The Avoidance Trap
Understanding Anxiety and the Cycle of Avoidance
Anxiety disorders affect millions of people worldwide, and while symptoms can vary widely, one core feature consistently appears across nearly all anxiety presentations: avoidance. As humans, we naturally tend to avoid things that make us uncomfortable or afraid. However, for those with anxiety disorders, this avoidance can become excessive, persistent, and significantly impact quality of life. This post explores why avoidance becomes central to anxiety, the many forms it takes, and evidence-based strategies to break free from its grip.
The Psychology of Avoidance in Anxiety
Avoidance is defined as the act of staying away from certain situations, people, environments, or internal experiences to prevent negative or unwanted thoughts, feelings, or consequences. While avoiding perceived threats is a natural survival mechanism, in anxiety disorders, this behavior becomes excessive and counterproductive.
The Anxiety-Avoidance Cycle
The relationship between anxiety and avoidance creates a self-perpetuating cycle that looks like this:
Anxiety: You experience symptoms of anxiety-physical sensations like increased heart rate or mental symptoms like racing thoughts
Avoidance: You feel uncomfortable and want these feelings to stop, so you avoid the situation, person, or thing causing them
Relief: By avoiding, you experience temporary relief from anxiety
Reinforcement: This relief negatively reinforces avoidance, making you more likely to avoid similar situations in the future
This cycle explains why avoidance, though seemingly helpful in the moment, actually maintains and strengthens anxiety over time. By avoiding feared situations, people never have the opportunity to learn that their fears are exaggerated or that they can cope with discomfort.
Theoretical Foundations
Several theoretical models help explain avoidance in anxiety:
Reiss's expectancy model suggests that during encounters with fear-provoking stimuli, individuals experience not only fear toward the stimuli themselves but also fear about the physical sensations elicited by these encounters. This "fear of fear" or anxiety sensitivity amplifies avoidance motivation.
The formula proposed by this model is: Fear behavior = Expectation of danger + (Expectation of anxiety × Anxiety sensitivity). This explains why people with high anxiety sensitivity are particularly motivated to avoid anxiety-provoking situations.
The Contrast Avoidance Model offers another perspective, suggesting that individuals with generalized anxiety disorder fear negative emotional contrast experiences. These individuals may worry excessively to maintain a negative emotional state, thereby avoiding the contrast of shifting from a positive to a negative emotional state.
The Many Faces of Avoidance: How Anxiety Manifests in Behavior
Avoidance behaviors can manifest in numerous ways. According to research, they generally fall into five main categories:
1. Situational Avoidance
Situational avoidance involves avoiding specific physical situations, places, or people that trigger anxiety. Examples include:
Avoiding crowded places due to panic disorder
Steering clear of social gatherings due to social anxiety
Not taking elevators due to claustrophobia
Canceling plans at the last minute
This is the most common and obvious form of avoidance and is a formal symptom of many anxiety disorders, including post-traumatic stress disorder.
2. Cognitive Avoidance
Cognitive avoidance refers to avoiding specific thoughts or mental images that provoke anxiety. This can be intentional or unintentional, as the brain may automatically divert attention away from anxiety-provoking thoughts. Examples include:
Suppressing thoughts about a traumatic event
Distracting oneself when worried thoughts arise
Engaging in wishful thinking or maladaptive daydreaming
Refusing to plan for potentially stressful future events
3. Protective Avoidance
Protective avoidance involves engaging in behaviors that offer the perception of safety. These are often called "safety behaviors" and can include:
Checking behaviors (repeatedly checking locks or appliances)
Carrying "just in case" items (medication, water, phone)
Always sitting near exits in public places
Using "good luck" charms
In social anxiety, safety behaviors fall into two categories: "avoidance" safety behaviors (concealing or limiting engagement, like avoiding eye contact) and "impression-management" safety behaviors (attempting to create a good impression, like rehearsing sentences).
