February 10, 2026 ⢠27 mins
In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) dive into Avoidant Personality Disorder, exploring Dr. Theodore Millon's six subtypes. We discuss a few interesting historical names before jumping into the characteristics of mild (Anxiously & Imaginatively shy); moderate (Hypersensitively & Phobicly Reticent); and severe (Conflicted & Self-Deserting) subtypes. Our conversation also critiques Millon's work, questioning the distinctiveness of avoidant traits compared to other personality disorders, and we invite listeners/viewers to share their thoughts and opinions.
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Chapters 00:00 Introduction & Historical Names 05:18 Millon's Six Subtypes of Avoidant Personality 5:38 Mild Type Overview    6:44 Anxiously Shy Type    9:14 Imaginatively Shy Type 12:05 Moderate Level Overview    12:28 Hypersensitively Reticent Type    14:31 Phobicly Reticent Type 16:55 Severe Level Overview    17:29 Conflicted Avoidant Type    19:40 Self-Deserting Avoidant Type 22:21 Our Opinions About the Subtypes 26:14 Summary & Conclusion
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(00:00):
Welcome to the Personality Couchpodcast, where we
discuss all things personalityand clinical practice.
I'm your host, Doc Bok, and I'm herewith my co-host, Doc Fish.
We are both licensed clinical psychologistsand private practice, and today we are
continuing our series on avoidantpersonality disorder.
(00:20):
In this episode, we unpack Millon's six avoidantsubtypes, and we begin by looking
at a few fun historical namesbefore unpacking the
mild, moderate, and severe versionsof avoidant personality.
So let's get to it.
While we couldn't find any historical subtypesapart from Millon's, we did find some
interesting names and descriptionsin history
(00:42):
that Millon later tied to theavoidant personality.
So Schneider in 1923 and 1950 coined theterm "aesthetic personality," which was
characterized by being proneto hypochondriasis, or
basically hyper-attuned to thebody and its dysfunction.
Which is very different from schizoid, becausethey are disconnected from the self,
(01:05):
so they're not going to be preoccupiedwith any of the body stuff.
And then Millon also pulled from Kretschmer'swork, noting a deep insecurity and
panic in these aesthetic types, oftenwithdrawing from the social world.
He further noted that theyare masochistic and
blame themselves easily and arechronically malcontent.
(01:27):
And then we have Kretschmer'sanesthetic and
hyperanesthetic continuum, which wetalked about in our first episode.
So it's essentially a continuum of insensitivity,or the anesthetic, at one end,
and then the sensitivity, or hyperaesthetic,on the other end.
Mm-hmm. So Kahn in 1931 coined theterm "passive autist."
(01:51):
So again, like "autistic" but not quite,so "passive autist," which described
difficulties with a fragmentedsense of self, where
there's a conflict between beingassertive and being submissive,
seeing the self as inept, unable to speakup, and this personality rides on
resentment and thus hides from the world.
(02:13):
Okay, so I do see where these traits arehelpful to split off from schizoid,
because they may be schizoidor they may not be, but
they can be part of multipletypes of personalities.
So Millon mentions Reich in 1933,who uses the word
"schizoid" to describe the dynamicsof the avoidant type.
So this type armors themselves with walls
(02:34):
that conceal and consume theinfantile anxiety.
So what that means is basically that
stoicism is a way to counterthe anxiety inside.
Okay, so sounds a bit schizoid-ish, defendingthe mine castle maybe, but not
necessarily because of extremeinner anxiety.
(02:55):
Yeah, yeah. So then Menninger in1930 also used the term
"isolated personalities" describedas "whistful outsiders."
So they want to be social but don't know
where to start and are overwhelmedby fear.
So feelings of social ineptitude and odditiesemerge because of that fear and
ultimately lead to not belongingin the group.
(03:19):
So it's a feedback loopof "I feel odd, so
I act odd, so people perceive me as odd."
I think maybe this sounds like atraumatized personality.
So for example, I think I've seen this asa very real dynamic in many people and
maybe increased in the kids thatgrew up in the COVID era.
But it's not necessarily a schizoiddynamic because
(03:42):
schizoids don't usually have a fear ofhumiliation or not belonging.
Yeah, yeah, I can see that. Sothen we also have phobic
character, which I know you'refamiliar with, Doc Fish.
This came up in 1945 by analysts like Fenichel.So phobic characters move away from
(04:02):
the desired situations orthings out of fear.
Okay, so MacKinnon and Michaels in1971 had a great quote.
So they said that these phobic charactersare preoccupied with security.
So they fear any possible threat to it, constantlyimagining the self in situations
of danger while pursuing the courseof greatest safety.
(04:27):
Which I think sounds likean Enneagram six.
Oh, definitely. Yeah, I agreewith you there.
So there were a couple other kind of honorablementions, so including Rado's
overreactive disorders and Horney'sdetached type, which
all sound a little like the avoidanttype that we know today.
(04:48):
Okay, so we can see a theme here that maybethese types, which later were coined as
avoidant personalities byMillon, are fearful.
So they have a distinctly poor view of theself, chronic low self-esteem, and are
incredibly anxious, often keeping their
distance socially for fear of criticismor disapproval.
(05:11):
Like they don't want others to seetheir faults on full display.
Yeah, exactly. But I do think we needto move to Millon's six subtypes.
Let's go. So as a quick recap,Millon divides up
his subtypes into three categoriesof severity.
There's mild, moderate, and severe.
(05:32):
Each category has two subtypesfor a total of six.
