# Motivation and emotion/Book/2013/Experiential avoidance

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## Overview

This chapter will look at what experiential avoidance is, why it is an important issue, how it leads to other psychological disorders, how to measure it, and finally how to treat it. Experiential avoidance is suppressing and avoiding thinking about or experiencing negative emotions after a traumatic incident (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004). It is important because it is a common issue that many people use to avoid certain negative elements in their life. The reason that a lot of people use experiential avoidance is because it can be socially unacceptable to express negative emotions such as sadness and anxiety (Hayes et al, 2004). The use of experiential avoidance over a long period of time can lead to the development of other psychological disorders (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004). The examples used in this chapter include posttraumatic stress disorder, depression, anxiety and binge drinking. Experiential avoidance can be measured using the Acceptance and Action Questionnaire. Experiential avoidance can be treated with Acceptance and Commitment Therapy.

## What is Experiential Avoidance?

Experiential avoidance is avoiding thinking about, talking about or generally dealing with any negative issues. It is mostly about avoiding bad feelings about anything that may have happened to a person (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004). Some examples of experiential avoidance is not talking about a particular topic in a conversation or avoiding going to a specific place because it brings up bad memories and emotions (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004). This is not necessarily bad in short term but in long term, this avoidance can cause many issues and harm to you (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004). Over time, the bad feelings tend to build up and may be experienced more often with other feelings such as guilt. They are also more likely to be more frequent and worsen over time (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004). This also involves changing and manipulating events so as to not encounter these places or the bad feelings that they elicit (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004). People who were more likely to have experiential avoidance were more likely to be more emotional towards positive and negative types of stimulus (Pickett et al, 2011).
Experiential avoidance has been linked to causing psychological disorders such as depression (Cribb et al, 2006; Gámez et al, 2011; Goldstone et al, 2011; Hayes et al, 2004; Marx & Sloan, 2005; Sloan, 2004). This is important because suppressing and avoiding these bad feelings are the cause of people getting mental illnesses rather than the actual events themselves. Some examples of these disorders involving experiential avoidance include psychodynamic theory, behavioural and cognitive theories (Gámez et al, 2011). Despite this history and precedence in other psychological disorders, experiential avoidance is a relatively new area of research for psychologists (Bond et al, 2011). Experiential avoidance has been included as a defence mechanism against negative emotions and events in psychodynamic theory in particular (Gámez et al, 2011; Goldstone et al, 2011). This is significant because it shows that experiential avoidance has been around for a long time and is a very common way to deal with negative experiences. The reason that many people use experiential avoidance is because it can appear to be a positive thing in the beginning. However, there is evidence that shows that this is not the case (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004).

## Why is Experiential Avoidance Important?

Experiential Avoidance is important because it can lead to the cause of various mental and psychological disorders. While it may appear to be positive and helpful in the short term, this is not the case for the long term (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004). This is important because it shows that experiential avoidance is not helpful in dealing with negative issues. Experiential avoidance is also a commonly used method to attempt to forget about negative issues or experiences (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004). People often do different things to avoid these issues such as drinking copious amounts of alcohol and avoiding the subject in conversations with other people (Gámez et al, 2011; Stewart et al, 2002). If experiential avoidance is left untreated, it can become worse and develop into a mental illness such as depression and posttraumatic stress disorder (PTSD) (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004). Experiential avoidance can also lead to anxiety disorders and can predict certain symptoms in other psychological disorders (Fergus et al, 2013; Goldstone et al, 2011; Gámez et al, 2011; Hayes et al, 2004; Sloan, 2004). Treating experiential avoidance is important because it can lower anxiety in many people. It would also be very beneficial for people who have experiential avoidance to have it treated and work through whatever they are avoiding. Therefore, experiential avoidance is important to many people.

### Posttraumatic Stress Disorder

One of the many psychological disorders that experiential avoidance can lead to is posttraumatic stress disorder (PTSD). This is a result of experiencing a life-threatening event. Experiential avoidance and another concept known as peritraumatic dissociation have been found to be likely to cause posttraumatic stress disorder (Marx & Sloan, 2005). Peritraumatic dissociation is known as when the traumatised person refuses to deal with the traumatising event (Marx & Sloan, 2005). If this is combined with anxiety, it can lead to the development of posttraumatic stress disorder (Marx & Sloan, 2005). Research has also shown that the seriousness of peritraumatic dissociation can be a link to how serious the posttraumatic stress disorder in a person is (Marx & Sloan, 2005). Peritraumatic dissociation has been found to be very similar to experiential avoidance because both concepts involve avoiding associations with stressful or negative life events such as a near death experience (Marx & Sloan, 2005). Peritraumatic dissociation has also been defined as avoiding all thoughts and stimuli relating to the traumatic event (Marx & Sloan, 2005). Other research has defined it as control parts of the traumatic experience but not all of it (Marx & Sloan, 2005). There is a lot of research that suggests that people who use experiential avoidance about a traumatic event are more likely to develop posttraumatic stress disorder (Marx & Sloan, 2005). Marx and Sloan (2005) have done a study to test this theory with undergraduate students who had experienced a traumatic event in their past. This study involved the use of self-reports. The results of this study indicated that both experiential avoidance and peritraumatic dissociation forecast the seriousness of posttraumatic stress disorder in traumatised individuals (Marx & Sloan, 2005). This is significant because it proves that experiential avoidance can lead to posttraumatic stress disorder and is also an important problem.

