Why Avoidance Makes It Worse – With Love from Dr. G
Alright folks. It’s been over one month now, and by this point many of you have probably noticed some very strong tendencies to avoid whatever makes you feel uncomfortable or whatever you find anxiety-provoking. Some of you may also be making an honest effort to not avoid, so you try to go out and do your “normal” but perhaps you now find that at times you suddenly want to escape the distressing situation. The reason we start to experience more anxiety is directly the consequence of our THOUGHT patterns. [Refer to my first posting, “Trauma 411” for an overview.] Remember, anxiety is defined as worry about potential (that means FUTURE) threats. It means, the anticipated negative outcome has not happened yet. Remember, we do not need to pay a debt we don’t owe. Try not to break Rule #1
(See the Bucket Rules posting)
But here’s the problem. Once we begin to worry about the possibility of a potential threat, then it impacts our behavior. We begin to pay more careful attention to those environmental cues (refer to the post called “How PTSD Develops”) that we now associate with the danger. But let’s not forgot, it was not the floodlights, or the screaming, or the crowd, or Jason Aldean’s music, or the sirens and alarms that harmed us. It was the bullets. Plain and simple, the guns shooting bullets at us, that was the ONLY REAL THREAT at the Route 91 concert. Thus, if we move forward in our lives and we now deem every associated environmental cue to be dangerous, we will likely begin to feel overwhelmed and find even normal social situations unmanageable.
Anxious (worried) thoughts and avoidance behaviors that ensue become positively reinforcing to one another. This scenario becomes a vicious cycle. As your anxiety increases, you make attempts to reduce it. Watch out for more subtle forms of avoidance such as using “safety behaviors, objects, people, or signals” or “superstitious objects.” This includes your fur babies. Perhaps you are going out, but now you always take a friend (and you did not necessarily do this prior to the Vegas shooting). Perhaps you didn’t sleep too well prior, but now your sleep is totally out of control, and you’re turning on the night light, locking your doors, checking windows numerous times. The unfortunate consequence of all of these behaviors is that they reinforce your believed inability to cope with the anxiety. As time goes on, you lose confidence in your coping skills. This, in and of itself, reinforces beliefs that all these associated cues are actually dangerous.
Why does that matter? Well, because in a truly dangerous, life-threatening situation, your brain can only focus on a limited number of “things.” And we want to make sure that our brain can focus on the actual “lion” and not the nearby bushes, trees, birds, grass, sky. Get my drift? When we lose this inability to discriminate between what is actually dangerous, we begin to perceive everything as dangerous. Not only are we at increased risk in terms of our inherent, hard-wired ability to react, but we will likely also be feeling totally overwhelmed all the time!
HOW WE FIX THIS: Maybe you don’t feel ready to go to the next Jason Aldean concert. So start smaller, and slightly less anxiety-provoking. Write down a list of all the things you think you may be avoiding right now, and then rank each one on a scale of 1-10. The “1” is a relatively low or minimal level of anxiety and thus avoidance. The “10” is the highest level of anxiety you can imagine (maybe panic attack zone), and thus you avoid it the most. Once you have established this FEAR HIERARCHY, then start with the activities listed at about a 3 or 4. The reason is, these activities will produce just enough anxiety for you to challenge. The goal of approaching feared activities in this way (called “Exposure”) is that we allow ourselves to have corrective learning experiences. We allow our brain to now understand that floodlights are not dangerous, and sirens won’t kill us, and screaming mobs of people are not the actual problem (just a consequence). Exposure helps us break the vicious cycle of anxiety. Remember, conditioned learning got us in the hole (Refer to the “How PTSD Develops” post). So, corrective learning will get us out of the hole.
Don’t give up folks! Exposure works. – Dr. G