The elaborate ways we turn away from and avoid difficult emotions can get us into trouble that can wind up worse than the emotions from which we were running. There are several different types of avoidance. According to McKay and colleagues, situational avoidance is the most commonly used kind of avoidance.
People who use situational avoidance may fear certain individuals or kinds of people, locations that make them feel panicked or anxious, different kinds of animals, foods, activities, or social situations. Cognitive avoidance is about avoiding internal events such as unpleasant or distressing thoughts or memories. With this type of avoidance, people usually take actions to suppress or reject the experience of certain kinds of thoughts that feel unpleasant or overwhelming.
Strategies to avoid unwanted internal events may involve consciously telling oneself not to think about something, or taking action to numb out to the unwelcome thoughts.
Cognitive avoidance can also show up as worry and rumination. You might handle your anxiety about the future and various risks in your life by constantly worrying about what might happen, running various scenarios over and over in your mind in the hope that constant vigilance will somehow prevent anything bad from happening, write McKay, Fanning, and Ona.
Sometimes cognitive avoidance looks like trying to replace undesirable thoughts with other stufflike daydreams, repetitive phrases, even prayers. Positive affirmations are often helpful for people, but saying them compulsively can be a way to avoid distressing thoughts or memories rather than work with them in a way that may provide long-lasting relief.
McKay and colleagues discuss protective avoidance as the use of excessive safety behaviors that might include checking, cleaning, over preparing, or perfectionism.
Clients who present with symptoms of obsessive compulsive disorder and eating disorders often utilize protective avoidance strategies.
But there is a curious flip side of protective avoidance as well. Procrastination is also considered a form of protective avoidance. Anyone who has ever experienced anxiety knows that it is typically a combination of mental and physical symptoms.
Tightness in the chest, shallow breathing, increased heart rate and sweaty palms may all show up along with distressing thoughts when a person feels anxious. These behaviors are problematic because in the long run they only serve to increase fear. Avoidance behaviors can take three different forms: avoidance, escape or partial avoidance. True avoidance behaviors involve the complete avoidance of the feared social situation. For example, someone afraid of public speaking might:.
When total avoidance is impossible, escape behaviors may be used as a means of dealing with feared situations. Escape involves leaving or escaping from a feared social or performance situation. Some examples of escape include. When neither avoidance nor escape is possible, partial avoidance also known as safety behaviors may be used to alleviate feelings of anxiety during social or performance situations.
Safety behaviors generally limit or control your experience of a situation. If safety behaviors have become a way of life for you, it might be hard to even be able to recognize if you are using them.
They may have become habitual ways of behaving that now you don't even know what it would be like not to use them. If you continue to feel anxious in situations even after facing them many times, this is a clue that you might be using safety behaviors.
Notice situations that you face often but that still cause you anxiety—and then identify what you might be doing in those situations to avoid feeling anxious, such as talking fast, avoiding eye contact, or wearing plain clothes to avoid drawing attention to yourself. While not using safety behaviors will result in increased anxiety in the short term, over the long term, it will help you to overcome your anxiety. The problem with avoidance behaviors is that they maintain the symptoms of anxiety.
The safety behaviors are often assigned value for "surviving" social anxiety, but then blame for the anxiety or awkwardness is still placed upon the self, perpetuating the cycle. If you always avoid giving speeches, or if you only give speeches without making eye contact, your anxiety about giving a speech will never diminish.
These behaviors prevent you from gathering evidence that disproves your maladaptive beliefs about social situations.
For example, if you always leave a party at the first sign of anxiety, you never have the chance to learn that if you stay long enough in the situation, your anxiety will eventually diminish. Instead of avoiding giving speeches, or only delivering them in a "safe" way, you need exposure to giving speeches without avoiding, escaping or using safety behaviors.
In fact, research has demonstrated that exposure treatment one component of CBT for social anxiety disorder will be less effective when a person is using safety behaviors. This suggests that reducing your use of safety behaviors when entering therapy may help to give you a better result.
Are you looking for a quick way to reduce your avoidance? Draw on the principles of the therapies mentioned above. For example, you might do the following:.
If you have an urge to hide in the bathroom at the next party you attend, promise yourself to go back out for at least five minute intervals before you return. Gradually work your way up to longer periods of returning to the party. The first step to effective treatment is to have a diagnosis made, usually by a mental health specialist. Speak with your doctor or health care provider about the best treatment for you.
A type of psychotherapy called cognitive behavioral therapy CBT is especially useful for treating social anxiety disorder. CBT teaches you different ways of thinking, behaving, and reacting to situations that help you feel less anxious and fearful.
It can also help you learn and practice social skills. CBT delivered in a group format can be especially helpful.
For more information on psychotherapy, please visit www. Many people with social anxiety also find support groups helpful. In a group of people who all have social anxiety disorder, you can receive unbiased, honest feedback about how others in the group see you.
This way, you can learn that your thoughts about judgment and rejection are not true or are distorted. You can also learn how others with social anxiety disorder approach and overcome the fear of social situations. Anti-anxiety medications are powerful and begin working right away to reduce anxious feelings; however, these medications are usually not taken for long periods of time.
People can build up a tolerance if they are taken over a long period of time and may need higher and higher doses to get the same effect. Some people may even become dependent on them. To avoid these problems, doctors usually prescribe anti-anxiety medications for short periods, a practice that is especially helpful for older adults. Antidepressants are mainly used to treat depression, but are also helpful for the symptoms of social anxiety disorder.
In contrast to anti-anxiety medications, they may take several weeks to start working. Antidepressants may also cause side effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe for most people, especially if the dose starts off low and is increased slowly over time.
Talk to your doctor about any side effects that you have. Beta-blockers are medicines that can help block some of the physical symptoms of anxiety on the body, such as an increased heart rate, sweating, or tremors. Your doctor will work with you to find the best medication, dose, and duration of treatment.
Many people with social anxiety disorder obtain the best results with a combination of medication and CBT or other psychotherapies. Don't give up on treatment too quickly. Both psychotherapy and medication can take some time to work. A healthy lifestyle can also help combat anxiety.
Make sure to get enough sleep and exercise, eat a healthy diet, and turn to family and friends who you trust for support.
For basic information about these and other mental health medications, visit www. For information on clinical trials, visit: ClinicalTrials. For more information on conditions that affect mental health, resources, and research, visit the NIMH website www.
The Mental Health Treatment Locator section of the Behavioral Health Treatment Services Locator lists facilities providing mental health services to persons with mental illness. Find a facility in your state at findtreatment. For additional resources, visit www.
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