Therapy, and how to change

Hi all. Not sure if my intro post should go here but as it is AvPD I've signed up to talk about I guess it's OK.

tl:dr - I have AvPD, not sure if I should continue with my therapist, would like some online support if there's anyone out there like me.

I'm male, 35, live in the UK. I have no formal medical history of any mental health issues but I've been conscious of the way I think and the way I am for years now and I have read about personality disorders. Recently I booked some sessions with a local therapist, we talked about my situation, my family and social history, we did some Y/N type tests, and he concluded that my attachment style is avoidant. I hadn't mentioned to him that I've read on the subject to avoid prejudicing the outcome but it came as no surprise.

My situation is that I am estranged from my family and have few friends, none close. My circle of friends has reduced over the last 5 to 10 years and because I don't like closeness and keep people at a distance none have been added. I have a good job though which pays well and which puts me in contact with a lot of people which ironically I enjoy and am good at. The people who know me through work see me as confident, intelligent, capable. The few people who know me better than that, the "few friends" above, suspect that I'm lonely, insecure and isolated. I hate this, it feels shameful because they are right of course, so I much prefer interaction with people who don't really know me and who like and respect the image I (think I) successfully portray.

I signed up with a therapist because I want to change the person I am, indeed I've come to realise that life without any meaningful relationships is empty and meaningless and I'd give anything to be more connected to others. However I'm not sure my therapist's solutions are worthwhile. Having ascertained what's wrong, he suggests that we continue to meet weekly and that doing so will reframe my internal view on attachment. He described it as "like a friendship, but focussed on me rather than him". I think it sounds like I'd be paying him to pretend to be my friend for an hour a week and that doesn't seem like it would help my self esteem. I think that solution might be a good starting point for someone who doesn't have any interactions with others, but I do have positive interactions with people they are just on a professional level with appropriate distance maintained.

Has anyone had a good experience working with a therapist treating AvPD? What did you/they do? Do you think I should continue with mine?

I think what might help me would be talking to people who have experience of the same problem and what has, or hasn't, helped them, so I'm hoping here is the place.

Hello allandnothing: Since this is your introductory post... welcome to PsychCentral from... the Skeezyks! I'm an older person & married. But, otherwise, I am pretty-much solitary... no family... no friends... not even any acquaintances really... by choice. I prefer to keep to myself. No good has ever come from me having anything to do with other people. (Allot of it is my own fault.) I consider my solitariness to be my gift to the world... By the way, although I've seen a number of psychiatrists & therapists over the years, none has ever offered me a diagnosis. So I don't know what mine might be.

I found your statement regarding seeing this therapist as "paying him to pretend to be my friend..." to be apropos. I no longer see a therapist. From my perspective, the ones I've seen ranged from mediocre to useless... I used to refer to my last therapist (who was actually the best of the lot) as: "rent-a-friend". I'd go in, I'd tell her about my exploits on the internet... she'd tell me about her horses... Anyway... I don't have allot of confidence in therapists. On the other hand, I know from reading posts here on PC, that there are people who say their therapists saved their lives. So I guess one's experience can vary. Hopefully you will get some additional perspectives from other members here on PC. Under any circumstances, I wish you well with your efforts...

Thanks for your reply Skeezyks, really appreciated.

I don't think much good can come of an hour of chat and I also find the disparity between the plan - improving my view of connecting with people - and the reality - chatting to someone who is not and will never be genuinely connected to me - a bit difficult to make peace with. But part of me thinks that is what an AvPD person would say! Definitely interested in other people's experiences with therapy.

I guess I was hoping therapy would challenge and change my mindset. I'm aware that I avoid interaction with people, I'm socially aloof, I push people away and "turn them off" me even before they get to know me hence never making friends. That's what I need to change, but needless to say I have no idea how.

You're lucky in a sense that you are married so clearly have one close, meaningful and accepting relationship in your life. For people like us that may be enough. A few years ago I had three friends, all distant (geographically) but people I would chat to and would see at least one of every couple of weeks or so. It felt like it was enough. But over time all three have faded, and having no-one close feels very different and very lonely at times. And especially at this time of year...

