Symptoms of PTSD: Avoidance (Part 3)

All quotes below are from the following Open Access sources and are solely intended for the education of the reader:

  1. Norrholm, S. D., & Jovanovic, T. (2010). Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters. Neuropsychiatric Disease and Treatment, 6, 517–532.
  2. Brousse, G., Arnaud, B., Roger, J. D., Geneste, J., Bourguet, D., Zaplana, F., … Jehel, L. 2011. Management of Traumatic Events: Influence of Emotion-Centered Coping Strategies on the Occurrence of Dissociation and Post-Traumatic Stress Disorder. Neuropsychiatric Disease and Treatment, 7, 127–133.
As described by Friedman [2006], exposure to a traumatic event … can produce a robust emotional response…, and this association can lead to PTSD avoidance symptoms…. (1)
Emotion-centered coping is an attempt to manage the emotional responses induced by the situation…. Numerous strategies belong to this category, including substance abuse, physical activity, expression of emotions, feeling of responsibility, minimization of the event, alteration, denial or avoidance of reality, hoping for a miracle, and use of the imagination. Among all these emotional behaviors, avoidance of the event seems to particularly influence evolution to PTSD, suggesting that emotion-centered strategies (avoidance, flight, denial, or self-accusation) may lead to more negative outcomes after a traumatic event…. (2)
One of the earliest theories proposed to explain avoidance behavior is Mowrer's 2-factor theory [Mowrer, 1960; Levis, 1981], which posits that escape of a fear-conditioned stimulus negatively reinforces avoidance behavior, thereby maintaining fear responses. Applied to PTSD, this theory suggests that avoidance of reminders of the trauma can maintain the disorder by preventing extinction of the original fear associations. (1)

One problem with avoidance is that it keeps you stuck. I think a lot of us construct walls of sorts to keep out the things we'd rather not see, hear, or think about. Certainly avoidance does have its place in preserving our safety and well-being, but when avoidance becomes crippling it is not healthy. And, evidently, scientific inquiry has led us to the conclusion that avoidance of (perceived) fearful things only strengthens the fear association in our brains. I don't know that there is a way to shut off the fear. But I do know that avoidance is only one way to handle it. Several other options exist. I know I have not explored those options enough. I am slowly getting there.

If you struggle with avoidance as well, please be assured that there are other methods of coping. Help is out there. We need to peek over the wall long enough to spot it.

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Thanks for reading! It's great to hear from you. -J

  1. I am glad to have read this because I have a friend who has 'avoided' facing situations in life because she's been hurt in the past, and it's understandable. I've been trying to give her encouragement. As you've pointed out, it can become a deeper problem if we don't learn how to cope or adjust. I think my friend has used the avoidance and flight strategies you've mentioned (and for a very long time) but I do see her making some progress. She's been searching scripture, especially Psalms. And she talks about these feelings and her reactions. Thank you for your wonderful post. And thank you also for your comments on my page. You had mentioned some difficulties you have faced recently and I will be praying for you that things smooth out.

    take care, dear one,