The relationship between psychopathy and personality disorders is actually a bit of a complicated one. Psychopathy can also be called psychopathic personality disorder, suggesting, of course, that psychopathy is a personality disorder; however, it is not listed as such among all the others in the Diagnostic and StatisticalManual of Mental Disorders, fifth edition (DSM-5) created by the American Psychiatry Association. The closest the DSM-5 gets is specifying a person with antisocial personality disorder as also a psychopath, but most researchers agree this isn't adequate. Many would argue that psychopathy needs its own diagnosis as a personality disorder separate from antisocial personality disorder. To make things more complicated, some people call those with antisocial personality disorder alone "psychopaths" but this is not accurate either (they would typically be known as sociopaths. Read Psychopath vs. Sociopath: What’s the Difference?).

What Is a Personality Disorder?

According to the American Psychiatric Association, personality disorders are "associated with ways of thinking and feeling about oneself and others that significantly and adversely affect how an individual functions in many aspects of life." (The Psychopath Brain: Is It Different From A Normal Brain)

Personality disorders tend to develop during childhood and adolescents but aren't typically diagnosed until adulthood (although underage youth can be diagnosed with specific personality disorder traits). In the case of psychopathy, it is considered a personality disorder as psychopathy's biggest characteristics are part of an individual's personality, namely: narcissism (Are narcissists psychopaths?), lack of empathy, lack of deep connections with others, lack of guilt, superficial charm, dishonesty, manipulativeness, reckless risk-taking and antisocial behaviors.

What Is Antisocial Personality Disorder and How Does It Relate to Psychopathy?

Antisocial personality disorder is defined in the DSM-5 as a pervasive pattern of disregard for and violation of the rights of others and the rules of society. As stated, this diagnosis cannot be given to non-adults but the following features must be exhibited before age 16 to qualify for the antisocial personality disorder diagnosis:

• Repeated violations of the law
• Pervasive lying and deception
• Physical aggressiveness
• Reckless disregard for safety of self or others
• Consistent irresponsibility in work and family environments
• Lack of remorse

Looking at the diagnostic criteria, it's clear that if one meets the criteria for a psychopath then one also meets the criteria for antisocial personality disorder. In other words, all psychopaths could be said to have antisocial personality disorder but all those with antisocial personality disorder are not necessarily psychopaths. This may be why, in the DSM-5, psychopathy is an optional secondary identifier for those with antisocial personality disorder.

Those who are psychopaths tend to have more symptoms and more severe versions of those psychopathic symptoms than those with antisocial personality disorder alone. For more information on the specific symptoms of psychopathy, please see: Does a Psychopath Test Exist? Diagnosing the Psychopath.

article references

A narcissist is a person who has narcissistic personality disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) whereas a psychopath (definition of psychopath) is a different diagnosis entirely and is usually judged based on the 20-item Hare Psychopathy Checklist (Does A Psychopath Test Exist). However, psychopaths are known narcissists, so are narcissists psychopaths as well?

What Is a Narcissist?

Narcissists suffer from narcissistic personality disorder and it is defined in the fifth edition of the DSM (DMS-5). Narcissists are characterized by a pervasive pattern of grandiosity (either in fantasy or in behavior), a constant need for admiration and a lack of empathy. Narcissism must be present by early adulthood and present itself in various context. Five of the following nine criteria must be met for a diagnosis of narcissistic personality disorder:

• A grandiose sense of self-importance
• A preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
• A belief that he or she is special and unique and can only be understood by, or should associate with, other special or high-status people or institutions
• A need for excessive admiration
• A sense of entitlement
• Interpersonally exploitive behavior
• A lack of empathy
• Envy of others or a belief that others are envious of him or her
• A demonstration of arrogant and haughty behaviors or attitudes

What Is a Psychopath Compared to a Narcissist?

According to the Society for the Scientific Study of Psychopathy, narcissism is an interpersonal symptom of psychopathy. Indeed, symptoms of narcissism like grandiosity, exploitive behavior and a lack of empathy are common in psychopaths. A psychopath could, and likely would, easily fit the diagnosis for narcissistic personality disorder as well, therefore, psychopaths are narcissists. (Relationship Between Psychopathy and Personality Disorders)

Are Narcissists Psychopaths?

However, just because there is some crossover and a person fits the criteria for narcissistic personality disorder does not mean that he or she is also a psychopath. In order to be considered a psychopath, many other psychopathic symptoms such as a lack of attachment to others, superficial charm, dishonesty, manipulativeness and reckless risk-taking come into play. Certainly, psychopathic narcissists exist, but they are not the norm.

article references

Famous people with avoidant personality disorder experience the same extreme shyness, fear of rejection, and feelings of inadequacy as the typical person who suffers from the condition (Symptoms of Avoidant Personality Disorder). Not many celebrities or otherwise famous people with mental illnesses step forward and publicly admit it.

