Avoiding Avoidance

Wanting to avoid adverse experiences is human. Every one of us will at times use avoidance to protect ourself and it can be an adaptive behaviour. While avoidance can help us stay safe, or may seem as harmless as putting something off for tomorrow, avoidance can also lie at the heart of mental health difficulties.        

Sometimes avoidance comes at the cost of pursuing our goals and can make it difficult to function. Minimising perceived risk or pain can become a band-aid — protective in the short term, but not necessary or helpful long term. Like overuse of a band-aid, continual reliance on avoidance can cause problems to fester, impair healing, and make us feel weaker than we are. Let’s explore what exactly avoidance is, when it’s healthy and when it’s not, and what we can do if we’re over using this coping strategy.

What is avoidance?

Avoidance is when we choose (consciously or subconsciously) to not engage, or to only partially engage, in an experience. Experiences can be a behaviour or situation (like talking in front of a group of people, or going to the shopping centre), but can also involve thoughts and emotions (like feeling sadness or thinking about a difficult memory).

People tend to use avoidance to limit a real or perceived threat to their physical, mental or emotional safety. What a threat could be differs between people. For some people, being evaluated by others may be a threat, or the prospect of performing poorly on a test. A threat could also be an emotionally experience, for example a desire to avoid feelings like anxiety, or shame, or boredom. We may prefer to eliminate the physiological symptoms of these emotions such as our heart beating quickly and feeling shaky. Avoiding the experience altogether (e.g., not doing the speech, repressing emotions) is one form of avoidance. A milder form of avoidance may be only partially engaging. For example, we may temper our emotional experience by staying on the ‘head/logical’ level, or we may use limiting safety behaviours (such as attending a party but only speaking to the people we know).

What is the advantage of avoidance? When does avoidance hurt us more than help us?

Avoidance as a behaviour makes sense in evolutionary terms. When humans encountered dangers such as predators it was adaptive to avoid these threats. The physiological response to danger for humans is even labelled ‘fight or flight,’ with flight being an avoidance of danger. Avoidance of genuine threats is adaptive (for example, avoiding walking alone late at night in an area known for crime). But with the way our mind processes information it can become difficult, especially when emotional, to discern what is strategic avoidance and when avoidance is self-limiting.

This is because, on some level, avoidance works. Problematic avoidance is a band-aid: in the short term it does its job (we feel better), but long term we may not be reaching our goals and living the life we desire. Problematic avoidance can manifest as not doing things that scare us even though we need or want to do them (like public speaking, socialising, learning something new). Some avoidant behaviour comes with its own set of problems too (e.g., procrastination increases stress, substance use causes health issues, detaching from others leads to disconnection). Avoidance can limit our functioning and produce emotional distress (such as stress, disconnection, frustration, shame etc.).

Our self-image can also be affected by avoidance. We can begin to believe that we can’t do or feel certain things. The longer we leave the band-aid on, the worse the imagined pain is of removing it. Just like physical wounds, emotional distress needs air to heal. Hiding away our pain through avoidance makes it harder for others to help us.

How to avoid avoidance

If you’re in a pattern of unhealthy avoidance there are several things you can do. The first step is to recognise that your avoidance is not helping you (to stop buying into the short-term gains). You may choose to write down the costs of avoidance to help you remember why you want to change.

Self-compassion is so important when dealing with avoidance. There is no need to shame ourselves or push for immediate change when addressing avoidance. As discussed, avoidance is on some level functional and certainly an understandable response to stress.

Recognising that change takes time can be helpful. The brain is plastic, meaning it has the capacity to change and we can learn new ways of thinking and being. However, change takes time and we need to give ourselves the chance to consistently practise a new thought pattern and behaviour before it becomes automatic.

You can ‘rip off the band-aid’ of avoidance, so to speak, by doing the experiences you are fearful of. This can be very challenging and it may be easier to break down the steps towards the avoided experience and gradually work towards change. Psychologists can help during this process and it is essential to make goals realistic. A professional can also give you alternative coping strategies to replace avoidant behaviour and can help you identify and reduce any ‘safety’ behaviour you perform (things you do to avoid the full feared experience).

Acceptance of difficult emotions and learning distress tolerance can also help in learning to confront feared experiences. Sometimes we may even have to address our core beliefs and attitudes to reduce avoidant coping. For example, unhealthy attitudes towards emotions (that we cannot feel or express certain emotions), can fuel avoidance. Avoidance can also come from maladaptive beliefs about ourselves or others (such as having low self-worth or believing others can’t be trusted).

In summary, avoidance is a common response to threats that can be adaptive or unhelpful. There can be many ways in which avoidance manifests and it can occur for a variety of reasons. Healing from chronic avoidance can be an empowering journey. If you are struggle with avoidance and would like assistance, please contact us and book in.

