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Dr. Sandra Smith-Hanen Biography

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“The problems arise when they become exhausted with their role of spouse or parent, and life involves more than work. AVPs put in huge efforts toward the tasks they do. They have very little energy left. Their families begin to feel the abandonment when ambivalence replaces the structure of rules or work. They can clean up the kitchen, help with homework, but the needed or intimate parts of relationships are more minimal. The other issue is often trying to hold the line, as it were. Many of the AVP’s psychological symptoms turn into health-related issues, which can further remove them”

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“To the significant other, the confusion can become enormous. They “hear” the AVP say, I want it, but I don’t. I want it all, not just some. I’m too overwhelmed; I can’t get what I really want. Poor me. I can’t deal with this, and you, too. I’m tired. I’m bored. I don’t care about your situation. Calm down. We don’t need emotions here. Only controlled access is allowed. These statements may or may not be said, but they are acted out.”

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“This means that emotional hoarding is occurring. How to balance the needs of others is difficult for them. Therefore, more AVPs need psychological treatment to assist on an ongoing basis. Add to this the fact that the spouse of the AVP recognizes the AVP has times of clarity. This just increases anxiety and defensiveness for both when the needed clarity is gone.”

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“The AVP’s ambivalence extends to displaying affection. They can at once show interest and then shut this interest off when the spouse responds more intimately. The spouse is left with feelings of disappointment and discouragement, annoyance, and confusion.”

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“The AVP often has intestinal issues. The intestines are indeed a second brain and need a significant amount of support. It may be interesting to note the polyvagal theory of Steven Porges (2011), who wrote about the tenth cranial nerve, which runs from the brain to the gut. Negative responses in the gut can occur when flight/fight/freeze responses are automatically activated.”

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“Judgment is literal, even in and with their own health. When someone wants and needs calm or regulation, there is an atmosphere of constraint created. When someone’s regulation is in part a self-created world, the other is now in uncertain territory. In an effort to diffuse the tensions, the AVP will often project an attitude of not caring and one of being overwhelmed.”

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“Empathy is difficult for the AVP. They do care about others and can be very aware of emotional content. AVPs are capable of expressing empathetic thought, though it is usually short lived. Their thoughts are often racing and difficult to find. They vacillate between what is fair or not. You might see an AVP give more empathy to a distant relative at an event than the significant other. They do care, but the feeling of that care response can be problematic. They are still hiding, balancing, and are fearful of rejection. Interactions rarely are confronted or dealt with.”

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“AVPs will hold the spouse accountable for “wrong” action. This is true even if the spouse felt he or she was supporting the AVP. The AVP is hypersensitive. They do have a continued suspiciousness of others and what they might do to them. This, in turn, maintains a fairly consistent internal defensive posture.”

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“In the beginning of their relationships, both short term and long term, the AVP seems to welcome assistance. As time progresses, they can see these same helpers as incompetent. This could be from a spouse helper to a therapist. When this occurs, passive–aggressive displays can be apparent, subsequent to distancing from a given relationship.”

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“Hence, the significant other has little to no input on this process. It’s already been done. The dramas/traumas have already been enacted. Their own memories carry negative emotions, even if they are not able to remember the details of the memory.”

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“We know that while AVP may be the least problematic of the personality disorders, it can have serious consequences in the lives of close family members, and particularly the significant other. Treatment can be initiated by an AVP, but often the focus is on other “symptoms,” such as failed relationships, anxiety, or depression. More often, treatment is initiated by the AVP’s significant other.”

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“The spouse sees all the wonderful aspects embodied in these relationships, and the missing pieces in their own relationship with the AVP. This is how the spouse would prefer to be treated. This causes anxiety, confusion, frustration, and loss for the spouse. Coworkers, colleagues, employees experience different levels of the AVP. The AVP’s perfectionism is usually full blown on the job, where the AVPs are at their best”

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“The non-AVP spouse feels the relationship is one sided in favor of the AVP. AVPs try to avoid personal issues and past issues. Let’s just start today is a common theme. After an argument, Doug doesn’t see any patterns in his behavior. June sees the importance of going forward but is frustrated with 15 years of the same situation. The spouse has brought up dissatisfaction to the AVP. They feel uncertain of themselves. They recognize they need more time and space to be or to relate to others. They are aware they don’t have goals. They do not know how to say no gently, yet firmly, so they are ashamed of themselves. They find that demands or suggestions stop them at some level. They have a sense that they need others so they can keep going. AVPs in relationships often feel they can’t give to their spouse. They find their spouse’s marital style intense and overstated. Often, this is how they view the spouse’s parental style as well. They want stress to be gone.”