Yeah, okay. So for the mildavoidant types,
they likely aren't going topresent to treatment.
Overall, they struggle with hypersensitivityand moving away from others if they
feel uncertain of being likedand not criticized.
(05:53):
So there's a radar for potentialrejection, and they
use this extreme caution whenengaging with others.
Unsurprisingly, as we'vebeen talking about,
they have low self-esteem andare shy and hesitant.
However, when they are in safesettings and feel
socially secure, they actuallycan function well.
(06:14):
Exactly. So they're self-conscious and uncertainof being accepted by others,
resulting in being waryin new situations.
They're expecting to be embarrassed. Theyfeel really uneasy socially.
So they do have like a super-antennathat constantly scans
their surroundings to pick up onwhere the danger might be.
So unsurprisingly, they prefer to bealone unless they feel safe.
(06:39):
Yeah, yeah, I like that. The superantennae. Very sensitive.
So the first of the mild subtypesis the anxiously shy type.
Okay, so characteristics ofthis type include
being private, feeling tense,being fearful.
However, they can look gentle, calm, andput together on the outside.
(07:02):
But under the surface, they are always onthe lookout and anticipating problems.
Okay, so Millon wrote thatthey are, quote,
"searching for escape throughself-knowledge
but seem to be lost at times in a never-endingquest for self-revelation,
a quest that, at its core, has a desirefor achieving psychic peace of mind."
(07:26):
Ooh, that's interesting. Searchingfor peace from within.
Yeah, so peace isn't fully there due to
that chronic pain and anguishabout existence,
leading to withdrawal into the self. Butwhat do you think this means, Doc Fish?
Yeah, I think it means that they are rejectingor avoiding their emotions moving
(07:47):
into their head and their mindto handle things.
But socially, they avoid beingthe center of attention.
But they do want to be recognized,but also they want
to be seen, but they don't actuallywant to be seen.
It's a conflict. They avoidsocial situations.
Yeah, exactly. They'll avoidthose confrontations,
(08:07):
conflict, any potential disagreementsto blend in.
And they lack assertiveness, really, and
have difficulty speakingup for their needs.
And they can appear to have verylow energy and be sluggish.
They're not efficient. They'renot practical.
And they can actually have a lot of difficultyfinishing what they start because of
(08:30):
self-criticism and a fear ofexternal evaluation.
Yeah, yeah. So feelings of inadequacy, lowconfidence, and devaluing the self are
really prominent featureshere of this type.
So given the right person, they might lettheir guard down and express themselves.
But if not, they can fade into the backgroundand disconnect from the world.
(08:53):
There are some similarities here with schizoid,especially in the withdrawal into
the self, the existential struggle,and low energy.
But the core that makes this avoidant isthe fear of negative evaluation,
sensitivity to rejection,and low self-esteem.
But enough about that. Let's lookat the next subtype.
Yes. OK, so the next type is theimaginatively shy subtype.
(09:18):
So this type is prone to fantasy,daydreaming, and
imagination as an escape fromthe difficult reality.
So these types are socially hesitant,preferring to avoid social troubles.
If they do engage in the social world, theyfind a niche to increase their security
and psychic stability, social peace,and predictability.
(09:41):
OK, so imaginatively shy avoidants minimizesocial interactions because they
believe that relationships do notlast and aren't genuine.
So they're reclusive. Yeah.
As a result, they depend onthe self. They do not
depend on others. They're not concernedwith others' welfare.
But at the same time, they're pretty apathetic.They don't take initiative to have
(10:04):
a better life. But they dofantasize about it.
Yeah. And they're their own worst enemy,
really, like not living up totheir own expectations.
So socially, there's discomfortand distrust of others.
And they can guard their fantasiesand have a hard
time accepting perspectives thatdiffer from their own.
(10:25):
And in these fantasies, they can actuallybecome fairly rigid, like getting into
the weeds about right and wrong and proceduresand things of that nature.
And at the same time, theyactually they don't
have any mojo to make the changethat the world needs.
So they just do about it in theirminds. Right. Right.
And then with that rigiditycomes control of the
(10:47):
environment so they can be meticulousand impose structure.
So this is where there's someobsessive compulsive
flavors here. There might be so similarto the anxiously shy.
They're also not competitive. They have lowself-esteem. They can actually be so
passive on an interpersonal situationthat they're self-sacrificing.
(11:08):
Yeah. So the defining feature of the imaginativeshy is their withdrawal into their
mind and their focus on the selfversus the anxiously shy
has a little more focus on othersand keeping the peace.
But they're still withdrawndue to that anxiety.
And I see a little bit of overlap with schizoidhere with all that fantasy stuff.
(11:30):
But the anxious rigidity definitelyfits with a more
anxious avoidant phobic or maybecompulsive flavor.
But Millon doesn't tell us anyof his thoughts on this.
Yeah. Yeah. The differenceis the phobic or
avoidant character's behavior isanxiety driven, really.
And the schizoid may or maynot be driven by
(11:51):
anxiety, but they both can withdrawinto their minds.
That's the behavior that we see.Yeah. So interesting stuff.
It gets a little easier to understand the differencebetween the moderate subtypes.
So with that, let's go to the moderate levelwhere we have two subtypes again.
We have the hypersensitivity reticent andthe phobicly reticent subtypes.
(12:14):
So the overall defining feature here is thatboth of these mild types that we just
talked about can disintegrateinto the moderate due to
isolation and fewer opportunitiesfor personal growth.
We'll start first with thehypersensitivity
reticent subtype, which overlapswith paranoid features.
