The Overcoming Avoidance Workbook by psychologist Daniel F. Gros aims to help you stop avoiding and start living. It takes a transdiagnostic approach, meaning it focuses on specific behaviours rather than the diagnoses in which they occur. The cover says that it’s for anxiety, depression, or PTSD, but the focus is on anxiety and depression.
The approach used is transdiagnostic behaviour therapy (TBT), which is a variation of cognitive behavioural therapy (CBT). The book is laid out much as TBT would be done in person with a therapist, with eight chapters that are each intended to be covered in a week, including worksheets and practice.
The author’s style is fairly blunt, although not excessively so. This is apparent when he tells readers at the beginning of the book that panic attacks won’t physically hurt you, no matter how much you might think they will. I think that for some readers, that bluntness will be really effective, but for others, it could be off-putting.
The model underlying the book’s approach is that a difficult event causes anxiety/depression, which leads to isolation, withdrawal, and avoidance, which worsens the anxiety/depression, and around and around it goes.
The author explains that the key intervention to end this cycle is using exposures. This approach varies from your standard prolonged exposure, where you would typically construct a hierarchy of feared situations to do exposure work. Instead, the author encourages you to dive right in and do a lot of exposure in a lot of different situations.
Avoidance is broken down into four different types: situation, physical sensations, thoughts, and positive emotion-promoting situations. The author explains when these are likely to occur and how to come up with exposures to fit them. The book also covers barriers that might get in the way of exposures being effective.
One thing that struck me as a bit odd was that the author equated not learning from an exposure to leaving too early. In prolonged exposure, the idea is that after about 45 minutes in a situation, the intense negative stuff will naturally decrease, and if you leave the situation before that, it just reinforces that being in that situation will make you anxious. The learning that the author was referring to was learning about the outcome that you were anticipating, because presumably, you thought the outcome would be worse than it was. I would think that not learning could just mean that needing exposure to that particular thing wasn’t actually the issue.
There was also the standard CBT stance that pushing yourself to do things will eventually result in increased positive emotions. I think it certainly can, no question, but the reality is, it’s not always that neat and tidy.
Of course, a book about avoidance is going to be all about dealing with avoidance. Still, it felt like the author was being simplistic in making avoidance the defining feature in anxiety in depression. Perhaps that’s where the transdiagnostic bit runs into problems. I suspect avoidance is more universally a key feature in anxiety, but perhaps less so in depression. Granted, if you’re picking up a book about avoidance, it’s probably a moot point anyway.
For potential readers who are wanting to tackle avoidance, I think the main deciding factor in whether this book will be good for you is whether you want a direct approach or a softer approach. If you want direct, this is your book, but if you want softer, this may not be your best option.
The Overcoming Avoidance Workbook is available on Amazon (affiliate link).
I received a reviewer copy from the publisher through Netgalley.
You can find my other reviews on the MH@H book review index or on Goodreads.
Oooo an interesting one. I’m not sure on the soft vs hard approach to be honest. It really depends on the specific style because some writers do the direct approach well whereas others come across as too cold or too removed from what they’re talking about. It’s interesting to see TBT being used, can’t remember many self-help styles books I’ve come across taking that approach. I think exposure therapy in this way could be quite effective, but I see your point on what he’s said about not learning and leaving too early. I don’t think they necessarily correlate that clearly, certainly not in every instance. Great review, Ashley! x
Thanks! Yeah, there were definitely good pieces to this. I don’t think all of the pieces work for me, but still good stuff there.
Yeah, from what you shared it sounds like there are definitely similarities between the two.
Sounds interesting, avoidance is a huge issue for me so this could be useful. It can be difficult doing exposure work as from my experience there have been times where it has resulted in negative emotions. Not always though. Still, I think facing your fears is the only real way to diminish them.
I agree.
Direct works for me, however, I have been trying a more gentle approach which has also worked wonders. It would be a nice experiment to see. When dealing with myself, the gentle works. When others dealing with me, the direct works better. I think because I find the grey area when I deal with others and with myself, I am too harsh. Balance, right?.
Balance, indeed.
People sometimes make things out to be cut and dry, black and white, and way to simplistic. I say no thanks to those people.
Yeah, life just isn’t that simple.
No, it’s not.
Direct works for me, I have to stick to the idea of ‘being disciplined’. I feel I have to conduct a reset in the form of being overly active for a short burst after a period of avoidance. Not as healthy as I’d like.
Will look into this, avoidance is a huge flaw of mine. Thanks
Not a huge fan of the blunt type of books, but the idea for a book like this is good. xo
This sounds interesting. I think your right, this approach would appeal to some but not all.
Yes, and so valuable to have multiple approaches available so there’s something that will fit for everyone.
Seems as though the author was avoiding discussing key features of disorders that could not be pinned to avoidance.
Yes, I think so. And that’s fine in a book about avoidance, but what seemed to be missing was the acknowledgement that those other things are there.
Seems worth reading!
sounds like an interesting read thanks for sharing !