Experiential Avoidance and PTSD - Why Acceptance Helps Us Heal

After a Trauma, Different Coping Strategies Can Have Different Outcomes

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Experiential avoidance is an attempt or desire to suppress unwanted internal experiences, such as emotions, thoughts, memories and bodily sensations. This unwillingness to stay in contact with internal experiences is thought to underlie many unhealthy "escape" behaviors, such as substance use, risky sexual behavior and deliberate self-harm, and may increase the risk of post-traumatic stress disorder (PTSD) in people who have experienced a severe trauma.

Understanding Experiential Avoidance

Avoiding negative internal experiences is a natural instinct that serves to protect us from harm. However, psychologists dating back to Sigmund Freud have argued that such avoidance can also negatively impact our mental health and behaviors.

In the 1990s, psychologists began referring to these avoidance and escape behaviors as "experiential avoidance." Experiential avoidance is seen as a coping style that may perpetuate problems or produce new ones. For example, trying to not to feel anxious may perpetuate anxiety instead of allowing it to dissipate.

In 1996, psychologists from the University of Nevada wrote in an important paper that "many forms of psychopathology are not merely bad problems, they are also bad solutions, based on a dangerous and ineffective use of experiential avoidance strategies."

Since then, experiential avoidance has been associated with:

Experiential Avoidance and PTSD

Experiential avoidance is believed to increase a traumatized person's risk of developing and maintaining PTSD.

For example, a study published in 2014 found that abused children were much more likely to develop PTSD if they tried to avoid painful thoughts and emotions after the abuse rather than talking about their negative feelings. Experiential avoidance strategies may in part explain why 40 percent of children who are abused develop PTSD over the course of their lives, while the other 60 percent do not.

Experiential avoidance is one of three emotion regulation strategies believed to increase the risk of PTSD. The other two emotion regulation strategies implicated in PTSD are rumination and thought suppression.

Experiential Avoidance and Acceptance and Commitment Therapy for PTSD

The opposite of avoidance is acceptance. Acceptance and Commitment Therapy (ACT) is a behavioral psychotherapy that was developed to reduce experiential avoidance.

ACT is based in the idea that suffering comes not from the experience of emotional pain, but from our attempted avoidance of that pain. Its overarching goal is to help people be open to and willing to have their inner experiences while focusing attention not on trying to escape or avoid pain (because this is impossible to do) but instead, on living a meaningful life.

There are five goals of ACT:

  1. Recognizing that trying to escape from emotional pain will never work
  2. Realizing that trying to control the pain is the problem
  3. Viewing yourself as separate from your thoughts
  4. Letting go of attempts to avoid or control thoughts and feelings 
  5. Living a meaningful and rewarding life

ACT is one form of treatment recommended for PTSD and other psychological problems related to experiential avoidance.

Also Known As: emotional avoidance, emotional unwillingness, thought suppression, unwillingness

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