(12:34):
These types are often highstrung, prickly,
suspicious, and hypervigilant topotential rejection or abuse.
Essentially, they look criticallyat their
environment, kind of side-eyeingit for potential threats.
Yes. And they can be moody with rapidlyshifting emotions and potentially long
periods of edginess and self-deprecation.
(12:57):
They expect rejection, but sometimesthey'll be sad about
it. Sometimes they'll be irrationallynegativistic about it.
This quote from Millon reallystuck out to me.
So he said that a hypersensitive reticentis apt to "make the molehill of a minor
and passing slight into a mountain ofpersonal ridicule and condemnation."
(13:19):
Oh, what an interesting quote. Yeah, thatwould be hard to live with, right?
Yeah, so their moodiness also is going tocome up from this pent-up resentment.
And they try not to expressanger and suppress
it, but it comes out anyway,kind of sideways.
So in social situations, they can "beunpredictable, irritably edgy, and
(13:44):
negativistic, engaging at times in wranglesand disappointments with others,
vacillating between momentsof being agreeable,
sullenly passive, and irritably angry,"according to Millon.
Yes, and keeping with the moody theme,while they can appear
apathetic because they do try to squishdown the sensitivity,
their intense, contraryemotions will come
(14:06):
out in like peevish and immatureoutbursts.
Right. So then they do feel guilty abouthow they act, but they also feel like
misunderstood, unappreciated, and demean,
which in some way justifies theirmoodiness and their anger.
So in their negativity, they believe that
(14:27):
positive things in their lifewon't even last.
Yep.
All right, so the second moderatetype is the phobicly
reticent subtype, which overlapswith dependent features.
So they cannot get relief from theirconstant generalized anxiety.
They very, very, very much want connectionand closeness, but they don't trust
(14:48):
others and they fear rejection from them.
But they also don't want toexpress their fear
of loss because, like, whatif it makes it happen?
Right. Yeah, like speaking thefear into existence.
Yeah. So then they displacetheir anxieties to
something safer or like what iscalled a phobic object.
So the phobic object allows them to redirectand discharge their fears, while
(15:10):
neither being conscious of them nor havingto deal with them forthrightly,
which means that they can then handle andtolerate any loss of that phobic object.
So what might this phobic object be?
Goodness. So it's just somethingtangible and acceptable.
So, for example, it's not going tobe the romantic partner.
It might be the dog next door.
(15:32):
It's not going to be the social situationat the public pool.
It's going to be like a fear of swimming.
So it's like a symbolic representationof the fear.
OK, this makes sense. So it's displacedfear onto something safer.
So it's like it's not the fear oflike being close to others.
It's like fear of that confined space.
(15:53):
Like I just hate elevators. Right.I don't like heights.
So it's like a generalizedanxiety that is then
displaced onto a thing thatmakes it acceptable.
Exactly. Yeah.
So speaking of phobic, though,they are unsurprisingly
prone to social phobia as they fearrejection and humiliation.
(16:14):
Exactly. So the difference between the hypersensitivereticent and the phobic
reticent is that the hypersensitivetype is super
moody and they suppress their fearand need for others.
The phobicly reticent seemsto displace it somewhere
where they don't actually have toacknowledge and face it.
Exactly. Yeah. Like we talked about theelevator, the swimming pool, the dog.
(16:37):
Like it's not about the person. It'sabout the feared thing.
But in a psychological reversal,it really
is about the feared personor people. Yeah.
You got it. So these moderate types can
disintegrate easily due toincreased isolation.
And so with that, let's move to thesevere level, which means
(16:58):
we're possibly at the avoidant personalitydisorder territory.
Yeah. So at this disorder level, avoidantswithdrawal from reality, they fear
humiliation and rejection so much that theydisengage from reality and others to
protect themselves and tendto their wounds alone.
It becomes intentional social isolationat this level. And here we have the
(17:23):
conflicted avoidant and theself-deserting avoidant.
Oh boy. All right. We'll start with theconflicted avoidant subtype and they
actually showcase more negativisticfeatures.
So their main conflict isthat they want to be
detached, but then they're scaredof being independent.
So they want attachment, closeness, acceptance,affection, but anticipate
(17:47):
experiencing like really intense pain and
disillusionment, which is then pairedwith like low self-esteem.
So if they try to be independent, they fearfailure would lead them to humiliation.
Right. So they have to rely on others, supportpeople, institutions, et cetera, but
they do so with very deep resentment, whichmeans the conflict remains, right?
(18:12):
They can't act alone becauseof self-doubt, but
they can't rely on othersbecause of mistrust.
Yeah. So grumpy and negativistic, these typessometimes lash out at others for not
seeing their needs, likefor affection and
nurturance, which risks their dependentsecurity on the other.
(18:33):
So to handle these conflicted feelings andanger, they withdraw and are anxious
with a chronic, like dysphoric,sullen mood.
So they are stuck in a cycle, like theseoutbursts lead to feeling humiliated,
which leads to withdrawingout of protection and
then anger about the conflict leadingto more outbursts.
(18:55):
Okay. Okay. So then another way, it's thecycle of constraint and then that leads
to angry acting out and then thatleads to remorse and regret.
And it's all because they suppress their
anger and it can lead to impulsivehostility.
Yeah. So conflicted avoidantsare moody. Like
they feel misunderstood, notappreciated, demeaned.
(19:19):
And then sometimes though, when they're notstressed, they're in denial of previous
resentments and present the self as well.