I have had "personality disorder not otherwise specified", a conglomeration of traits none of them enough to qualify for a specific personality disorder. And I have an anxious-ambivalent attachment style so that’s another difference between our situations. But I’ve been in therapy for 5 and a half years that is similar to what you described and it HAS been helpful. I’d been in a lot of therapy before which was not. But in my case, the “pretend” relationship elicited my problematic attachment responses and has helped me develop better ones.

Would you feel comfortable seeing the therapist again and asking him some more about the process and how it is supposed to work?

Thanks here today. I'm definitely comfortable seeing or at least communicating with my therapist again, we have a session booked in after the holiday and I'll either attend that or email him explaining my concerns and asking for his views.

I've found talking to him positive in a way. It was really interesting to talk completely openly and honestly about painful issues, in a way I've never done before and would never do outside of therapy in the real world. I have no emotional response to the idea of more sessions, I'd happily do it if I thought it would be worthwhile. I guess part of posting here is to get some other views on if it would indeed be worthwhile.

Welcome to Psych Central.

I have been officially diagnosed with AvPD, twice actually. That and a lot more things... I see 3 therapists, one of whom does Somatic Experiencing. At my last session we identified my isolation as the next target for therapy, and I see her today. Well see how that goes.

I have had success with SE treating Dependant PD.

Thanks kecanoe, and I hope your session goes/went well. I've never heard of Somatic Experiencing so that's something else to read up on. Appreciated

I think perhaps what the therapist is trying to do is to allow you to recreate the parental attachment relationship so that you have an opportunity to heal old wounds and perhaps learn more adaptive styles of forming attachments with others. It's called transference-focused psychotherapy. You'll find stuff about it on Google.

I have had lots of therapy over the years, some of it useful, some of it not, but I sincerely believe that the only therapy that will help me overcome my extreme distrust of people is transference-focused psychotherapy. Which at the moment, is out of reach financially. Added to that I don't want to unravel my life when I have a child to care for.

If you go into this type of therapy, it's a big commitment. It won't be easy, but I believe it will be worth it.

Thanks Simone, that's really interesting and another thing to read about. Appreciated.

To be honest I worry that my therapist doesn't really have a plan beyond meeting once a week for a chat. If he is thinking about something as sophisticated as transference-focussed therapy he should really share that plan with me, shouldn't he?

Yes, I think he should. But that doesn't necessarily mean that all therapists will. I could be way off base, but given that he referenced attachment, I thought it might fit.

Perhaps you should have a discussion with him about his long-term plans? Keep in mind that you needn't stay with this therapist if you aren't comfortable with his approach. Test the waters, interview other therapists as well, if it makes you feel more comfortable. You are going to be doing the most important work of your life, so it needs to be a good fit.

Merry Christmas!

First of all: Welcome!

Re: Therapy and how to change.

Pre-supposes one wants to change. I'd rather not. I like me as I am.

So, I'm not officially diagnosed, although my T believes I very much fit in with AvPD. I got put into counselling when diagnosed with bp2, but we don't really do much about my bipolar - well the depression but not a whole lot.

Instead, he's made it a goal (for himself as well as me really) to view him as a safe, trustworthy person. I've been seeing him for about 2.5 years and about the most I can say would be "more than I used to".

So really, it's actually useful for me. I keep thinking he will end counselling with me (it's free,not like he's keeping me for a paycheque as he is paid a salary and not per client). For me, it's a lot of practice just talking "in the moment" about how I'm feeling... and to practice not lying about how I'm feeling... things like that. It's hard to share how I'm feeling and what I'm actually thinking, so I find it useful for that. Even after 2.5 years I still can't bring up the things that matter most to me - I'll avoid them like the plague once I'm in the room. So I email him if there's stuff I know I won't say that I need to say.

