Metacognitive interpersonal therapy. a clinical case of avoidant personality disorder - Davide 31 yrs. old patient suffering from Avoidant Personality Disorder and treated with Metacognitive Interpersonal Therapy (Procacci e Popolo, 2003; Procacci, Petrilli, Dimaggio, 2003). He had difficulties to identify his own thoughts and feelings, mindreading difficulties and was not able to detach from his own schemadriven representations of the others. Treatment was initially focused on identifying the range of feelings he experienced in stressful interpersonal conditions: it emerged that the patient representated the self as inadequate and constantly fearing the anticipated harsh critiques from the others. He felt embarassed and socially rejected or humiliated, and these feeling lead him to isolate in order to avoid critiques and suffering. As a consequence he felt different and distant from the others or sometimes reacted with anger to the anticipated stigmatisation. The therapy helped him in recognising positive aspects of the self. A constant regulation of the therapeutic relationship was needed in order to prevent alliance ruptures and prevent early dropout. At the end of treatment patient was more able to understand that his fears of being judged were more the consequences of his life history than the actual trend of relationships.
Key Words: Avoidant Personality Disorder; Therapeutic Relationship; Metacognition; Interpersonal Cycles.
Parole chiave: disturbo evitante di personalità; relazione terapeutica; metacognizione; cicli interpersonali.