People suffering from anxiety issues often go through the uneasiness caused by excessive fear and threat. However, it is actually the avoidance behaviors that they display that are the main reason for their impairment. This is because avoidance behaviors stop them from carrying out routine functions like socializing, dealing with their feelings, etc.
Take the case of a person with OCD. While behaving obsessively can be the cause of concern for him, it is the avoidance behaviors that stop him from normal functioning. For instance, he may perform certain compulsive behaviors like tapping, or checking repeatedly if the doors are closed to avoid any threat or harm.
Thus, what you need to understand here is that fear is a natural response to and is not generally dangerous. It is a natural, automatic response to the threat which is necessary for survival. It results in identifying danger, putting us in fight or flight mode, and taking actions that help us survive. For instance, we may either fight back or run away from the danger. Whereas anxiety is more related to muscle tension, avoidance behaviors, and being vigilant so as to be prepared for the upcoming danger.
Now, what can prove to be harmful is the avoidance behavior seen in people with anxiety. For instance, the fear of talking to people may make them avoid meeting people for work. This may deny them some good work opportunities.
Similarly, people may resort to heavy drinking or drug abuse to avoid painful thoughts.
Let’s have a look at what avoidance behavior is, is avoidance a form of anxiety, how does avoidance prevent anxiety, and how can we reduce avoidance behavior.
What is Avoidance Behavior?
The American Psychological Association (APA) defines avoidance behavior as a single act of a string of actions that help a person to avoid or predict painful events, situations, and stimuli. This also includes conditioned aversive stimuli.
Typically, avoidance behaviors are taken as maladaptive as a response to anxiety or fear. This is because they add to or maintain anxiety disorders. That’s why psychotherapies like Prolonged Exposure or CBT expose people with anxiety to situations, events, or people that trigger anxiety. The idea is to reduce or discourage such people from displaying avoidance behaviors which include escaping or behaviors that induce safety.
Well, there are circumstances where avoidance behaviors can be therapeutic and effective coping strategies for people with anxiety disorders. This is because such behaviors may improve a person’s sense of control over the possible threat as well as the surrounding environment.
So, Is Avoidance a Form of Anxiety?
The question that you may be asking yourself right now could be “Is avoidance a mental disorder” or “Is avoidance a form of anxiety?”
Well, avoidance is not a form of anxiety or mental disorder. Instead, avoidance behaviors are one of the typical characteristics of some anxiety disorders. In fact, the fear and anxiety resulting from an anxiety disorder are closely linked to avoidance behaviors. Though in some cases, avoidance may be adaptive in nature in place of being maladaptive. That is, these avoidance strategies may serve as adaptive coping strategies to deal with anxiety disorders.
Let’s first discuss why avoidance results in maintaining anxiety disorders.
Why Does Avoidance Make Anxiety Worse?
There are various theories of avoidance learning that explain why avoidance makes anxiety worse. These will help us to understand how avoidance leads to maintaining anxiety disorders.
1. Fear, Anxiety, Fear Generalization, and Avoidance
The theory that explains fear and anxiety leading to avoidance behaviors and fear generalization is the Pavlovian Fear Conditioning. As per this theory, avoidance is a consequence of fear and anxiety. Further, one develops fear or anxiety because of Pavlovian Conditioning.
One of the most famous psychological cases where Pavlovian conditioning was first applied is the Little Albert Experiment. In this experiment, an 11-month olds child named Little Albert was exposed to a white rate (Conditioned Stimulus (CS)) to which he showed no fear.
But, the psychologist John B. Watson and his student Rosalie Rayner combined the white rat with the loud noise of a hammer striking the metal bar (Unconditioned Stimulus (UCS)).
When the boy was exposed to such a pairing, Little Albert showed fear and avoidance behaviors, even when he was exposed to the white rat alone. Not only this, the little boy also showed fear and avoidance behaviors towards objects that were similar to the white rat. This indicated words fear generalization. That is, once conditioned to fear an object, one also fears and avoids objects that are similar to the fear object.
Thus, fear and avoidance behaviors towards safe stimuli (CS) and novel stimuli which are similar to the fear object increase instances where people are reminded of the feared object. Therefore, each time they come across the feared object or something similar to it, they experience more fear and anxiety.
For instance, a woman lost her first job because she was not used to checking and replying to emails. Now, whenever she receives any email or a message from a colleague, it triggers fear and anxiety. Even though the email may be an appreciation from a senior or a simple work request. She gets extra vigilant in checking her inbox and delivering work as requested.
