ABSTRACT
Pervasive interpersonal fear-avoidance connotes the core psychopathology of the chronic patient; fear-avoidance is usually characterized by a detached-withdrawn interpersonal style. Examining patient profiles on The Interpersonal Circle reveals that most scores peak on the submissive-hostile (S-H) octant, denoting extreme interpersonal fear and detachment from others. Patients frequently describes a developmental history rife with instances of either psychological insults or serious psychological-emotional trauma. Another consequence of early-developmental maltreatment is a concomitant derailment/retardation of normal cognitive-emotional maturational growth. When the chronic psychopathology remits, it signals that patients are no longer stuck-in-a-rut as they interact in more flexible ways. The interpersonal skills of Cognitive Behavioral Analysis System of Psychotherapy (CBASP) clinicians, who facilitate feelings of felt safety with patients, play a critical role in the avoidance-to-approach counter-conditioning process. Patients must practice daily the lessons of treatment to prevent the loss of extinction of the older psychopathology.