Written by Erica South, Psychologist

What to Expect When You See a Psychologist

Deciding to seek psychological support can be an important step in identifying and improving mental health difficulties. When seeking other health support, such as attending our local GP or dentist, we may have past experience and/or a model in our head of what the process entails. If you’ve never been to counselling before you may not know what will happen in the session. Below are some common concerns and questions around commencing therapy.

What’s a psychologist’s role?

Psychologists working in private practice help individuals identify and manage mental health difficulties. People seeking therapy may want help with a wide range of difficulties ranging from diagnosable mental health conditions (such as major depression, panic disorder or PTSD), to communication difficulties, or support while going through a stressful time). Some psychologists can also be involved in diagnosing and supporting those with neurological conditions and/or developmental delays.

During therapy your psychologist will work to conceptualise:

·       Your current difficulties

·       Short and long-term factors that have contributed to these struggles

·       What keeps these problems going

·       What helps with the problem — protective factors.

Psychologists are university-trained health professionals who have knowledge about how the brain works and skills in delivering evidence-based interventions to improve your mental health. 

What is the difference between a psychologist and a psychiatrist?

Psychologists deliver talk-based therapy from a biopsychosocial framework, meaning they consider biological, psychological and social/environmental factors that contribute to mental health. Talk-therapy is a term that refers to evidence-based techniques that can treat mental health difficulties and can be an alternative or adjunct to medication. Psychiatrists are medical doctors who have specialised in mental health. While they may also deliver talk-therapy, psychiatrists have more of a biological focus and are able to prescribe and monitor medication use.

What is the process to see a psychologist?

You do not need a referral to see a psychologist, though many people seek one from their GP who may be able to give you a Mental Health Care Plan. Mental Health Care Plans enable clients to receive a rebate for up to 10 sessions per calendar year, reducing the cost out-of-pocket per session. If you have private health this may alternatively assist with the cost of sessions.

Feelings about commencing therapy

Attending therapy can come with a variety of feelings. It is natural to have some anxiety before attending your first psychology session. Talking about our difficulties with someone we have just met can feel overwhelming, but psychologists want to provide you with support and are trained in how to listen so you will feel comfortable and supported.

Some people also have feelings of ambivalence about therapy. This can occur if you hold stigma towards the process (which unfortunately has existed within our society). You may also feel unsure about engaging in therapy again if you have had previous negative experiences in counselling. When we are struggling, feelings of hopelessness and low motivation can be present, which may also make you skeptical of how much therapy can help. Psychologists are aware these feelings may be present and can give you education around the process of therapy, as well as accept and work with mixed feelings about attendance.

Seeking help can also involve a feeling of relief and after starting the process you may feel supported and more hopeful about improving your wellbeing.

What happens in the first session?

In your first psychology session you may:

·       Be familiarised with the process of psychological therapy

·       Share your story and what has brought you to the session

·       Identify goals

·       Start to build a working relationship with the psychologist and sense if you feel comfortable with them

Initial psychology session/s tend to be focused on information gathering more than strategies. Your psychologist will want to fully understand your current difficulties and background factors, as well as gain a sense of who you are as a person and your goals.

It’s important for your therapist to have a clear conceptualisation of your mental health so they can give you an effective and tailored intervention. While you are speaking with your psychologist for the first time it is important to remember:

·       You can give your psychologist feedback and influence the pace and focus of the session

·       If you are unsure of what to talk about your psychologist can give you some prompting questions

·       You are getting a feel of how you ‘click’ with your psychologist. You can always give feedback and/or see another psychologist if you feel your therapist is not a good fit for you.

What happens in subsequent sessions?

In subsequent sessions with a psychologist you will start working towards your goals in therapy. This may often involve some discussion of your current wellbeing and any significant events, as well as time to learn a new skill/strategy.

Many clients find that talking about their difficulties and having a supportive professional listen is helpful. Psychologists rely on evidenced-based therapy models and techniques to assist you improve your wellbeing. These ideas may be conveyed throughout conversation or taught in a more didactic way, depending on what works for the client. How your therapist works with you will also be influenced by their style of therapy and personality, as well as by your unique needs.

You can take an active role in sessions, working together with your therapist and possibly completing collaboratively agreed upon between-session tasks. Giving feedback to your psychologist about your goals, your experience of therapy, and any obstacles or concerns, can help make therapy as effective as possible.

Summary

Seeing a psychologist for the first time can involve varied emotions. During an intake session your psychologist will gather information about your current difficulties, history and goals so that they can understand your therapy needs. Subsequent sessions will involve the development of a working relationship with your therapist where they will provide support and information to assist you meet your goals. While therapy may feel daunting to start with, it can be the beginning of a helpful journey towards improved mental health.




Erica South, Psychologist