Emotional Avoidance in PTSD

Emotional avoidance is a common reaction to trauma. In fact, emotional avoidance is part of the avoidance cluster of post-traumatic stress disorder (PTSD) symptoms, serving as a way for people with PTSD to escape painful or difficult emotions.

Avoidance refers to any action designed to prevent the occurrence of an uncomfortable emotion such as fear, sadness, or shame. For example, a person may try to avoid difficult emotions through the use of substances or dissociation.

Avoidance Cluster Behavior

The avoidance cluster of PTSD symptoms is categorized as the attempt to avoid distressing memories, thoughts, or feelings as well as external reminders such as conversations about the traumatic event or people or places that bring the event to mind. Avoidance behaviors are effectively an effort to withdraw from situations and feelings that produce trauma-related symptoms.

Moreover, people engaging in avoidance may have emotional numbing symptoms such as feeling distant from others, losing interest in activities they used to enjoy, or having trouble experiencing positive feelings such as happiness or love. Avoiding emotional experiences is common among people who have PTSD.

Emotional Avoidance in PTSD

Research shows that people with PTSD often try to avoid or “push away” their emotions, both emotions about a traumatic experience and emotions in general. In addition, it has been found that trying to avoid feeling emotions may make some PTSD symptoms worse or even contribute to the development of PTSD symptoms after experiencing a traumatic event.

Drawbacks of Emotional Avoidance

Emotions serve important psychological and physiological purposes. Your emotions provide you with information about yourself and the things going on around you. They communicate and motivate action. For example, fear tells you that you may be in danger; sadness tells you that you may need some time to take care of yourself or seek help from others.

If someone is determined to avoid feeling their emotions, they may eventually turn to more drastic and unhealthy ways to avoid them, such as substance use.​ Avoiding your emotions also takes considerable effort, and as the emotions you are avoiding 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. Research has also suggested that avoidance coping leads to chronic worry.

Management and Treatment

The best way to start managing your symptoms is to develop healthier coping mechanisms that allow you to identify, accept, and process your emotions. Therapy can provide the opportunity to express and understand your emotions as well as examine the sources of those emotional responses.

Cognitive Behavioral Therapy (CBT)

In addition to examining emotions connected directly to the traumatic event, cognitive behavioral therapy (CBT) may address how certain thoughts or ways of evaluating a situation may be contributing to your emotions.

Therapists who practice CBT typically focus on what is going on in the individual's current life, rather than past events, and the focus is on moving forward in time to devise more effective strategies for coping with life.

Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy (ACT), on the other hand, focuses on breaking down avoidance and helping a person place their energy into living a meaningful life (and being willing to experience whatever emotions arise as a result).

Social Support and Self-Monitoring

Whichever therapy you choose, getting help 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 thoughts.

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 negative emotion, such as reading a book, calling a trusted friend, or taking a bath. This may give the emotion some time to decrease in strength, making it easier to cope with.