But they should.

When well-known people with mental disorders speak openly about their illnesses, it helps reduce mental health stigma and encourages other people to step up and seek help for their own issues.

Despite the reluctance of many to speak up, a couple of courageous celebrities with avoidant personality disorder (APD) have: Actress Kim Basinger and singing superstar, Donny Osmond.

Kim Basinger. You may know this beautiful and talented actress from one or more of the many movies in which she starred: The Natural, 9 ½ Weeks, Never Say Never Again, LA Confidential and many more. Basinger talks openly about her APD and reflects on the intense fear she felt when asked to read in front of her class as a child. She also talks about the effects of her disorder and how she copes in interviews about the HBO movie Panic: A movie about coping.

When she accepted her Oscar award for the movie LA Confidential, she revealed that she didn't know what to say even though she had rehearsed a speech for a few days before. She has been in therapy, the primary treatment for avoidant personality disorder, which helps her better cope when required to socialize with others.

Donny Osmond. During an interview back in 2000, Osmond admitted that he had been diagnosed with avoidant personality disorder and talked about his intense fear of going on stage. He said that even though he appeared on stage with his family and, later, alone as a teenager countless times, he experienced debilitating fear and anxiety each time right before walking on. He revealed that at one point, he was so intensely fearful that if given a choice to go on stage or die, he would have chosen death. He narrated a documentary about severe social anxiety called Afraid of People.

Other Famous People with Avoidant Personality Disorder

It's difficult to identify other famous people with avoidant personality disorder because no other celebrities have publicly revealed they suffer from it. Here are a couple of deceased celebrities whose behaviors indicate they might have had APD:

Michael Jackson –Jackson was an iconic pop star who lived as a virtual recluse. He wore masks and disguises when going out in public and didn't seem to enjoy public attention the way many stars do. He built an amusement park on his property so he could go there without encountering the crowds at public parks. People who knew him reported that he was painfully shy. Jackson died in 2009 of a medication overdose.

Glenn Gould. A renowned Canadian pianist, Gould began composing at age five. He lived as a recluse and preferred to "interact" with people through his piano compositions. Friends describe him as shy and kind. He died of a stroke in 1982.

In reality, there probably aren't too many other famous people with avoidant personality disorder, since becoming a celebrity requires people to interact with the public via stage, in person, on film, live radio, etc. Regardless, it's empowering for both celebrities and their fans to go public with their struggles with mental illness.

article references

Living with borderline personality disorder (BPD) isn’t easy. It’s common to feel helpless when dealing with the intense emotions, emptiness, anger, and other symptoms of the disorder. The symptoms of BPD can impact every aspect of your life. But even with the suffering and chaos this condition causes, many people learn ways to cope and increase quality of life.

How Living with Borderline Personality Disorder Impacts Your Life

You've probably been living with borderline personality disorder since adolescence or early adulthood and can see that it has affected every part of your life. You may notice the negative impact of your disorder in the following areas:

Career. Work, hobbies, and school give people a way to improve themselves and pursue a fulfilling purpose in life. Borderline personality disorder interferes with educational and professional success. You may find that you have a pattern of relationship problems with teachers, coworkers, your boss, or other people in authority. You may feel as if you can't function during some of the intense emotional episodes arising from your BPD, causing you to miss unacceptable amounts of work or school. Consequently, you may have trouble holding down a job or being successful in educational pursuits.

Relationships. A pervasive and consistent pattern of interpersonal conflict and instability represents a key symptom of BPD. This means you will likely have great difficulty forming and keeping stable and lasting relationships of almost any kind. Like others with the disorder, you probably experience a significant amount of conflict with friends and loved ones. (Read about borderline personality disorder relationships.)

People without BPD do not dramatically change their feelings and perceptions about friends and loved ones in a flash. If you have untreated BPD (borderline personality disorder treatment information), you may not be aware that your pattern of rapidly changing views about those around you isn't normal and that it's destructive when it comes to forming stable relationships.

This erratic behavior causes a great deal of stress for those who might otherwise want a relationship with you, causing them to distance themselves from you. This can further reinforce your unclear sense of personal identity and contribute to feelings of loneliness and emptiness. (Learn about BPD and romantic relationships.)

Legal. Living with borderline personality disorder that's untreated can lead to legal problems. Your unregulated anger and aggression may lead you to assault others, throw things, or destroy the property of others. You may engage in impulsive behavior like shoplifting, reckless driving, illegal drug use, and other activities that could lead to arrest and, thus, legal issues.

