Avoidance to Acceptance

Written by Paul Paris, Ph.D.

Do you procrastinate? Do you push off the stuff you don’t want to do to some indeterminate future? Avoiding things in day to day life is fairly common, especially when associated with something unpleasant or something we just do not want to do but feel we must.

I remember as a college undergraduate, I would defer completing a required paper until the last minute. Sound familiar? I’d spend time with friends, go to the movies, eat out, and generally enjoy myself instead. How good that felt! But lo and behold, the night before the assignment was due, I rushed like mad to get it done, often pulling an all-nighter with exhaustion the next day from lack of sleep. Then came added worry about all the other assignments I had put off.

There is an adaptive function to avoidance behavior in our lives, especially in the short-term. Often, that behavior proves ineffective in the long term or results in negative consequences that we did not foresee. It’s the human condition: immediate gratification or immediate avoidance of unpleasant or unwanted stimuli. And, it is often reflexive, that is, we enjoy the things that bring us pleasure and escape the things that bring us pain.

Sometimes in the immediate moment, that reflex is called upon for our survival and adaptation. For example, during or after a traumatic, life-threatening event, people often experience emotional numbness, feelings of unreality, even disconnection from their own bodies. In the short-term, the adaptive function helps mobilize the mind and body for survival in what we call the fight-or-flight response. In the long term, if the traumatic memories, feelings, and triggers are avoided, they may maintain — even intensify — the trauma symptoms.

Human behavior is shaped by reinforcement, the reoccurrence of the same behaviors again in similar circumstances. In avoidance, negative reinforcement is involved. Unpleasant emotions, memories, thoughts, sensations, or environmental triggers such as places, colors, or activities are avoided. This avoidance only increases the likelihood that they will be avoided again in the future. But those unpleasant experiences never really go away and may worsen if avoidance continues.

ACT (Acceptance & Commitment Therapy) acts on the idea that the more a person fights against or tries to avoid his or her negative experiences, the stronger these experiences have a hold on the person. In my clinical experience, most problems involve avoidance, or avoidance is the key issue in why the problem continues or worsens.

So, how can we take care of ourselves when avoidance becomes problematic? First, we must honor our limits and understand that the root of the problem is not our own fault. For example, people cannot perform at work while allowing themselves to re-experience the intense emotional content related to the loss of a loved one during their workday. Such individuals may suppress those intense thoughts or feelings, waiting to get home to cry and grieve. Especially in grief and trauma, it is important to not overwhelm ourselves by doing too much too soon. Everyone’s grieving journey is unique.

ACT also uses mindfulness as a technique as it can help individuals to accept their experience and to counter conditioned avoidance responses. What is mindfulness? It is the conscious directing of attention to the present moment in a gentle and nonjudgmental way, without trying to change anything in that moment. Many techniques foster this state of mind, but it takes lots of practice, especially with our busy minds generating thoughts. Exposure therapy, which is facing fears and other discomforts through direct experience, can also help to counter avoidance. It is not for everyone, however. This technique requires working with a therapist who honors your limits and preferences.

Because I use a lot of metaphors and symbolism in therapy, I want to share how I like to describe not only avoidance, but the therapy process itself:

A person is in pain and wants a better life. The person is standing on a shore, and there is a swamp between themselves and the shore across on the horizon. On that other shore is their better life. The swamp length between the shores is infinite, so the only way to get to the other shore is to go through the swamp. But the swamp is filthy, smelly, and slimy. The person may wait a long time to decide if they even want to cross, but they’re still in pain, and yearning for that better life on the other shore. They may need help from someone else. A raft may be offered to them, but they don’t know how to paddle. Perhaps the helper shows them how to paddle, or what technique to use if they get stuck in the swamp. Finally, the person decides to cross the swamp. Their oars get stuck in the slime, but they can wrest it out, and at times, the person starts rowing back to the original shore because the smell is too strong. It takes the person a long time to get to the other shore, but once they get there, they are grateful that they have a better life. Their pain may still come and go, but their better life makes it all seem worthwhile. They are able to cope.

We are conditioned and trained to try to change our “negative” emotions. They need to go away, or maybe we shouldn’t feel that way in the first place, or we need to do something to make them go away. But, what if we were to sit with those emotions, allow ourselves to feel them, and still work towards having the life we really want? Therapy is not just about symptom reduction, it is about enhancing quality of life.

All of us experience normal emotions such as sadness, happiness, and anger throughout our lives. Even if they’re intense, what would it be like to experience those feelings and observe them instead of trying to take them away? This is not an easy question to answer, but if avoidance is going on in your life, it may be helpful to think about why certain things are avoided and whether that avoidance behavior is working for you. If the answer is no, therapy or mindfulness techniques are options to try for improving the quality of your life.

Image: Tanya Dawn on flickr and reproduced under Creative Commons 2.0