Does anyone else do this? Preferably for those officially dx'd w/AvPD

I'm in therapy for Personality Disorder NOS w/avoidant features, anxiety, depression, etc. I had planned to post this question in the Psychotherapy forum (and might, still), but thought those with avoidant personality disorder or the same dx as mine, might be best able to think this question through more clearly.

My T has asked me more than once, "Why is it that you can journal so much of what you feel after our sessions, but can't talk about those feelings in our appts.?"

My original take on this was that journaling about my feelings seems to make them less intense. I've been in therapy about 8 months and have a fairly secure attachment to my T (though not yet where T wants me to be). I've read almost everything researchers have written in the past 20 years about avoidant attachment, but can't figure out why I can't talk in therapy about the feelings I journal about. I guess it's possible that I'm afraid my T will think my feelings are foolish and don't want to be criticized, but I can read what I journal in later therapy sessions and not feel foolish. It could also be that I don't yet trust my T as much as I think I do.

If any of you have experienced this problem or can imagine my situation, I would be grateful to hear any opinions, thoughts, suggestions anyone can share.

Why not email your journal to him ahead of time, or parts of it, and tell him that's what you want to go over in your next session?

Not being able to talk in therapy is probably based in trust issues, anxiety about disappointing him, feeling unworthy of having emotions, feeling unworthy of expressing emotions, and feeling unworthy of getting sympathy for emotions. And in my case, I shut down to avoid feeling like I'm too close to someone and therefore need to cut all ties with them.

Feeling too close could be the big problem. If you feel like it's something more than a professional relationship, then you won't be able to make any progress. I had a therapist once who did that on purpose. In order to facilitate closeness, she told me waaay too much personal stuff about herself, and I completely shut down and couldn't talk to her. If your therapist has shared personal information, or if you have concocted (fantasized) information about their personal life, then it could be that it's too close to a "friendship" (even though it can never be a real one) and it's no longer effective therapy for you.

It takes me a really long time to talk about some of my feelings. I just admitted to t2 (who I have been seeing for almost 6 years) that I want her to think I am perfect and that I edit what I say so that I have her approval.
It seems like I could have said that years ago, but I could barely speak the words.

You brought up some interesting and certainly possible suggestions about what's happening. I can't email the journal for two reasons...first, I write it long hand, and secondly, my T wants me to read what I've journaled - he won't read anything I've journaled ahead of time. (I think it has something to do with hearing how his clients read what they've written - where do they put emphasis, etc.)

T has shared minimal personal information. I've tried not to think much about her/his personal life, though I probably know more than I should. I've read a journal article recently that encouraged the T to share more personal information (books they read, what they do in spare time, etc.) w/avoidant attachment style clients - don't know about personality disorder, but probably avoidant - as ..."Burke (1994) emphasized the utility of therapist self-disclosure as forming a bridge between an old and a new object experience. Dismissive patients may be particularly in need of such information about how a new attachment figure can be different from previous ones. Unambiguous self-disclosure by the therapist may help to combat the defensive exclusion of pertinent attachment-related information typical of the dismissive style." (Connors, Mary E., (The Renunciation of Love: Dismissive Attachment and its Treatment) I don't necessarily subscribe to this technique, but according to this article, Dr. Connors says, "A dismissive patient of mine told me that it was my willingness to be human with her (e.g., answering her questions about what I liked to read) that made her able to risk vulnerability with me."

At any rate, your note of "...based in trust issues, anxiety about disappointing him, feeling unworthy of having emotions, feeling unworthy of expressing emotions, and feeling unworthy of getting sympathy for emotions" is most likely a big part of my problem. I was allowed to express only certain feelings growing up and I've struggled with fears of disappointing my T since I began therapy, so...

Thanks, so much for your response. Though this is for another conversation, I have to mention that these researchers/therapists make me crazy how they seem to use the terms "dismissive" and "avoidant" interchangeably. There have been some articles targeting this problem, with some clinicians/researchers finding a distinct difference between the two terms. Once I figure out my own problem here, I'll post on these terms and see what others think.