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“Most spouses of AVPs appear to have an early history of independence in their upbringing. They are often analytical in their approach and overall thinking. Almost all of the spouses state they like to be close. They appear to be planners and goal directed. Overall, they have strong expectations of themselves and others they are close to. They are now unhappy and see their spouse as unhappy. They have an underlying sense of wanting to fix the issues of the spouse.”

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“Others living with avoidant persons will often say the worst thing is that they can’t give to them. This, too, is regulated comfort, love, support; an adult patient stated his worst experience with his avoidant ill mother was not being allowed to comfort her. Turning off the I care for you or quickly withdrawing for no apparent reason is very confusing. They may show great care when others need it, which is often what the AVPs want themselves. Phrases such as I can’t, You do it, That’s past, I don’t have time are used frequently in relationships. When a spouse “quits,” there is a sense from the AVP of I get to quit. AVPs no longer need to be responsible. Ah, but wait—there is no one to take care of … or … take care of me.”

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“For AVPs, if they find that they are upset and see a caring spouse become upset with them, it is a release. However, since these are repeated patterns and no stable patterns are maintained, the spouse often becomes more anxious and does hold this anxiety. The AVP is able to see this, at some level. The increased agitation has the effect of keeping the spouse preoccupied and more distant. Nothing is seemingly moving forward. The spouse, like the AVP, can become stuck. June and Doug can both be anxious, distant, or preoccupied. Avoidants have found that they can transfer some of their avoidant and angry responses to other family members. In doing this, their intention is to transfer some of their anxieties to another person to act out or hold for them. This can occur due to living together or can be part of the AVP’s messages that a family member hears and then displays. This effect of transferred anxieties can be experienced by the children, the spouse, and maybe even the family pets. The AVP’s inability to positively confront situations produces many scenarios. Unfortunately, this can often produce in others a negative image of the person acting on behalf of the AVP. This, at some level, registers for the AVP, and shame and guilt become the results of this active/passive position.”

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“AVPs are usually willing to show or tell others about their external or physical pain. In so doing, they avoid sharing the internal pain they feel. They can overdwell on their anatomical issues. This ambivalent thinking can be self-defeating. And AVPs fear finality. Some patients have not had a recommended surgery, due to the finality of having the problem fixed. The avoidant person’s gauging of their own body is flawed. Some avoidants are quick to seek treatment for their bodily concerns. The tensions they absorb have produced some very real problems. On the other hand, some avoidant persons tend to “ignore” these concerns until a significant health event occurs. As a group, they do need rest, less stressful environments, and dietary consistency, but they are not good at these following these restrictions.”

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“They base their behavior on fear of both criticism and rejection. However, they also want to relate. We see them placing their weight on one side of the teeter-totter and then the other. This occurs in most aspects of their lives. On one side, they will strive to look and act close to perfect, in order to establish connections. Then, they will do things to keep others away. They consciously or unconsciously set themselves up to be the first to reject. Others will then respond with the desired rejection or criticism. The dynamic is one of success to failure, failure to success.”

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“Perfectionism has its own set of judgment issues. The AVP may see the partner as less than perfect and can exclude them on such a basis. These erroneous judgments, at best, impede their social relationships and, at worst, leave them alone. The way in which they reflect on their lives and the lives of others is so often done from one perspective—theirs.”

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“Over the years, the significant other can come to feel shame, even though this was not part of their coping mechanisms. Shame can therefore be used by the significant other. Either consciously or unconsciously, they may use shame in interaction with the AVP. Part of this is due to the fact that the significant other fears being guilty (hurting the AVP). When communication becomes more and more difficult in relationships, shame increases in both partners. The other may find that, without using shame, the AVP doesn’t respond in any meaningful way: What is wrong with you? One of the major struggles of the partner of the AVP is in the area of whether they need to hold the AVP responsible for his or her actions. This is a truly difficult piece for the spouse. They have a sense that the AVP is not deliberately trying to hurt them. June often is confused. She doesn’t know if Doug is understanding the hurt he is inflicting.”

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“These scenarios are repeated over and over again in daily living. The spouse feels anger, frustration, and confusion. They ask for a different approach, but usually, over years, it ends up in a hopeless state of confusion. AVPs state they love their spouse, but the question remains for them: To what end? The spouses would like their life to be different, but often they end up in stagnation.”

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“There may also be a paranoid response in the AVP, a sense of imminent harm by a family member, which sets up protection devices. The AVP thus controls situations, even though there is only a short-term gain. In the long term, this produces more hurt and anger for the people involved. The avoidant, however, has a sense of relief in that they can relax a bit. They have done the “right” action, or they have kept tensions at a given level once again. They do not want the blowup from tension. This is too difficult, as more may be released than their system can handle. Also, there may be an illusory sense of closeness, and of success. These scenarios also keep boredom at bay. It is a type of delusion they create and operate under. They do this to justify their behavior. This delusion is very difficult for family members to penetrate with rational thought.”

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