Many of us avoid tasks from time to time. We may avoid our tax returns, booking a dentist appointment, deep cleaning our oven or having an uncomfortable conversation. We tend to avoid these situations due to the uncomfortable feelings they elicit. We subsequently ‘solve’ the problem of sitting with uncomfortable feelings by distracting ourselves with mindless activities that serve no benefit or are even detrimental. However, our ‘solutions’ to tolerating discomfort (i.e. our avoidance strategies) cause a whole new problem - procrastination, a sense of ‘stuckness’, interpersonal difficulties and low self-efficacy to name a few.

Avoidance in small doses is very normal and common. However, for many people it can become problematic. For example, if you chronically avoid dentist visits your dental health is likely to suffer, and you may end up paying more for treatment than regular preventative care. That means negative consequences for both your health and financial situation. Whilst some situations can be avoided, there are many situations that are impossible to avoid, making it an unhelpful coping mechanism long-term.

There is a strong link between people who engage in avoidance and anxiety disorders. This is because avoidance reduces anxiety in the short-term, but never teaches us to deal with our anxieties head on. Following the immediate relief of avoiding a situation that we fear, anxiety about the feared situation increases in the long-term. For example, if you fear enclosed spaces and therefore consistently avoid elevators by using stairs – your body will learn that: 1) elevators are ‘dangerous’ and; 2) that you are unable to tolerate the anxiety they elicit.  So avoidance is a ‘strategy’ that relieves the short-term anxiety ‘phew, I can just take the stairs’, but that actually perpetuates anxiety ‘ok, there is an elevator, I need the stairs’.

The good news about becoming aware of your avoidance patterns is that they are possible to overcome. Here are some general guidelines to help you on this journey;

•  Write down a list of 10 situations you tend to avoid. What feelings or thoughts do these situations elicit? For example, do you avoid an assignment because you worry that it won’t be perfect? Do you avoid a conversation with someone because you fear they won’t like you? Do you avoid a phone call because you worry you will seem stupid if you stumble over your words?

• Rank how uncomfortable the situations make you feel on a scale of 1-10 (1= not very uncomfortable, 10= highly distressing).

• Starting with the situation with the lowest ranking, write down what thoughts you notice before this situation. For example, before making a necessary phone call, maybe you tell yourself “I’m going to say something silly….. I don’t know what to say” or “They will think I’m an idiot”.

• Ask yourself how likely it is that your thoughts will come true (on a scale of 1= very unlikely, - 10= extremely likely).  What’s the evidence for and against this thought? If you score yourself highly on this thought coming true, ask yourself, does it matter? Is it helpful to fear saying something silly? What thoughts do I fear others having, if I happen to momentarily fumble my words?

• Set yourself a goal to expose yourself to this situation as soon as possible. Continue to ask yourself “How likely?” and “Does it matter?” questions when you notice your default thoughts starting to arise.

• Notice how you feel afterwards.  Ask yourself if any of your original thoughts came true.

• Gently expose yourself to the situation multiple times until you feel more confident and less anxiety towards the situation.

• Gently work your way up your original list, continuing to use the same thought challenging process. You can also build in some deep breathing practice if needed.

• Speak with your GP about a referral to a psychologist to discuss your concerns further.  

If you avoid what you fear, then fear will be in charge. If you face your fears, then you could be in charge. At PCP&AH, we provide a safe environment so that you can face your fears together with your psychologist and be in charge of your life.

  Author: Tegan Bradilovic

Clinical Psychologist