2. Avoidance to Protect Oneself From Threat Results in Anxiety
One of the typical things that a person does when he anticipates a threat or is anxious is to display defensive behavior. Now, such a behavior may include avoiding the feared situation or threat to reduce anxiety. Such a behavior may help the person temporarily or in the short-term. However, he may keep feeling fear and anxiety in the long-term.
The following explains how fear and anxiety result in avoidance behaviors and avoidance adds to more anxiety with the help of avoidance theories.
(a) Avoidance Used as a Defense for Perceived Threat
The theory that explains this is the Perceptual-Defensive-Recuperative model. This involves three stages. In the first stage, a person perceives threat.
In the second stage, the person adopts defensive behavior like avoiding people, places, thoughts, or events that remind him of the pain. Or doing activities that save you from the threat . These are called Safety Behaviors which are also a kind of avoidance behavior. Such behaviors help the person to reduce the pain sensitivity.
Finally, he enters the recuperative stage where the behaviors linked to pain return after the threat has passed. Thus, avoidance here may help the person in reducing anxiety in the short-run. However, he may continue to experience fear and anxiety in the long run.
For example, say you perceive the threat of being judged by people for your looks. Now, in order to not feel the pain associated with your looks, you avoid meeting certain people (avoidance behavior) or only step out with makeup on (safety behavior, also a type of avoidance) .
Such defensive behaviors may help you to reduce anxiety associated with perceived threat in the short-run. However, the fear and anxiety will certainly resume once the threat has passed. In this case, people whom you were supposed to meet or the need to step out of home.
In other words, your concerns with regards to your looks will keep appearing in the long-run.
(b) Avoidance Learned Through Negative Reinforcement
B.F. Skinner’s Operant Conditioning also explains how fear and anxiety results in learning of avoidance behavior. Operant Conditioning states that learning depends upon action and its outcome. That is, a behavior is likely to be repeated in the future if such a behavior results in positive or favorable outcomes. However, a behavior is less likely to be repeated in the future if it results in negative or unfavorable outcomes.
Say a person fears talking to people and chooses an action of not taking phone calls which results in reduced anxiety. The chances of avoiding the phone calls in the future increase as this results in reduced anxiety. Thus, the person learns the behavior of avoiding phone calls through negative reinforcement. This is because avoiding the phone results in no anxiety or reduced anxiety for the person.
Now, this too may be helpful temporarily. But, the person may continue to be unwilling to take calls and face such anxiety in the long-run. He continues to believe that taking calls is a threat and should be avoided no matter what.
Further, he does not challenge his devastating thoughts about what may happen if he attends the phone calls. Similarly, he also continues to be extra vigilant of the danger and safety cues which adds to his anxiety.
How Can I Break the Avoidance Cycle?
The main characteristic of anxiety is constant and excessive worry about the anticipated threat. You try to deal with a potential or future occurrence that you think would be devastating. This typically takes place by you being extra vigilant and focusing on cues of such a future occurrence. You also pay attention to yourself and see if you can deal with such a threat.
However, when you see your anxiety symptoms occurring, you get an understanding that you won’t be able to deal with the event. This is what makes you more anxious and initiates the vicious anxiety cycle.
The Vicious Cycle of Anxiety
(1) Being Extra Vigilant
As mentioned earlier, the vicious cycle of anxiety begins with you increasingly inspecting the environment for threat. This leads to increased physical symptoms of anxiety like headache, shortness of breath, stomach pain, etc
(2) Escape or Avoidance Behaviors
Now increased physical symptoms result in restricting your focus only on yourself. This is when you take actions that will keep you away from feeling anxiety. That is, you will either escape or avoid the situation, people, places, conversations, etc.
(3) Short-term Relief From Anxiety
Such avoidance behaviors certainly help in providing relief from anxiety in the short-run. This is because you longer have to face the feared stimuli like socializing, receiving a phone call, going to a shopping center, etc.
(4)Anxiety and Fear Exist in the Long Run
Avoidance may certainly be helpful in reducing anxiety temporarily. However, you will continue to face fear or anxiety from the feared stimuli in the long-run. That is, there will be increased physical symptoms of anxiety, excessive worry, loss of confidence in dealing with anxiety, increased avoidance and safety behaviors.
This will add to more fear and anxiety and that’s how the vicious cycle of anxiety will continue. This is because you are not disconfirming your excessive worry about the anticipated threat. Further, you are continuously scanning the environment for signals of the upcoming danger and what you can do to avoid, escape, or save yourself from such a threat.
This results in more anxiety and generalizing of fear or threat to other situations.