Right. But this false veneer cracks easilyunder the pressure or stress of life.
Exactly. That leads us to thelast of the severe
subtypes, which is the self-desertingavoidant.
(19:42):
So the self-deserting avoidantsubtype overlaps
with melancholic and sometimesschizotypal features.
So they withdraw into theself to avoid any
discomfort regarding relatingto other people.
They usually start with fantasyas a coping
skill, but then they find thatfantasy isn't enough.
It just highlights their pain and their miseryand their anguish. So they succeed
(20:06):
in avoiding social exposureand humiliation,
but then they can't escapetheir inner torment,
which is melancholic. So theycan't turn to others.
They're socially aversive, but then there'salso high self devaluation and merging
avoidant and depressive or melancholicpersonalities.
Okay. So they end up kind of seeking to undotheir self-conscious awareness, which
(20:31):
then results in abandoning the self likethey neglect their wellbeing and have
trouble with even the smallestinkling of self-care.
Right. So tragically, some actually headtowards suicide and then some also head
towards emotional numbness through whatevermeans that could mean for them.
So sometimes the avoidanceof the cognitive
(20:53):
self-awareness might lead to a splittingof consciousness.
So this is actually very similar to schizotypals,right? So that's where reality
and the self start to fall apart andfragment becoming disorganized.
So help me break down this what this
means though, Doc Fish, becausethis is really deep.
(21:14):
Okay. All right. So not only do they rejectothers because socializing is
intolerable, they start to reject the selfbecause their inner world becomes
intolerable, which leads to a breakdown intheir thought organization and reality.
Yeah, everything is just too much.People are too much.
(21:34):
Inner thoughts are too much. Abandonthe self and split off.
Ooh, yikes. Okay. So the conflictedavoidant is
another more severely disintegratedmoody type.
But the difference between the conflictedand the self-deserting types is that the
conflicted deals with their conflict of dependencyand rejection by acting out and
(22:00):
then withdrawing in this vicioustantruming, moody cycle.
The self-deserting though reacts to this conflictnot necessarily externally, but
internally. So they splitoff from the self
because the conflict insideis intolerable.
That's exactly right. Now, I do think it wouldbe helpful to share our thoughts and
(22:23):
opinions about Millon's subtypesthat we've been
fairly opinionated about his workthis far in this series.
That we have. Yes, we have been pretty criticalin this whole series about Millon's
coining of avoidant personality disorder,even though we think he's one of the
greatest personality shrinksof all times.
But that said, we do both agree that avoidantpersonality does have some unique
(22:49):
traits. Like there's something here. Millonwas picking up on something. Like we're
just not quite sure that it shouldbe a disorder in the DSM.
And one of the critiques that we and othertheorists have is that avoidant overlaps
so much with a lot of theother personality
disorders. But let's break this downjust a little bit more.
(23:10):
One thing I can't help but question is thedifference between these subtypes and
corresponding like opposite subtypesin the other personalities.
So for example, for the avoidant, Millonhas the hypersensitive with paranoid
flavors. But then he has an insular paranoidsubtype that has avoidant flavors.
(23:30):
So it makes me wonder like how different arethey really? Yeah. Or the phobic for
the avoidant, they have thedependent features.
But then there's also a disquieted dependentsubtype with avoidant features. So are
they different? How differentcan we really actually
separate the avoidant from these overlapsand other personalities?
(23:53):
Now, I can't technically answer this questionyet because I haven't dove too deep
into some of these other personalities. ButI'm curious. It makes me question it.
I see what you're saying here. Like in mostof Millon subtypes across personalities,
he notes that each subtype has featuresof other personality types.
And to your point, how do you know which dysfunctionalpersonality style is driving
(24:16):
the bus? Like, are they different types ofthe same thing? Like, I'm thinking of
cheese right now. Like, let'suse a cheese analogy.
So are some of these subtypes like distinguishingbetween mild and sharp cheddar?
Like, at the end of the day, it's still cheddarcheese. Like, you know what I mean?
Yeah, I mean, so like how moldyare they at their core?
(24:38):
Oh, that too. That too. Yeah. And just keepingwith the cheese analogy, hang with
me for a sec. With some of these subtypes,like, are they blends of cheeses that
have been rebranded to be something
different? But really, it'sjust the same thing.
Like, kind of like if I were to mix mild andsharp cheddars, add in a Monterey Jack
and call it like a mac and cheese blend. Youknow, at the end of the day, it's the
(25:01):
same thing. Just rebranded, repackaged,repurposed.
Sorry, Millon. I really like that. That'sa good cheese analogy. I like it.
Now, according to the DSM, thereis a lot of overlap between
avoidant and schizoid. Schizotypal,dependent, and paranoid.
Yeah. So negativistic isn't a disorder in theDSM anymore, but it used to be called
(25:25):
passive-aggressive personalitydisorder. I think
that personally fits with the conflictsof the avoidant.
So then I'll be back to the questionof whether avoidant is
its own personality disorder, a trait.Is it its own cheese?
Is it its own cheese? Doesn't have a buddy?What else did it get packaged with?
(25:47):
Yep. I mean, that's beenour question this
whole series. Is it even astandalone diagnosis?
So, I mean, we have our opinions, but fornow we'll leave it up to our listeners
and viewers to cast their vote onYouTube. That poll is still
open about whether or not you thinkit should be a diagnosis.
So we're also curious about what you thinkwith these subtypes and if you identify
(26:10):
with them. So let us know inthe comments if so.
