Overcoming Obstacles in CBT by Craig Chigwedere & Yvonne Tone & Brian Fitzmaurice & Michael McDonough

Author:Craig Chigwedere & Yvonne Tone & Brian Fitzmaurice & Michael McDonough
Language: eng
Format: epub
ISBN: 9781446292594
Publisher: Sage Publisher
Published: 2011-12-30T16:00:00+00:00

Involuntary Experiential Avoidance

‘Paul, for reasons that we don’t understand, it seems that once you have experienced this emotional “shut-down”, the body can become very sensitive to normal feelings. These normal feelings or sensations are interpreted by the system, as a warning of the onset of something terrible, so that in future the body automatically “shuts down” for the sake of safety. This mechanism would have been useful, for example in Stone Age times, when there was a lot of danger from predators. Most of the predators that would have presented a danger to us, such as lions and tigers, would prefer to kill for themselves, so being still and appearing dead would have reduced the chances of being attacked. “Shutting down” emotionally would have reduced fight-or-flight-related emotional and bodily reactions, which may have reduced the risk of drawing the attention of the predator. Sadly, even though we’re no longer surrounded by predators, our fear-response system has not been updated. Unfortunately, the body does not distinguish between situations. It reacts only to the feelings, which may be entirely harmless.

Once the shutting-down response is “switched on”, for example by an accident, it becomes a way of avoiding all intense feelings that may lead to pain or distress. The body therefore begins to shut down, seemingly at random in response to any arousal feelings, which may be caused by a variety of unrelated and harmless situations. So, it is possible that when you feel bodily sensations that are similar to those you felt at the time of the accident, your body automatically associates them with the onset of pain and distress and shuts down to protect itself. Your avoidance of distressing situations might then not only maintain but increase the fearfulness of the avoided situations, so that the next time you are confronted with them, they are more likely to cause bodily sensations, resulting in more shutting down. How does this sound to you?’

Poor rationale giving can become an obstacle to therapy, with several risks. The patient might:

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