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Some time ago I noticed some strange things in Sherlock's behaviour and started a research. I found out, that Sherlock might be suffering from an Anxious (avoidant) Personality Disorder (APD) published in the ICD 10 under the Code F 60.6


Then I started looking for more clues and realised there were quite a lot of them, which I hadn't noticed before. I think it's quite interesting and so I decided to write this post.

Sherlock's personality disorder is probably a result of a complex trauma suffered in childhood.

Now to the causes and symptoms for APD according to the ICD 10 list.

Causes:

1. Rejection and emotional neglect by parents and siblings
2. Bullying
3. Parents are experienced as oppressive, restrictive, lacking emotions and sensitivity

Symptoms:

  • Hypersensitivity to rejection/criticism
  • Self-imposed social isolation
  • Extreme shyness or anxiety in social situations, though the person feels a strong desire for close relationships
  • Avoids physical contact because it has been associated with an unpleasant or painful stimulus
  • Feelings of inadequacy
  • Severe low self-esteem
  • Self-loathing
  • Mistrust of others
  • Emotional distancing related to intimacy
  • Highly self-conscious
  • Self-critical about their problems relating to others
  • Problems in occupational functioning
  • Lonely self-perception, although others may find the relationship with them meaningful
  • Feeling inferior to others
  • In some extreme cases, agoraphobia
  • easy to order around, have difficulties defending themselves
  • sadness and anxiety are the prevailing states of mind
  • restrictions in lifestyle because of need to have physical security
Sources:
1. Wikipedia /
2. "Dual Diagnosis and the Avoidant Personality Disorder" http://www.toad.net/~arcturus/dd/avoid.htm

And now for the clues in the series.

Causes:

Authoritarian parenting style based on fear
Emotional abuse and neglect by his father
Bullying and physical abuse by his classmates

1. As a child he sets a compound fracture himself and wears longsleeved shirts so that he doesn't have to tell his dad. (S.1,Ep.6)

2. Sherlock and his brother call their father "mercurial" and "capricious" (S.2,Ep.8)

3. Sherlock says, that his father doesn't care about him and that he is a "serial
absentee

4. At boarding school he is bullied and gets savagely beaten by his classmates
frequently over a period of several years. (S.1 Ep.3, S.2,Ep.4)

5. Sherlock calls his father a "Lovecraftian horror".
Main themes of this genre are the hopelessness and helplessness of the
characters towards a malignant force and intangible fear. ( S.2, Ep.22)

6. Sherlock calls his father an "old tosspot" and a combination of "Adolf Hitler and Bernard Madoff" in front of Joan Watson
Victims of emotional abuse often fight back by insulting their abusers.


Symptoms:
  • has got difficulties holding eye-contact

  • calls his home his "sanctum sanctorum" and keeps half a dozen surveillance cameras inside the house


  • Keeps a knife hidden at the entrance so that he can grab it without looking (S.2,Ep.9)

  • says that he can't make connections. Watson answers that they just frighten him. (S.1, Ep.1)

  • always appears to be tense and nervous outside his house - usually keeps his hands in his pockets ( because they're trembling S.2,Ep.24)

  • only leaves the house when absolutely necessary, tries to take files home or lets them send to his home

  • positions himself in a room always in a way that he can see everybody and the door. He never stands free but leans against something to 'cover' his back. When he can't do that he gets dizzy. ( S.2/Ep.18)

  • extreme low self-esteem - Always questions his value as a person

  • stutters when he talks about very personal matters (S.1, Ep.4 / S.2 Ep.7)

  • always keeps at least an armlength distance to other people, avoids body contact

  • tries to avoid shaking hands with people. When he has to take one he moves backwards with the upper part of his body

  • trusts nobody - even follows Watson at the beginning of her stay with him. (S.2,Ep.5)

  • uses "Amygdala" as suggestive word to hypnotise himself.
    • The Amygdala is responsible for the modulation of fear and negative emotions.
    • In people suffering from depression and anxiety the Amygdala is overstimulated (S.1,Ep.2)

  • suffers from an anxiety attack when his sponsee Randall enters his home for the first time (S.2, Ep.11)

  • when Watson asks him if he wants to go back to London after his brother told him that his father wanted him back, he answers "What I want is irrelevant." (S.2,Ep.8)

  • isolates himself socially

  • shows symptoms of severe anxiety as he unexpectedly meets Gay in his living-room and turns his back on her to talk to Joan (S.2,Ep.14)

  • when Joan Watson comes home she always announces that she is back as early as she opens the frontdoor.

  • when Sherlock works in a room, Joan addresses him as soon as she enters the room and only approaches when she is sure that Sherlock noticed her. Captain Gregson does the same.
    • on one occasion Watson can't announce herself, because Sherlock stands in the room with headphones on. When she approaches Sherlock complaints : "You have startled me." (S.3,Ep.11)

  • on the pavement he mostly walks on the side of the houses when he his out with others.

