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AVOIDANT PERSONALITY DISORDER

Arathi Kannan

M.Crim.; M.Sc. (Applied Psychology)

It is largely common to fear being judged or criticised by the people around us. In fact, this fear often causes fleeting moments of distress and discomfort. Over time, these feelings may pass, and we continue with our daily routine. Unfortunately, these feelings of distress and discomfort are not fleeting and don’t pass easily for someone with Avoidant Personality Disorder (AVPD). AVPD is an entrenched behavioural pattern defined by social inhibition, hypersensitivity to negative evaluation and feelings of inadequacy.

Studies have found it to be one of the most common personality disorders in India. It has an early age onset and a lifelong impact. A person with AVPD tends to isolate themselves from any situation they deem potentially embarrassing. This could range from expressing an opinion, meeting new people to attending job interviews. They also have difficulty creating and maintaining relationships. Owing to their social isolation, they tend to have lower social support and self-esteem.

Individual therapy is found to be the most effective form of treatment for a person with AVPD. Cognitive Behaviour Therapy (CBT) focuses on challenging the maladaptive belief of self and others constructed by a person with AVPD. A combination of behaviour modification and cognitive restructuring helps manage the longstanding patterns that cause impairment across all social domains. Cognitive restructuring helps challenge the anxiety that arises from the misconceptions of social situations.

Clients are taught to face difficult situations and desensitize themselves to the feelings of discomfort that may arise. They learn and rehearse many skills including how to respond appropriately in social situations, making eye contact, being assertive in appropriate ways, and greeting people with a smile. Establishing a trusting relationship with a therapist can often serve as a model for clients to evaluate other relationships in their lives.

OBSESSIVE THINKING

Arathi Kannan

M.Crim.; M.Sc. (Applied Psychology)

You have a thought, a thought that stays in your mind for a while. Now imagine it staying for days, weeks, months, even years. It is repetitive, persistent and unwanted. Eventually, it starts to take over your everyday life. It seeps in when you try to do daily tasks like watching television, spending time with family, and even going for a job.

These are the signs of obsessive thinking. These are unwelcome thoughts, worries or doubts that repeatedly play on one's mind. It causes distress and anxiety in the person. This also leads to a reduced quality of life. The symptoms typically manifest at adolescence or young adulthood. They increase gradually, starting from mild intrusion and eventually leading to severe obsessions. The symptoms also worsen under stressful situations.

Many people having obsessive thoughts tend to find these obsessions irrational. As a result, they do not seek treatment for the illness which can lead to an increase in distress. It is essential to identify the problem and seek help at the earliest to control the symptoms. Cognitive Behaviour Therapy (CBT) has been found to be a beneficial form of treatment for obsessive thoughts.

CBT applies several cognitive restructuring methods to change the way an individual processes these obsessive thoughts. The methods include challenging the validity of the thought through Socratic questioning — a set of questions asked to the client to assess the usefulness and accuracy of a thought, thought stopping techniques, and also through action plans that will help the client work towards eliminating these obsessive thoughts between sessions. There are also several activities that help reduce the anxiety caused and gradually improve the quality of life.

Activities in CBT can be modified depending on the need of the client ― the severity of their symptoms, their lifestyle, and their ability to work towards improvement. In cases of severe obsessions, CBT is usually combined with medication in order to control symptoms of obsessive thinking.

ALCOHOLISM IN WOMEN

Arathi Kannan

M.Crim.; M.Sc. (Applied Psychology)

Alcohol addiction in women has been consistently on the rise and the taboo around the idea of women consuming alcohol has led to a ubiquitous silence on the problem. There are many aspects like environmental pressures from friends and family along with work-related stress that cause alcoholism. This, in addition to low-cost, constant access like during ladies’ nights at bars escalates the frequency of their consumption. Addiction is also genetic, therefore increasing its health risks twofold as it can have drastic effects on future generations.

Alcoholism causes various behavioural changes among women. Excessive alcohol consumption can cause aggression, impatience, lower self-esteem, reckless and risky behaviour. These can include indulging in dangerous sexual activities with strangers and poor financial decisions. These situations can often lead to dire consequences owing to their vulnerability in an inebriated state. Another typical behaviour is smoking while consuming alcohol. This causes detrimental health effects as dependency on alcohol increases the frequency of smoking.

Research on the adverse health effects of alcohol use disorder in women is limited. However, it is essential to understand that the impact of alcohol addiction manifests differently among men and women. Women are more susceptible to comorbid health issues like cardiovascular diseases, cancer, brain damage, and cirrhosis. They can have liver damage in shorter periods of alcohol dependence in comparison to men. It also affects their mental health, with rates of depression and anxiety being higher among women who are dependent on alcohol.

Behavioural treatments are found to be most effective in addressing alcohol addiction. Cognitive Behaviour Therapy (CBT) focuses on the individual’s need and allows clients to be involved in their treatment process. They have a say in how they wish to bring about alterations in their lifestyle. CBT targets the thoughts and feelings a person experiences before indulging in addictive behaviour. These are then modified using a variety of techniques and equip the client with skills that aid towards recovery.