Effectively Dealing with Borderline Personality Disorder

You can take concrete steps to help you in dealing with borderline personality disorder. Following these suggestions could increase your quality of life and lead to a more fulfilling future. Steps you can take to cope with BPD are:

• Seek professional help – This is the most important step. Borderline personality disorder is a serious illness. The intense inner experience, distorted thought patterns, and resulting negative behaviors are not things that you should try to handle by yourself. An experienced psychologist or psychiatrist will have a number of effective therapeutic techniques that can help, including Dialectical Behavior Therapy (DBT) for borderline personality disorder. All it takes is a strong commitment from you to get better. Take this first step toward living a better life and get help.
• Educate yourself – Step away from any shame you may feel about your disorder and educate yourself about it. When people get a diagnosis of diabetes or heart disease, they don't hide in shame, they learn all they can about their illness so they can take an active part in recovery. You should do the same. Check out books from the library, read authoritative information online (like the information you find here at HealthyPlace) and talk to others with BPD.
• Create a safety net – People with BPD experience a wide range of very intense and painful emotions on a daily basis. Sometimes these extreme emotions change from hour-to-hour. This can put you at risk for suicidal thoughts and ideation. Your plan should outline what you will do in the event of a crisis. You need to know what steps you will take if you feel the urge to hurt yourself or someone else. You might plan a quick route to a nearby emergency room; have your therapist's direct line on hand; plan to call a suicide hotline or other psychiatric helpline. Have these numbers programmed into your phone and keep it with you at all times.
• Build a support network – Ask your therapist about local BPD support groups that you can join, so you can connect with others who truly understand what it's like to live with the disorder. Your doctor may want you to attend a therapist-led group at first. Then, when you've made progress, he or she can put you in touch with a less formal, client-led group.
• Exercise and take time to relax – It's critical that you actively care for yourself. Good self-care can help stabilize your emotions and put you in a better position to cope in appropriate ways when things get tough. Set up a routine to ensure you get regular exercise, eat healthy meals, and get enough sleep. You might also practice relaxation techniques, such as meditation or yoga.

When it comes to mental health, knowledge and action save the day. Learn all you can, actively seek professional help, and take steps to ensure your safety during a crisis. Living with borderline personality disorder doesn't have to mean a lifetime of emotional agony and failure. By taking steps toward change, you can live a happier and more fulfilling life.

article references

Experts liken borderline personality disorder relationships to a roller coaster ride, but not the entertaining kind you go on at Six Flags or Disney World. BPD relationships of any kind are intense, chaotic, and full of conflict, but this is especially true for intimate relationships.

People with borderline personality disorder have severe issues with interpersonal relationships, whether they are romantic (BPD and Romantic Relationships), casual, or professional. These issues result in the chaos and upheaval that punctuate the inner and outer experience of the person with the disorder.

Please note, even though BPD affects men about as often as women, far more women are diagnosed with the condition. For this reason, and in the interest of simplicity, this article will use the pronouns “she” and “her” throughout.

Evolution of Borderline Personality Disorder Relationships

How do borderline personality disorder relationships evolve? They usually start out with excitement and fun, but end in turmoil and pain, leaving the non-BPD partner deeply hurt and confused.

Given this reality, why begin dating someone with borderline personality disorder in the first place?

First, understand that many people with BPD are kind, caring individuals with a lot of positives to offer in a relationship. That said, people are most frequently drawn to individuals with the disorder because of the initial excitement and passion they bring to a relationship. These relationships go through an intense honeymoon period – one in which the BPD partner puts you on a pedestal, claiming that she has found the perfect match. What she's really looking for is someone to rescue her from the emotional agony and chaos plaguing her inner life.

It's exciting and flattering for someone to feel so intensely about you. It makes you feel needed and purposeful. People who have been in these relationships often report incredibly passionate and exciting sex. But, once the short-lived honeymoon phase begins to fizzle out, problems start to emerge. It's during this phase that your partner begins to see that you are not, indeed, flawless. Her idealized view of you comes tumbling down. Since individuals with borderline personality disorder tend to see things in black and white (one of the symptoms of BPD), she may have trouble validating the fact that everyone makes mistakes and then forgiving you for yours.

Despite these disruptive cycles, it is possible to make these relationships work. It simply takes a generous amount of commitment, patience, and understanding to pull it off. At this point, you've got to step back and decide whether you're willing to go all in and do whatever it takes.

How To Deal With Someone With Borderline Personality Disorder

Once you've decided to move forward with the relationship, the next step involves learning how to deal with someone with borderline personality disorder.

