Showing up for your own life: Cognitive therapy of avoidant personality disorder

Cognitive therapy, with its emphasis on structure, time-effectiveness, action, and key thoughts, puts great demands on clients who suffer from Avoidant Personality Disorder (AVPD). Such clients typically shy away from situations in which they feel at risk for failure, rejection, embarrassment, or general discomfort. As such, cognitive therapy potentially presents AVPD clients with the very skills, knowledge, and experience they are lacking, and therefore may be particularly efficacious. On the other hand, the perceived demands of cognitive therapy can scare AVPD clients out of treatment before benefits can accrue; therefore, the therapist must tread lightly. A cognitively based conceptualization of AVPD is presented, along with its concomitant strategies for change. An illustrative case is presented, in which the client learns to chip away at his morbid fear of failure and rejection, and to develop his coping resources through gradual changes in attitudes and daily habits. © 1999 John Wiley & Sons, Inc.