Avoidance:

As I’ve been growing, over the past three years, into my shoes as a therapist - learning the trade, building up my skills, and deepening my intuition - I’ve been faced again and again with the question: How do we overcome avoidance? Avoidance is the most common treatment-resistant issue I’ve come across. And when I do come across it I know that I’m in for the long-haul and that I’m going to be navigating a lot of difficult questions. Questions from the client like: Why can’t I just do the thing I know I’m supposed to? And questions for myself like: How much of this resistance is a choice? And how much of it is a reaction we have no control over? These questions don’t have simple or consistent answers. 

Avoidance comes in a lot of different shades, and the more I reflect on it the more versions of it I find. In relationships avoidance is the inability to have difficult conversations or respond productively to conflicts. In depression avoidance is the feeling of shame or hopelessness which tells us we will never overcome our circumstances. In anxiety it is the thing which brings us comfort in the short term and keeps us anxious in the long-term. It is the distraction, the substitute. And in all these, avoidance keeps us, again and again, from strengthening our skills to tolerate exposure to the harder parts of life: the pain of rejection, the uncertainty of an unpredictable future, the grief of change. 

There’s research which provides evidence that avoidance, while nice in the short term, has concerning, long-term consequences for our mental health; Including in anxiety or eating disorders, relationship skills, general personal growth, cyclical issues in the workplace, emotional exhaustion, and general overwhelm. (Hershcovis at. al., 2017) (Holahan et. al., 2011) (Vanzhula,  et. al., 2020). Avoidance in the equivalent of living paycheque to paycheque - it’ll get us by, but it won’t set us up for success in the future.

Avoidance isn’t always a bad thing (much like the 2019 article by Hofmann and Hay explores), sometimes it’s the best option we have available. Sometimes it’s the thing that will get us through today so that we can better face tomorrow. When used sparingly, avoidance can be incredibly helpful. I try to think of it like ‘right now, I’ll take a break from this feeling, but tomorrow, I’ll get back to it.’

The worst kind of avoidance is the kind that is used without any other supplementing strategy. Where nothing we do seems to break the cycle. Where the avoidant reaction is so automatic there is no opportunity to pause and change direction. Where the belief that ‘I can’t do this’ is so deeply ingrained that once fear comes up there’s nothing that can comfort or ground the nervous system. In this way avoidance is a subtle kind of trauma response: a learned protective mechanism that is so strong it takes over the whole body and mind to the point that we can’t even recognize our own actions for what they are. It’s something we learned when we were young or scared, something our parents taught to us, something that developed out of a lack of support. 

Avoidance Looks Like:

Active/Social

• Procrastination

• Distraction (ie. phones, social media, instant messaging, movies, etc.)

• Busyness and workaholism

• Escapism (parties, social events, fantasy, daydreaming, books…)

• Derailing conversations or changing the topic (ie. when our partners are upset with us we find a way to be upset with them instead)

• Projection (ie. in a moment of insecurity I may become critical in order to avoid accountability)

• Passive-aggression (straight up aggression or direct communication would be the non-avoidant alternatives to approaching problems or sore feelings in a round-about way)

• Avoiding uncomfortable or dangerous situations or spaces (actual or perceived, or even something that feels dangerous no matter that our rational selves know better)

• Avoiding eye contact, conversation, or missing meet-up times

• Overprotectiveness (trying to avoid suffering for ourselves or other people is certainly based in good intentions but may take away from us the opportunities necessary for learning how to tolerate suffering which will eventually be unavoidable)

• Chemical coping - substance use, sex, food, etc. which is used to create a positive feeling and avoid a negative one

Cognitive

• Perfectionism

• Toxic positivity (efforts to always be happy or to only talk about positive things mean that the important and difficult issues never get named and never get resolved)

• Rumination (sometimes we use cognitive strategies to avoid emotional discomforts, like repeating mottos, going over a conversation in our minds, overpreparation or over planning, going over potential scenarios repetitively, etc.)

