avoidant personality disorder

Nils Holmberg (nils.holmberg@a-klinikka.fi)
Tue, 25 May 1999 09:27:12 +0300

Dear colleagues
Last week I mailed an inquiry concerning pcp-treatment with a client diagnosed as an "avoidant personality disorder". As there´s been no response, I repeat my inquiry, realizing I have to give some more details before I can expect any response.
The client is a 40-year old female with social inhibition,feelings of inadequacy and oversensitivity to evaluation. In her childhood she was a victim of religious abuse, who has been having a rough time lately due to sexual harassment on her job. I´d very much like to get some comments from more experienced pcp-colleagues about this constellation of "superego"-harassment in the past and sexual harassment in the present. The client´s parents were involved in a rather emotional version of christianity that can be seen as resulting in her negative construing of emotionality in general (her parents were terribly tight in their construing of her childhood behaviour) and construing of herself as "bad" and "worthless" if she´s giving any overt signs of interest in the opposite sex. After treating the symptoms from the acute problems, what could be seen as a viable treatment target from a pcp-viewpoint? I´ve been searching pcp-literature for ideas concerning avoidant behaviour, but haven´t be
en able to find much. If there´s anyone with ideas that might help me move forward with my own construing of this, I´d be very grateful indeed. Before entering the clinic the client had been in contact with a mental health service center, where the problem was neatly medicalized with ordination of sedatives but no effort to reformulate the problem. She´s been unhappy about this and wants to get more psychological help (and at the same time getting off the sedatives-hook).
So, any shared experience is appreciated.
Thanks in advance
Nils Holmberg
clinical psychologist, Ph.D.
Järvenpää Addiction Hospital