Customer Reviews

Distancing: A Guide to Avoidance and Avoidant Personality Disorder

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This book has a number of problems and contains little helpful content for clinician or APD sufferer:

Firstly, although this book is presumably intended to be a definitive work, it does not address the specific descriptors of the DSM criteria. Indeed, across the whole book the DSM (Diagnostic & Statistical Manual of Mental Disorders) is only accorded half a dozen of the 200 pages.

Second, the relationship between "avoidance" and Avoidant Personality Disorder is not made clear, so that the terms seem to be used synonymously. This enables the author to include the descriptions of "avoidant" behaviour which make up the bulk of the book. These descriptions include much aggressive and extrovert behaviour which directly contradicts the DSM diagnostic criteria.

Third, little attention is given to the "classic" APD sufferer, presumably because this would furnish few of the anecdotes with which the book is decorated. I suppose the chronic withdrawal of "classic" APD is rather unspectacular, given the extent to which social interactions are avoided. Nonetheless, it is the nominative topic, and should have been properly addressed.

Fourth, little space is given to speculation about causation. In the chapter "The literature" various names are cited with usually only a paragraph on their observations and opinions. An exception is made for Freud, who gets five pages. With a straight face, Kantor quotes "Anxiety in males is 'always ultimately a fear of castration'". Kantor also seems to agree with Freud, parenthetically, that the incest taboo is a prime cause of avoidance, if not of APD, but no clinical evidence is produced.

Fifth, an inordinate number of the anecdotes (I would not call them case studies) concern gay men. Kantor does not appear to have considered the socio-cultural, as opposed to clinical, causes of their behaviour.

Sixth, the following clinical observation may give you pause:
"Entirely unacceptable for some patients are treatment techniques that involve either sex with surrogates or the therapist watching the couple having sex so that he can make helpful, on-the-spot suggestions. This is especially true for obsessives ... and paranoids ... ." (p. 142)
You may disagree that an aversion to being observed in coitus by one's therapist is a sign of a personality disorder!

Despite some controversy over the term's legitimacy, I believe that APD warrants a serious and thorough study. It is a shame that this book does not sufficiently address APD in a way useful to clinician, student or patient.

I found this book quite boring and of little use. The author spends a great deal of time describing the various presentations of Avoidant Personality Disorder, such that there is little, behaviorally, that is not explained in terms of APD. Further, he may state that a certain behavior is reflective of APD, but then go on to state how the exact opposite behavior could also reflect APD, rendering both statements fairly useless. Next, the sections about how to assist someone with APD in therapy was rudimentary enough as to be insulting to a practitioner. If a therapist was actually considering some of the approaches the author advises against, the therapist had better go back to school or change careers, not read a book. Finally, there are a handful of suggestions offered to the individual who suffers from APD, but again, they are varied enough to include just about anything that might be helpful and there are mutually exclusive activities suggested, with rationales for doing each. I would think the book would either confuse a client or provide enough suggestions that a client could find several he was already doing (as part of his avoidant spectrum) such that there would be little motivation to make any change and much frustration as to why things weren't getting better. Very disappointing.

While this book touched on the main core of problems in AvPD (Avoidant Personality Disorder) and was very useful in that respect, adding in the information about its contribution to other disorders, as well as some examples, confused me. One story depicted an antique store worker responding to an inquire about a lamp with a rude, blunt "no."...as an avoidant myself, i cannot comprehend how someone with AvPD would do this, as it is likely to cause conflict and draw attention. The different therapys talked about in this book, though they might really cure this disorder, is nearly impossible to do by someone who is AvPD and has severe anxiety. All in all, the book is good, as well as almost the only book about AvPD, so who am I to gripe?

This text is a different read for me,in that it is a text book.It
was some what dificult to follow,but is also written for the lay reader.
Avoident disorders are common,and complex.For me this book is a real find.

This book is an embarrassment and of little help to anyone on either side of the proverbial coach. Tragic that it may be the only book written on the subject of APD.

As a student studying psychology, I found the book Distancing to be very helpful in establishing connections to several personality features not mentioned in the DSM-IV. One of these features is anger. According to Kantor, when avoidants passively fear rejection they will often produce that rejection by mere excess and/or ill-suited anger (Kantor, 1993: 42). The subject of anger was not a major focus in the book, but it provides new avenues into research of the avoidant personality. It is possible that aviodence may, in fact, have a strong connection to voilent behavior when combined with sexual frustration. The frustration of rejection (or fear of) may result in violent acts perpetrated against vulnerable targets such as women, children, or even men as was the case with Jeffery Dahmer.