Eliminating Avoidance
Melissa G. Hunt, Aaron T. Beck in Reclaim Your Life From IBS, 2022
Imagine for a moment that you were really creeped out by snakes. (This probably won’t be hard. Most people in the world really don’t like snakes much. In fact, most primates really don’t like snakes much!) But now imagine that your fear of snakes is so bad that it interferes with your life. You won’t go camping or even do any gardening because you might encounter a snake. You freak out if a snake appears on TV or in a movie, or if you come across a picture of a snake in a magazine. What would you normally do? Avoid them! Even to the point of quickly changing the channel or closing the magazine. What does that avoidance do? It sensitizes you! You see the picture or image, your heart thuds, you feel a little jolt of adrenaline, you quickly get rid of the image, and then you start to feel less scared. You’ve just told your brain, “Wow! That was scary and dangerous! Good thing I got away from it.” This just seems to confirm that snakes are really threatening and should be avoided at all costs.
Psychosocial Aspects of Diabetes
Jahangir Moini, Matthew Adams, Anthony LoGalbo in Complications of Diabetes Mellitus, 2022
With frequent panic attacks and avoidance behaviors, drug therapy plus intensive psychotherapy is needed. Antidepressants, benzodiazepines, and combinations of these can be helpful. When antidepressants are used with benzodiazepines, it is usually as an initial treatment. The benzodiazepines are slowly decreased in dosage and often eventually discontinued or used more sporadically. Some patients respond well only to combination therapy. Psychotherapies include exposure therapy and cognitive-behavioral therapy are also used together. Exposure therapy helps patients to directly experience and confront feared situations in a controlled environment, and reduce avoidance until the fear is extinguished. Cognitive-behavioral therapy teaches how to recognize and change distorted thoughts and false beliefs, and modify behaviors to become more adaptive to situations. With diabetes, treatment may also involve relaxation training incorporating slow breathing techniques while monitoring CO2 levels in order to prevent hyperventilation. Biofeedback is an additional therapeutic technique that can improve symptoms of anxiety or panic while reducing the respiratory rate. This method gives patients visible evidence of how they are improving, thus providing them with a sense of control over their symptoms. Breathing training is helpful in panic disorder whether there is or is not any concurrent respiratory problems.
Entering the Woods at the Darkest Place—Experiential Engagement
Brian C. Miller in Reducing Secondary Traumatic Stress, 2021
The research on secondary trauma is awaiting the same kind of enlightenment that occurred in burnout research. Heretofore, experiential avoidance has been viewed as a symptom of, rather than a contributing cause of, secondary trauma. But this hole in the research quickly closes when we remind ourselves that secondary trauma is a form of trauma. And in the trauma treatment field, we have established—to the point of exhausting—the fact that exposure (the exact opposite of avoidance) is the treatment of choice. Exposure therapy is, in effect, also learning how to avoid avoidance. If a person with a trauma history avoids memories and feelings associated with a traumatic event, we expect the sequelae of the trauma—mood disturbance, anxiety, intrusive images—to continue unabated. Persons with trauma history also must be challenged to enter the woods at the darkest place. In trauma treatment, we call it exposure therapy.
Child Maltreatment Among Older Adults: A Narrative Review of Psychotherapeutic Interventions and Clinical Considerations
Published in Clinical Gerontologist, 2023
Rachel Zack Ishikawa, Ilana Ander, Dominique L. Popescu, Chirag M. Vyas, Olivia I. Okereke
Exposure is a strategy used in many cognitive-behavioral therapies to help individuals confront avoidance and overcome fear. In Prolonged Exposure (PE; Foa & Rothbaum, 1998) individuals are taught to approach previously avoided trauma-related memories, emotions, and situations. Confronting avoidance shows individuals that trauma-related experiences and emotions are safe, allows individuals to experience what they had previously avoided, and decreases PTSD symptoms. PE typically requires 12–15 sessions over a period of 3–4 months, and includes two types of exposure: imaginal and in vivo. Imaginal exposure involves the detailed and recorded retelling of the trauma narrative, which is then processed in session between patient and therapist. The patient then listens to the recording between sessions. In vivo exposure involves confronting feared situations outside of the session. Patients identify avoided behaviors and situations that elicit trauma-related fear, and gradually engage with these situations. As with imaginal exposure, repeated and prolonged exposure to feared stimuli gradually decreases fear and PTSD symptoms. Two case studies described these treatments among survivors in their late 50s.
A theoretical framework for addressing fear of falling avoidance behavior in Parkinson’s disease
Published in Physiotherapy Theory and Practice, 2023
Merrill R. Landers, Maria H. Nilsson
FOF can also trigger exaggerated or disproportionate avoidance behavior which may be more likely associated with affective processes, including anxiety and catastrophization (i.e. imagining the worst-case scenario), both of which figure prominently in contemporary understanding of fear. While activity avoidance can be adaptive (i.e. appropriate) it can also be maladaptive (i.e. inappropriate or disproportionate). In either case, the most important reason for the necessity of this theoretical framework and for developing treatment strategies, is that avoidance behavior can stimulate a vicious cycle, which may put one at an even greater risk for a future fall because of deconditioning and weakening of balance systems (Figure 1) (Brozova, Stochl, Roth, and Ruzicka, 2009; Dennison et al., 2007; Landers et al., 2021; Matinolli et al., 2009).
Female victims of acquaintance rape in college: Incidence and effects of encounters with perpetrators
Published in Journal of American College Health, 2023
Stephanie C. Bell, Lori A. Wolff, Melissa Skolnick
Data from multiple studies provides a range of behaviors and lifestyle changes in which college women participate after being raped.3,28–30 The effects range from changing jobs,3 to dropping out of school.29 More specifically, the Campus Sexual Assault Study (CSA)3 revealed other lifestyle changes victims made based on their previous knowledge of the perpetrator prior to their rape. For example, over 60% of women reported trying to avoid their assailant on campus. More specific forms of avoidance included: a) dropping a class or classes, b) changing their major, c) changing universities, d) changing residences, and e) quitting their job. The same sentiment was echoed in a Department of Justice (DOJ) civil rights investigation completed at the University of New Mexico.29 The DOJ found that students who were victims of sexual violence (including acquaintance rape) avoided certain parts of the school’s campus, dropped classes, lost scholarships, expressed a variety of negative health effects including PTSD, and some withdrew from the university entirely.29
Related Knowledge Centers
- Avoidant Personality Disorder
- Cognitive Behavioral Therapy
- Psychoanalysis
- Substance Abuse
- Experiential Avoidance
- Stressor
- Solitude
- Escapism
- Post-Traumatic Stress Disorder
- Approach-Avoidance Conflict