A man describes a lifelong, keenly felt wish for close friendships, but says shyness, tension, and a fear of embarrassment have left him isolated and lonely despite that genuine desire for acceptance. He has found some comfort in solitary hobbies, and has managed to form a few close relationships, but only with people he experiences as completely uncritical of him. What is this?

This is anxious (avoidant) personality disorder: an acutely felt need for friendship combined with a lack of the social skills or confidence needed to form relationships, shyness and easy embarrassment leading to isolation despite a genuine, strongly felt wish for acceptance, some compensation through solitary pursuits, and a capacity to form relationships specifically with people experienced as uncritically accepting. It is not schizoid personality disorder, in which the person has little underlying wish for closeness at all — the defining feature here is exactly the opposite, an intense, keenly felt desire to make friends. It is not social anxiety disorder alone, since this pattern is more generalised across many areas of social encounter, with pervasive low self-esteem, rather than limited to one or a few specific situations. And it is not dependent personality disorder, which centres on relying on others to take charge once relationships are formed, not primarily on the difficulty forming them in the first place.