### Depression

Research has shown that experiential avoidance can often lead to depression (Cribb et al, 2006). The use of experiential avoidance to conceal negative emotions and experiences can cause depression if it has not been treated (Cribb et al, 2006). Although there has not been a great deal of research, there is enough that suggests that using experiential avoidance to forget about negative issues will lead to the development of depression (Cribb et al, 2006). However, there is one study that set out to find out whether there is any link or causality between different types of avoidance, including experiential avoidance, and depression. This experiment gave several measurements to test different aspects of anxiety, depression and avoidance to undergraduate students (Cribb et al, 2006). One of the measures included was the Acceptance and Action Questionnaire, which is used to measure experiential avoidance in particular (Cribb et al, 2006). The results of this experiment were that there was definitely a link between experiential avoidance and depression (Cribb et al, 2006). This is important because it shows that avoiding negative emotions and memories can become worse and lead to depression. However, there is the possibility for more research in this area, which would be beneficial for people who are experiencing depression or using experiential avoidance in their lives (Cribb et al, 2006). This is also important because it shows that experiential avoidance is not a good way to work through negative issues in the long run. This knowledge could also benefit the community by reducing levels of depression in many people.

### Anxiety and Binge Drinking

Experiential avoidance, as well as many other types of avoidance, can lead to the development of anxiety disorders. In the DSM-IV, avoidance is one of the main symptoms of anxiety disorder (Stewart et al, 2002). This is important because it shows that trying to forget about negative emotions and memories can cause anxiety, which is a very common mental disorder. Experiential avoidance can also lead to binge drinking, which is also a popular method to forget about negative events (Stewart et al, 2002). This is important because many people attempt to drown their sorrows in alcohol. This is also significant because anxious people also drink copious amounts of alcohol to forget their negative issues and problems (Stewart et al, 2002). Research has shown that there is a link between anxiety, experiential avoidance and drinking alcohol to forget about negative emotions and memories (Stewart et al, 2002). One particular experiment tested the links between anxiety, experiential avoidance and motivations to binge drink in undergraduate students (Stewart et al, 2002). The results of this particular experiment showed that there was a link between experiential avoidance and the motivation to binge drink to avoid negative emotions and memories (Stewart et al, 2002). This is important because it shows that experiential avoidance can lead to binge drinking for the wrong reasons such as to forget about negative emotions as well as to raise the mood of the person who is using experiential avoidance (Stewart et al, 2002). This is also significant because there are a lot of people who use alcohol to drown their sorrows after a traumatic incident and this does not help them. However, there is more room for research between experiential avoidance and alcohol (Stewart et al, 2002). Therefore, experiential avoidance is important because it is experienced by many people and it can lead to binge drinking.

## Measurement
### Acceptance and Action Questionnaire

The main method used to measure experiential avoidance is a self-report over time. One particular self-report method that has been used a lot is the Acceptance and Action Questionnaire (Bond et al, 2011). This is the most popular questionnaire to measure experiential avoidance (Bond et al, 2011; Gámez et al, 2011; Sloan, 2004). The Acceptance and Action Questionnaire consists of up to 16 different items that measure aspects of experiential avoidance such as suppressing certain thoughts or feelings and changing routines such as avoiding going to specific places, which could evoke negative emotions (Bond et al, 2011). There have been a lot of research and experiments to prove whether the Acceptance and Action Questionnaire has been helpful to people in various aspects of their lives (Bond et al, 2011); Sloan, 2004). The Acceptance and Action Questionnaire has been very useful for experiential avoidance (Bond et al, 2011; Sloan, 2004). An example of this is that experiential avoidance has been treated in many people. This is important because it shows that the Acceptance and Action Questionnaire has been useful for reducing experiential avoidance in people.
It has also been successful for many other aspects of life and other mental illnesses (Bond et al, 2011). Some examples of these other successes also include emotional intelligence and social desirability (Bond et al, 2011). The Acceptance and Action Questionnaire has been able to predict and help with many life issues such as job success and anxiety (Bond et al, 2011). The Acceptance and Action Questionnaire has also been edited to assist people with other problems such as coping with epilepsy and smoking addictions (Bond et al, 2011). This is important because it shows that the Acceptance and Action Questionnaire can be applied to other parts of life and many other negative issues in life can cause experiential avoidance. In the case of experiential avoidance, the best type is the original Acceptance and Action Questionnaire.
The Acceptance and Action Questionnaire has some flaws. For example, the Acceptance and Action Questionnaire only covers two aspects of experiential avoidance (Gámez et al, 2011). These are an intrusion of a persons values and not accepting sadness (Gámez et al, 2011). This is important because it shows that the Acceptance and Action Questionnaire may not cover all aspects and issues with experiential avoidance. One major issue with the Acceptance and Action Questionnaire is that it has not ben found to be particularly consistent (Bond et al, 2011; Gámez et al, 2011). This is important because it shows that the Questionnaire may not be valid or reliable. When it has been applied to validity tests such as the test-retest method, the Acceptance and Action Questionnaire did not receive an outstanding result (Bond et al, 2011; Gámez et al, 2011). It has also been less successful in other countries where people don’t speak English very well or are well educated (Bond et al, 2011). This is significant because the Questionnaire should be a universal concept like many other psychological theories. However, for many people in the western world, the Acceptance and Action Questionnaire has been very successful in removing experiential avoidance in many people.

