He also had a hypochondriacal father who worried constantly that he might get polio and even kept him at home for months in quarantine so that he would not come into contact with the polio virus. “To ice the cake,” as the patient said, “he dressed me up in high shoes, like the ones actual polio victims wore, and forced me to wear knickers that had gone out of style and were made out of wool that, because of my allergy to lanolin, itched me so intensely that I could hardly function in social situations unless I wore shortie pajamas underneath to act as a lining—only to be regularly humiliated when, as predictably happened, my pajamas spontaneously fell down and stuck out from below.” Not surprisingly, later in life, the boy developed a pervasive shyness that in effect said, “I am too ashamed of myself to get close to anyone, for if I stay away from people, I won’t be dangerously on display and mocked as a result.”
COMORBID AVPD AND PARAPHILIA
Paraphiliac avoidants are disabled in loving because they limit their attraction to the (paraphiliac) object or situation—one that, by definition, represents only part of normative patterns of arousal and activity. An example is an overfondness for a particular body part such as a foot. For paraphiliac avoidants, the attraction to the part is an aspect of the process of distancing themselves from the whole. Part of the process is that paraphiliac avoidants find themselves compulsively attracted to relationships that are dysfunctional because they are nonreciprocal. Thus a subway marauder experienced a decrease in sexual arousal when a partner promised (threatened) to get close. So he rubbed women in the subway because with such strangers, a full personal and sexual relationship was completely out of the question.
COMORBID AVPD AND NARCISSISM
Narcissistic avoidants tend to avoid less out of fear and more out of a preoccupation with their own needs, one that can be selfish in the extreme. Thus a single man at the beginning of the evening complained to his blind date, “I had to interview 90 women just to get you,” and at the end of the evening, “I’ve dated women with small breasts, and I’ve dated women with large breasts, but no matter how hard I try, I can’t seem to find a woman whose breasts are exactly the right size.”
Narcissistic avoidants don’t get close to, and maintain a solid relationship with, others because they jealously guard an identity of which they are inordinately fond. They have difficulty giving up “being me” in order to become “us.” They feel that “who I am” (my masculinity, my identity as an independent man, my emancipated status as a woman) is more important than “who I am with.” They are entirely too willing to stand on principle, even though that means standing alone.
COMORBID AVPD AND PASSIVE-AGGRESSION
Passive-aggressive avoidants antagonize others in subtle ways. Their goal is to provoke others to withdraw from them in a way that allows them to deny that they are the ones orchestrating the withdrawal from others.
COMORBID AVPD AND AGGRESSIVE PERSONALITY DISORDER
The same avoidant individual can be, and often is, both afraid of criticism and highly judgmental and critical of others.
A Case Example
One aggressive avoidant had few friends/lovers because, as she herself complained, she couldn’t keep from criticizing everyone she knew both for things beyond their control, like their looks, financial status, and emotional problems, and for things within their control, but essentially unimportant, like wearing yesterday’s clothes or recommending and taking her to all the “wrong” places. For example, she was very close to a colleague for many years, until that colleague got slightly depressed and needed someone to talk to, at which time she told her, “I am not interested in doing therapy with my friends” and refused ever to see her again. She also often criticized people for things that were her own fault. For example, “utterly shattered” over having missed a bus stop (though the next stop was only a few blocks away), she found herself severely castigating the bus driver for not reminding her to get off—even though, assuming (incorrectly) he knew her from earlier trips, she had not bothered to tell him the location of her stop. She often attacked innocent people just because they were around and available to be savaged. Sometimes it was the messenger, sometimes it was the next person to come along after the last person who troubled her, and sometimes it was the repairman who was trying to fix the problem. For example, she excoriated the bus driver of the bus that came (for there being so few busses) because she was angry at the driver of the bus that did not come. She excoriated an airline ticket agent when her luggage was lost, although it was the person who handled the luggage, not the ticket agent, who, if any abuse were deserved, was the one who merited it. Finally, she
often went back in time to tease out one thread from the skein of life’s normal give-and-take, stretch the simple unremarkable strand, and weave it into a tapestry horrific enough to give her the reason she needed to act out negative feelings about potentially positive relationships. Thus, after 43 years of not seeing a childhood companion, she was reintroduced to him at a large party she gave, whereupon she spontaneously announced, loudly and unforgivingly, and to all present, “Here’s the boy who, when we were both two years old, threw dirt in my carriage.”
COMORBID AVPD AND PASSIVE-DEPENDENT PERSONALITY DISORDER
Some Type IIc passive-dependent avoidants “actively” surround themselves with a protective shell to effectively hide out from a world they perceive to be threatening and rejecting They do this by forming a (possibly unhealthy) dependent relationship with one to avoid having healthy relationships with many. They might become overly close to a parent to avoid having a lover (or to avoid having to go to work) or form an overly close codependent relationship with a single partner to avoid other outside relationships. Some seek safety by becoming dependent on groups of like-minded avoidants. On the positive side, these groups enhance self-esteem through imparting a sense of belonging that makes all concerned feel wanted and involved. On the negative side, by becoming overly possessive, they enhance pathological intragroup attachments that isolate the group members from the outside world.
Other passive-dependent avoidants are simply too inactive to actively relate to others, for that means doing the work required to meet someone like Mr. or Ms. Right. I advised one patient from northern New Jersey desperate for, but unable to meet, a partner to go to New York and try hanging around a special place where bachelors go to meet women. In response, he could do no better than complain, “Too far. Too hard to get there.”
In still other cases, the passivity is not the cause but, rather, the result of the primary avoidant problem. One avoidant, afraid that being active could lead to being rejected, refused to follow her friends’ advice to be more forward with men. For example, when a man she liked said good-bye to her, ignoring her friends’ advice to say, “I won’t let you get away until I get your phone number,” she merely said goodbye back and let it go at that. In her case, it was guilt and shame about her humanity that led her to hold back, for she believed that simply acting interested in a man meant that she was proposing to have an illicit liaison with him.
When passive avoidants like her find themselves in a troubled relationship, they tend to both welcome the troubles and make little or no active attempt to fix them. Typically, they ask or allow others to take full responsibility for the outcome of their lives—deputizing virtual strangers into telling them what to do. Rather than looking for problems and coming up with solutions on their own, they write letters to newspaper columnists, or to me, asking, “What do you think I should do?” or they find therapists who tell them whether to stay or go. Predictably, they select that columnist or therapist they know, intuitively, by reputation, or from past experience, will encourage them to leave. Then they lead them on by only giving them information that would seem to suggest they should go and censoring information that might suggest they should stay.