The role of avoidance of emotional material in the anxiety disorders
Section snippets
Behavioral theories of emotional avoidance and anxiety
Recognition of the role of avoidance in behavioral models of anxiety came with Mowrer's (1960) two-factor theory of fear acquisition and maintenance. Until this point, behaviorists had focused on the role of classical conditioning in fear associative learning (Wolpe, 1958), but had failed to explain the resilience of clinical levels of fear and anxiety despite the easy extinction of even the strongest levels of fear in laboratory settings (Annau & Kamin, 1961). Mowrer (1960) proposed that once
The consequences of emotional avoidance: basic research
These behavioral models explain how emotional avoidance may interfere with extinction of learned emotional associations (thereby maintaining anxiety levels), and may elicit behaviors that interfere with or limit the range of behavioral responses (leading to diminished behavioral flexibility and diminished quality of life, as is seen in many anxiety disordered clients). However, a body of research suggests that emotional avoidance may have additional negative consequences that may further
Emotional avoidance and the anxiety disorders
Individual differences in the suppression/avoidance of emotions are related to a range of poor mental health outcomes. The tendency to avoid emotional expression has been associated with self-reports of less positive and more negative affect, poorer interpersonal functioning (including experiencing more emotional distance and receiving less social support from others; Gross & John, 2003), and higher levels of arousal when exposed to threat (Notarius & Levenson, 1979). Further, the tendency to
Future research
There is promising theoretical and empirical evidence of a link between an emotionally avoidant stance and the experience of clinical anxiety. However, more work is needed to better understand the outcomes associated with avoidance of aspects of the emotional response, and how these may be implicated in various forms of anxiety. This young literature is plagued by definitional and methodological challenges, difficulties in determining developmental/causal pathways, and measurement dilemmas.
Clinical implications
Because the construct of avoidance has been highlighted in behavioral models of anxiety acquisition and maintenance for more than five decades, psychotherapies employing exposure to and approach of fear-eliciting stimuli have been developed for diverse forms of anxiety [including phobia (e.g., spider phobia, Öst, 1996), panic (e.g., Barlow, Craske, Cerny, & Klosko, 1989), PTSD (Foa, Rothbaum, Riggs, & Murdock, 1991), and social anxiety (Heimberg, Liebowitz, Hope, & Schneier, 1995)]. While these
Acknowledgements
We thank Amy Wagner for her helpful comments on an earlier draft of this manuscript. Preparation of this paper was supported in part by National Institute of Mental Health Grant MH68962 to the first author.
References (189)
- et al.
Thought control strategies in obsessive-compulsive disorder: A replication and extension
Behaviour Research and Therapy
(2003) - et al.
Emotional processing and panic
Behaviour Research and Therapy
(2004) - et al.
Behavioral treatment of panic disorder
Behavior Therapy
(1989) - et al.
Are emotions frightening?II. An analogue study of fear of emotion, interpersonal conflict, and panic onset
Behaviour Research and Therapy
(1998) - et al.
Coping strategies and panic
Journal of Anxiety Disorders
(1988) - et al.
The effect of worry on cardiovascular response to phobic imagery
Behaviour Research and Therapy
(1990) - et al.
The nature of worry in generalized anxiety disorder: A predominance of thought activity
Behaviour Research and Therapy
(1990) - et al.
Perceived functions of worry among generalized anxiety disorder subjects: Distraction from more emotional topics?
Journal of Behavior Therapy and Experimental Psychiatry
(1995) - et al.
Avoidant coping style and post-traumatic stress following motor vehicle accidents
Behaviour Research and Therapy
(1995) - et al.
Patients with generalized social phobia direct their attention away from faces
Behaviour Research and Therapy
(2002)