• Suppressing or distracting from particular thoughts or feelings or memories

• Spiritual bypassing (using our religious or spiritual beliefs to avoid real problems or doubts), prayers, rituals (perhaps like the ones common in OCD-like compulsions)

• Affirmations or positive thinking used excessively or beyond what is helpful

• Rationalization or intellectualization

• Chronic worrying or obsessive thoughts both of which are uncomfortable but perhaps less uncomfortable then a more active solution, and certainly less productive

Emotional

• Difficulty or inability to identify feelings or speak about emotions, or speak about emotions in a calm or thoughtful way

• Discomfort around other people’s emotions

• Conflict anxiety (while understandable, conflict is natural and a part of healthy relationships, it allows us to express ourselves and become aware of issues that need our attention)

• Secondary emotions (replacing uncomfortable emotions like sadness or insecurity with emotions we’re more comfortable with, like anger or passive neutrality)

• Numbness or dissociation or denial

• Panic, anxiety, emotional dysregulation (panic disorder is developed after we learn to fear the sensations and feelings associated with anxiety and panic instead of taking them as a signal for a need for self-care)

Avoidance boils down to not wanting to feel a thing I’m feeling. The problem is, feelings are meant to be acknowledged and explored. When done right, emotions are a rich source for information, identification, and self-narrative. But when avoided they don’t just submit and wilt away, they grow in intensity and persistence. Then, instead of practicing sitting with these difficult feelings, building our skills for navigating and responding to them, we lose that expertise. So now we’re faced with a bear and no weapons instead of a cub with a net.

Moving Forward Through Avoidance

Most of us have a vision of the future where things come easily, work and relationships and happiness don't require too much effort. Avoidance happens because we want to preserve that image. We are, on some level, willing to sacrifice our happiness in the moment for the chance of happiness in the future. Obviously this isn't rational. But avoidance works to keep us from questioning or even acknowledging these things. How do we tell ourselves It's time time to find a solution without first noticing that there's a problem?

The hard truth is that mental health and healthy relationships take work: full time, life-long work. And contemplating that work while keeping up with our jobs, our families, our friends, our homes, is so overwhelming that we respond by shutting it all out. But, if we contemplate what life is like, what life will always be like, as long as we continue to fail to engage with these issues is much, much worse.

“You are resilient too, and you have the inner strength to face these painful feelings.” - Dr. Dennis London

As a therapist I have learned that avoidance requires:

• Meeting people where they’re at

• A lot of patience and managing frustration

• A prolonged period of making and holding space for resistance

• Reminding myself and my clients that we’re not looking for perfect, we’re just trying for better

• Building up confidence slowly and celebrating every small step (slow progress often acts as an affirmation that we aren’t capable of solving out problems or changing our patterns)

• Accepting that if we can’t make change in the moment avoidance comes up, we can make changes in the time afterward (apologizing, taking it back, changing our minds, etc.) and that that still counts as improvement

• Naming and acknowledging avoidance when it comes up

• Naming and acknowledging the difficult feelings that are being avoided

Sources

Gillette, 2022: https://psychcentral.com/health/how-to-stop-avoiding-what-scares-or-overwhelms-you#why-is-it-unhelpful

Hershcovis & Cameron & Gervais & Jennifer, 2017; https://www.researchgate.net/publication/313684220_The_Effects_of_Confrontation_and_Avoidance_Coping_in_Response_to_Workplace_Incivility

Hofman & Hay, 2029: https://pmc.ncbi.nlm.nih.gov/articles/PMC5879019/

Holahan, Moos, Holahan, Brennan, Shutte, 2011; https://pmc.ncbi.nlm.nih.gov/articles/PMC3035563/

Jesen, 2024: https://students.ouhsc.edu/news/articles/emotional-avoidance-and-mental-well-being

Lebow, 2022: https://psychcentral.com/health/types-of-avoidance-behavior

London, 2023: https://thepsychologygroup.com/how-to-avoid-avoidance/

Nygaard, 2024: https://www.sandstonecare.com/blog/avoidance-behavior/

Scott, 2024: https://www.verywellmind.com/avoidance-coping-and-stress-4137836

Vanzhula, Sala, Christian, Hunt, Keshishian, Wong, Ernst, Spoor, Levinson; 2020: https://onlinelibrary.wiley.com/doi/abs/10.1002/eat.23254