Anxiety and avoidance: why avoiding helps you today and harms you tomorrow

“I really can’t make it tonight. Say hi to everyone from me.”

The message takes three seconds to write. Outside it is Saturday evening, a friend is celebrating her fortieth birthday, and the present is already bought and wrapped on the shelf. When you press “send”, something in your chest lets go. Your shoulders drop. Your breathing deepens. You put on a series and, for the first time that day, you feel safe.

The next month there are fewer invitations. Six months later there are hardly any. And when one day you do head out for a coffee, the anxiety at the café door is stronger than ever before.

That is what this piece is about: avoidance, the most human response to anxiety, which genuinely helps you in the moment — and which, precisely for that reason, takes the most from you in the long run. I will write about why the brain learns avoidance so quickly, how it hides in small habits you do not even notice, how life slowly shrinks around it, and how you can find your way back, step by step.

Relief that comes at a price

Avoidance is not weakness. It is one of the oldest and most sensible responses we have. If you see a snake on the path, stepping back is the right decision. The brain is built to avoid danger before you have even thought about it — and throughout history that has kept us alive.

The trouble starts when the alarm begins to ring at things that are not dangerous: a phone call, a meeting, driving on the motorway, a crowded shop, a check-up at the doctor’s, a conversation with your partner. The body responds as though it were standing in front of a snake, and stepping back brings the same relief. Only this time you lose something you did not need to lose.

Anxiety in some form is part of almost everyone’s life, and anxiety disorders are more common than we think. In a large American study led by Ronald Kessler, around 29 per cent of people met the criteria for one of the anxiety disorders at least once in their lifetime — they were the most common group of mental disorders of all. And in almost all of them, avoidance runs through like a red thread. I described it briefly in the glossary under avoidance; here I want to go deeper into why it is so stubborn.

Negative reinforcement: why the brain learns to run

As far back as the middle of the last century, the psychologist O. Hobart Mowrer described how anxiety keeps itself going in two steps. First, fear becomes attached to a situation — sometimes through a bad experience, sometimes by chance, sometimes because we have seen it in others. Then comes the second step, which is the key to understanding avoidance: every time you avoid the situation, anxiety drops, and that relief strengthens the avoidance.

This is called negative reinforcement. “Negative” does not mean bad; it means something is taken away — in this case an unpleasant feeling. Behaviour that removes discomfort becomes entrenched, just as behaviour that brings a reward does. The brain writes down a simple rule: It was dangerous. I withdrew. I survived.

What matters most is what you do not learn. Because you left, you never find out what would have happened if you had stayed. You do not find out that after ten or twenty minutes the anxiety would have eased on its own. You do not find out that you would have got through the birthday party, perhaps even enjoyed it. The fear goes untested — and an untested fear is always bigger than reality.

How life slowly shrinks

Avoidance rarely arrives all at once. You do not wake up one morning and decide never to leave the house again. It comes in small, reasonable steps, each with a good excuse.

First you stop driving on the motorway, because the country road is “nicer”. Then you only go to the shop in the morning, when it is quiet. Then you let your partner do the shopping. Then you cancel a trip because it is too far. Each decision makes sense on its own. Together, though, your world gets smaller — and the anxiety does not shrink, it moves to the new border. What used to be safe becomes new dangerous territory.

This is the most insidious thing about avoidance: anxiety adjusts to the size of your world. When you retreat from the road, the shop starts to worry you. When you retreat from the shop, the corridor outside your flat starts to worry you. People who ended up staying at home because of severe panic often say that in the end they felt anxious even at the thought of the post box. With panic this path is especially marked; I wrote about it in Fear of fear: how panic learns to return.

Safety behaviours: the avoidance you don’t notice

Some people do not avoid situations — they go to the party, take the train, attend the meeting. And yet the anxiety does not ease. Often this is because they are accompanied by safety behaviours: small habits meant to prevent disaster.

The British psychologist Paul Salkovskis described them in the early 1990s. Examples:

• you sit as close to the exit as possible;
• you always carry a bottle of water, a tablet, a fully charged phone;
• you rehearse everything you are going to say in your head beforehand;
• at a party you stick to one person or one glass the whole time;
• in a shop you walk quickly and avoid people’s eyes;
• you keep asking others whether everything is all right.

Why is this a problem? Because you credit your success to the safety behaviour, not to yourself. “I got through the meeting because I sat by the door.” “I didn’t faint because I had water with me.” So the fear stays untouched, even when you face the situation. Later experiments by Salkovskis and colleagues showed that people who face situations without safety behaviours change their beliefs about danger much more than those who keep them.

Some safety behaviours are very hard to spot. A glass of wine before meeting people. Headphones on the bus. A joke that shifts attention before anyone can ask anything. From the outside it looks like ordinary everyday life; on the inside it is still escape.

Avoidance in the mind

We avoid not only places and people, but also our own thoughts, memories and feelings. Steven Hayes and colleagues coined the term experiential avoidance for this: an unwillingness to stay in contact with unpleasant inner experiences, and all the effort we put into changing or silencing them.

It can be pushing thoughts away, keeping constantly busy so there is no time to feel, soothing yourself with alcohol or food, scrolling on your phone the moment discomfort stirs. And also what looks like thinking: endless mulling that feels like problem-solving but in fact protects you from having to decide and take a risk. I wrote about this in Decision paralysis: when thinking it over becomes a way of avoiding.

The paradox is well known from Daniel Wegner’s research: people who were asked not to think about a white bear thought about it more often than those who were free to think about it. Thoughts we push away come back. Rather than fighting them, it helps to notice them and let them be — that is the subject of How to notice a thought instead of following it: an introduction to cognitive defusion.

