 Interpersonal avoidance always dictates that the patient's primary focus remains on himself or herself (i.e., patients stay "in their heads").In such a psychosocial functioning state, these individuals remain helpless and hopeless and continue to respond to themselves in a solitary and never-ending circle of pain, fear, anxiety (and depression); hence, they are unable to connect with their interpersonal world in any informing way—we diagnose this pattern of living, chronic depression (Comments above taken from McCullough, 2000