1. Learn all you can about the disorder by reading up on symptoms, triggers, possible causes, and treatments.
2. Insist that your significant other seek borderline personality disorder treatment. Take steps to help her find a psychiatrist or psychologist with experience in treating BPD.
3. Find a counselor for yourself who understands the disorder and who can help you cope during times of crisis with your partner.

When you move past just dating and are living with someone with borderline personality disorder, following these suggestions may help bring a modicum of peace and order to the relationship:

1. Do what you say you'll do. Whatever you've told your significant other you'll do, do it. If you've told her you won't do something, don't do it. It's that simple. Staying consistent and predictable will help assuage her intense and excessive fear of abandonment. The best rule of thumb here is to keep your word. Sometimes, despite your best efforts, you still end up the target of a tearful meltdown; don't get sucked into the drama.
2. Give honest, gentle feedback. If she comes home and tells you about how her boss or coworker treated her unfairly at work, don't affirm her beliefs unless you believe her perception is accurate. People with borderline personalities often don't have any inkling about how their behavior impacts others. So, give honest feedback. You might say something like, "I know it sucks to get passed over for a promotion. I'm so sorry it made you feel so awful." That's a true statement and remains true regardless of what really happened. It does suck to get passed over!
3. Don't play the rescuer. Encourage your loved one to take responsibility for her choices and actions. If she overspends and now can't afford that day at the nail salon, don't pony up the money for that manicure.
4. Don't play into arguments. Since people with BPD have trouble with self-identity and self-awareness, they also frequently think comments are pointed at them, when, in fact, they are not. Bring home flowers, and she may wonder if you're cheating. Give a compliment about something she did, and she may say you're secretly making fun of her efforts. If your loved one misinterprets something you've said, you may bear the brunt of a raging fit about how disgusting and judgmental you are. Don't get involved. Explain your true intentions and stay calm.

It sounds exhausting and sometimes the struggle leaves you feeling powerless and defeated. When you feel this way, focus on the positive aspects and good days in your relationship. Whether you're just dating, or are in a borderline personality marriage, making the relationship work won't be easy, but it can be done.

article references

Wondering about famous people with borderline personality disorder? Not many celebrities or otherwise famous folks come right out and admit to having a personality disorder or other mental illness. But when they do, it helps reduce the stigma and may encourage the not-so-famous who suffer from the illness to seek help. One brave football superstar, Brandon Marshall, publicly announced that he has borderline personality disorder back in 2011. Marshall even started a foundation to raise awareness about mental health and increase dialogue about mental illness. His courage in coming forward with his own struggles will likely inspire countless other people to seek help for theirs.

Armchair Psychology – Famous People With Borderline Personality Disorder

While it's impossible to actually diagnose famous people with borderline personality disorder from our living room sofas, the behavior of certain celebrities definitely shows they have symptoms of borderline personality disorder and may be dealing with BPD. Celebrities with borderline personality disorder, based on behavioral observations and without an official diagnosis, include:

1. Amy Winehouse

• Self-Injury
• Shame
• Volatile relationships
• Substance abuse
• Impulsive
• Suicidal
• Eating disorder

2. Pete Doherty

• Impulsive
• Shame
• Excessive anger
• Volatile relationships

3. Britney Spears

• Excessive anger
• Mood swings
• Reckless behavior (i.e. driving)
• Substance abuse
• Eating disorder

4. Courtney Love

• Substance abuse
• Excessive anger
• Shame
• Self injury
• Possible eating disorder

5. Lindsey Lohan

• Reckless behavior (i.e. driving)
• Substance abuse
• Eating disorder
• Promiscuous sex
• Self injury

6. Princess Diana

• Eating disorder
• Mood swings
• Reckless behavior
• Substance abuse
• Possible self injury

7. Angelina Jolie-Pitt

• Self injury
• Volatile relationships
• Sexual confusion
• Eating disorder

There might be many more celebrities with borderline personality disorder and other mental health issues. One can only hope that some of them will follow Brandon Marshall's lead and come forward, offering hope and encouragement to others who suffer in silence and who want to seek borderline personality disorder treatment.

article references

Treatment for avoidant personality disorder (APD) is challenging because the patient must open up and trust the therapist for it to work. People with avoidant personality disorder are reluctant to trust anyone, making it difficult for the therapist to establish a strong working relationship. Despite the challenge, a committed client and compassionate therapist can often develop a relationship that has a satisfactory level of trust around which therapy can begin and, hopefully, deal with the avoidant personality disorder symptoms and related problems.

