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PTSD and Emotional Avoidance

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Updated June 19, 2014

PTSD and emotional avoidance go hand-in-hand. Many people with PTSD try to get away from or avoid their emotions. Emotional avoidance is part of the avoidance cluster of PTSD symptoms.

Avoidance symptoms make up one cluster of PTSD symptoms. Specifically, the avoidance cluster of PTSD symptoms include:

  • Making an effort to avoid thoughts, feelings, or conversations about the traumatic event.
  • Making an effort to avoid places or people that remind you of the traumatic event.
  • Having a difficult time remembering important parts of the traumatic event.
  • A loss of interest in important, once positive, activities.
  • Feeling distant from others.
  • Experiencing difficulties having positive feelings such as happiness or love.
  • Feeling as though your life may be cut short.

The first symptom includes the avoidance of emotional experience, which is common among people with PTSD.

Emotional Avoidance in PTSD

It has been found that people with PTSD often try to avoid or “push away” their emotions, both emotions about a traumatic experience and emotions in general. Studies have found that people with PTSD may withhold expressing emotions. In addition, it has been found that the avoidance of emotions may make some PTSD symptoms worse or even contribute to the development of PTSD symptoms after the experience of a traumatic event.

Why Emotional Avoidance Does Not Work

It is important to recognize that we have emotions for a reason. Our emotions provide us with information about ourselves and the things going on around us. For example, the emotion of fear tells us that we may be in danger. The emotion of sadness tells us that we may need some time to take care of ourselves or seek out help from others. Given the important role they play in our lives, our emotions are there to be experienced and they want to be experienced.

Therefore, while emotional avoidance may be effective in the short-run and may provide you with some temporary relief, in the long run, the emotions you're trying to avoid may grow stronger. Basically, your emotions may “fight back” so they can be be experienced and listened to. If someone is determined to avoid his emotions, he may then turn to more drastic and unhealthy ways of avoiding emotions, such as through substance use.

Avoiding our emotions also takes considerable effort, especially when those emotions are strong (as they often are in PTSD). As avoided emotions grow stronger, more and more effort is needed to keep them at bay. As a result, little energy may be left for the important things in your life, such as family and friends. In addition, using all your energy to avoid certain emotions may make it difficult to manage other experiences, such as frustration and irritation, making you more likely to be “on edge” and angry.

What Can Be Done

The most important thing to do is to reduce the extent that you try to escape your emotions. Of course, this is a lot easier said than done. If you have been avoiding your emotions for a long time, it may be difficult to release them. Sometimes, when we let our emotions build up, they may escape all at once, like a dam breaking. This may lead to our emotions feeling out of control.

It is important to find ways to release your emotions. Therapy of all kinds can be very helpful in this regard. Cognitive-behavioral and psychoanalytic/psychodynamic therapies all give you the opportunity to express and understand your emotions, as well as examine the sources of those emotional responses. In addition to examining emotions connected directly to the traumatic event, cognitive-behavioral approaches may address how certain thoughts or ways of evaluating a situation may be contributing to your emotions. Acceptance and Commitment Therapy (or ACT), a particular type of behavior therapy, focuses on breaking down avoidance and helping a person place his energy into living a meaningful life (and being willing to experience whatever emotions arise as a result). Psychoanalytic/psychodynamic approaches may pay more attention to early childhood experiences and their influence on your emotions. Either way, therapy can provide you with a safe place to express and approach your emotions. Seeking social support from trusted loved ones can also provide a safe way to express your emotions. Finally, writing about your feelings can also give you a safe and private way to release your deepest feelings.

If your emotions feel really unclear or unpredictable, self-monitoring may be a useful strategy for you. It can give you a sense of what situations bring of certain thoughts and feelings. Finally, if your emotions feel too strong, try distraction instead of avoidance. Distraction can be viewed as “temporary avoidance.” Do something to temporarily distract you from a strong emotion, such as reading a book, calling a friend, eating comforting food, or taking a bath. This may give the emotion some time to decrease in strength, making it easier to cope with.

Sources:

Hayes, S.C., Luoma, J.B., Bond, F.W., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44, 1-25. Hayes, S. C., Strosahl, K.D., Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York, NY: Guilford Press.

Roemer, L., Litz, B. T., Orsillo, S. M. & Wagner, A. (2001). A preliminary investigation of the role of strategic withholding of emotion in PTSD. Journal of Traumatic Stress, 14, 149-156.

Salters-Pedneault, K., Tull, M.T., & Roemer, L. (2004). The role of avoidance of emotional material in the anxiety disorders.

Applied and Preventive Psychology, 11, 95-114.

Tull, M.T., Gratz, K.L., Salters, K., & Roemer, L. (2004). The role of experiential avoidance in posttraumatic stress symptoms and symptoms of depression, anxiety, and somatization. Journal of Nervous and Mental Disease, 192, 754-761.

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