  • Lestrade did a talk on deduction. Sherlock is angry that he stole his ideas but when Joan suggests to tell him in person he only answers "To what end?" whereas he has no difficulty to bring Lestrade to task for his mistakes in the case. (S.2, Ep.16)

  • Sherlock is talking to an injured woman. Lestrade butts in and Sherlock leaves the room with a sarcastic comment but without defending himself. (S.2, Ep.16)

  • Sherlock does "balancing exercises" in a pitch-black room with a cock perched on his shoulder.
    • I interpreted this as trying to control his breathing to fight his anxiety attacks. Chickens have got a so called "vibration organ" with which they can sense vibrations in complete darkness in order to recognise approaching dangers.
      Afterwards he his lying on his stomach on the living-room floor.
      Anxiety attacks are often accompanied by an impaired balance.
      Lying on the floor reduces the symptoms. (S.2,Ep.17)

  • Lestrade criticises Sherlock in front of Joan for serving him clues on a silver-platter. Sherlock is so hurt that he calls Lestrade "Sir". Joan has to lift his spirits afterwards. (S.2/Ep.17)

  • When the doorbell rings, it's always Watson to open. On one occasion when Watson isn't home and he has to open the door himself, he hesitates for quite some time and only lets the woman in after she asks him to and states her intentions.
    Then Sherlock sits at the opposite side of the room and isn't able to take the USB stick out of her hand. She has to leave it on a stool. (S.2, Ep.18)

  • Bell invites Sherlock to his party. Sherlock doesn't want to go, because he thinks that he is not really wanted ("I will always be an outsider") and fears that the other guests will hold him accountable for Bell's injury. (S.2,Ep.18)

  • After "stabbing" the robber, who is hiding under the sheet in the morgue, with a needle, the guy comes up in a sudden move. Sherlock flinches and moves back to the wall of the tiny room. When the detective woman talks to him he isn't able to answer anymore, he just makes a gesture with his shoulders.
    Later he is balancing on a ladder with one foot, although he could have moved it to reach the shelf comfortably.
    He might be doing it in order to restore his equilibrium after the panic attack. (S.2, Ep.19)

  • "We are everyone" , in exchange for information, makes Sherlock stand on a square with a poster in his hand saying "Punch me in the arm to help me catch a murderer". He has to endure this procedure for quite some time. It costs him so much energy, that he, after Watson tells him to relax, sits down in an armchair without protesting and falls asleep, although the information hasn't been checked yet. (S.2,Ep.19)

  • Holmes and Watson want to look at the medical files of the inmates at a prison. The assistant who opened the door for them, steps behind Sherlock to talk to him. Sherlock immediately takes two steps sideways to put some distance between himself and the man, then looks at him with suspicion. (S.2, Ep.19)

  • Sherlock observes a house on the opposite side of the street. He leans with his back against a car, although he would have a much better view if he turned around and faced the street. But because this would mean having his back uncovered, he doesn't do it. (S.2, Ep.20)

  • At the precinct, Captain Gregson goes into his office. The door behind him closes with a loud noise. Sherlock flinches, while Bell doesn't react at all. (S.2, Ep.21)

  • Sherlock comes home after Joan's rescue. He enters the house, sees the armed guards and the doctor and immediately starts breathing fast and heavily (hyperventilation). Joan notices that, gets up and says to Sherlock that everything is alright, but only after Sherlock moves very close to her and she reassures him that she is O.K., he is able to get his breathing under control. (S.2, Ep.23)

  • Sherlock walks alone on the street after he visited the ex-wife of the victim. He phones Joan who is in the flat of the victim. During the entire call he turns his head in every direction seeming extremely nervous. He even bites his lip. After he ends the call, he immediately stops a cab and gets in. (S.2, Ep.23)

  • The doorbell rings. Joan looks at Sherlock who doesn't react, so she opens the door. It's the ex-wife of the victim. Sherlock appears and indicates to her to come in. He doesn't walk ahead though, but let's her pass and follows.
    Before the doorbell rang, Sherlock was relaxed in his body language. Now he is very tense and breathless. He doesn't get any further than the next wall, where he waits for Joan to join them. Only when Joan is standing next to him, he is able to calm down a little bit, but in the following conversation he still keeps his hands in his pockets. (S.2, Ep.23)
    • This intensification of Sherlock's anxiety could be a result of the taser attack of his brother.

