Avoidance, not anxiety, may be sabotaging your life

ANXIETY, for many people, is like an unwelcome houseguest

- a lingering presence that causes tension, clouds the mind with endless ‘what ifs’ and shows up as various physical sensations.

In my practice, I see many patients beaten down by anxiety.

One patient said anxiety makes her heart hammer like a wild drum at the thought of public speaking.

Another patient said anxiety makes him toss and turn all night, haunted by worries about his romantic future.

And yet another patient said anxiety makes his stomach churn at the thought of confronting his underperforming team.

They are not outliers. About 12 per cent of US adults regularly felt worry, nervousness or anxiety, according to a National Health Interview Survey conducted between October and December 2022.

Anxiety, though, is not the puppeteer pulling the strings in many of our lives.

There is a more subtle and insidious marionette, and it’s called psychological avoidance.

When we avoid certain situations and decisions, it can lead to heightened anxiety and more problems.

Psychological avoidance is a way to avoid discomfort Psychological avoidance is a quick fix to an uncomfortable emotion. It offers emotional relief, but the relief is fleeting and often comes at a heavy cost.

Psychological avoidance is akin to an ostrich burying its head in the sand, choosing ignorance over confrontation, all while a storm brews in the background.

My client’s social anxiety disorder - manifesting as a fear of public speaking - triggered a career detour into a lowerpaying job.

She’s trading 25 per cent of her potential income just to sidestep public speaking.

My other client’s worry about future relationships made him lose sleep, which in turn led to tardiness and decreased productivity at work.

The cost of mental healthrelated productivity loss is staggering.

A study conducted by researchers within the World Health Organisation estimates that depression and anxiety disorders cost the global economy US$1 trillion each year in lost productivity.

And for my third patient, discomfort with confrontation caused him to overlook his team’s performance issues, jeopardizing his company’s success.

In each case, the real villain isn’t anxiety.

It is avoidance, a strategy that not only fails to solve problems but fuels them.

Psychological avoidance isn’t about the actions we take or don’t take, but the intentions behind them.

If our actions aim to squash discomfort hastily, then we’re probably avoiding.

For each of my clients, avoidance became a crutch, initially tempering their anxiety but progressively amplifying it.

Psychological avoidance, rather than alleviating anxiety disorders, can exacerbate them.

Three patterns of psychological avoidance Understanding the patterns of psychological avoidance is the first step toward change.

Here are the three ways people tend to practice psychological avoidance.

Reacting

Reacting is any response that seeks to eliminate the source of discomfort.

It’s when we reply hastily to an email that upsets us or raise our voices without considering the consequences.

We are engaging with the situation, but only to make the discomfort vanish quickly.

Reacting often just fuels the fire, leading to even more problems.

This often feels like operating a pressure cooker without a pressure valve.

Retreating

Retreating is the act of moving away or pulling back from anxiety-inducing situations. For example, my client with the fear of public speaking took a different job to avoid it.

Others may reach for a glass of wine to numb out or scroll through social media feeds instead of facing a difficult conversation.

While it may feel good in the moment, this avoidance comes with a hefty price tag because it tends to increase anxiety, since the underlying situation is still there.

Remaining

Remaining is sticking to the status quo to avoid the discomfort of change. Many of us cling to a job or relationship even when we know it’s not good for us.

Familiarity may breed comfort, but we are still stuck in the long run.

Strategies to overcome psychological avoidance

Psychological avoidance is a powerful enemy, but there are three science-based skills to fight it.

Shifting

Shifting involves checking in with your thoughts, especially when anxiety comes knocking.

In those moments, we often have black-and-white, distorted thoughts, just like my client, who was worried about being in a romantic relationship, telling himself, “I will never be in a good relationship.”

Shifting is taking off dark, monochrome glasses and seeing the world in color again.

Challenge your thoughts, clean out your lenses, by asking yourself, “Would I say this to my best friend in this scenario?”

My client was able to change the way he talked to himself. Imagining what a friend would say, he thought to himself, “I have a lot to bring to relationships” and “I’ve had successful relationships in the past.”

Wearing these new glasses allowed him to sleep better at night and set him on a journey to pursue what matters most to him.

Approaching

The opposite of avoiding is approaching, which is not about charging at your fears headon, but taking a step that feels manageable.

Ask yourself: What is one small step I can take toward my fears and anxiety to overcome my avoidance.

My client volunteered to read a book to her son’s classroom as the first step in overcoming her fear of public speaking.

Even the smallest act of facing our fears can rewire our brain to deal with anxiety better, rather than sidestepping it.

Aligning

Aligning is living a valuesdriven life, where our daily actions are aligned with what matters the most to us: our values.

This is the opposite of what most of us do while anxious. In moments of intense anxiety, we tend to let our emotions, not our values, dictate our actions.

To live a values-driven life, we need to first identify our values, whether that is health, family, work or something else.

Then we need to dedicate time and effort to our values.

Aligning actions with values can reduce anxiety and improve the quality of our lives.

The tendency to engage in psychological avoidance may be strong but by understanding its patterns and using the right strategies, we can navigate this challenge and come out stronger.

Remember, it’s not about being fearless, but about not letting fear dictate our lives.

Luanna Marques, PhD, is an associate professor of psychiatry at Harvard Medical School, founder and director of Community Psychiatry Pride at Massachusetts General Hospital, and a former president of the Anxiety and Depression Association of America.