A Mixed Methods Study Investigating the Mediating Effects of Experiential Avoidance on the Relationship Between Alexithymia and Psychological Distress

Previous research has suggested that experiential avoidance mediates the relationship between alexithymia and psychological distress. However, commonly used measures of alexithymia and experiential avoidance have been questioned regarding their validity. Therefore, the aim of this study was to investigate the mediating role of experiential avoidance on the relationship between alexithymia and psychological distress using a sequential explanatory methodology. First, previous quantitative findings were replicated using improved psychometric questionnaires on a sample of 211 adults residing in the UK, analysed using the bootstrap statistical method set to 5,000 samples at a 95% confidence interval. Results showed that experiential avoidance fully mediated the relationship between alexithymia and psychological distress. However, this relationship was not found for two facets of alexithymia: Difficulty Identifying Feelings (DIF) and Externally Oriented Thinking (EOT). The subsequent qualitative investigation explored how men with an externally oriented thinking style experience emotions and psychological distress. This was analysed using template analysis, a thematic codebook approach. Overall, the combined results suggested that life experiences can lead to an avoidance of contact with unwanted private experiences, and that this avoidance accounts for the relationship between alexithymia and psychological distress. Additionally, the results suggested two potential mechanisms through which EOT did not relate to elements of psychological distress. First, that EOT may be functioning as a protective factor against both positive and negative emotional affect. Second, that traditional patriarchal pressures may have caused a rejection of emotional content and a preference for avoidant coping leading to a lack of distress disclosure and underscoring on mood questionnaires. Important theoretical and clinical implications were discussed through the lens of Counselling Psychology, leading to a critical evaluation of common assumptions that may underlie modern therapeutic techniques and contribute to social injustice.