Therapy Primary Avoidant Personality Disorder Treatment

Avoidant personality disorder treatment usually involves long-term psychotherapy led by a clinician with specific experience in treating the disorder. Treatment typically moves slowly at the beginning because people with avoidant personality disorder have a tendency to distrust others .The therapist may also prescribe medications to help reduce the influence of certain symptoms, such as anxiety and depression.

Common avoidant personality disorder treatment approaches include:

Psychodynamic therapy – With this approach, the therapist actively empathizes with the client's painful inner experience to build the trust relationship. The goal of this approach involves helping the client develop a keen and accurate sense of self-awareness. The therapist then assists the client in identifying unconscious thought processes that influence his or her daily behavior. Through this process, the client can examine and find closure for conflicts and painful emotions stemming from past dysfunctional relationships. The therapist will then use talk therapy to guide the client in seeing connections between his or her deep personal shame and how it affects social and interpersonal functioning.

Cognitive behavioral therapy (CBT) – The CBT approach assumes distorted and inaccurate thinking patterns create the foundation for avoidant personality disorder. The therapist will use CBT techniques to change the distorted thought patterns by examining and refuting the truth of the assumptions surrounding them.

For instance, suppose a client strongly believes he is inferior to others and that others would not like him or value his company. The therapist would test the validity of his belief by asking him to name some friends who do enjoy spending time with him. The therapist might also ask the client to talk about past social experiences that he enjoyed. In this way, the doctor shows the client that people do enjoy his company and that social activities can be fulfilling and fun. This illustrates, at least in one way that his fear and insecurity about social situations are irrational and unfounded. This represents a simplistic example of a technique used in CBT called cognitive restructuring.

Talk therapy – Talk therapy is a therapeutic approach wherein the clinician leads the client in conversation about his or her experiences, attitudes and behaviors. It can be incorporated into any therapy approach. By maintaining a conversational dialogue about his or her fears, shame, and insecurities, a client learns to be less sensitive to criticisms and rejection. Therapists use talk therapy in both individual and group therapy settings.

Group therapy – Most therapists would recommend waiting until the client has made some progress toward recovery before putting him or her in a group therapy environment. But for the client who is ready, group therapy can give the avoidant personality a positive social experience and help them accept feedback in a safe and controlled setting.

Successful avoidant personality disorder therapy requires a commitment for the long-term. It can be expensive, but it's worth it if it helps the client function better in social and other situations where he or she must interact with others.

Avoidant Personality Disorder Medications

Although specific avoidant personality disorder medications do not exist, doctors often prescribe antidepressants or anti-anxiety medications to reduce the intensity of some of the more debilitating APD symptoms. These symptoms often arise due to co-occurring conditions, such as clinical depression or anxiety. Alleviating the effects of these others disorders, while treating the personality disorder, may increase the chances of a successful outcome.

Avoidant Personality Disorder Prognosis

With compassionate and continued treatment, avoidant personality disorder prognosis is fair to good. People can develop the ability to function in more fulfilling ways in social situations and at work by sticking to the therapist's treatment plan and instructions.

article references

Avoidant personality disorder symptoms first appear in childhood, but often don't seem out of the ordinary until late adolescence or early adulthood. Most children show some fear and shyness when confronted with new people and circumstances; and these behaviors do not necessarily mean that they will eventually develop avoidant personality disorder. It's only when these behaviors persist and continue into adulthood that they become troublesome.

Avoidant Personality Disorder Symptoms Profoundly Troublesome

Avoidant personality disorder symptoms and behaviors have a deeply negative impact on the lives of those suffering from the condition (this includes celebrities and famous people with avoidant personality disorder)

Individuals with avoidant personality disorder may the following symptoms:

• Experience excessive emotional pain when others disapprove of them
• Avoid intimate relationships, fearing shame and ridicule
• Have only one or two close friends, if any at all
• Avoid casual interactions and social contact
• Avoid social activities or jobs that involve significant contact with others
• View potential challenges with excessive pessimism
• Exhibit extreme shyness and inhibition in social situations
• Perceive him- or herself as inferior to others, socially inept, and unattractive
• Be preoccupied with fear of criticism and rejection

You may spot an individual with symptoms of avoidant personality disorder in a number of situations. For example, a person you know may go to a work-sponsored party or school dance, but remain in a corner of the room either alone or chatting with one to three people he knows well. If you have seen this individual dance and socialize at other parties, it's probably just an isolated incident. But if you see this scenario occurring over and again in social situations with this person, he may be showing signs of avoidant personality disorder.

Alternatively, imagine a woman you know is always reluctant to attend social activities that you think she would enjoy. The only way you can get her to even consider participating is by offering repeated encouragement and support that reassures them the others there will accept her. Even while at the event, she may misconstrue innocent comments from others as thinly veiled criticism, requiring you to constantly offer up reassurances that they meant nothing negative by what they said. If nothing else, this woman clearly has a severe lack of self-confidence. If this is a pervasive pattern across every aspect of her life, she probably needs to see a mental health professional for an assessment.

