Avoidance has to do with everything we do to avoid feeling unpleasant things. From trying not to think about something that makes us suffer, to attempting to relieve the physical discomfort of an emotion or to avoid going places that trigger discomfort. Sometimes it can be subtle and we don't even notice we're doing it, other times it can be quite explicit and conditioning. While it may provide a temporary relief, it often becomes harmful in the long run - it paradoxically increases the intensity and frequency of the emotions we didn't want to feel in the first place.
Some examples of avoidance that end up being transversal to several anxiety disorders:
- avoiding areas with lots of people for fear of feeling ill and it being difficult to leave;
- not going to social events for fear of our social performance being judged;
- staying in bed/at home to avoid facing a difficult day ahead;
- not using public transport or lifts for fear of being trapped;
- not doing physical exercise for fear of physiological activation (fear of physical sensations such as tachycardia or dizziness);
- repeatedly calling a person to find out if they are OK as a way of reducing our worry;
- not drinking coffee (again, for the fear of physiological arousal);
- resorting to substances as a way of relieving an unpleasant emotional state;
- avoiding looking into the eyes of another person for fear of triggering shame and embarrassment;
Other types of avoidance, sometimes less explicit but equally frequent, are:
- Procrastinating, avoiding, even for a moment, tackling a difficult work task which we feel we are not fully capable of doing;
- Perfectionist behaviour (for example, reading over our writing several times) in an attempt to escape the possibility of failure;
- Constantly asking for validation as a way of reducing the anxiety of having to make a decision on our own;
- Ruminating, in an attempt to obtain a feeling of security, because in that way we are 'thinking' and even 'solving' a problem;
- listening to music or using the mobile phone as a distraction from difficult thoughts;
- Bringing water/food or SOS medication as a safeguard in case we "feel unwell";
(...)
Indeed, these avoidance behaviours can assume various forms. However, the same behaviour can be both adaptive in one situation and maladaptive in another, depending very much on the underlying purpose it is serving. What really matters is the function (the why of the behaviour) rather than the form (the behaviour itself). For example, not doing exercise for fear of the physiological activation that will ensue (e.g. tachycardia, dizziness, ...) is a form of avoidance. However, exercising in order to distract myself from a feeling of frustration that has arisen related to work or a relationship is also a form of avoidance.
Why do these behaviours end up being harmful in the long run?
According to the cognitive-behavioural approach, what makes a behaviour occur more often is combining it with a reinforcement. An obvious example: if I post a photo on social media and get interactions (likes, comments), those interactions will act as positive reinforcement. In the future, the likelihood of feeling the urge to post new photos will increase. Posting a photo made me feel good because of the social validation.
But there is also another way in which behaviours are reinforced. If by posting a photo, I'm temporarily distracting myself from the sadness I'm feeling, then that also makes me feel "good". This time because it has "removed" or soothed some kind of discomfort. The behaviour has been reinforced and the likelihood of me posting a photo again will also increase, but for different reasons. This time through negative reinforcement - I "removed" an aversive stimulus - sadness - even if only momentarily. Whenever we "escape" anxiety, this is the process that is taking place. For a moment, we appease the anxiety and all the discomfort that comes with it. Whatever action caused that relief will be reinforced, and the likelihood of us doing it again will increase.
Ultimately, we are puppets of both pain and pleasure, occasionally made free by our creativity. - António Damásio
Thus, we will become more and more dependent on these behaviours to deal with anxiety, which will decrease the opportunities for us to learn how to truly manage our emotions. These behaviours will further strengthen the idea that anxiety is dangerous and that we are not capable of dealing with it. All of this means that when we are confronted with anxiety and are unable to escape it, this emotion will become even "bigger" and more frightening. We are in a cycle of perpetual escape.
However, the aim is not to get angry at this very human condition, or to eliminate avoidance completely. To eliminate it suddenly, or without psychotherapeutic help, would be very destabilising. These avoidances also have a protective function, to maintain stability and security. And they are often adaptive! Not only do they contribute to our survival in some cases (e.g. escaping from a real threat), but also to our self-care. We all avoid to some extent, and that's a good thing! If I get a headache, I'll take a pill to stop it. If I feel frequently worn out in a certain context, then I'll dose the amount of times I'm exposed to that context. It's avoidance, but it's also a way of looking after myself!
The solution then is to maintain a balance between challenge (exposing ourselves to fears) and self-care (seeking comfort).
We will always be motivated by the search for pleasure and the escape from discomfort. And so there will always be a tendency to rely too much on forms of relief and control. It is important, however, to be aware that this search for "good feelings" and escape from "bad feelings" in the immediate moment may make more interesting and long-term goals impossible.
Procrastination can be a good example. By frequently distracting ourselves from tasks that activate some momentary anxiety, we may be jeopardising an important ultimate goal for us.
Therefore, a long-term perspective can help us to understand if these avoidances are having more consequences than benefits. If they are conditioning our life and if we are using them in a rigid way, in which we react to fears automatically, without having much power of conscious choice.
When there is a healthy relationship with avoidance, in which we choose when to use it, but are not limited only to this way of responding to anxiety, then there is flexibility! We can think of a kind of commitment we make with ourselves: am I willing to feel some discomfort as I move towards goals that are important to me in the long term? Am I willing to feel anxiety and frustration as I develop as a person and move out of my comfort zone? At the same time, am I available to prioritize my self-care in this process? Am I available to adjust certain goals that may be too demanding? Am I available to pick myself up and protect myself when I feel I need to?
It's not supposed to be an easy balance to make. It implies self-knowledge: knowing our personality patterns, our vulnerabilities as well as our limits. It requires curiosity about the "messages" that our emotions and our body are giving us. And reading these messages is not always easy! But it is precisely this posture of curiosity that allows us to get out of our usual automatic patterns and make more conscious choices.
So, living a life with flexibility, means directing ourselves towards important goals and extending our comfort zone, while paying attention to self-care. Allowing ourselves to seek comfort when the world becomes too "overwhelming". Allowing ourselves to slow down when the pace is too intense. Allowing ourselves to let go of or adjust goals that may be getting too demanding. Only then can we continue, in a healthy and sustainable way, to grow as people.