  • Sherlock observes a shop from a car. When Watson arrives, she asks him why he rented a car. He answers that he didn't rent it but needed a place to sit and that this was the best observation post. Watson looks around. You can see stairs right behind the car from where you would have had an even better view. She doesn't comment on that fact though. (S.2, Ep.24)

  • Sherlock is confused about Mycroft "sacrificing" himself and returning to work for MI6, so that Sherlock wouldn't be send to prison.
    He can't understand he could mean so much to his brother that Mycroft would do this for him without getting something in return. (S.2, Ep.24)

    Sherlock: "I'm just confused. You owed me...nothing."
    Mycroft: "You are my brother."


  • Sherlock and Marcus want to interview a suspect. They have to park the car outside the complex and walk a short distance to the appartment. Sherlock calls Watson and talks to her until they reach the door.
    Watson is irritated because he could have given her the information later as it wasn't that important. On the whole way Sherlock looks around himself although in company of Bell and appears to be extremely nervous when they finally arrive. (S.3 Ep.3)

  • Sherlock finds out that Watson wrote a "Casebook" where she described him and the his cases. He is shocked and feels spied on, although Joan never made the text public. He is so frightened that he lets Kitty sign a nondisclosure agreement and doesn't dare to read the text. (S.3 Ep.5)


  • A woman appears at Sherlock's door while he is alone at home. He opens the door with his Singlestick in hand and never puts it aside during the whole conversation. It looks as if he is keeping her at bay with it. (S.3, Ep. 13)


  • Watson wants to move back into the brownstone. When she comes to her appartment with packing foil under her arm, she meets Sherlock who already got all the boxes packed with the help of an aquaintance. When Joan says that she has engaged a professional moving company, Sherlock says that the house is their sanctum and their stronghold and that only over his mouldering corpse he would let strangers with boxes of unknown contents beyond its doorstep. (S.3, Ep.15)


  • Sherlock meets with Oscar, a companion from the days of the height of his druguse. Oscar bends over to touch the button on Sherlocks lapel. Sherlock only suppresses the impulse of arming his hand away with difficulty. But when he is attacked and gets thrashed by two men shortly after, he shows no defensive reaction at all. (S.3,Ep.16)

  • Sherlock tells Watson that he knows she can relate to a profound sense of guilt, but that she can't relate to a profound sense of shame. (S.3,Ep.16)

  • After Sherlock has spent a night in a cell he says that it is interesting to spend a night there and that he is reminded that they are good places for bad people (S.3, Ep.16)

  • Sherlock makes the following statement:

    "Family is the tie that binds. But while one end undergirds human civilisation, the
    other end is a noose, that chokes away our individuation." (S.3.Ep.17)

    • In developmental psychology a disturbance in the individuation process is considered to be the cause for personality disorders and neuroses. Disturbances of individuation are a result of pathogenic family structures. (e.g. emotional neglect and authoritarian and harsh parenting)
I don't know if the writers of the show intended it that way, but it's so consistent, that I think they might have.
I am looking forward to your opinion on the matter.
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I doubt Sherlock has low self esteem. He has hubris and he is socially inept, he does not sensor what he says and says what is on his mind regardless of the consequences. That is how Bell got shot, because he ruined a man by exposing his past. It was difficult for Sherlock to say he was sorry and take responsibility for his actions. If anything he finds most people boring and not his intellectual equal or even interesting.

Sherlock has trouble forming deep meaningful relationships. He felt rejected as a child by his father. He was not close to his brother and they apparently spent most of their childhood and adult life competing as to who was the smarter brother. I think Sherlock was jealous of Mycroft because solving the puzzles were so easy for Mycroft while Sherlock had to work hard at it. Hence, Sherlock felt Mycroft wasted his gifts and was too lazy to care.

Very little is ever spoken of his mother. Sherlock opened up to one woman, Moriarity, and when he thought she was dead, he turned to heroin. He tries to distance himself from any relationship so he won't get hurt again.

Despite his protests, he deeply cares for Joan, and is protective of her but does not know how to express or admit it.
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I don't think Sherlock suffers from an Anxious (avoidant) Personality Disorder but when I read that list of symptoms I realized that I most definitely do!
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You could argue that and sure you could argue that he has a sort of social anxiety disorder; the list could go on. But with that said, I don't think he has any type of low self-esteem or inferiority issues. If anything he thinks he's superior to everyone else. He just thinks of everything from a technical standpoint, sharply to a point that he doesn't think much of emotion. He thinks he's above emotion.
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Sherlock does not have Avoidant Personality Disorder anymore than a normal person has Avoidant Personality Disorder with regards to fire. You can be quite normal and have a strong fear of fire without anything else being wrong with you. The reality of what fire can do does not mean your fear of it is abnormal. It would take an irrational fear of fire (where you can't even look at pictures or videos of it) for it to become close to the type of severity metaphorically related to a person with Avoidant Personality disorder.