All right. So today we unpacked the six avoidantpersonality subtypes, according to
Millon and shared some of our thoughtsand opinions about them as well.
So we hope that you'll tune in forthe rest of the series
and don't forget to like, subscribe,give us a shout out.
We've also got blogs, visualsand references that
(26:32):
coincide with each episode atwww.personalitycouch.com.
And if you're a provider looking to consultabout a case or if you're in need of
psychodynamic therapy or a deep dive
psychological evaluation, QuestPsych can help with that.
I'll provide a link in the shownotes. Be well, be
kind. We'll see you next time onthe Personality Couch.
Welcome to the Personality Couchpodcast, where we
discuss all things personalityand clinical practice.
I'm your host, Doc Bok, and I'm herewith my co-host, Doc Fish.
We are both licensed clinical psychologistsand private practice, and today we are
continuing our series on avoidantpersonality disorder.
(00:20):
In this episode, we unpack Millon's six avoidantsubtypes, and we begin by looking
at a few fun historical namesbefore unpacking the
mild, moderate, and severe versionsof avoidant personality.
So let's get to it.
While we couldn't find any historical subtypesapart from Millon's, we did find some
interesting names and descriptionsin history
(00:42):
that Millon later tied to theavoidant personality.
So Schneider in 1923 and 1950 coined theterm "aesthetic personality," which was
characterized by being proneto hypochondriasis, or
basically hyper-attuned to thebody and its dysfunction.
Which is very different from schizoid, becausethey are disconnected from the self,
(01:05):
so they're not going to be preoccupiedwith any of the body stuff.
And then Millon also pulled from Kretschmer'swork, noting a deep insecurity and
panic in these aesthetic types, oftenwithdrawing from the social world.
He further noted that theyare masochistic and
blame themselves easily and arechronically malcontent.
(01:27):
And then we have Kretschmer'sanesthetic and
hyperanesthetic continuum, which wetalked about in our first episode.
So it's essentially a continuum of insensitivity,or the anesthetic, at one end,
and then the sensitivity, or hyperaesthetic,on the other end.
Mm-hmm. So Kahn in 1931 coined theterm "passive autist."
(01:51):
So again, like "autistic" but not quite,so "passive autist," which described
difficulties with a fragmentedsense of self, where
there's a conflict between beingassertive and being submissive,
seeing the self as inept, unable to speakup, and this personality rides on
resentment and thus hides from the world.
(02:13):
Okay, so I do see where these traits arehelpful to split off from schizoid,
because they may be schizoidor they may not be, but
they can be part of multipletypes of personalities.
So Millon mentions Reich in 1933,who uses the word
"schizoid" to describe the dynamicsof the avoidant type.
So this type armors themselves with walls
(02:34):
that conceal and consume theinfantile anxiety.
So what that means is basically that
stoicism is a way to counterthe anxiety inside.
Okay, so sounds a bit schizoid-ish, defendingthe mine castle maybe, but not
necessarily because of extremeinner anxiety.
(02:55):
Yeah, yeah. So then Menninger in1930 also used the term
"isolated personalities" describedas "whistful outsiders."
So they want to be social but don't know
where to start and are overwhelmedby fear.
So feelings of social ineptitude and odditiesemerge because of that fear and
ultimately lead to not belongingin the group.
(03:19):
So it's a feedback loopof "I feel odd, so
I act odd, so people perceive me as odd."
I think maybe this sounds like atraumatized personality.
So for example, I think I've seen this asa very real dynamic in many people and
maybe increased in the kids thatgrew up in the COVID era.
But it's not necessarily a schizoiddynamic because
(03:42):
schizoids don't usually have a fear ofhumiliation or not belonging.
Yeah, yeah, I can see that. Sothen we also have phobic
character, which I know you'refamiliar with, Doc Fish.
This came up in 1945 by analysts like Fenichel.So phobic characters move away from
(04:02):
the desired situations orthings out of fear.
Okay, so MacKinnon and Michaels in1971 had a great quote.
So they said that these phobic charactersare preoccupied with security.
So they fear any possible threat to it, constantlyimagining the self in situations
of danger while pursuing the courseof greatest safety.
(04:27):
Which I think sounds likean Enneagram six.
Oh, definitely. Yeah, I agreewith you there.
So there were a couple other kind of honorablementions, so including Rado's
overreactive disorders and Horney'sdetached type, which
all sound a little like the avoidanttype that we know today.
(04:48):
Okay, so we can see a theme here that maybethese types, which later were coined as
avoidant personalities byMillon, are fearful.
So they have a distinctly poor view of theself, chronic low self-esteem, and are
incredibly anxious, often keeping their
distance socially for fear of criticismor disapproval.
(05:11):
Like they don't want others to seetheir faults on full display.
Yeah, exactly. But I do think we needto move to Millon's six subtypes.
Let's go. So as a quick recap,Millon divides up
his subtypes into three categoriesof severity.
There's mild, moderate, and severe.
(05:32):
Each category has two subtypesfor a total of six.
Yeah, okay. So for the mildavoidant types,
they likely aren't going topresent to treatment.
Overall, they struggle with hypersensitivityand moving away from others if they
feel uncertain of being likedand not criticized.
(05:53):
So there's a radar for potentialrejection, and they
use this extreme caution whenengaging with others.
Unsurprisingly, as we'vebeen talking about,
they have low self-esteem andare shy and hesitant.
However, when they are in safesettings and feel
socially secure, they actuallycan function well.
(06:14):
Exactly. So they're self-conscious and uncertainof being accepted by others,
resulting in being waryin new situations.
