Increasing Affect Tolerance

A number of authors have noted that some clients go to great lengths to avoid experiencing certain emotions and have been emphasizing the value of working to increase their willingness and ability to tolerate intense affect. Marsha Linehan emphasizes this in her Dialectical Behavior Therapy (a CBT approach to treating Borderline Personality Disorder) and Farrell and Shaw argue that this is a prerequisite to treating BPD effectively and do a nice job of describing methods of doing this (Farrell, J. M. & Shaw, I. A. (1994). Emotional awareness training: A prerequisite to effective cognitive-behavioral treatment of borderline personality disorder. Cognitive and Behavioral Practice, 1, 71-91.).

Taylor and Rachman have done a fair amount of empirical research into avoidance of affect wich is quite relevant:

Taylor, S. & Rachman, S. J. (1991). Fear of sadness.Journal of Anxiety Disorders. Vol 5(4) 375-381. ABSTRACT:Proposes that sadness can serve as a source of fear and avoidance, especially if it has been associated with aversive consequences such as embarrassment or rejection by others. Sadness may also be feared if it is perceived to be the precursor of more intense reactions, such as bereavement. The hypothesized components of the fear of sadness are described, and their links with avoidance behavior are outlined. Case vignettes illustrate some of the consequences of sadness that may be feared. Questionnaire responses of 753 undergraduates further support the validity of the concept of the fear of sadness. As predicted, Ss' fear of sadness increased with the intensity of sadness and was as prevalent as well-documented fears such as fears of snakes and spiders.

Taylor, S. & Rachman, S. J. (1992). Fear and avoidance of aversive affective states: Dimensions and causal relations. Journal of Anxiety Disorders, 6, 15-25. ABSTRACT: Examined whether the fear of anxiety (FOA) and fear of sadness (FOS) can be reduced to other, well-established classes of fear and the relationships between these fears and the avoidance of stimuli that evoke these emotions. The Fear Survey Schedule-III, modified to include items assessing the FOA and the FOS, was administered to 330 university students. Measures of agoraphobic avoidance and of the avoidance of saddening stimuli were also completed. Factor analysis of the Fear scale reveal that the FOA and the FOS loaded on separate factors and were not subsumed within other, well-established classes of fear. Results of causal modeling support the hypothesis that FOA contributed to agoraphobic fear and that both fears promoted agoraphobic avoidance. Support was also found for a causal model in which FOS engendered a fear of the cues to sadness and that both fears promoted the avoidance of sadness-evoking stimuli.

Rachman, S. (1980). Emotional processing. Behaviour Research & Therapy, 18, 51-60. ABSTRACT: Presents a working definition of the concept of emotional processing with the aim of integrating a set of clinical and experimental observations. If successful, the concept may help to unify such apparently unrelated events as obsessions, the return of fear, abnormal grief reactions, nightmares, and treatment failures. Factors that may facilitate or impede emotional processing are presented, and some circumstances that may give rise to initial difficulties in processing are mentioned. Several theoretical problems are posed, and some methodological innovations offered.

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