# the differences between Avoidant Personality Disorder and Social Anxiety Disorder



## Akira90125 (Jun 12, 2009)

from Martin Kantor's "Distancing: Avoidant Personality Disorder":

"In the realm of the mode of expression of the social anxiety, patients
with a Social Phobia express their social anxiety not directly but indirectly,
that is, symbolically. They pour it into interpersonal terror that appears
strictly in response to specific trivial social cues. Social phobics do not
withdraw from interpersonal relationships so much as they withdraw from
interpersonal situations-from discrete trivial prompts that symbolize interpersonal relationships-neatly packaged, tangible happenings that are
stand-ins for interpersonal upheavals. These upheavals are condensed
and externalized to become outwardly expressed holographic representations
of intense inner conflict. For example, a patient who fears urinating
in public or a patient who fears signing her name to a check while others
watch is expressing what are dynamically deep interpersonal fears of criticism
and rejection clinically in a condensed and displaced fashion. Examples
of social phobias each with their underlying meaning follow: A
phobia of blushing that signifies being criticized for turning red hot; a
phobia of eating in public that signifies being criticized for using the
mouth in situations where observed; a phobia of speaking in public that
signifies being exposed and vulnerable to humiliation; a phobia of urinating
in a public men's room that signifies exposing one's genitals to the man standing in the next urinal, in turn signifying vulnerability and castration
anxiety; and a phobia of signing one's name to a check while others
watch and wait in eager anticipation that signifies a fear of cooperating
and thus of being called submissive. In short, social phobics wall off and
contain their interpersonal fears of criticism and humiliation, in effect relegating them to short-lived pseudointerpersonal encounters that simultaneously refer to, and obscure, the real thing.

I believe that social phobics do this for a specific reason and purpose.
Unconsciously they make a choice to be less interpersonally shy, remote,
and withdrawn than avoidants, that is, to remain more interpersonally
outgoing and related than patients with AvPD. They desire and hope to
keep their whole personality out of it. So they involve only part of their
personality, doing so intentionally in order to leave the rest of the personality
intact. As a result, unlike many patients with AvPD, social phobics
are by nature outgoing, and able to form close and lasting relationships,
and even to do so easily. They tend to be happily and permanently attached
or married to someone, and they are often professionally quite successful. Their problems tend to consist merely of troublesome islets of
panicky withdrawal. This insular expression of social anxiety in turn
spares the rest of their lives, permitting full and satisfactory relationships
to take place on the mainland.

In contrast, patients with AvPD wear their faint avoidant hearts on their
sleeves. They present clinically with mild to severe generalized relationship
difficulties. They fear closeness and intimacy and commitment itself,
not a substitute, stand-in, or replacement for these. As a result, avoidants
are clinically more socially anxious and withdrawn than they are phobic,
that is, they present not with an encapsulated fear on the order of a fear
of public speaking but either with a generalized shyness that consists of
difficulty meeting people, or with an ambivalence about relationships that
consists of difficulty in sustaining relationships with people they have
already met. As a consequence, they are either painfully tentative about
seeking out relationships in the first place or, if not tentative, then ambivalent
about the relationships they find, so that they start relationships only
to then pull back from them."

you can download the book here: http://ebookee.org/Martin-Kantor-Di...ity-Disorder-Revised-and-Expanded_355123.html


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## Kon (Oct 21, 2010)

Akira90125 said:


> a phobia of speaking in public that signifies being exposed and vulnerable to humiliation; a phobia of urinating in a public men's room that signifies exposing one's genitals to the man standing in the next urinal, in turn signifying vulnerability and castration anxiety; and a phobia of signing one's name to a check while others watch and wait in eager anticipation that signifies a fear of cooperating and thus of being called submissive.


I don't agree that those phobias signify anything like that. At least it doesn't apply to me but I read of some people discussing the book and I did find the discussion of his 4 types interesting:

1. Shy/Social Phobic - socialize, but have trouble at social events 
2. Mingles - hang out alot and seem social, but have problems connecting with people 
3. 7 year itch type - they can only be in relationships for so long before they feel the need to bail 
4. Dependent/co-dependent - usually have dependent relationships with parents or significant others to avoid having relationships with other people


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## metamorphosis (Dec 18, 2008)

It's a thin line almost splitting hairs. There's always grey areas with two psychological disorders so closely related. I mean you can have overlapping symptomatology or fluctuate towards one or the other. Than the question arises; How important is it to unglue the two; that may be solved in the exact same way/meds/protocol/etc!!


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## Paul (Sep 26, 2005)

Akira90125 said:


> a phobia of urinating in a public men's room that signifies exposing one's genitals to the man standing in the next urinal, in turn signifying vulnerability and castration anxiety


So this guy is seriously saying that socially anxious people secretly fear someone in the men's room coming after them with a knife and castrating them? This is sillier than Freud. Also leaves women's restroom anxieties a bit of a mystery.

_a phobia of signing one's name to a check while others
watch and wait in eager anticipation that signifies a fear of cooperating
and thus of being called submissive._

So Martin's theory is apparently that SAers are grunting caveman who want to beat their chests and are afraid of not being the alpha male. Don't know if he's including women in this, but either way he's being silly. Seriously, a fear of cooperating?

To me the important difference between SA and AvPD (which have some overlap) is simply that AvPD involves habitual avoidance, while SA doesn't have to though it may.


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## Kon (Oct 21, 2010)

Hoth said:


> To me the important difference between SA and AvPD (which have some overlap) is simply that AvPD involves habitual avoidance, while SA doesn't have to though it may.