They're expecting to be embarrassed. Theyfeel really uneasy socially.
So they do have like a super-antennathat constantly scans
their surroundings to pick up onwhere the danger might be.
So unsurprisingly, they prefer to bealone unless they feel safe.
(06:39):
Yeah, yeah, I like that. The superantennae. Very sensitive.
So the first of the mild subtypesis the anxiously shy type.
Okay, so characteristics ofthis type include
being private, feeling tense,being fearful.
However, they can look gentle, calm, andput together on the outside.
(07:02):
But under the surface, they are always onthe lookout and anticipating problems.
Okay, so Millon wrote thatthey are, quote,
"searching for escape throughself-knowledge
but seem to be lost at times in a never-endingquest for self-revelation,
a quest that, at its core, has a desirefor achieving psychic peace of mind."
(07:26):
Ooh, that's interesting. Searchingfor peace from within.
Yeah, so peace isn't fully there due to
that chronic pain and anguishabout existence,
leading to withdrawal into the self. Butwhat do you think this means, Doc Fish?
Yeah, I think it means that they are rejectingor avoiding their emotions moving
(07:47):
into their head and their mindto handle things.
But socially, they avoid beingthe center of attention.
But they do want to be recognized,but also they want
to be seen, but they don't actuallywant to be seen.
It's a conflict. They avoidsocial situations.
Yeah, exactly. They'll avoidthose confrontations,
(08:07):
conflict, any potential disagreementsto blend in.
And they lack assertiveness, really, and
have difficulty speakingup for their needs.
And they can appear to have verylow energy and be sluggish.
They're not efficient. They'renot practical.
And they can actually have a lot of difficultyfinishing what they start because of
(08:30):
self-criticism and a fear ofexternal evaluation.
Yeah, yeah. So feelings of inadequacy, lowconfidence, and devaluing the self are
really prominent featureshere of this type.
So given the right person, they might lettheir guard down and express themselves.
But if not, they can fade into the backgroundand disconnect from the world.
(08:53):
There are some similarities here with schizoid,especially in the withdrawal into
the self, the existential struggle,and low energy.
But the core that makes this avoidant isthe fear of negative evaluation,
sensitivity to rejection,and low self-esteem.
But enough about that. Let's lookat the next subtype.
Yes. OK, so the next type is theimaginatively shy subtype.
(09:18):
So this type is prone to fantasy,daydreaming, and
imagination as an escape fromthe difficult reality.
So these types are socially hesitant,preferring to avoid social troubles.
If they do engage in the social world, theyfind a niche to increase their security
and psychic stability, social peace,and predictability.
(09:41):
OK, so imaginatively shy avoidants minimizesocial interactions because they
believe that relationships do notlast and aren't genuine.
So they're reclusive. Yeah.
As a result, they depend onthe self. They do not
depend on others. They're not concernedwith others' welfare.
But at the same time, they're pretty apathetic.They don't take initiative to have
(10:04):
a better life. But they dofantasize about it.
Yeah. And they're their own worst enemy,
really, like not living up totheir own expectations.
So socially, there's discomfortand distrust of others.
And they can guard their fantasiesand have a hard
time accepting perspectives thatdiffer from their own.
(10:25):
And in these fantasies, they can actuallybecome fairly rigid, like getting into
the weeds about right and wrong and proceduresand things of that nature.
And at the same time, theyactually they don't
have any mojo to make the changethat the world needs.
So they just do about it in theirminds. Right. Right.
And then with that rigiditycomes control of the
(10:47):
environment so they can be meticulousand impose structure.
So this is where there's someobsessive compulsive
flavors here. There might be so similarto the anxiously shy.
They're also not competitive. They have lowself-esteem. They can actually be so
passive on an interpersonal situationthat they're self-sacrificing.
(11:08):
Yeah. So the defining feature of the imaginativeshy is their withdrawal into their
mind and their focus on the selfversus the anxiously shy
has a little more focus on othersand keeping the peace.
But they're still withdrawndue to that anxiety.
And I see a little bit of overlap with schizoidhere with all that fantasy stuff.
(11:30):
But the anxious rigidity definitelyfits with a more
anxious avoidant phobic or maybecompulsive flavor.
But Millon doesn't tell us anyof his thoughts on this.
Yeah. Yeah. The differenceis the phobic or
avoidant character's behavior isanxiety driven, really.
And the schizoid may or maynot be driven by
(11:51):
anxiety, but they both can withdrawinto their minds.
That's the behavior that we see.Yeah. So interesting stuff.
It gets a little easier to understand the differencebetween the moderate subtypes.
So with that, let's go to the moderate levelwhere we have two subtypes again.
We have the hypersensitivity reticent andthe phobicly reticent subtypes.
(12:14):
So the overall defining feature here is thatboth of these mild types that we just
talked about can disintegrateinto the moderate due to
isolation and fewer opportunitiesfor personal growth.
We'll start first with thehypersensitivity
reticent subtype, which overlapswith paranoid features.
(12:34):
These types are often highstrung, prickly,
suspicious, and hypervigilant topotential rejection or abuse.
Essentially, they look criticallyat their
environment, kind of side-eyeingit for potential threats.
Yes. And they can be moody with rapidlyshifting emotions and potentially long
periods of edginess and self-deprecation.
(12:57):
They expect rejection, but sometimesthey'll be sad about
it. Sometimes they'll be irrationallynegativistic about it.
This quote from Millon reallystuck out to me.
