half rises from her seat, about to go, then thinks better of it.

Please doctor, there’s no need to lie to me just in order to make me feel better.

I know my good sides, and they don’t amount to much.

If we disagree on this crit, crucial point, perhaps I should start looking for another therapist.

A glass of water and mounds of tissue paper latent, we are back on track.

She dreads the idea of group therapy. I’m a social cripple, she says. I can’t work with other people, she protects.

I decline the promotion to avoid working with the team. Her boss thought highly of her until she turned his offer down.

So in effect it’s all her fault, and she has earned the abuse that she is being subjected to on a daily basis.

Anyhow, he overestimated her abilities, capabilities and skills, she insists.

Why can’t she interact with her co-workers?

Well, she explains that’s precisely what we are supposed to find out, isn’t it?

She retorts. Everyone is too critical and opinionated. She can’t stand it.

She accepts people as they are, unconditionally, and why can’t they treat her the same way?

She fantasizes about getting married one day to a soulmate, someone who would love and cherish her, regardless of her blemishes.

I ask her to describe how she thinks she is being perceived by others.

She says shy, timid, lonely, isolated, invisible, quiet, reticent, unfriendly, tense, risk averse, resistant to change, reluctant, restricted, hysterical, and inhibited.

That’s quite the least I comment. How does she view herself?

The same, she largely agrees with people’s perceptions of her.

But he doesn’t give him the right to view her offense, it just means she says, glad she’s 26 years old, and avoidant.