Some of the other characteristics of avoidant personality disorder are more difficult to spot because they occur within a person's inner experience. The constant fretting over real and perceived shortcomings and internal planning about how to avoid embarrassment and rejection aren't obvious to others. Certainly, the intense emotional pain a person with avoidant personality endures when he or she experiences real or perceived rejection isn't readily visible. You may notice the person crying or with her head in her hands, but most likely she will grieve over the incident alone.

Diagnosis of Avoidant Personality Disorder

Only a mental health professional, such as a psychologist or psychiatrist, can give a diagnosis of avoidant personality disorder. The clinician will conduct a comprehensive psychological evaluation to assess the history and severity of symptoms.

He or she will compare symptoms and other findings to the diagnostic criteria for avoidant personality disorder laid out in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM 5). If enough criteria are met, the client will receive a positive diagnosis for the condition.

Once the client receives a definitive diagnosis, the doctor can begin to develop a treatment plan that fits the client's individual needs and help relieve the avoidant personality disorder symptoms.

article references

People with avoidant personality disorder (APD) have a lifelong, deeply ingrained pattern of extreme shyness, extreme sensitivity to rejection, distrust of others, and deep feelings of inadequacy. Those suffering from the disorder try to avoid social situations and close relationships due to their excessive fear of rejection. They actually want to have relationships and participate in fun social activities, but lack the confidence and interpersonal skills they need to succeed in these situations. All this makes avoidant personality disorder treatment very challenging.

What Is Avoidant Personality Disorder

To answer the question -- what is avoidant personality disorder – it's important to first understand what it is not. Avoidant personality disorder is not the typical shyness or social awkwardness we all feel at times. Everyone lacks confidence or feels inadequate in some isolated situations. Those with avoidant personality disorder constantly deal with these feelings in the extreme and have likely done so since childhood or early adolescence. Their intense fear of rejection has no obvious basis and stems from distorted thought patterns. (Read about famous people with avoidant personality disorder.)

Avoidant personality disorder is a severe mental health condition that permeates every aspect of a person's life. People suffering from it cannot stop dwelling on their own perceived shortcomings. They rarely form relationships, but when they do, they only interact with people they strongly believe will not reject them. Rejection and embarrassment are so intensely painful for people with avoidant personality that they choose loneliness rather than take the risk. The following features define avoidant personality disorder:

• Negative emotion – intense anxiety, fear of rejection and embarrassment
• Detachment – social withdrawal, intimacy avoidance, diminished ability to experience pleasure
• Permeate all situations – behaviors occur at home, work, and in community
• Significant distress and impairment - in social, work, or other daily life activities
• Early onset – behaviors appear no later than early adulthood (i.e. 20s)

Causes of Avoidant Personality Disorder

Researchers don't have a clear understanding about the causes of avoidant personality disorder. Most experts believe development of the disorder is influenced by a combination of genetic, social, and biological factors. People who have certain genetic profiles or an illness that changes their appearance may be at greater risk for developing the condition.

Many individuals with the disorder have endured painful childhood experiences involving brutal parental criticism and rejection. Children naturally want to bond with their parents, but due to the constant parental rejection and ridicule, it's virtually impossible for a healthy bond to form. This leaves these children hungry for close relationships, yet lacking the skills to form and maintain them.

They begin to develop a protective psychological shell that shields them from further parental ridicule and rejection. The resulting social awkwardness may cause peers to tease and ridicule them as well, contributing to the intense fear of social interactions. Reports on avoidant personality disorder statistics suggest that about 1 percent of the U.S. population suffers from the condition and it appears just as frequently in males as in females.

People who think they may suffer from this mental health condition should seek help from a psychologist or psychiatrist. The clinician will compare symptoms, behaviors, and history to avoidant personality DSM criteria and make a diagnosis. With long-term treatment, typically talk therapy combined with psychotherapy, people with the disorder can often develop some ability to relate with others and engage socially.

article references

Have you ever said "I"m no good at relationships"? Here are some reasons you may feel that way and ways to improve your relationships.

Common Questions About Relationships, And Some Answers

I've never been very good at relationships, of any kind. I don't even know how or where to begin.

