On Experiential Avoidance: Practical Issues in Treatment

Elvin’s alcohol problem was truthfully a surface level issue. He did drink too much and way too often, but he drank particularly because he wanted to suppress his feelings of inadequacy. He hated the idea of being weak, something that had been ingrained into him as a child. So, as he felt more incapable to manage his world he would drink. Of course the drinking made him more incapable of managing his world and so he drank more. A self-destructive cycle was created. His dominant issue was a fear of his feelings, but only through recognizing and addressing those feelings would he truly find help and change.

We have begun a series of posts on experiential avoidance, or phobia of inner experiences. Last week I wrote about the primary conceptual issues that we must help people grasp if they are to make progress in confronting their undesirable emotions, memories, and thoughts. This week we will look at some key practical issues in treatment. There are three practical steps to helping someone overcome their fear of internal experiences: (1) Awareness, (2) Reflection, (3) Confrontation.

First, individuals must learn to become aware of their avoidance. I cannot change what I do not recognize, and so learning to sense when we are avoiding certain emotions becomes important. Avoidance is not always a conscious choice, sometimes we are unaware that we are avoiding such things, and so taking time to develop our sense of ourselves can be an important first step. This requires us to regularly spend time evaluating ourselves and our reactions. Elvin took a short survey for me, every day, for three weeks. Over time we began to see some patterns. The survey involved answering the following key questions:

1. What inner experience (feeling, memory, or thought) did I attempt to avoid today?
2. What did I believe would happen if I allowed myself to experience it?
3. What did I do to avoid that experience?
4. What significant things were happening in my life today?

The questions are simple, though not always simple to answer, and the idea was to get Elvin thinking about himself and evaluating his responses. Over time we began to see he feared sadness because it made him look weak, which meant, in his mind, that he was not a real man. This was a significant breakthrough in our counseling and began to open up doors to lasting help.

Awareness does not solve the problem. Initially the goal was not to stop avoiding the experiences, but to be able to identify when and how he was avoiding the experience. Awareness helps us to begin to make sense of what we are avoiding, why we are avoiding it, and how we can plan to address it.

Second, individuals struggling with internal experiences must give time to reflect on their experiences. Reflection is an effort to consider and make sense of our internal experiences. Our emotions can be overwhelming precisely because we don’t always understand them, we simply experience them. Reflection allows us to then begin to make sense of what we feel, identify sources, causes, and, in time, make choices.

For Elvin, as with most individuals, this began with learning retrospective reflection. This meant he would take time to reflect on his emotions after the fact. In time we wanted him to reflect on what he was experiencing in the moment, but we started here. Think back and reflect on what you felt, did, attempting to understand it and explain it. He kept a journal that would guide him in processing his internal experiences. So each day he would reflect on one or more situations and answer the following questions:

1. What happened (what was the situation that sparked your inner experience)?
2. What were your thoughts, feelings, sensations, or predictions?
3. What did you do?
4. What did you want?
5. What could you have done differently?
6. What similarities and/or differences do you notice about this experience and other experiences?

As he learned to reflect on experiences after the fact he was developing the habit of reflection which would help him in the moment too. Over time he habituated reflection enough that he could begin to reflect even in the midst of the experiences, but this took lots of time and is never perfect.

Lastly, individuals struggling with internal phobia must learn to confront their experiences. Confrontation requires us to know the truth and this always takes us back to God and His Word. My emotions, memories, sensations, and predictions tell me many things. Sometimes they are accurate, but often they are wrong, misguided, or only partially true. I need to know the objective truth of God’s Word which speaks back to my internal experiences. Psalm 22 serves as a great example of this type of Biblical confrontation.

In Psalm 22 the author regularly confronts his feelings and thoughts with the truth of God’s character and activity. The text vacillates back and forth with doubt and truth. The author states his concerns and then shifts with the word “yet” to assert the truth he most needs to hear in that moment. An outline of part of the passage will serve us well.

1-2 describe his feelings of abandonment: “why have you forsaken me”

• 3-5 give the response: my forefathers trusted in you and you delivered them!

6-8 describe feelings of self-condemnation. Here the author asserts that he is not like his forefathers. “I am a worm,” he says.

• 9-11 recall God’s faithfulness through his own life. “On you was I cast from my birth, and from my mother’s womb you have been my God,” he says.

The text goes on like this, back and forth. He preaches truth to himself, confronting his inner experience with objective truth. God has spoken, God has acted, God has proved His faithfulness. Remember it. Recall it. Tell yourself what you have forgotten. Confrontation takes practice and assistance, especially when we have not been accustomed to feeling our feelings. Good counselors will need to demonstrate this and help individuals practice it.

Elvin used my Truth and Lies Chart to help himself develop this habit. Regularly, multiple times a day even, he would sit down and tell himself the truth. He would point out what was partially true about his feelings/thoughts, and then remind himself of how God’s Word clarified things further. Sometimes he had to tell himself that his emotions/thoughts were simply wrong, and point to Scriptures that countered them. Over time he has seen tremendous change in his inner experience.

Both the conceptual and practical issues are important for helping people navigate their inner experiences. Biblical Counselors want to be patient and gracious with those who have developed this phobia. We know that our inner experiences can be troubling, but God’s Word holds out hope for navigation. Helping people learn to be aware, reflect, and confront their inner experiences is a means to helping them develop godly responses to their feelings. God cares about how we feel and He can help us navigate undesirable feelings.