Avoiding Avoidance (Part 1)


An article in the December, 2011 issue of “Men’s Health” magazine begins: “I am Neurotic,” and proceeds to explain how the brain possesses “the key to perhaps the single most powerful change a (person) can make to increase (positivity in their life).” Yawning at these grocery store check-out headlines, I overcame the impulse to toss the article aside – and I’m glad I did. The article quickly became more substantive as I began noticing familiar and credible names from the research literature. The magazine article continued:

“What is this life-changing step? Facing your fears.” (Anticipating my yawn, the writer quickly regained my attention) “Hey, stick with me, because this isn’t what you think it is….No, this is about facing something less obvious than fear, but more insidious. It’s about facing the way you avoid fear and other negative emotions, or how you distract yourself from them, or how you comfort yourself in the face of them….If you are doing anything to escape having a feeling you don’t like, you will fear that feeling even more the next time around. And research shows that you will also lessen your chances of success in a host of measures of well-being, from health to work to relationships.”

Okay. The writer had me at “hello”; I mean “avoidance.” “Avoidance” is a different subject – and an important one in the literature. But, I began to yawn again at the next line: “To tap this potential wellspring of life improvements, you need only commit to a five-step action plan.” Really? Just 5 steps? Like Curly in the movie “City Slickers” telling Billy Crystal’s character that he needed to know just “one thing,” I felt my intelligence insulted. I momentarily felt myself back at the grocery store check-out line. But, the writer was obviously anticipating such reactions because he continued: “Smirk if you must, but follow along. You might just pick up a life skill that starts out feeling seriously strange and ends up feeling strangely serious.” Swallowing my pedantry – and my pride – I yawned for the last time. The author behind the “five steps” was David Barlow, PhD, and Professor of Psychology and Psychiatry at Boston University; also Founder and Director Emeritus of the Center for Anxiety and Related Disorders at Boston University. In the words of the article author, “David Barlow is a towering figure in psychology.”

My reticence became attentiveness. “What are the five skills?”

Skill #1: Name Your State and Focus on Your Place

“First, you need to be able to identify your state of mind without labeling it or judging it, and that means fixing your attention on what’s actually happening (in the present moment). This can be complicated because our anxieties can exist as thoughts, physical sensations, or behaviors – or a combination….Say, ‘My heart is racing, but I’m actually sitting here and I am okay.’” Dr. Steven C. Hayes at the University of Nevada, Reno calls this “looking at your emotions (memories, thoughts, body sensations) rather than from your emotions” (2005).

Skill #2: Use Simple Questions to Puncture Negative Thoughts

Basically, skill #2 is about “catastrophizing”; all that worst case scenario stuff. So, “Ask yourself a few questions before you decide you’ll be homeless or single: What’s the evidence for that thought? What would a friend tell me to do in this situation? Is there another way to look at the problem? You may find that the beliefs that make you miserable can’t survive rational answers to the simplest questions.” This is basically what cognitive therapy teaches.

Skill #3: Stop Dodging Your Feelings

“You’re probably doing all kinds of things to distract yourself from uncomfortable thoughts and feelings. These efforts are what are known as ‘safety behaviors,’ and they make you their prisoner over time. So stop it – now.” (Dr. Barlow calls this skill the essence of the five skills.) “The next time you feel tempted to escape an antsy feeling, hang in there. Take stock of it. Name it. Watch it for a while. Admire the way your body reacts to the chafing reality. Then ride it all out, like that rafting trip that has you praying first and then smiling later. The discomfort always ends. You survive.”

Skill #4: Stop Letting Bad Feelings Dictate Worse Actions

“Feeling shy and want to cancel your social plans for the night? Go through with them anyway….The idea isn’t to fake positive thoughts. You don’t have to tell yourself you are going to love the party; you might not….Disconnect feeling blue from staying home. Disconnect feeling bad from frowning….Feelings don’t have to motivate what you do, and that’s especially true for negative ones. They’re just feelings, not mandates for action.” Reminds me of a statement by renowned psychiatrist William Glasser in his book Choice Theory (1998): “We choose all our actions and thoughts, and indirectly, almost all our feelings and much of our physiology.” We do indeed choose our actions, but we also choose our thoughts in that we interpret and even dispute them; for example, a physically exhausting workout at the fitness center (for a healthy person) can be thought of as good and healthy, or interpreted as signs of a heart attack. As Glasser observes, these choices indirectly influence our emotions and our physiology; an extremely important matter to consider when we opt for avoidance.

Speaking of physiology, the magazine article reads: “Don’t try to stifle the way your body expresses emotions you don’t like. And you shouldn’t try to override your emotions with drugs or alcohol either. Your body’s fear-response system is just doing its job, and those reactions have evolved over millennia….Breathlessness, light-headedness, sweating, or a twisting feeling in your stomach are all legitimate physical reactions to anxiety; evidence that your body is trying to give you extra energy and focus for the task at hand. Sure, it’s called the fight-or-flight response, but from now on, you’re going to stand and fight.”

Skill #5: Visit Your Anxieties Every Now and Then

“It’s not too many emotions that cause mood and anxiety disorders. It’s our relationship with our emotions….Just place yourself in the situation you dislike most, without your safety net. This goes straight to the heart of the (five-step method). If you satisfy your need to feel safe, you grant undue power to the circumstances you’re seeking protection from….If Barlow is right, it’s not emotions that create clinical problems…much less everyday distress….What allows those problems to take hold are all the desperate attempts we make to protect ourselves from the emotions that make us feel bad.”

Earlier, I mentioned Steven Hayes, PhD, Professor of Psychology at the University of Nevada, Reno. Dr. Hayes is one of the key developers of what is known as Acceptance and Commitment Therapy (ACT), which is very much in line theoretically and therapeutically with David Barlow’s approach. In the “Men’s Health” article, Hayes is cited as saying: “Your ability to tolerate uncomfortable emotions is probably the broadest single psychological concept we know how to change, and with the biggest impact I know of. People’s willingness to sit with uncomfortable emotions and find some meaning in them—feeling, learning, moving on—predicts positive outcomes in their ability to lose weight, quit smoking, stick to an exercise program, learn new software, do well at work, and survive burnout. And it correlates with all these other things like reducing depression and anxiety.” Dr. Hayes has MUCH to say about the problem of “avoidance”; so much in fact that I’ve decided to talk more about it in my next blog: Avoiding Avoidance (Part 2).

Bill Bray, Colorado Springs, CO

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