Relationships begin with you, because you are half of any relationship you join. So start with yourself! Don't count on a relationship to "cure" a poor self-image. It won't work. But here are some measures that can:

• Make an inventory of your best, most attractive qualities and affirm them to yourself often.
• Avoid unrealistic standards and all-or-nothing thinking: "If I don't make an A on every test, I'm a total failure."
• Challenge yourself to accept and absorb compliments: a simple "thank you" raises self-esteem; negations, such as, "You like this outfit? I think it makes me look dumpy," lower self-esteem.
• Remember that there are no guarantees. Making gains requires taking risks. Seek out new experiences and people; then approach them with openness and curiosity. Each is an opportunity.
• Don't expect overnight success. Close friendships and intimate love relationships both take time to develop.

I don't think I have a poor self-concept. I feel pretty good about myself. But this is a big city, and it's easy to get lost in the crowd. How do I go about meeting people?

Your question implies that you see meeting people as something which requires effort, and you're right! No matter how stunningly attractive you may be, passively waiting for others to throw themselves your way not only doesn't work very reliably, it doesn't allow you to be very choosy. Here are some common-sense approaches which you may find helpful:

• The best way to meet people is to put yourself in places where there are likely to be other people who share your interests and values: classes, ticket lines at sporting or cultural events, cashier lines at stores and restaurants, and workshops. And join an organization! Check with various organizations for information on groups based on religion, athletics, academics, political/special interests, ethnicity/culture, and service or charity.
• Once you're with people, initiate a conversation by: asking a question, commenting on the situation, asking for or offering an opinion, expressing some interest, showing some concern, or offering or requesting help.
• Once you've engaged someone in conversation, let him or her know you're listening and interested. Make eye contact, adopt an open posture, reflect the feelings you hear, paraphrase what he or she is saying, and ask for clarification if you don't understand.
• And, again, remember: no risks, no gains. Don't be discouraged if you and the other person don't "click" first and every time.

One thing that's difficult for me in relationships is "hanging on to myself." It seems that once I get close to someone -- roommate, friend, or lover -- I give in and accommodate so much that there's nothing left of me.

It's hard to experience fulfillment in a relationship which is not equal and reciprocal. The best way to avoid "giving yourself up" in a relationship is to develop some assertiveness skills. Learn how to express your feelings, beliefs, opinions, and needs openly and honestly. Here are some guidelines:

• When stating your feelings, use "I-statements." Avoid accusatory or blaming "you-statements." They usually only result in defensiveness and counterattacks.
• You have a right to have feelings and to make requests. State them directly and firmly and without apology.
• Acknowledge the other person's point of view, but repeat your request as many times as necessary.
• Learn to say "no" to unreasonable requests. Offer a reason -- not an excuse -- if you choose, but your feelings are reason enough. Trust them.

Won't I lose my friends and lovers if I always insist on getting my own way?

Assertiveness is not about always getting your way. Nor is it about coercing or manipulating. Those are acts of aggression. An assertion does not violate another's rights, and it does not preclude compromise. But a compromise, by definition, meets the needs of both people as much as possible. If your friend or lover is unwilling to compromise or has no respect for your feelings, maybe there's not so much to lose.

My romantic partner and I seem to be coming from different worlds sometimes. It's pretty frustrating. What can we do about it?

It's normal for relationship partners to have different needs in at least few areas, such as: spending time with others vs. spending time with each other, wanting "quality time" together vs. needing time to be alone, going out dancing vs. going to a ballgame, etc. Differing needs don't mean your relationship is coming apart, but it is important to communicate about them to avoid misunderstandings.

• Tell your partner directly what you want or need ("I would really like to spend time alone with you tonight"), rather than expecting them to know already ("If you really cared for me, you would know what I want").
• Set aside time to discuss unresolved issues: "I'm feeling uncomfortable about...and would like to talk about it. What time is agreeable to you?" Pouting, sulking, and the "silent treatment" don't make matters any better.
• Inevitably you and your partner will have conflicts, but they needn't be nasty. Here are some tips for "Fair Fighting":
  • Use assertive language.
  • Avoid name calling, or intentionally calling attention to known weaknesses or sensitive issues ("hitting below the belt").
  • Stay in the present, don't dwell on past grievances.
  • Listen actively - express back to your partner what you understand his/her thoughts and feelings to be.
  • No "gunnysacking" (saving up hurts and hostilities and dumping them on your partner all at once).
  • If you are wrong, admit it!

Even when we're communicating well in other areas, my partner and I often get bogged down when it comes to talking about sex. I often feel we have very different expectations in this area.

First of all, it is important to be aware of your own feelings: how you feel about your partner, how comfortable you feel in his or her presence, what does and doesn't feel comfortable or desirable in terms of physical closeness or sexual contact. Trust your gut feelings.

