Role of avoidance and safety behaviors

Avoidance behaviors and safety-seeking behaviors, although strategies that people use with the intention of reducing or preventing anxiety and distress, paradoxically play a crucial role in the maintenance and perpetuation of anxiety disorders.

Understanding their function is essential for treatment.

Avoidance. Short-Term Relief, Long-Term Problem

Avoidance involves actively avoiding situations, people, places, thoughts, or sensations that are associated with anxiety or perceived as threatening.

For example, a person with social phobia may avoid going to parties, or someone with agoraphobia may avoid leaving the house.

The primary mechanism by which avoidance maintains anxiety is through negative reinforcement.

When the person avoids the feared situation, they experience immediate relief from the anticipatory anxiety or distress that it caused.

This relief acts as a reward that reinforces the avoidance behavior, making it more likely that the person will avoid it again in the future.

The problem is that by avoiding, the person never has the opportunity to:

• Disconfirm their fears: They cannot test whether their catastrophic predictions about the situation were actually true certain.

• Becoming Habitualized to the Anxiety: Doesn't allow the anxiety to decrease naturally through prolonged exposure.

• Developing Coping Skills: Doesn't practice how to handle the situation or the anxiety it generates.

As a result, the fear of the situation remains or even increases, and the person's world shrinks as they avoid more and more situations.

Safety-Seeking Behaviors. False Protection

Safety-seeking behaviors are more subtle actions that people take in feared situations with the intention of preventing the anticipated catastrophe or to feel less anxious.

Unlike complete avoidance, the person does face the situation, but with "aids" or "crutches."

Examples include always carrying a bottle of water or medication in case of a panic attack, mentally rehearsing each sentence before speaking in a social situation, or going with someone to places that generate anxiety.

The problem with these behaviors is that, if the feared catastrophe does not occur,The person attributes the absence of danger to the safety behavior rather than to the actual safety of the situation or their own ability to cope with it.

For example, if someone with panic disorder always carries their medication and does not have an attack, they may think, "I didn't have an attack because I had my medication," rather than, "I didn't have an attack because the situation was not dangerous or because I can manage my feelings."

Thus, safety behaviors also prevent disconfirmation of fears and maintain the belief of vulnerability, perpetuating anxiety.

Part of treatment involves identifying and gradually eliminating both avoidance and these safety behaviors.