As discussed, vicious cycles play a critical role in sustaining your anxiety disorder. However, you can adopt certain strategies to break this vicious cycle.
How Can We Reduce Avoidance Behavior?
The next question that may come to your mind is how can we reduce avoidance behavior. Well, here are some strategies that you can adopt to reduce avoidance behavior.
(1) Understand the Vicious Cycle of Avoidance
People with anxiety disorders do not purposely allow anxiety and avoidance behaviors to show up. If you are facing anxiety issues, you do not choose to bring in anxiety or show avoidance behaviors in fearful situations. However, the issue is that once the avoidance behavior shows up, it consumes your thoughts and takes control over your emotions and behaviors. As discussed earlier, escape and avoidance behaviors only provide temporary relief from anxiety. But, you must understand that it doesn’t resolve the anxiety issues permanently.
This is because instead of disapproving of your catastrophic predictions, you are getting into learning behaviors. You continue to believe in the fact that the feared stimuli is dangerous and must be avoided no matter what. This intensifies your avoidance and safety behaviors and makes you extra vigilant for signals of danger and safety.
This turns vicious and self-limiting in nature. Therefore, the first step should be to understand this vicious avoidance cycle which helps you to know how you behave, what you worry about, your physical symptoms, etc so that you can know how to break it.
(2) Identifying and Changing Your Behaviors
Identifying what you do in situations that prompt anxiety will come from understanding the vicious cycle. Only then would you be able to change those behaviors. But, why is there a need to identify and change avoidance and safety behaviors?
Let’s take an example here to understand what kind of behaviors you may exhibit and why you need to alter them. Say, you have issues with attending phone calls and hence choose to avoid them. This is because you think taking phone calls may end up consuming your precious work time and leave you exhausted.
Now, you may exhibit the following types of behaviors to reduce your anxiety.
(1) You May Overtly Avoid the Feared Stimuli
Over avoidance is when you dont’ attend the phone calls. This is because you believe that your anticipated fear of you being left with less time or exhausted would come true. Thus, in overt avoidance, you don’t get into the situation where someone would take up your valuable time and leave you exhausted.
(2) You May Covertly Avoid the Feared Stimuli
This is when you take the phone calls but have a conversation with yourself. This is hidden avoidance where you are physically there in the anxiety provoking situation. But, you may not indulge in it.
This may include you saying repeatedly that you shouldn’t have received the call and that you are losing out on precious time. You may not show much interest in having a detailed conversation with the person on the other side. But, this ultimately leaves you sad. Thus, in covert avoidance,
Further, each time you avoid or escape from the feared situation, you are validating that the situation is threatening as you anticipated it to be. So, if you’re taking the phone calls that you were earlier avoiding, you are validating that it is not as bad as you predicted it to be.
Thus, it simply goes like this. The more times you prove your catastrophic predictions, the more evidence you have that the anticipated event was not dangerous.
(3) Alter Your Expectations About Upcoming Threat
Here’s what your original expectation would sound like:
” That person will consume all my time and leave me exhausted. Then, the guilt of offending that person and the pressure of not being able to do my work will leave me sad.”
Here’s what your new expectations can sound like:
” The person I’m talking to may take my time. But, I don’t need to talk for hours. I can talk for sometime, discuss things that add value to the conversation, learn from the other person’s perspective, make them feel good, and get to know him/her better.
(4) Gradually Expose Yourself to Fearful Events
Instead of facing your fear all at once, it’s better to start small and then lead your way towards the intensely feared situations. This will enhance your confidence, reduce your anxiety, and will help you encounter situations that are critical to be dealt with in your case.
Thus, slowly approaching your intensely feared situations is called Graded Exposure. This involves you beginning with facing events that are easier for you to deal with. As you get comfortable and used to such situations, you then shift to more challenging situations. This way, you build up on your confidence, utilize what you have learnt, and face the most challenging situations in a step-by-step way.
Thus, doing this repeatedly over time helps you reduce your anxiety and fear with regards to those situations.
How Does Avoidance Prevent Anxiety?
Until now, we discussed how avoidance behavior can be self-limiting, add to more anxiety, and provide only a temporary fix to your anxiety issues. But in this section, we will discuss Adaptive Avoidance.
Adaptive avoidance is when avoidance behaviors are actually helpful in coping with anxiety disorders. Coping as a concept is a little challenging to understand. This is because coping occurs in a variety of ways.
What are Avoidance Coping Strategies?
(1) Problem-focused Coping
(2) Emotion-focused Coping
(3) Approach Coping
(4) Avoidance Coping