Experiential Avoidance and PTSD

Experiential Avoidance and PTSD PTSD Coping Print Experiential Avoidance and PTSD By Matthew Tull, PhD twitter Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. Learn about our editorial policy Matthew Tull, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on June 24, 2019 Post-Traumatic Stress Disorder Overview Symptoms & Diagnosis Causes & Risk Factors Treatment Living With In Children Aleli Dezmen / Cultura / Getty Images 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: Anxiety and generalized anxiety disorderBipolar disorderDeliberate self-harmHigh-risk sexual behaviorObsessive-compulsive disorderPanic disorderSubstance abuseSuicideTrauma and post-traumatic stress disorder  Trichotillomania How Experiential Avoidance Hurts People With PTSD Experiential avoidance is believed to increase a traumatized persons 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% of children who are abused develop PTSD over the course of their lives, while the other 60% 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, 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: Recognizing that trying to escape from emotional pain will never workRealizing that trying to control the pain is the problemViewing yourself as separate from your thoughtsLetting  go of attempts to avoid or control thoughts and feelings  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