Anxiety, Avoidance, and Desensitization: Understanding the Relationship

Therapy for Anxiety and Avoidance Behavior

Sometimes anxiety and avoidance go hand-in-hand. When people feel anxious about a particular situation or person, they may either implicitly or explicitly avoid it. While some avoidance is typical in daily life, chronic avoidance can cause significant impairment and also exacerbate the very anxiety symptoms you hope to reduce.

Understanding Anxiety Disorders

Anxiety disorders are common, and the term ‘anxiety disorder’ refers to specific psychiatric conditions that entail excessive worry or fear. Anxiety disorders can affect both your physical and mental health. Without proper treatment or support, they may decrease your overall quality of life.

Some of the main symptoms of anxiety disorders include:

  • the constant worry that interferes with daily functioning
  • panic attacks
  • intense fears about a specific object, situation, or place
  • sleep problems, including insomnia or nightmares
  • difficulty concentrating
  • muscle tension and/or chest tightness
  • restlessness or feeling “on edge”
  • chronic sense of hypervigilance

Research shows the average age of onset for anxiety disorders is 21. However, many children and adolescents experience anxiety concerns, and it is important for caregivers to be aware of early warning signs.

Although there is not a cure for anxiety, you can learn how to recognize and properly manage excessive fear. In doing this, you reclaim a sense of empowerment in daily life.

Anxiety and Avoidance Behaviors

Avoidance behaviors refer to intentional or unintentional actions to reduce or prevent exposure to a feared situation. Avoidance offers a sense of control and relief in the short term, but it can perpetuate and worsen anxiety in the long run.

Avoiding Social Situations

People with social anxiety disorder may miss certain social events to avoid feeling embarrassed or negatively judged by others. This can lead to social withdrawal or difficulty with making meaningful relationships. When relational trauma intersects with anxiety, it can exacerbate low self-esteem and make it challenging to trust others.

Procrastination

Sometimes anxiety shows up via procrastination. People may put off certain tasks they deem overwhelming. The fear of failure can also drive procrastination tendencies. It feels easier to avoid doing something than confront the risk of doing it wrong. This, however, can reinforce patterns of self-sabotage and exacerbate low self-esteem or internal guilt.

Compulsive Behaviors

Compulsive rituals, such as washing hands several times or checking to ensure the stove is turned off, effectively reduce anxious thought patterns or intrusive thoughts in the immediate moment. However, this relief is short-lived. Compulsion often begets compulsion, sometimes reinforcing feelings of self-doubt or learned helplessness.

Substance Use

Some people seek to manage their anxiety by escaping it altogether. Drugs and alcohol certainly offer this kind of outlet, but chronic substance use heightens mental health problems and can make anxiety feel even more debilitating.

Dissociation

Sometimes the body dissociates in response to anxiety. Dissociation refers to feeling disconnected from feelings, physical sensations, thoughts, or sense of self. Dissociation can be a trauma response. It is not always a conscious avoidance strategy, but it can emerge through frequent daydreaming, forgetfulness, and feeling ‘zoned out.’

Anxiety, Avoidance, and Desensitization

Avoidance strategies can offer some immediate comfort, but they don’t actually reduce anxiety, and they can simultaneously magnify feelings of loneliness and shame. In addition, some strategies may directly counteract your core values. For example, if you long for connection, avoiding others inherently makes relationships harder to access and maintain.

If you recognize that you frequently avoid fears instead of facing them, you may feel like you’re in a chronic state of stuckness. You might also feel like your anxiety is running your life.

Avoidance also prevents people from understanding that their fears may be irrational. It may hinder personal and professional growth, often diminishing opportunities for positive experiences. It may even block the development or practice of healthy coping mechanisms.

Understanding Desensitization

Desensitization refers to how emotional reactivity to a particular stimulus reduces over time. Exposure therapy specifically focuses on this. This type of therapy is rooted in the concept that being safely and gradually exposed to an anxiety-provoking stimulus can diminish the fear.

  • In vivo exposure: Directly facing the feared object, situation, or activity in real life.
  • Imaginal exposure: Imagining the feared object or situation in therapy.
  • Interoceptive exposure: Intentionally drawing upon physical sensations that feel scary but are generally benign (e.g., rapid heartbeat).
  • Sustained exposure: Remaining in a feared situation until the anxiety feels significantly decreased or extinct.

The overarching goal of any form of desensitization work is to tolerate anxiety. This doesn’t happen right away. Instead, it comes with time, patience, and repeated exposure.

For example, if you fear public speaking, you allow yourself to really feel that fear without engaging in a typical avoidance behavior. You ride out the severe anxiety and allow it to dissipate organically.

Over time, this can establish a sense of implicit safety. You start to trust that you can safely cope with a real or perceived threat, and you may no longer feel as debilitated by negative thoughts about the worst-case scenario. The anxiety may not completely go away, but it levels out in a more manageable way.

Therapy for Anxiety and Avoidance Behavior in the Greater St. Louis Area

Avoidance coping strategies can have a protective function. While the anxiety may feel debilitating and avoidance the only tool, it is also treatable with more effective strategies. You can learn how to manage your fears without trying to avoid them altogether. You can also learn how to manage your emotions and regulate the level of stress you feel in everyday life.

In my work with anxiety and avoidance behaviors, I help clients understand and manage their worries effectively. It’s important to honor the benefits of avoidance while also safely introducing other coping strategies. We’ll do this at a pace that feels safe and respectful to your journey.

My approach to treatment is multifaceted, pulling from attachment-based care, exposure-response prevention, DBT, CBT, somatic therapy, and mindfulness. Please contact me today to schedule an initial consultation.