So he said that a hypersensitive reticentis apt to "make the molehill of a minor
and passing slight into a mountain ofpersonal ridicule and condemnation."
(13:19):
Oh, what an interesting quote. Yeah, thatwould be hard to live with, right?
Yeah, so their moodiness also is going tocome up from this pent-up resentment.
And they try not to expressanger and suppress
it, but it comes out anyway,kind of sideways.
So in social situations, they can "beunpredictable, irritably edgy, and
(13:44):
negativistic, engaging at times in wranglesand disappointments with others,
vacillating between momentsof being agreeable,
sullenly passive, and irritably angry,"according to Millon.
Yes, and keeping with the moody theme,while they can appear
apathetic because they do try to squishdown the sensitivity,
their intense, contraryemotions will come
(14:06):
out in like peevish and immatureoutbursts.
Right. So then they do feel guilty abouthow they act, but they also feel like
misunderstood, unappreciated, and demean,
which in some way justifies theirmoodiness and their anger.
So in their negativity, they believe that
(14:27):
positive things in their lifewon't even last.
Yep.
All right, so the second moderatetype is the phobicly
reticent subtype, which overlapswith dependent features.
So they cannot get relief from theirconstant generalized anxiety.
They very, very, very much want connectionand closeness, but they don't trust
(14:48):
others and they fear rejection from them.
But they also don't want toexpress their fear
of loss because, like, whatif it makes it happen?
Right. Yeah, like speaking thefear into existence.
Yeah. So then they displacetheir anxieties to
something safer or like what iscalled a phobic object.
So the phobic object allows them to redirectand discharge their fears, while
(15:10):
neither being conscious of them nor havingto deal with them forthrightly,
which means that they can then handle andtolerate any loss of that phobic object.
So what might this phobic object be?
Goodness. So it's just somethingtangible and acceptable.
So, for example, it's not going tobe the romantic partner.
It might be the dog next door.
(15:32):
It's not going to be the social situationat the public pool.
It's going to be like a fear of swimming.
So it's like a symbolic representationof the fear.
OK, this makes sense. So it's displacedfear onto something safer.
So it's like it's not the fear oflike being close to others.
It's like fear of that confined space.
(15:53):
Like I just hate elevators. Right.I don't like heights.
So it's like a generalizedanxiety that is then
displaced onto a thing thatmakes it acceptable.
Exactly. Yeah.
So speaking of phobic, though,they are unsurprisingly
prone to social phobia as they fearrejection and humiliation.
(16:14):
Exactly. So the difference between the hypersensitivereticent and the phobic
reticent is that the hypersensitivetype is super
moody and they suppress their fearand need for others.
The phobicly reticent seemsto displace it somewhere
where they don't actually have toacknowledge and face it.
Exactly. Yeah. Like we talked about theelevator, the swimming pool, the dog.
(16:37):
Like it's not about the person. It'sabout the feared thing.
But in a psychological reversal,it really
is about the feared personor people. Yeah.
You got it. So these moderate types can
disintegrate easily due toincreased isolation.
And so with that, let's move to thesevere level, which means
(16:58):
we're possibly at the avoidant personalitydisorder territory.
Yeah. So at this disorder level, avoidantswithdrawal from reality, they fear
humiliation and rejection so much that theydisengage from reality and others to
protect themselves and tendto their wounds alone.
It becomes intentional social isolationat this level. And here we have the
(17:23):
conflicted avoidant and theself-deserting avoidant.
Oh boy. All right. We'll start with theconflicted avoidant subtype and they
actually showcase more negativisticfeatures.
So their main conflict isthat they want to be
detached, but then they're scaredof being independent.
So they want attachment, closeness, acceptance,affection, but anticipate
(17:47):
experiencing like really intense pain and
disillusionment, which is then pairedwith like low self-esteem.
So if they try to be independent, they fearfailure would lead them to humiliation.
Right. So they have to rely on others, supportpeople, institutions, et cetera, but
they do so with very deep resentment, whichmeans the conflict remains, right?
(18:12):
They can't act alone becauseof self-doubt, but
they can't rely on othersbecause of mistrust.
Yeah. So grumpy and negativistic, these typessometimes lash out at others for not
seeing their needs, likefor affection and
nurturance, which risks their dependentsecurity on the other.
(18:33):
So to handle these conflicted feelings andanger, they withdraw and are anxious
with a chronic, like dysphoric,sullen mood.
So they are stuck in a cycle, like theseoutbursts lead to feeling humiliated,
which leads to withdrawingout of protection and
then anger about the conflict leadingto more outbursts.
(18:55):
Okay. Okay. So then another way, it's thecycle of constraint and then that leads
to angry acting out and then thatleads to remorse and regret.
And it's all because they suppress their
anger and it can lead to impulsivehostility.
Yeah. So conflicted avoidantsare moody. Like
they feel misunderstood, notappreciated, demeaned.
(19:19):
And then sometimes though, when they're notstressed, they're in denial of previous
resentments and present the self as well.
Right. But this false veneer cracks easilyunder the pressure or stress of life.
Exactly. That leads us to thelast of the severe
subtypes, which is the self-desertingavoidant.
(19:42):
So the self-deserting avoidantsubtype overlaps
with melancholic and sometimesschizotypal features.
So they withdraw into theself to avoid any
discomfort regarding relatingto other people.
They usually start with fantasyas a coping
skill, but then they find thatfantasy isn't enough.
It just highlights their pain and their miseryand their anguish. So they succeed
(20:06):
in avoiding social exposureand humiliation,
but then they can't escapetheir inner torment,
which is melancholic. So theycan't turn to others.