Good point, kecanoe. I told my T just a month ago that I edit what I say in sessions, not exactly knowing why. Since I'm so fearful of disappointing T, I could very well be wanting to appear perfect - or not wanting to risk the disapproval all avoidant PDs experience. I'm sorry it took you so long to unburden yourself and I hope doing so will give you some sense of relief. I'm sure your T is glad to know that's how you feel. Good for you!

Dismissive attachment style is different from avoidant attachment style, which is different from Avoidant Personality Disorder. I doubt they are used interchangeably in scholarly papers. (If they are, that's a good sign whoever wrote it doesn't know what they're talking about.) That's a big problem when you search symptoms online - what gets returned isn't specific and it jumbles everything up, so it's really easy to confuse what you're reading. So for dismissive attachment perhaps self disclosure would be helpful, but for AvPD people, it could cause as many blockages as it opens up, and I think you agree with that.

I don't know what the aim of your therapy is, but it might be worth it to take some time in your sessions to work on the process of therapy itself. If you are holding yourself back because you're afraid of creating disappointment or being judged, then you'll make excruciatingly slow progress or even none at all. Your therapist is supposed to help you make progress, and if he can't adapt to make that possible (by reading your journal for instance) then you won't be able to break through your wall, and it might be that you're not as good a match with your therapist as you need and deserve and it's time to find a better one.

I'm a little confused about your post, but appreciate your opinions. The journal articles I'm reading are written by the top researchers/clinicians in the field of attachment theory. Researchers can't yet agree on how to categorize attachment styles - there's a three-trait style and four-trait style. I guess I would be interested to know who you're reading...?

I don't know that I agree w/anything you've said, but reserve my opinion for further consideration. The aim of my therapy (or my goal) is not up for discussion. In pursuing this goal, therapy is what we engage in 50 min. every week. Obtaining a good working alliance and helping the avoidant client feel a safe and secure attachment to their T is what furthers the process of therapy. Keeping the client in therapy long enough to make changes depends on the relationship between the T and client.

The "fear of being judged" or criticized are two possible characteristics of the avoidant client. Therapy goes slowly for those who are primarily avoidant. Speed in getting through therapy is never a good indicator for successful outcomes.

My choice of Ts is my decision. You seem to be making assumptions based on information you don't have. Thanks for responding, but I'm not interested in defending my T, the scholarly articles and books I read, or the progress I'm making or not making in therapy with someone who knows very, very little about my situation.

My gut says to ignore your direct request for a response, but it's needling me to death to leave you hanging, which you probably actually expected or even hoped for. At the risk of sounding like a complete hypocrite, no one told you to get defensive about anything. Though I understand that the avoidant response to "you deserve better" is to deny everything completely.

Attachment style is how people have relationships; a personality disorder is a pattern of behavior in all areas of one's life. For you it might seem like they overlap and align based on your own experience, but they absolutely are separate things. If you're reading something about an attachment style, you can't say that it automatically applies to a personality disorder. It might resonate for you, but there are people who, for instance, can have secure attachments in spite of their avoidance. I had given you an example, but alas, the compulsion to edit has overtaken me.

Additionally, I never said that the goal of therapy was to speed through it. I'll give you the benefit of the doubt, but it feels like you were accusing me or putting words in my mouth. At any rate, again, from the perspective of someone with an AvPD diagnosis, which is the opinion you were seeking, I can tell you that progress in therapy for avoidants can be quick or slow or even seem to be moving backward, and the rate of change and progress is not tied to the diagnosis. One common reason that someone with AvPD leaves therapy is because the changes happen too quickly. By change I mean the acquisition of less maladaptive coping techniques, not that the PD itself changes.

I have answered you generally (regardless of how personally you took it) because I know there are tons of people who could read this thread and glean insight. You asked, why can't you talk to your therapist the way you can write in your journal? I answered you, and suggested ways to get over that hurdle. You had asked for suggestions, but you didn't like the ones I offered, and made it clear in your response. Avoidant people don't stick their necks out unless they're fairly sure they'll get a positive response. Because I'm fairly sure of the exact opposite in this case, I'm done sticking my neck out in this thread. I'm not sure other avoidants would chance it either. But you never know, maybe you'll get advice that you like from someone else.