I think low self-esteem may also be a major difference. I think it's far more severe or a necessary criterion to be diagnosed with AvPD; whereas, it's possible to have high self-esteem but still have SAD. One would think it would be difficult to have AvPD and have normal/high self-esteem.


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## sparky10 (Dec 30, 2008)

The social anxiety disorder i read somewhere is that you dont want to embarrass humiliate yourself when around others. Whereas the avpd is more concerned with people humiliating them or embarrasing them. Now this is way oversimplified but it does highlight a good point. I think avpd sufferers find being around anyone difficult in any situation. There is also a very deep sense of inadequacy in ones core self in avpd which usualy is not found in the social phobic.


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## Paul (Sep 26, 2005)

Kon said:


> I think low self-esteem may also be a major difference. I think it's far more severe or a necessary criterion to be diagnosed with AvPD; whereas, it's possible to have high self-esteem but still have SAD. One would think it would be difficult to have AvPD and have normal/high self-esteem.


I don't agree. I at least used to be extremely avoidant (wouldn't talk in school unless forced by a teacher, never made a friend all the way through school, still takes a month to work up nerve for a phone call, etc), and don't think I ever had self-esteem issues. Looking it up, the official AvPD diagnostic criteria are that you must fit *at least 4* of the following: 

persistent and pervasive feelings of tension and apprehension;
belief that one is socially inept, personally unappealing, or inferior to others;
excessive preoccupation with being criticized or rejected in social situations;
unwillingness to become involved with people unless certain of being liked;
restrictions in lifestyle because of need to have physical security;
avoidance of social or occupational activities that involve significant interpersonal contact because of fear of criticism, disapproval, or rejection.
 I've always fit 5 or 6 of these despite my solid self-esteem. I believe I'm socially inept (the evidence is pretty strong), but I certainly don't believe I'm inferior -- but it says "or" not "and".


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## Kon (Oct 21, 2010)

That's true. I think that may be a reason why they seem to be moving to change the AvPD ctiteria:

"Individuals who match this personality disorder type have a negative sense of self, associated with a profound sense of inadequacy, and inhibition in establishing intimate interpersonal relationships. More specifically, they feel anxious, inadequate, inferior, socially inept, and personally unappealing; are easily ashamed or embarrassed; and are self-critical, often setting unrealistically high standards for themselves. At the same time, they may have a desire to be recognized by others as special and unique. Avoidant individuals are shy or reserved in social situations, avoid social and occupational situations because of fear of embarrassment or humiliation, and seek out situations that do not include other people. They are preoccupied with and very sensitive to being criticized or rejected by others and are reluctant to disclose personal information for fear of disapproval or rejection. They appear to lack basic interpersonal skills, resulting in few close friendships. Intimate relationships are avoided because of a general fear of attachments and intimacy, including sexual intimacy.

Individuals resembling this type tend to blame themselves or feel responsible for bad things that happen, and to find little or no pleasure, satisfaction, or enjoyment in life's activities. They also tend to be emotionally inhibited or constricted and have difficulty allowing themselves to acknowledge or express their wishes, emotions - both positive and negative - and impulses. Despite high standards, affected individuals may be passive and unassertive about pursuing personal goals or achieving successes, sometimes leading to aspirations or achievements below their potential. They are often risk averse in new situations."

http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=20


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## justine2691 (Jan 8, 2011)

From all of the readings I've done (from the most recent of texts and medical journals), the thing that I've always determined as being the most different between the two disorders is the fact that sufferers of AvPD will almost always avoid a situation whereas those with SA will oftentimes still go out. Other than that, a majority of the symptoms are exactly the same---the degree to which they are experienced may differ though. But I'm not a psychologist, that's just what I get from this 'official' stuff.


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## Akira90125 (Jun 12, 2009)

i think a lot of you guys have nailed it on the head. habitual avoidance versus exposure (more or less)


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## Akira90125 (Jun 12, 2009)

metamorphosis said:


> Than the question arises; How important is it to unglue the two; that may be solved in the exact same way/meds/protocol/etc!!


axis I versus II, different treatment. but i agree with what you said before hand


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## Kon (Oct 21, 2010)

I only have one truly avoidant behaviour: public speaking/oral presentations. But it is much more severe than anyone's I know. I got a panic attack in grade 7 and have never done another one. I even chose/quit programs based on avoiding oral presentations. But my SAD in most other situations is quite mild.


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## antonina (Oct 25, 2008)

Akira90125 said:


> axis I versus II, different treatment. but i agree with what you said before hand


My doctor said the treatment for both disorders is basically the same. They use CBT and exposure.


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## bloodswordfire1473 (May 23, 2011)

thanks akira90125 that was very very informative stuff!


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## estse (Nov 18, 2003)

The people with SA have friends.

The people with AvP have none or few (whom they don't count).


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## Arisa1536 (Dec 8, 2009)

the above is not true, people with SA can have no friends as well as those with AvP and vice versa, often with Avp it can be disguised for awhile
Since its a personality disorder and not just a phobia, mood plays a major factor into how one sees themselves socially and adepts to social situations like work and school etc

Also, Avoidant personality disorder like most personality disorders are not usually recognized until one is over the age of 18. SA can start at any age
CBT can help both but that mixed with medication is better


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## soulsurviver (Jun 17, 2014)

I have been diagnosed with avoidant personality disorder, my psychiatrist said that S/A is exactly that, anxiety in social situations, but, avpd is about avoiding feelings, talking about them and avoiding getting close to others.


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