They're socially aversive, but then there'salso high self devaluation and merging
avoidant and depressive or melancholicpersonalities.
Okay. So they end up kind of seeking to undotheir self-conscious awareness, which
(20:31):
then results in abandoning the self likethey neglect their wellbeing and have
trouble with even the smallestinkling of self-care.
Right. So tragically, some actually headtowards suicide and then some also head
towards emotional numbness through whatevermeans that could mean for them.
So sometimes the avoidanceof the cognitive
(20:53):
self-awareness might lead to a splittingof consciousness.
So this is actually very similar to schizotypals,right? So that's where reality
and the self start to fall apart andfragment becoming disorganized.
So help me break down this what this
means though, Doc Fish, becausethis is really deep.
(21:14):
Okay. All right. So not only do they rejectothers because socializing is
intolerable, they start to reject the selfbecause their inner world becomes
intolerable, which leads to a breakdown intheir thought organization and reality.
Yeah, everything is just too much.People are too much.
(21:34):
Inner thoughts are too much. Abandonthe self and split off.
Ooh, yikes. Okay. So the conflictedavoidant is
another more severely disintegratedmoody type.
But the difference between the conflictedand the self-deserting types is that the
conflicted deals with their conflict of dependencyand rejection by acting out and
(22:00):
then withdrawing in this vicioustantruming, moody cycle.
The self-deserting though reacts to this conflictnot necessarily externally, but
internally. So they splitoff from the self
because the conflict insideis intolerable.
That's exactly right. Now, I do think it wouldbe helpful to share our thoughts and
(22:23):
opinions about Millon's subtypesthat we've been
fairly opinionated about his workthis far in this series.
That we have. Yes, we have been pretty criticalin this whole series about Millon's
coining of avoidant personality disorder,even though we think he's one of the
greatest personality shrinksof all times.
But that said, we do both agree that avoidantpersonality does have some unique
(22:49):
traits. Like there's something here. Millonwas picking up on something. Like we're
just not quite sure that it shouldbe a disorder in the DSM.
And one of the critiques that we and othertheorists have is that avoidant overlaps
so much with a lot of theother personality
disorders. But let's break this downjust a little bit more.
(23:10):
One thing I can't help but question is thedifference between these subtypes and
corresponding like opposite subtypesin the other personalities.
So for example, for the avoidant, Millonhas the hypersensitive with paranoid
flavors. But then he has an insular paranoidsubtype that has avoidant flavors.
(23:30):
So it makes me wonder like how different arethey really? Yeah. Or the phobic for
the avoidant, they have thedependent features.
But then there's also a disquieted dependentsubtype with avoidant features. So are
they different? How differentcan we really actually
separate the avoidant from these overlapsand other personalities?
(23:53):
Now, I can't technically answer this questionyet because I haven't dove too deep
into some of these other personalities. ButI'm curious. It makes me question it.
I see what you're saying here. Like in mostof Millon subtypes across personalities,
he notes that each subtype has featuresof other personality types.
And to your point, how do you know which dysfunctionalpersonality style is driving
(24:16):
the bus? Like, are they different types ofthe same thing? Like, I'm thinking of
cheese right now. Like, let'suse a cheese analogy.
So are some of these subtypes like distinguishingbetween mild and sharp cheddar?
Like, at the end of the day, it's still cheddarcheese. Like, you know what I mean?
Yeah, I mean, so like how moldyare they at their core?
(24:38):
Oh, that too. That too. Yeah. And just keepingwith the cheese analogy, hang with
me for a sec. With some of these subtypes,like, are they blends of cheeses that
have been rebranded to be something
different? But really, it'sjust the same thing.
Like, kind of like if I were to mix mild andsharp cheddars, add in a Monterey Jack
and call it like a mac and cheese blend. Youknow, at the end of the day, it's the
(25:01):
same thing. Just rebranded, repackaged,repurposed.
Sorry, Millon. I really like that. That'sa good cheese analogy. I like it.
Now, according to the DSM, thereis a lot of overlap between
avoidant and schizoid. Schizotypal,dependent, and paranoid.
Yeah. So negativistic isn't a disorder in theDSM anymore, but it used to be called
(25:25):
passive-aggressive personalitydisorder. I think
that personally fits with the conflictsof the avoidant.
So then I'll be back to the questionof whether avoidant is
its own personality disorder, a trait.Is it its own cheese?
Is it its own cheese? Doesn't have a buddy?What else did it get packaged with?
(25:47):
Yep. I mean, that's beenour question this
whole series. Is it even astandalone diagnosis?
So, I mean, we have our opinions, but fornow we'll leave it up to our listeners
and viewers to cast their vote onYouTube. That poll is still
open about whether or not you thinkit should be a diagnosis.
So we're also curious about what you thinkwith these subtypes and if you identify
(26:10):
with them. So let us know inthe comments if so.
All right. So today we unpacked the six avoidantpersonality subtypes, according to
Millon and shared some of our thoughtsand opinions about them as well.
So we hope that you'll tune in forthe rest of the series
and don't forget to like, subscribe,give us a shout out.
We've also got blogs, visualsand references that
(26:32):
coincide with each episode atwww.personalitycouch.com.
And if you're a provider looking to consultabout a case or if you're in need of
psychodynamic therapy or a deep dive
psychological evaluation, QuestPsych can help with that.
I'll provide a link in the shownotes. Be well, be
kind. We'll see you next time onthe Personality Couch.
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