### Other Types of Measurement

There are many other types of self-report methods that can measure different aspects of experiential avoidance (Gámez et al, 2011). These include suppressing negative thoughts and avoiding certain places that can bring up negative memories etc. Many people have thought that there should be a new method to measure experiential avoidance because the Acceptance and Action Questionnaire is so inconsistent (Gámez et al, 2011). This is important because experiential avoidance is a common problem amongst many people which can lead to them suffering from negative thoughts and depression. A new measurement should also be able to measure and cover all aspects of experiential avoidance rather than only a few of them. Therefore, it is important to create a consistent and successful method to measure experiential avoidance to help people who may be suffering from it.
One particular study that has created a new method to measure experiential avoidance attempts to cover all aspects of experiential avoidance. It also covers other aspects such as the Big Five personality traits (Openness to new experiences, conscientiousness, extraversion, neuroticism and agreeableness), happiness with life outcomes and links to the development of mental illnesses as a result of experiential avoidance (Gámez et al, 2011). This is important because it is more comprehensive than the Acceptance and Action Questionnaire and it covers all the areas of experiential avoidance. This particular study created this new type of measurement for experiential avoidance and covered all the different aspects and tested it on undergraduate students (Gámez et al, 2011). This new measurement worked very well when it came to measuring the different aspects of experiential avoidance and was more consistent than the Acceptance and Action Questionnaire (Gámez et al, 2011). However, there are some limitations with this study too. For example, the undergraduate test subjects were not particularly diverse and the measurement has not been tested again since (Gámez et al, 2011). This is important because the new measurement should be able to test experiential avoidance in anyone regardless of his or her background. The lack of retesting is also important to show whether it will really work to measure experiential avoidance on people in the future (Gámez et al, 2011). Regardless, this new measurement can be promising and is a good example for methods to measure experiential avoidance so that people will be able to recognise it in time and get treated before it gets too bad.

## Treatment
### Acceptance and Commitment Therapy

Acceptance and Commitment Therapy is used to treat a number of issues that include not being able to make or keep commitments, avoiding emotions as well as experiential avoidance (Hayes et al, 1994). While it may be socially acceptable to ignore negative stimulation or not show any emotions, this can be problematic because experiential avoidance can develop into a psychological disorder (Hayes et al, 1994; Hayes et al, 2004). The aim of Acceptance and Commitment Therapy is to treat experiential avoidance by getting the patient to stop controlling and suppressing the negative emotions and to work through the issues that have caused them to use experiential avoidance in the first place (Hayes et al, 1994; Marx & Sloan, 2005).
Acceptance and Commitment Therapy uses a number of stages for the patient to work through to treat their experiential avoidance.
| Stage | Description |
| First | Patient to stop suppressing any negative emotions and recognise that it is pointless |
| Second | Let the patient know that their experiential avoidance is affecting their life |
| Third | Create different circumstances that can allow the patient to accept their emotions and not suppress them anymore |
| Fourth | Encourage the patient to decide what they value in their life |
| Fifth | Tell the patient to stop controlling their negative emotions and accepts them as a part of life |
| Sixth | Allow the patient to determine what they would like to do in the future based on their values and accepts the negative events as being in the past and a part of their life |
(Hayes et al, 1994)
The theory behind the creating of Acceptance and Commitment Therapy is known as Relational Frame Theory. This theory is based around language and perception in social contexts (Hayes et al, 2004). According to this theory, in social situations humans have learnt that certain feelings and behaviours are not okay in public and are therefore viewed as negative (Hayes et al, 2004). For example, sadness is seen as a bad emotion and people will then attempt to ignore feeling sad unless it is socially appropriate. This has also led to the creation of experiential avoidance where people will ignore their negative emotions because it is socially acceptable (Hayes et al, 2004). People will also avoid certain places because it could bring up these negative emotions (Hayes et al, 2004). Acceptance and Commitment Therapy works around this social context that certain emotions are negative and forces the patient to experience and work through them (Hayes et al, 2004).

## Conclusion

This book chapter covered the topic of what experiential avoidance is, why it's important, how to measure it as well as how to treat it. Experiential avoidance is important because it can affect many people and lead to the development of worse psychological disorders if it is not treated in time. There has been a lot of research about experiential avoidance and its links to other psychological disorders, how to successfully measure it and how to treat it. However, a lot more research in all these areas is still needed. Experiential avoidance can be treated using the Acceptance and Action Questionnaire. It has been linked to many psychological disorders such as depression, anxiety and post traumatic stress disorder. Experiential avoidance can be treated with Acceptance and Commitment Therapy.