Experiential Avoidance

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Anti-Avoidance techniques are often an important part of becoming freer in life and are an integral part of Acceptance and Commitment Therapy (ACT), a cutting-edge Cognitive-Behavioral Approach to healing.  Here's an interesting description of "Experiential Avoidance" and how it is implicated in mental health challenges

Experiential avoidance (EA) has been broadly defined as attempts to avoid thoughts, feelings, memories, physical sensations, and other internal experiences—even when doing so creates harm in the long-run.[1] The process of EA is thought to be maintained through negative reinforcement—that is, short-term relief of discomfort is achieved through avoidance, thereby increasing the likelihood that the behavior will persist. Importantly, the current conceptualization of EA suggests that it is not negative thoughts, emotions, and sensations that are problematic, but how one responds to them that can cause difficulties. In particular, a habitual and persistent unwillingness to experience uncomfortable thoughts and feelings (and the associated avoidance and inhibition of these experiences) is thought to be linked to a wide range of problems.

 
EA has been popularized by recent third-wave cognitive-behavioral theories such as Acceptance and Commitment Therapy (ACT). However, the general concept has roots in many other theories of psychopathology and intervention.
 

Empirical Evidence

  • Laboratory based thought suppression studies suggest avoidance is paradoxical, in that concerted attempts at suppression of a particular thought often leads to an increase of that thought.[12]
  • Studies examining emotional suppression and pain suppression suggest that avoidance is ineffective in the long-run.[13][14] Conversely, expressing unpleasant emotion results in short-term increases in arousal, but long-term decreases in arousal.[15]

Relevance to Psychopathology

Seemingly disparate forms of pathological behavior can be understood by their common function (i.e., attempts to avoid distress). Some examples include:

Diagnosis Example Behaviors Target of Avoidance
Major depressive disorder Isolation/suicide Feelings of sadness, guilt, low self-worth
Posttraumatic stress disorder Avoiding trauma reminders, hypervigilance Memories, anxiety, concerns of safety
Social phobia Avoiding social situations Anxiety, concerns of judgment from others
Panic disorder Avoiding situations that might induce panic Fear, physiological sensations
Agoraphobia Restricting travel outside of home or other "safe areas" Anxiety, fear of having symptoms of panic
Obsessive-compulsive disorder Checking/rituals Worry of consequences (e.g., “contamination”)
Substance use disorders Abusing alcohol/drugs Emotions, memories, withdrawal symptoms
Eating disorders Restricting food intake, purging Worry about becoming “overweight,” fear of losing control
Borderline personality disorder Self-harm (e.g., cutting) High emotional arousal

[edit]Relevance to Quality of Life

Perhaps the most significant impact of EA is its potential to disrupt and interfere with important, valued aspects of an individual’s life.[21] That is, EA is seen as particularly problematic when it occurs at the expense of a person’s deeply held values. Some examples include:

  • Putting off an important task because of the discomfort it evokes.
  • Not taking advantage of an important opportunity due to attempts to avoid worries of failure or disappointment.
  • Not engaging in physical activity/exercise, meaningful hobbies, or other recreational activities due to the effort they demand.
  • Avoiding social gatherings or interactions with others because of the anxiety and negative thoughts they evoke.
  • Not being a full participant in social gatherings due to attempts to regulate anxiety relating to how others are perceiving you.
  • Being unable to fully engage in meaningful conversations with others because one is scanning for signs of danger in the environment (attempting to avoid feeling “unsafe”).
  • Inability to “connect” and sustain a close relationship because of attempts to avoid feelings of vulnerability.
  • Staying in a “bad” relationship to try to avoid discomfort, guilt, and potential feelings of loneliness a break-up might entail.
  • Losing a marriage or contact with children due to an unwillingness to experience uncomfortable feelings (e.g., achieved through drug or alcohol abuse) or symptoms of withdrawal.
  • Not attending an important graduation, wedding, funeral, or other family event to try to avoid anxiety or symptoms of panic.
  • Engaging in self-destructive behaviors in an attempt to avoid feelings of boredom, emptiness, worthlessness.
  • Not functioning or taking care of basic responsibilities (e.g., personal hygiene, waking up, showing up to work, shopping for food) because of the effort they demand and/or distress they evoke.
  • Spending so much time attempting to avoid discomfort, that you have little time for anyone or anything else in your life.
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