Ok. Starter: I'm diagnosed with bipolar. My T brought up AvPD to me one day. I pretty much refuse to see the psychiatrist as I panic - once he didn't show up or cancel, another time one told me counsellor that he thought I really didn't like him, just things like that.... I pretty much only agree to go if my counsellor thinks I need a discussion about medication. I don't give an option for them to talk or diagnose me the few times I've been at them. So I've never been diagnosed, but my counsellor does think I'm there or at least have a lot of strong features with it. Just telling you that as you asked for diagnosed only.

I've been with my counsellor for 3 years. I still don't open up properly and he only sees me emotional when he absolutely pushes my buttons with topics he knows I don't want to talk about (which means it's what I need to talk about).

I email him sometimes when I've had a meltdown or panic. They are always quite brief, but he's told me that he knows what I'm feeling and thinking a lot more when I've written it out to him. I email so that I can't avoid telling him - I just hit send without rereading what I typed so I can't erase it.

I've also emailed to ask/tell him things based on what we've talked about or something he's said. Sometimes it can take me months to finally bring it up (such as asking about why he thought of AvPD)

One advantage for me in regards to journaling is that I feel no pressure to get things said right, or so that I am understood. t1 has me journal whenever I am in conflict and then he reads it in session. I think it is easier for me to write than tell because I can always just not take my journal in, where if I say something I can't take it back.

I didn't intend to exclude anyone who has traits of AvPD - glad you posted. Most people who think they have symptoms or signs of AvPD are self-diagnosing and that's not a healthy way to go about things.

Did you actually ask your T (therapist) why he thought of AvPD? If so, did he respond? Many Ts don't want to give out diagnoses, for various reasons. Are you comfortable w/your T? Trust him? Avoidant clients often find it difficult to tell their Ts anything of any depth, mostly because it's hard for them to recall things that relate to emotional issues. But also because they don't want to be criticized or judged, among other things. Sounds to me like you're working on things as you can, which is good.

I wish you well. Working out the problems AvPD clients have is difficult and often takes a lot of time. I hope you'll keep working w/your T.

Yep I've been with my counsellor for three years now - he's pushed at my limits a lot so he seems to know what will make me shut down and what will prompt emotional responses - he's noticed that I can share facts no problem, but I don't actually share or show my emotions about it.

Basically... He picked up on it just through the things I eventually shared and how I'd respond to things. It's what he works with me on, and not the bipolar that is the reason why I got placed with him (I've got good self management for those for the most part). I was shocked because I'd read about it before and see myself in the criteria. (I wanted to be a psychologist for awhile and had done a lot of reading on lots of different disorders).

I spoke sometime ago to my psych about traits and was told that anyone can display different personality traits from time to time but thats just not enough for an offical PD diagnoses.

I think the recommended therapy, CBT, works for people with traits, because the symptoms can come and go depending on life circumstances. Traditional CBT doesn't work so well, to say the least, for people with full blown AvPD. They may look the same on the outside, but there actually is a big difference between people with AvPD and people with avoidant traits.

Hahaha! My counsellor gave up on cbt with me. I can change behaviours but for the life of me that stuff (nor dbt) seems to do a damn thing towards changing how I feel and think about myself. I felt like a massive failure when trying to do those. He eventually told me that I am great at filling out things and giving the answers and recognize stuff.... But none of that matters when I still believe it's all bulls*** at the end. I actually still feel like a failure with it, but well, I also hated it.

My T cannot diagnose. I refuse to see a psychiatrist for anything other than medication review (and even those my T has to spend ages convincing me that I really should go). Therefore I will never know. And I am ok with that. AvPD is a lens that my T views me with, and it helps him work with me. The struggles I deal with on a daily basis are more in line here than just anxiety.

This is a support forum, not a judgement forum. I relate with AvPD so I post here. I have always been upfront about not having a diagnosis.

It's not a judgment, it's a fact that there's a difference between having AvPD and having avoidant traits. If you just have traits, luckily you won't have all the personality disorder symptoms, which is a separate list that people overlook. It's simply a different experience.

Look at it like a disease like diabetes. If you have pre-diabetes you have to do a lot of similar self care as people with diabetes, like watching your diet and getting regular checkups, but it's not as extreme as having full blown diabetes. And definitely if you are pre-diabetic you can learn a lot from people with diabetes, and people with diabetes can learn from pre-diabetics.

I agree, im just not very good at it for many reasons.