The Essential Guide to Overcoming Avoidant Personality Disorder by Martin Kantor

Author:Martin Kantor
Language: eng
Format: epub, pdf

THERAPY

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CHAPTER 10

A n Overview of Avoidance Reduction

Table 10.1

Eclectic/Holistic Avoidance Reduction

The analytic dimension: the therapist obtains information about and imparts insight into the dynamic aspects of the individual’s avoidances. The information is obtained from a study of the patient’s past life and of his or her current avoidant fantasies and behaviors, including transference ideation/behavior.

The cognitive dimension: the therapist identifies and corrects illogical, inappropriate, and often paranoid interpersonal negative thinking, partly to help the patient recognize and acknowledge the positive aspects of relationships the patient currently views as all negative.

The behavioral dimension: the therapist, informally or formally, asks the patient to perform a series of graded, nonavoidant, connective interpersonal tasks of progressive difficulty in order to approximate nonavoidance in a gradual, stepwise fashion.

The interpersonal dimension: the therapist identifies and understands specific avoidant interpersonal anxieties and shows avoidants how the outer manifestations of anxiety (anxiety equivalents) such as shyness can make others uncomfortable, leading others to react by thinking not “he is afraid of me,” but “she is too stuck up to talk to me.”

The educative dimension: the therapist enhances motivation by enumerating the virtues of relating over being isolated and teaches the patient the social skills that can lead to pleasurable and rewarding experiences, which in turn inspire further attempts at fuller social mastery.

The supportive dimension: the therapist provides the patient with a warm, reassuring, healing holding therapeutic environment within which the therapist attempts to reduce relationship anxiety directly, e.g., with such reassurances as “you will get over your anxiety if you patiently persevere.”

The pharmacotherapeutic dimension: the doctor prescribes selected patients antianxiety and/or antidepressant agents, always keeping in mind that many patients would prefer to at least try verbal therapy before taking medication. 2 3

establishing and improving friendships; and (12) use indicated phar-macotherapeutic agents, such as beta-blockers, monoamine oxidase inhibitors, or serotonin uptake inhibitors, to reduce anxiety. Millon and Davis further recommend that these different therapeutic modalities take place in a supportive setting, where the therapist counters apprehension with “freehanded empathy and support,” the “therapist’s only recourse.”3

My approach is action oriented because it emphasizes doing as well as thinking. It goes beyond utilizing the more “passive” therapeutic techniques that rely exclusively on influencing and changing through understanding to emphasize the more “active” therapeutic techniques, particularly behavioral approaches where the therapist exhorts patients to convert from avoidance to nonavoidance by facing their fears now, as best they can, through exposing themselves directly to situations that make them anxious so that they can take that all-important leap from understanding what troubles them to actively doing something about it.

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