"being aware of your crap and actually overcoming your crap are two very different things." – christina, grey's anatomy

Avoidance: Not always a bad thing

ostrich-head-In-Sand I was reading some new research out of UNC Chapel Hill: “Differences in Coping Across Stages of Recovery from Eating Disorder.” I’ve been on a coping skills streak for awhile now (hence my series on coping skills), so I was excited to see the study.

The introduction contains the best definition for “coping” that I’ve seen to date:

Coping refers to the thoughts and behaviors that people engage in so as to manage, tolerate, or reduce internal or external demands that are appraised as exceeding an individual’s resources and is typically thought of as a factor that mediates the relation between stress and the onset of psychiatrist illness.  Coping is often depicted as a multi-dimensional construct, including task-, emotion-, and avoidance-oriented skills.

The whole article is definitely worth the read (and you can download the whole text for free), but there were two things in particular that I found interesting:

  1. The healthy controls had the highest level of avoidance-oriented coping skills
  2. Partially-recovered individuals were closer to those with active eating disorders, while fully-recovered individuals coped more similarly to the healthy controls.

The avoidance finding was a pleasant surprise (for me).  I’ve always believed that avoidance is a healthy coping skill to some extent… but have had therapists who insist that it is maladaptive.  The article makes a good point about this:

[Avoidant] strategies can be effective in the short-term for reducing pain, stress, or anxiety, and can include some adaptive strategies (e.g., spending time with a special person or going for a walk…)

The second finding about partially-recovered vs. fully-recovered was also validating to see.  The only distinguishing criteria between fully and partially-recovered individuals was the presence of psychological recovery.  I think that sometimes in treatment, individuals can be deemed “recovered” even when they are still struggling with a lot of the old, destructive thoughts.  Personally, I have found this partially-recovered stage to possibly be the toughest.  You’re not using your eating disorder to cope and you don’t have the level of care and/or support as you did at the height of your disorder, but you’re still struggling psychologically.

There are lots of other great points made in the article, so I highly suggest that you take a look!

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5 Comments

  1. Thanks!

    Hey, I’m participating in a research study with UNC!

  2. If by avoidance strategies they mean “Distraction,” then YES, I absolutely agree that distraction can be used in both healthy and appropriate ways. There is a difference between distraction and avoidance. Distraction is being able to put something away or out of mental reach for a period of time while fully intending to come back to face the issue that is triggering the avoidance (i.e. flashback, exposure to feared foods, etc). Avoidance, in its simplest definition could be synonymous with escaping. Avoidance can happen in multiple ways through excessive sleeping, using substances, performance/perfectionism, excessive exercising, ED, wearing a mask that is incongruent with one’s true emotions, etc. In avoidance, our deepest defense mechanisms tend to show up such as repression, minimization, rationalization and even denial.

    Distraction – I’m all for it. I’m using the word “distraction” and I believe the article refers to the same concept with their word “coping.”

    Avoidance – Thumbs down. At some point, a person will need to build distress tolerance and sufficient confidence to usher some type of normalcy back into life.

    Cesar G., MA
    Twitter: @cesargamez
    Blog: http://www.FamilyInsights.net

  3. I wrote a long comment on this post and for some reason it’s not showing up. I don’t want to retype it. Oh well.

    Cesar

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