The Power of Avoidance Forces

Do you ever question why there are so many people taking antidepressant medication, many of whom seem to have pretty good lives? Do you wonder why some people linger with depression for so long, even though they have taken numerous medications? And, why do you think that some people bounce back from depression so well while others don't get up from what seems to be relatively weak blows? These and other related questions should not seem so vague and difficult to understand after reading this book. It took a very long time for medicine to abandon the idea that fever, bleeding, coughing, etc., were not the disease process. So too, psychology is now focusing more on the core causes of psychological distress and disorders, as opposed to symptoms such as depression. Although it is certainly tempting to view depression, anxiety, eating disorders, gambling and drug/alcohol abuse and other psychological problems as the "illness," more careful and closer examination reveals that these psychological difficulties are usually associated with consistent underlying causations, particularly patterns of avoidance and escape. In other words, these disorders are typically "side effects" of maladaptive coping styles inherent in personality functioning. The importance of this distinction cannot be underestimated because it guides how we interpret and treat various psychological problems. When we simplistically see symptoms as the psychological problem, there is a tendency to resort to short-term palliative treatments while failing to focus on core causations of the so-called disorder(s). We may view the gambler or alcoholic as a victim of being born with a disease. Or, we may simply see the sufferer as having to cope with genetically driven anxiety or depression which permanently affects their functioning, and is best treated with medication. Some might even view the depressed person as lacking the courage to change or adapt constructively. These orientations may not only help undermine responsibility and active coping on the part of the sufferer but, at the same time, suggest that superficial answers are the most appropriate way to perceive them. At best, medication is a general approach to specific problems and treats symptoms (Church & Brooks, 2010). Does anyone really believe that psychiatric medication goes to specific areas of the brain and fixes, repairs or adjusts the neurons or brain centers involved in various behavior problems? Moreover, medication often fails to produce positive effects and/or causes negative ones (e.g., side effects) while leaving the underlying cause(s) unexposed. Frequently, symptoms return when medication is curtailed.

A symptom-disease approach tends to be appealing to many physicians, patients, family members, and even some insurance and pharmaceutical companies. It seems cheaper in the short-run, convenient, tends to relieve feelings of responsibility on the part of the sufferer, offers a quick fix approach to the wishful thinker, and promises less effort up front. We know that insurance companies are under intense pressure to show profitability in the short run, leaving them less and less concerned about what is in the in the best long-term interest of the patient. Sadly, it often leaves the patient suffering with subpar and narrowly focused treatments. More to the point, treatment of effects rather than causes is likely to be superficial at best and, at worst, leads to more intense feelings of helplessness, hopelessness and demoralization while delaying treatment targeted at underlying causes of their problem(s). In some cases this type of ineffectiveness may even help facilitate suicide ideation and/or behavior (Church and Brooks, 2009).

After performing individual and group psychotherapy for several decades with people suffering from depression and many other psychological disorders, it became evident that traditional cognitive-behavioral psychotherapy was only minimally effective with some clients, particularly those suffering from chronic psychological disorders. Simply getting clients to substitute more rational and constructive thoughts and behaviors for presumably distorted, illogical or self-defeating ones was often ineffective or only yielded partial positive changes.

We are all aware of the power of motivation in both causing and sustaining our behavior patterns. We all experience the motivational conflict of both been drawn toward (approach) and away from (avoid) a goal or outcome. Clearly, we cannot obtain our desired outcomes when we are unable to approach and complete goal-directed behaviors. If this type of behavior pattern becomes consistent, then we are almost assured of being dissatisfied. Of course, it seems reasonable to ask why a person capable of logical and rational thought would routinely avoid seeking important goals. Fortunately, there is relevant research bearing on this question, some old and some new. Many decades ago, Dollard and Miller (1950) demonstrated that, as we get closer to a goal object, avoidance forces accelerate in strength faster than approach forces. The resulting effect of this phenomenon is that we may "chicken out" just prior to engaging in goal directed behavior, even in the face of something greatly desired. Another relevant and related research finding is that unpleasant events tend to be more powerful than pleasant ones (Baumeister, et. al., 2001). For example, it is been estimated that, generally speaking, for most people winning $1000 has about the same emotional intensity as losing $200. Thus, it becomes easy to see why we may be hesitant to approach goals that are associated with negative emotions, such as anxiety and fear. Although we have a strong desire to obtain certain goals, we can be overwhelmed by the anticipation of unpleasant feelings (e.g., anxiety) of stressful (e.g., fear) or painful events. To place this conceptual framework in another context, although we are social animals who desire affection and intimacy, the anxiety and fear related to rejection, embarrassment and/or disapproval renders many of us to loneliness, alienation and withdrawal. It is, of course, understandable that we usually try to avoid the unpleasantness caused by psychological and physical pain. Moreover, avoidance of pain is wired into our biology because it tends to enhance survival potential. Thus, we naturally tend to avoid fire, things that smell and taste horrible, people who could harm us, etc. However, when patterns of avoidance are inappropriate and/or excessive, the probability of psychological maladjustment increases and survival potential may very well decrease. Clearly, we need to know when it is imperative to confront painful experiences, even when our natural propensity is to avoid or escape (e.g., surgery). As will become clear, realistic confrontation of life stressors generally leads to development of better adaptive skills, more self-confidence, healthier relationships and greater life satisfaction. Contrariwise, excessive patterns of avoidance lead to opposite outcomes.

The critical significance of facing situations involving psychological pain helps us introduce an overlapping and key concept, acceptance. As will become clear throughout this book, we cannot untangle avoidance from acceptance. Fundamentally, we need to accept the realities of facing and enduring, as well as the negative outcomes that occur with excessive avoidance of such. A main theme of this book is that...