Sherlock's immense intelligence relative to the general population is what causes alot of his symptoms, not a genetic/psychological condition that stimulates irrational responses. He doesn't avoid people because he's experiencing an irrational impulse, he avoids people because his intelligence has given him ample evidence that its presence makes them uncomfortable and withdraw. It would be like saying a tiger has Avoidant Personality Disorder because it doesn't feel comfortable walking down the street. Panicked people, strange violent behavior, strong social response, staying at home to avoid all that doesn't have an irrational basis. And that individuality is going to create alot of the other symptoms as well: shyness in social situations (but desire for relationship,) mistrust of others, highly self conscious, etc.

In fact, one of the major symptoms that Sherlock doesn't have that clues you into the fact he doesn't have AvP is his strong self-esteem. He doesn't feel inferior to others (quite the opposite,) he doesn't loathe himself (he loathes aspects of his personality but that's true for everyone,) and he certainly doesn't struggle with feelings of inadequacy (except related to his sobriety but even that becomes a source of his self-esteem, i.e. "look at how long I've remained sober/clean, I am better than my addiction.") A true AvP sufferer is tormented by inadequacy, fears of being unworthy, unloved. Sherlock gets lonely but that's because Irene keeps him on a short leash with her letters.


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Spot on.
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You can see it that way , too, of course.
I just want to say that, before I created this post, I spoke to a psychologist about the matter, because I didn't want to publish something that would prove to be nonsense, as I am not professionally trained in this field. She assured me, that, considering the clues I found, it was absolutely probable that I was right.
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Do you know much about the written character, Dr. Arthur Conan Doyle's Sherlock Holmes? That's right. Doyle was a Doctor. There is a lot of thought put into that, over many many years. If you want to examine the character you should start there. But, I seriously doubt the writers have written into their over view of THIS Sherlock Holmes to have a Personality Disorder. I know very well what a Personality Disorder is, having known 2 people very closely with two different variations of the Disorder.... and I can tell you without doubt that this character does not have anything like that. He is simply a genius and as a result is very quirky. That's it. It's very easy to piece symptoms together and come up with a variety of patterns. But the writing for this show is not that dense... it's fictional fiction. Dr. Doyle gave a lot more thought to his Holmes and the only issue he had was spattered drug use (but not drug addiction according to Holmes himself) and a hard time dealing with the dull day in day out of human existence.

“…My mind rebels at stagnation. Give me problems, give me work, give me the most abstruse cryptogram, or the most intricate analysis, and I am in my own proper atmosphere. I can dispense then with artificial stimulants. But I abhor the dull routine of existence. I crave for mental exaltation…”

- Sherlock Holmes, ‘The Sign of Four’
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Some of that might be true. But he definitely got a panic attack in Episode 14 when he turned his back on Gay. And this is absolutely irrational because Gay did neither reject him nor was she representing any danger. And why does he always lean against something to cover his back and positions himself so that he can see eberybody, even in the precinct.
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I had to rewatch parts of the episode to see what you were referring (sic) to. His unease with Gay was the result of him being surprised in his home. Sherlock has few places he is comfortable at but where he lays his head/sleeps/experiments is one of those places. Therefore, being surprised in his home is something he both tries to mitigate and responds poorly to when it happens.

Furthermore, his agitation at the beginning of the program was due to being placed into an uncomfortable position by his charge, Randal. Because he is new to being a sponsor, he was worried about performing his role properly. That we can further confirm his agitation was not with Gay was shown by his nonchalance later in the episode while she sleept on the couch. A true AvPD sufferer would not be so calm with a stranger in their abode. The fact that Sherlock invited her and was comfortable playing music in her presence suggests his agitation earlier was at being startled, not by her.

As for his furtive behavior, that is easier to explain. He is a world-famous detective who has apprehended scores of criminals. In other words, he has a long list of enemies and friends of enemies who would be more than happy to see him beaten to a bloody pulp. And since a decent criminal is very unlikely to telegraph their intent, Sherlock must remain vigilant. He chooses environments where his back (the position most vulnerable to sneak attack) is protected, making any potential threat attack him from the front, the side (still watched by his peripheral vision) or, in extreme cases, above and below. Furthermore, while a normal person might feel comfortable being surrounded by the police, Sherlock is all too aware that a bad apple can, and will, turn up everywhere, nevermind his ingratiating habit of offending people with his observations. While Capt. Gregson and Det. Bell are friendly and supportive of Sherlock, for the most part, I can say with certainty not everyone in the precint or department thinks very highly of him. With that much animosity, even in the company of the Capt, one never knows when an 'accident' may occur. And none of that even begins to approach the moral conflict many of them would have with his various and wide-ranging criminal contacts (Moriarity the foremost of them.) No matter how many cases he solves, Sherlock will always be a drug-addict/criminal waiting to be captured in many minds.
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I said ingratiating, I meant abrasive.
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