Overcoming Anxiety and the Cycle of Avoidance
By Dr. David Keiling. A simple metaphor to remember to help you break the cycle of avoidance and regain control of your life!
The Dreaded Task
We can all likely remember a time when we didn't want to do the dishes! Let me set the stage: dinner has just finished, there’s a few dishes in the sink, and your new favorite TV show is about to start. You take a look at the dishes, feel some reluctance, maybe some anxiety or dread, and decide to leave them for the next day. Immediately following this decision, you sit down on the couch and feel the emotional discomfort fade away. Fast forward to a few nights later and you’ve repeated this process several times. You now have a sink full of dirty dishes and the task feels more daunting. Now, you may not just feel reluctant, but overwhelmed with anxiety and stress.
There are two choices at this point - avoid or go towards. Many of us (myself included) have chosen to further avoid and feel the momentary relief that avoidance provides. However, this choice creates further difficulty as the dishes continue to pile up, making the task that much harder when we are eventually forced to confront it. Facing the dishes will certainly be difficult, but if we are able to work through the discomfort and anxiety, we can accomplish the task and be left with a clean sink and feeling of accomplishment.
Understanding the Avoidance Cycle
This example is not just literal advice on keeping up with our dishes at home, but a metaphor for understanding the cycle of avoidance and how it exacerbates anxiety in the long run. The avoidance cycle refers to when we are presented with a situation that we perceive as anxiety-provoking, non-preferred, or threatening, and we experience an unpleasant emotion (e.g., anxiety or discomfort). In an effort to relieve our uncomfortable emotion, we avoid the feared stimulus. This provides momentary relief, which is very reinforcing (it makes our brains want to keep avoiding again and again). The downside is that avoiding the thing that makes us anxious actually intensifies the anxiety over the long run. It unintentionally reinforces the idea that the situation is dangerous, and since we've avoided the situation, our brains never get to learn that we can cope with it!
Wondering how to break the cycle of avoidance? I suggest 2 main tasks. As discussed above, it’s important to move towards and face the feared situation, as well as build distress tolerance skills to make facing the situation more doable.
Move toward: Moving towards the feared situation is easier said than done, but in most contexts it’s worth it. If it’s extremely difficult, we can do this with the support of professionals and loved ones. To continue with the dishes example, we may recruit a spouse or roommate to come engage in conversation while we wash them. They are not the ones doing the dishes, but they are supporting us in approaching the feared/dreaded stimulus. It is also important to plan a positive experience following completion of the task - go watch that TV show once you finish the dishes, for instance!
Build distress tolerance /coping skills: One of the largest barriers we experience in approaching the feared situation is that the discomfort and anxiety can feel too overwhelming. To combat this we need to use distress tolerance skills. Distress tolerance is all about “getting through” a tough situation. In our continued example this may be playing music while washing the dishes, using a dishwasher, or putting on the TV show while you wash the dishes. The task may still be difficult, but these supports can make it a bit more tolerable. When it comes to anxiety overall, a few helpful strategies include:
Paced breathing: slow controlled breaths to slow the heart rate which in turn reduces anxiety
Mindfulness Grounding: Using our five senses to ground ourselves in the current moment.
Temperature: Grab an ice pack, get some fresh air, or splash cold water on your face. Reducing body temperature can also reduce overwhelming emotions
Progressive muscle Relaxation: Tensing and relaxing muscles beginning at the top of the body and slowly moving downward.
Listening to music: Listening to music is an amazing coping skill, especially listening to happy/positive music to change or enhance our mood.
Talking to a friend or love done: Positive relationships can, of course, make difficult situations easier
Intentional self-talk: pay attention to how you’re thinking about the anxiety-provoking situation. Are you telling yourself you can’t do it? Using all-or-nothing terms, or catastrophizing by envisioning the worst possible outcome? Imagine coaching yourself like a skilled professional coach would talk to their athlete. Messages like “This may be uncomfortable, AND I can do it” or “I’m feeling nervous right now, but I know in the long run this will help me overcome my anxiety” will help you be more successful in approaching the feared situation.
We hope you find the tips in this article helpful. If you’d like individualized support with overcoming the anxiety-avoidance cycle or your overall mental health, reach out to us today via the “Get Started” button at the top of this page, or our “Contact Us” page!