Avoidance moves into relationships too

In relational family therapy, in which I am training, we often notice that avoidance is not just a matter for the individual. The people close to us adapt to it — lovingly and with the best of intentions. A partner takes over the phone calls, the shopping, the driving, the conversations with the school. The family stops suggesting outings. Gradually the whole system organises itself around one person’s fear.

A conversation about it might go something like this (a composite, not a real person):

“Could you call the plumber tomorrow? You know I don’t like phoning.”
“I can. Though last week I also called the doctor, the bank and your mum.”
“I know. Sorry. It’s just… it’s so easy for you.”
“It’s easy for me because I do it. And you do it less every time.”

There is no malice in this conversation. But there is something that, over time, weighs on both of them: one with the sense of having to carry everything alone, the other with a sense of being incapable. In children the same mechanism is called family accommodation, and I wrote about it in Anxiety in children: how to recognise it and how to help. In adults the principle is the same: change does not mean that the person close to you suddenly stops helping, but that the two of you agree together on small steps back.

Gradual approach: how you find your way back

If avoidance keeps fear going, approaching it reduces it. This is the core of exposure, one of the best-researched methods for anxiety, which is part of cognitive behavioural therapy and is used by other approaches too.

For a long time it was thought that exposure works because the body “gets used to” the fear and the anxiety drops after a certain time. A newer view, developed by Michelle Craske’s group, emphasises something else: what matters is that you learn something new. That the expected disaster does not come. That you can bear the anxiety. That the feeling was frightening, but the situation was not. This new experience does not erase the old one; it takes its place alongside it and gradually wins out.

This has practical consequences. You do not have to wait for the anxiety to vanish completely before you leave. It matters more that you stay long enough to check whether what you feared actually happened. And that you repeat the steps in different circumstances, so the new experience is not tied to one place only.

To plan your steps, an exposure ladder is useful: a list of situations from easiest to hardest that you take on one at a time. Below is an example for someone who stopped seeing people after a difficult period.

Exercise: the smallest step forward

You can do this exercise today. It takes ten minutes to plan and a little courage to carry out.

1. Choose one area where you avoid. Not everything at once. Ask yourself: where does avoidance cost me most — contact with people, work, movement, health?
2. Write down five steps from easier to harder. The first should be so small that it brings mild discomfort, not panic. Around 3 or 4 on a scale of 0 to 10.
3. Before the first step, write down what you fear. As concretely as possible: “I’ll blush and someone will comment on it.” “My heart will start pounding and I won’t be able to breathe.”
4. Take the step without one safety behaviour. Stay long enough to test your prediction. Do not run when the anxiety rises — watch how it changes.
5. Afterwards, write down what actually happened. What you predicted, did it happen? What did not? How strong was the anxiety at the start, and how strong at the end? Repeat the step until it becomes bearable, then move on to the next.

If the anxiety rises very high during the exercise, breathing with a longer out-breath can help — not as an escape, but as a way of staying. For steps with panic specifically, see Exposure: why panic has to be approached, not avoided.

When avoidance is not the enemy

I want to be careful here, because the message “approach your fear” can be misunderstood.

Some things should be avoided. If your partner humiliates or threatens you, withdrawing is not anxious avoidance but looking after yourself. The same goes for a workplace where you are being bullied, or for relationships that constantly drain you. Setting boundaries is something different from running away. If you are in a violent relationship, the SOS helpline for women and children who are victims of violence is available in Slovenia on 080 11 55.

Rest is not avoidance. Someone who is exhausted or burning out needs to step back from demands. The difference is whether you withdraw to recover or because you are afraid. The same behaviour — saying “no” to an invitation — can be a healthy choice one time and a step towards a shrinking life another. A useful question is: would I do this even if I weren’t afraid?

After trauma, approach is different. With memories of traumatic events, exposure belongs in the hands of a professional who knows how to make sure the experience does not overwhelm you. With severe forms of anxiety, addiction or obsessive-compulsive disorder, too, it is not wise to start on your own.

Not everything at once. Avoidance was built up over years; it does not have to be torn down in a week. A step that is too big and ends in panic and flight can even strengthen the fear. Small, repeated steps are slower, but more lasting.

When to seek help

If you notice that your life has shrunk noticeably, that you are avoiding work, the doctor or people who matter to you, that you are dulling the anxiety with alcohol or sedatives, or that despite your efforts you are not making progress, it is time for professional help. A good first step can be your GP, who can rule out physical causes and, if needed, refer you to a psychiatrist or clinical psychologist. Cognitive behavioural therapy and other forms of psychotherapy have good support for anxiety; if you are held back by thoughts that always predict the worst, read “What if …”: why the brain would rather predict a hundred disasters than one calm day.

In therapy you do not have to “conquer your fear” before you come. Quite the opposite: the first session is often the first rung on the ladder. If, alongside the anxiety, you have thoughts that you can no longer go on living, call the mental distress helpline Klic v duševni stiski on 01 520 99 00 in Slovenia (every day from 7 pm to 7 am) or the Samaritans helpline Samarijan on 116 123 in Slovenia (24 hours a day). In an emergency, call 112.

What to remember

• Avoidance reduces anxiety in the moment — and for precisely that reason keeps it going in the long run (negative reinforcement).
• When you step back, you do not learn that the anxiety would ease on its own, or that you could manage. The fear stays untested.
• Safety behaviours are avoidance in miniature: you credit them with your success, not yourself.
• We also avoid thoughts and feelings, and those close to us often adapt to our avoidance.
• The way back is a gradual approach in small, repeated steps — except where stepping back is a healthy boundary or rest.