Exploring The Relationship Between Avoidant Personality Disorder And Intimacy

Medically reviewed by Nikki Ciletti, M.Ed, LPC
Updated October 8, 2024by BetterHelp Editorial Team

Avoidant personality disorder (AVPD) often involves symptoms like low self-esteem, an intense fear of rejection, and more. Trouble with intimacy is another possible symptom that may lead individuals with AVPD to avoid expressing their thoughts, needs, and boundaries with friends or partners. Therapy can often help those with AVPD adjust their thoughts and beliefs to be more constructive, empowering them to improve their communication skills and relationships. 

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Connection is possible with avoidant personality disorder

What is avoidant personality disorder?

Avoidant personality disorder, sometimes called AVPD, is thought to affect around 1.5% to 2.5% of the population

The Diagnostic and Statistical Manual of Mental Disorders (DSM-V), a guide by the American Psychiatric Association, lists AVPD as a “cluster C” personality disorder. Cluster C personality disorders typically involve feelings of fear or anxiety that affect the ways people live their lives. Other examples of cluster C disorders include obsessive-compulsive personality disorder (OCPD, which differs from obsessive-compulsive disorder or OCD) and dependent personality disorder. 

Often starting early in life, AVPD typically involves extreme shyness and a fear of rejection. People with AVPD may go out of their way to avoid social situations or situations where they might be criticized or disliked. Common symptoms of AVPD may include the following:

  • Fearing humiliation, rejection, or criticism
  • Avoiding activities that involve significant interpersonal contact
  • Becoming easily embarrassed in social situations
  • Being afraid of making mistakes, especially when interacting with others
  • Having a sense of being “socially inept”
  • Having low self-esteem
  • Avoiding relationships
  • Needing reassurance that others won’t respond to them negatively

People with AVPD often desire emotional closeness and social connection. As a result, they may feel lonely or isolated when they avoid social situations. Social isolation has been linked to stress, sleep problems, and a higher risk of heart disease. Loneliness due to AVPD may also contribute to other mental health challenges, like depression, anxiety, and substance use disorder. 

What’s the difference between AVPD and social anxiety disorder?

You might notice some similarities between AVPD and social anxiety disorder (also known as “social phobia” or “SAD”). Like AVPD, SAD usually involves the fear of situations where one could be judged by others. Some common triggers of social anxiety include public speaking, talking on the phone, and using public restrooms. 

That said, there are a few differences between AVPD and SAD:

  • People with social anxiety disorder tend to avoid specific social situations, like talking to strangers or eating in public. People with AVPD may be more likely to avoid all social situations. 
  • People with AVPD may be more likely to have a negative view of themselves than people with social anxiety. 
  • People with social anxiety disorder may have more self-awareness regarding their anxiety. They may understand that their fears of judgment are unrealistic or overblown. On the other hand, people with AVPD may be more likely to believe they truly lack social skills. They may also be more likely to take criticism at face value. 
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It’s possible to be diagnosed with both social anxiety disorder and avoidant personality disorder. Past research has found that over 50% of people with social anxiety disorder may also meet the criteria for AVPD

Avoidant personality disorder and intimacy: What’s the connection?

Now that you understand avoidant personality disorder, you might wonder about the effects it can have on intimacy. While no two couples are the same, it can be common for AVPD to create challenges for couples. 

People with AVPD tend to struggle to be vulnerable with others and fear judgment in social situations. They may also have trouble getting close to people, which can be a barrier to pursuing intimate relationships. If they do, they may be extremely sensitive to rejection. In a 2023 literature review, researchers point out that AVPD tends to be linked to a lower likelihood of relationships.

For people with AVPD who enter relationships, intimacy can still be a challenge. The same 2023 paper notes that a common feature of AVPD is “restraint in intimate relationships in fear of ridicule.” People with AVPD may struggle to say what they really think or express their physical and emotional needs. These behaviors often stem from a fear of criticism and rejection, but they can lead to challenges in intimate relationships. 

For example, someone with AVPD might be less likely to communicate their boundaries to their romantic partner. As a result, their partner might unknowingly violate their boundaries, potentially leading to stress and resentment. 

Other possible intimacy-related challenges for people with AVPD include those listed below:

  • Avoiding emotional or sexual interactions out of fear of judgment
  • Having trouble expressing concerns or opinions
  • Being extremely sensitive to their partner’s body language, tone of voice, and other social cues
  • Avoiding having difficult conversations
  • Avoiding potential relationship conflicts
  • Being reluctant to share personal details, thoughts, and feelings with their partner
  • Having trouble relaxing around their partner

Challenges like these may make it harder to establish and maintain physical and emotional connections in a romantic relationship. 

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Connection is possible with avoidant personality disorder

Getting relationship support when you have avoidant personality disorder

Intimacy can be intimidating when you have AVPD, whether you’d like to be in a relationship or you’re in one already. That said, it may be possible to reduce your symptoms—including trouble with intimacy—with the right support. Studies have found that, with treatment, as many as 50% of people diagnosed with AVPD will no longer meet the criteria for the disorder after 10 years. That’s why, if you haven’t already, you may want to consider starting treatment. 

According to the National Library of Medicine, therapy is normally considered the most effective treatment for AVPD. For example, cognitive behavioral therapy (CBT) generally focuses on helping individuals change negative thoughts and beliefs that are affecting their behavior. This may be a helpful option if AVPD is creating challenges in your relationships. Working with a therapist may also help you manage any other mental health concerns you may be experiencing. 

If you struggle with social interactions due to AVPD, finding a therapist you can open up to might be a challenge. Online therapy may help. On platforms like BetterHelp, you can change therapists whenever you’d like, for any reason, which may make it easier to find one with whom you are comfortable working. 

Research shows that online therapy may benefit people living with AVPD. According to a 2022 study, online therapy may be an effective intervention for individuals with personality disorders. In addition, existing evidence suggests that online therapy can produce the same results as traditional face-to-face therapy.

Takeaway

Avoidant personality disorder, or AVPD, normally involves a fear of rejection and criticism. As a result, people with AVPD may avoid social interactions and be reluctant to start relationships. Those who do enter relationships may face challenges with intimacy, such as trouble expressing themselves and communicating their needs. These challenges can put a strain on couples. However, it may be possible to reduce AVPD symptoms and improve relationships with the help of a therapist, whether online or in person.
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