Demystifying ACT: A Practical Guide for Therapists

Learn how to apply ACT principles in your everyday practice.  Earn 5 CE/CME credits.

Learn more
Last Updated Dec 8, 2022|

The Inflexahex Model in ACT: Acceptance vs Experiential Avoidance

By DJ Moran, PhD

This presentation is an excerpt from the online course “Demystifying ACT: A Practical Guide for Therapists“.

Highlights

  • Many people act as if their own private experiences, their emotions and their sensations need to be gotten rid of.
  • The attempt to try to get rid of them actually makes them happen more.
  • We are looking out for that in our case conceptualization.

 

Transcript

In this training for Acceptance and Commitment Therapy case conceptualization, let’s look at the converse relationship between acceptance and experiential avoidance. And in order to do that, let’s briefly talk about some cases.
Consider this. If a woman doesn’t want to think about her shame related to her past infidelity, she might start a habit of drinking vodka every day because it helps her not to focus on her indiscretions and influences her to pass out during the evening. And therefore, she is not having the thoughts or feelings of shame.

How about another one? A woman who doesn’t like the feelings of nervousness when she goes outside can elect to stay inside her home for weeks or years on end.

Let’s take a moment to look at a teenager who reports hating having private images that she’s contaminated. And if she could just rid herself of those private events for a few minutes by washing with bleach, she can make herself feel better and avoid that experience. But then she has to do it again and again and again in order to avoid that experience.

Or we can investigate a man who thinks he’s been disrespected and feels less macho on the highway when he gets cutoff by another motorist. And he can rid himself of these denigrating private events by acting very aggressively or even violently towards another so-called offender.

In each one of these cases, we’re talking about experiential avoidance. The individual doesn’t want to have a particular emotion, sensation, urge, feeling and they do things in order to rid themselves of these kinds of experiences.

Many people act as if the private experiences of shame, nervousness, contamination and dejection as we might call clinically relevant events, we look at them as if they were problems that need to be eliminated. People are often given the message from society to pursue happiness and relaxation and avoid unpleasant emotions and thoughts.

This kind of experiential avoidance agenda has two drawbacks. The first is that a vital life is bound to include experiences of sadness and anger and other feelings that we label as uncomfortable. Anyone dedicated to living a meaningful mission knows that there are bound to be difficulties and disappointments at times. Avoiding emotional struggle and practical difficulties is impossible when one has become committed to personally worthwhile long-term goals. The second drawback of experiential avoidance is that it usually just doesn’t work. It’s not effective to try to get rid of your emotions because they likely come back later on. Such avoidance seems to be the problematic process that transforms ordinary feelings, urges and sensations and thoughts into clinical issues. Attempts to avoid private experiences often lead to more problems than they solve. In fact, experiential avoidance exacerbates these problems.

Take a look at the clinical situations that I brought up. The woman who drinks vodka to get rid of her thoughts of her infidelity and her shame, she probably feels more shame for passing out so often due to her alcoholism.

The woman who doesn’t go outside and so she ends up with an agoraphobic repertoire and she stays in her house for years, she never gets a chance to counter-condition the anxiety. She never learns the skills on how to live a life outside. So staying inside actually makes it more likely that she’ll stay inside.

The teenager who washes her hands over and over again might actually make lesions in her hands by using the bleach and the Brillo Pad and the really hot water. And now, she has taken her healthy hands and made them unhealthy and actually porous and more likely to be contaminated. So of course, she’s washing them all the time.

The man who feels like he’s been disrespected and then engages in road rage, at the end of that, maybe he realizes that doing so and acting violently actually makes him less respectable. And maybe his kids or friends in the car with him actually respect him less for flying off the handle.

In Acceptance and Commitment Therapy, we’re looking for our client’s repertoire of experiential avoidance. What are people doing in order to not feel certain emotions?

And is this attempt to not have these emotions and unwillingness to accept what is just genuinely showing up in their life, is that attempt actually exacerbating their clinically relevant problem?

When doing a case conceptualization, we’re going to be talking to our clients and gathering data finding out what is it that you’re doing related to the present problem that is actually making your life less enjoyable, impeding you from following through on your values and actually exacerbating the problem. In experiential avoidance in case conceptualization, we’re recording what our clients are reporting and what we see from them that influences them to have a life that’s inflexible.

And then we encourage them to accept their emotions, sensations and urges, be willing to actively contact them directly, fully without defending against them because that’s what leads to effective behavior.

The key point to this training is that many people act as if their own private experiences, their emotions and their sensations need to be gotten rid of. And the attempt to try to get rid of them actually makes them happen more and we’re looking out for that in our case conceptualization.

More ACT presentations