Currently he has decided that we're working on identifying my actual first emotions in situations. Which,although it sounds simple.... isn't actually all that simple for me!

Thought I would post the outcome of this for anyone who is interested.

I emailed my therapist with my concerns at the start of the year. As I had a final session booked and paid for he suggested I come in for that and we could talk about if there was a way forward and decide from there. I did, talked about my concerns, he made what seemed like a few good suggestions as to things we could try and I agreed to continue on a session by session basis.

I had two more sessions. The second was pretty frustrating, he asked me if there was anything I wanted to talk about and there wasn't really but he didn't seem to have any ideas so I spoke about a couple of things that had happened that week. He just repeated them back to me in a nodding dog sort of way. I felt that he didn't have any ideas as to how to help me (and I don't think he liked or respected me particularly) so I called time on therapy with him.

I'm now back living day to day, enjoying work but with my life empty outside of it, and with no idea of how to change and improve. I've searched extensively online for solutions to AvPD and have drawn a blank. Really frustrating, or depressing, depending on my mood.

If anyone has the cure - please do post it!

Not a cure (as there isn't one) an understanding.

http://forums.psychcentral.com/avoid...dy-change.html

thanks snap, you say you aren't very intelligent but i think you are

i see saw back and forth :/ (with progress)

pretty much just giving up on things though, i figure if i dont let it bother me, how can it
but doesnt make me happy

Don't think there is a cure either. One has to learn to accept w/o being outrageous or resigned. With time, phases of feeling angry/bitter get less frequent.
I'm feeling you- wish you well.

Hi,

just signed up to answer as this fits into my own situation so well. I’m also currently in therapy. Similar issues but not specific AvPD diagnosis.

I think you should go back and continue with the therapist. I also have moments when I don’t know what to talk about. You could talk about what you wrote here. Some of the most important moments were when I talked about how my therapist made me feel during the therapy.

For me it is also important that I go there every week - and we continue until my issues are fixed. No end date set. It took me a while to accept that.

You could also try another therapist. I knew from the beginning that I would get along with my therapist. I tried another therapist before and knew that it wasn’t right fit. Some sessions are still really difficult but overall it has been helpful. Should have gone earlier.

First of all... hello fluffy + and welcome to PC!

Personality traits and personality disorder don't have a cure. But, it doesn't mean you can't learn to live with it and having it under control.
I wouldn't have been able to improve alone. I needed therapy.
If you don't trust in your therapist, try another one. I don't know much about new therapy techniques. There have been mentioned a lot here. I think that a good specialist should be able to follow whatever of these techniques.
Never give it up. This is like any other flaw or handicap other people have and they learn to live with them. Perhaps, having this disorder makes of you a special person in many good senses.

Good luck!

I don't think you can ever have it "under control." What's there to control? The urge to stay away from people? If anything, a "cure" would probably look like someone who had less self control, who kept themselves less contained. You can't control your avoidance anyway. Even if you ignore the urges and go out into the world interacting with people, the thoughts and impulses would still be there inside your head, and there's no way to stop or adjust them, not really. They always come back.

I don't like the idea that my personality is a flaw or a handicap. One has a handicap, one is not a handicap. When it comes down to it, a person is their personality. Maybe my personality has some odd quirks by other people's standards, but my entire self is not flawed because I think differently, or because I approach the world differently.

I also don't think that the only solution is just to learn to live with it. That's a very dark and hopeless scenario. Although it can't be cured, one can't recover from it, or however you want to state it, one can learn to manage it better. First by learning about it, then by paying attention to what your limits are and figuring out how to stay within them in a way that gives you the most of what you want from life. Everyone's life is a jigsaw puzzle. No one gets exactly what they want, it's all compromise after all.

The point of therapy is to figure out what is most important to you and then figure out a way to get it. It could very well be that "connecting with others" is too big a concept to start with. Perhaps "I'd like to create a relationship with this one person I know of whom I admire" or "I'd like to figure out what type of person I should look for to have a relationship with" might be a more manageable starting point.