• Communicate what YOU really want sexually. Express what you enjoy and also what you are not comfortable with.
• Communicate clearly to your partner/date what your limits are. Be prepared to defend your limits. If you mean No, then say "No," and don't give mixed messages. You have the right to be respected and you are NOT responsible for your partner/date's feelings or reactions.
• Both partners have a responsibility in preventing unwanted sexual contact. Men must recognize that no means no, regardless when she says it, and regardless whether you think she is saying "yes" nonverbally. If a person says "no" and is still coerced or forced into having sex, then a rape has occurred.
• If you feel unsafe, leave the situation immediately - fifty to seventy percent of rapes are perpetrated by an acquaintance of the victim.

I hear a lot about "co-dependency" in relationships. What exactly is that?

Co-dependency originally referred to the spouses or partners of alcoholics and the ways they attempt to control the effects of the other person's dependency on alcohol or drugs. More recently, the term has been used to refer to any relationship in which one person feels incomplete without the other and thus tries to control him/her. Some characteristics of co-dependency are:

• Fear of change or growth in the other person.
• Looking to the other person for affirmation and self-esteem.
• Feeling unsure where you end and the other person begins.
• Exaggerated fear of abandonment.
• Psychological games and manipulation.

A healthy relationship is one that allows for the individuality and growth of both persons, is open to change, and allows both individuals to express their feelings and needs.

A lot of your answers seem to assume we're talking about heterosexual relationships. What about same-sex relationships? Do the same principles apply?

All humans have the same needs for love, safety, and commitment. Gays, lesbians, and bisexuals are no different. All evidence suggests that same-sex attraction, while rarer than other-sex attraction, is simply a different orientation, not a "perversion," anymore than being blue-eyed or left-handed (also relatively rare) are "perversions." But there are some differences:

• Since both partners are of the same sex, the characteristics of that gender may be exaggerated in the relationship. Sometimes that can be very nice. Other times it can be experienced as a problem.
• Partners in same-sex relationships must deal with the stress of homophobia, society's widespread fear and condemnation of their sexual orientation. Feeling unable to be open about one's relationship with friends, colleagues, and family can leave the same-sex couple isolated and deprived of a support network.
• Homophobia can also affect the self-esteem of same-sex partners, making the normal ups and downs of a relationship all the more difficult.
• Finally, homophobia can affect non-romantic same-sex relationships. For instance, two female friends, two brothers, or even fathers and sons, may feel reluctant to express their affection and caring for each other for fear of being thought gay.

Why do gays and lesbians stay hidden so much? One of my friends didn't tell me he was gay until after I had known him a full year.

• Many gays and lesbians do stay hidden for much or all of their lives, and given the prevalence of homophobia, it's easy to see why. But other same-sex oriented people, on this campus and all over the world, have made the decision to be themselves boldly and openly, in the belief that that is the best way to counteract stereotypes and discrimination.
• Your friend may not have felt certain of his sexual orientation when he first met you, or he may have just decided to do you the honor of trusting you to be a part of his "coming out," or his process of acknowledging, accepting, and disclosing his gayness. Ask him about it. He'll probably appreciate your sincere interest.

What about bisexuals? Are they for real, or just very confused?

For a long time, bisexuals were thought to be confused, "half-and-half" people. But there is growing recognition that while some people who think of themselves as bisexual may be in a transition towards one orientation or the other, many genuinely feel a strong attraction towards people of both genders. They're not so much "half" as "both" - they feel no confusion, and have no desire to change.

I hate ending relationships. And breaking up with romantic partners never seems to go well.

Saying goodbye is one the most avoided and feared human experiences. As a culture, we have no clear-cut rituals for ending relationships or saying goodbye to valued others. So we are often unprepared for the variety of feelings we experience in the process. Here are some guidelines many people find helpful:

• Allow yourself to feel the sadness, anger, fear, and pain associated with an ending. Denying those feelings or keeping them inside will only prolong them.
• Recognize that guilt, self-blame, and bargaining are our defenses against feeling out of control, feeling unable to stop the other person from leaving us. But there are some endings we can't control because we can't control another person's behavior.
• Give yourself time to heal, and be kind to yourself for the duration: pamper yourself, ask for support from others, and allow yourself new experiences and friends.

I seem to get into the same pattern in all my relationships. I get afraid of losing my partner; then we get into a big argument and break up in anger. Sometimes I even think I may have picked a fight just because I'm scared to keep the relationship going. Does this make any sense?

Yes, it makes a lot of sense, and congratulations on recognizing a pattern. That's the first step towards change. People get into a variety of painful or "dysfunctional" patterns in relationships. Often, those patterns are based on old fears and "unfinished business" from childhood.

If you feel "stuck" in a pattern and unable to change it, talking to a professional counselor may help.