Academic journal article International Journal of Psychology and Psychological Therapy

A Proposal for Synthesizing Verbal Contexts in Experiential Avoidance Disorder and Acceptance and Commitment Therapy

Academic journal article International Journal of Psychology and Psychological Therapy

A Proposal for Synthesizing Verbal Contexts in Experiential Avoidance Disorder and Acceptance and Commitment Therapy

Article excerpt

EXPERIENTIAL AVOIDANCE DISORDER

An obvious feature at the basis of most psychological disorders is the presence of a generalized pattern of deliberate actions to remove or avoid a state of suffering or distress that constrains personal functioning and finally does not fulfil the expectations of distress reduction, but instead has the effect of increasing the very suffering that the person wants to remove. This suffering can show up in many different forms, and the strategies employed in order to reduce it are manifold. These particular forms and strategies constitute the criteria employed in the definition and classification of different psychological disorders according to the formal diagnostic taxonomies currently employed in mental health systems (DSM and ICD). However, a functional analysis of the different disorders shows that many of them share a common functional "stem" that has been termed destructive experiential avoidance (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996; Luciano & Hayes, 2001), and that they can be conceptualized as topographically different instances of the experiential avoidance disorder (EAD).

EAD can be understood as an ineffective generalized behavioral class of verbally regulated avoidance that can be described according to the classical paradigm of self-control, with the addition of more recent formulations on verbal behavior and derived relational responding (see Hayes, Barnes-Holmes, & Roche, 2001). Functionally, self-control abilities constitute an operant class established through individual history as a repertoire of choice between incompatible contingencies signalled by different (verbal) discriminative stimuli. According to this, the person undertakes actions that involve the loss of reinforcing contingencies in the short run. However, the consequences of these very actions have a symbolic positive value due to their relationship with probable positive results in the long run. EAD can be thought of as a special instance of a lack of self-control where the person has come, through personal history, to value "the need of feeling well" as an absolute priority in order to embark on committed valued actions. For someone behaving in accordance with such pattern, personal performance is mainly determined by attempts to remove and avoid immediate distress, even though it may be costly in the long run, with a general impairment in personal life. Paradoxically, the person behaving under this schedule is deeply convinced that the plan followed with their actions is totally correct and necessary in order to live. For example, following the rule "I can't live with these terribly painful thoughts. Have to do something to remove them". This behavioral pattern is controlled both by an immediate (and tricky) reduction of pain and distress (negative reinforcement) and by the extraordinary power of "being right" or being coherent with one's own thinking (positive reinforcement); in other words, feeling that one's actions are correct in order to go towards one's valued goals (Luciano & Hayes, 2001). A person acting according to such plan hardly has any real possibility of choosing a different direction.

This pattern of destructive experiential avoidance can be explained appealing to an individual history where multiple longitudinal interactions, either accidentally or deliberately, promote the control of private events as if they were causes for actions. This promotion is, first of all, culturally given for human organisms whose verbal repertoires are characterized by the fundamental features of bidirectionality (mutual and combinatorial entailment) and transformation of functions (Hayes, Barnes-Holmes, & Roche, 2001; Hayes, Strosahl, & Wilson, 1999). However in the present paper we argue that specific contingencies have to be involved for this sort of rigid, ineffective verbal regulation to become the predominant repertoire in a particular individual where the natural characteristics of verbal behavior become a trap. …

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