Avoidance vs. Exposure

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How Exposure Can Help You Manage Your Anxiety

BY DR ANDREAS COMNINOS

One of the most common problems people experience as a result of anxiety and other strong emotions is that they avoid situations that trigger any hint of discomfort. This might mean physically avoiding the situation as a whole, or subtly avoiding the situation by tolerating an anxiety provoking situation by mentally clocking off (physically confronting an anxiety provoking situation, but mentally distracting from the situation by focussing on something else, like social media on your phone).

Does anxiety make you want to hide?

Does anxiety make you want to hide?

Avoidance is understandable in one sense, after all, we all like feeling comfortable. No one intentionally wants to endure an unpleasant feeling, right? If you have an itch, you scratch it. If a mosquito is buzzing around, you’ll instinctively swat it or brush it away. These brief ‘problem-solving’ strategies are effective in getting rid of small problems in the sense that they solve the problem without causing any further difficulties, but what about emotional or psychological discomfort? Does avoidance help or hinder when it comes to anxiety?

Does Avoidance Actually Work As A Long Term Solution?

In the short term, avoidance seems to work. Let’s say you’re feeling anxious about attending a social gathering you’ve been invited to. You decide not to go and your anxiety immediately dissipates, success, right? Avoiding a situation seems simple enough when it works – but in the long run – does it? Does avoiding anxiety help you to feel more confident and more in control, or is the anxiety still there (and possibly stronger) next time you’re faced with a similar situation?

Avoidance can make things worse not better long-term

Avoidance can make things worse not better long-term

Avoiding the social gathering you were dreading might help you to avoid feeling anxious, but it raises other issues as well. You might feel left out, lonely, and regret missing out on an opportunity to be with your friends, and worse, feel stuck and disempowered by your anxiety. You might even feel so stuck and disempowered that you become depressed, or angry at yourself for letting your anxiety win yet again.

So let’s say you’re brave enough to attend the party, but in order to cope, you decide to only speak to the people you know, stay close to the door (for an easy escape), or continually check your phone for ‘something’ to distract you. This is called ‘experiential avoidance’ which is a subtler form of avoidance. Physically you’re present, but mentally you’re tuned out so you can avoid feeling anxious.

Initially, avoidance (physical or experiential avoidance) seems like a great way to manage anxiety, but while it might help you to feel less anxious in the short-term, it has other undesirable consequences. It leads to other emotions, and more importantly, it doesn’t get rid of your anxiety. In fact, avoidance leads to the maintenance of fear because when you avoid a situation (whether directly or subtly), you prevent yourself from learning new information that may help you to feel less anxious next time, like – that wasn’t as bad as I thought it would be – or – once my anxiety passed, that was actually enjoyable. Worse, avoidance can actually increase your anxiety because overtime it lessens your confidence in your ability to cope.

So if responding to your anxiety with avoidance is the problem what’s the solution?

ANSWER: Exposure Therapy

What Is Exposure?

Most people know what avoidance is, but a recent survey found that many people don’t know what exposure is – even people who struggle with anxiety. Exposure is the opposite of avoidance, and it’s the very thing that can either reduce anxiety and/or change how we respond to our anxiety so that we’re free to do what’s most important to us in our lives.

Exposure exercises aim to reduce, change, or eliminate your anxiety by gradually bringing you into contact with mild anxiety so that you can practice regulating your anxious symptoms. As you get better at practicing these skills you can ‘raise the bar’ and expose yourself to more challenging situations.

Exposure is best done with the help of a clinical psychologist. A clinical psychologist can help you to identify the specific skills you need to cope, and help you to set progressive and achievable goals so that you see that even though you might think you can’t, you can cope with your anxiety.

A graduated approach to exposure might seem confusing, but when you’re unsure, just remember this. Avoidance increases your anxiety, exposure reduces your anxiety and increases your freedom.

Andreas is a Clinical Psychologist with over 10 years of clinical experience. He works with adolescents, HSC and university students, adults, couples, and families with a wide range of cognitive, emotional, behavioural, and physical difficulties, and draws from a range of effective, evidenced-based treatments including Cognitive Behaviour Therapy (CBT), Acceptance & Commitment Therapy (ACT), Schema Therapy, and Mindfulness to empower his clients and help them to live more meaningful lives.


 

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