4. Somatic Avoidance
Somatic avoidance aims to limit physical sensations associated with anxiety. People engaging in this form of avoidance may:
Avoid exercise that increases heart rate
Avoid temperature extremes that cause physiological arousal
Avoid foods or substances that might trigger sensations similar to anxiety
Avoid thrill rides or scary movies
5. Substitution Avoidance
Substitution avoidance involves replacing uncomfortable thoughts, feelings, or emotions with alternatives that seem more manageable. Common examples include:
Using drugs or alcohol to cope with anxiety
Becoming angry to mask feelings of fear or vulnerability
Binge eating or restricting food intake
Excessive screen time (binge-watching TV, gaming, social media scrolling)
Breaking the Cycle: Evidence-Based Approaches to Overcoming Avoidance
Fortunately, several evidence-based treatments specifically target avoidance in anxiety disorders:
Exposure Therapy
Exposure therapy is considered a first-line treatment for anxiety disorders5. It involves systematically confronting feared stimuli in a controlled, gradual manner to reduce anxiety over time. Types include:
In vivo exposure: Directly facing the feared situation in real life
Imaginal exposure: Vividly imagining the anxiety-provoking scenario
Virtual reality exposure: Using technology to simulate feared situations
Interoceptive exposure: Deliberately triggering harmless physical sensations similar to anxiety symptoms
Prolonged exposure (PE), commonly used for PTSD, combines imaginal and in vivo exposure. The patient describes the traumatic event in detail and also confronts related situations in real life. Research consistently shows that exposure therapy is highly effective for reducing avoidance behaviors and anxiety symptoms.
Cognitive-Behavioral Therapy (CBT)
CBT addresses both the cognitive and behavioral aspects of anxiety. For avoidance, CBT typically includes:
Education about the anxiety-avoidance cycle
Cognitive restructuring to challenge catastrophic misinterpretations
Behavioral experiments to test feared outcomes
Gradual exposure to feared situations
The CBT model emphasizes how catastrophic misinterpretations of bodily sensations and situations lead to anxiety, which then triggers avoidance and safety behaviors, maintaining the cycle.
Acceptance and Commitment Therapy (ACT)
ACT offers an alternative approach, focusing less on reducing anxiety and more on accepting it while pursuing valued activities. For avoidance, ACT teaches:
Acceptance of anxiety-related discomfort rather than struggling against it
Mindfulness skills to observe thoughts and feelings without judgment
Clarification of personal values
Committed action toward value-based goals despite anxiety
Rather than trying to control or eliminate anxiety, ACT helps people learn to carry their anxiety while still engaging in meaningful activities.
Mindfulness
Mindfulness can be a powerful tool for addressing anxious avoidance. By cultivating present-moment awareness and nonjudgmental acceptance, mindfulness helps individuals recognize their anxiety-driven urges to avoid certain situations or feelings without automatically acting on them. Instead of escaping discomfort, mindfulness encourages gently observing anxious thoughts and bodily sensations as they arise, reducing the tendency to react with avoidance behaviors. Research shows that mindfulness-based therapies are moderately to highly effective in reducing anxiety symptoms, with some studies finding outcomes comparable to those of medication, but with fewer side effects. Through practices like mindful breathing, body scans, and acceptance of internal experiences, individuals learn to face rather than flee from anxiety triggers, ultimately breaking the avoidance cycle and fostering greater resilience and well-being.
Steps to Overcome Avoidance
If you're struggling with anxiety-driven avoidance, consider these evidence-based strategies:
Recognize avoidance patterns: Identify which types of avoidance you engage in and how they affect your life.
Create an exposure hierarchy: List anxiety-provoking situations from least to most challenging.
Practice gradual exposure: Begin with less challenging situations and progressively work toward more difficult ones.
Eliminate safety behaviors: Identify and gradually drop safety behaviors that maintain anxiety.
Practice acceptance: When anxiety arises, practice observing it without judgment rather than immediately trying to escape it.
Seek professional help: Work with a trained therapist who specializes in evidence-based treatments for anxiety.
Conclusion
Avoidance may provide temporary relief from anxiety, but it ultimately strengthens anxiety's hold and narrows one's life. Understanding the different forms of avoidance and implementing evidence-based strategies to confront feared situations can break this cycle and lead to lasting improvement.
Remember that facing anxiety is challenging, and progress often involves temporary increases in discomfort. However, with persistence and proper support, it's possible to overcome avoidance and reclaim a fuller, less restricted life. As research consistently demonstrates, the path through anxiety-not around it-leads to genuine recovery.
References
Krypotos, A.-M., Effting, M., Kindt, M., & Beckers, T. (2015). Rethinking avoidance: Toward a balanced approach to avoidance in anxiety disorders. Frontiers in Behavioral Neuroscience, 12, Article 5879019. https://pmc.ncbi.nlm.nih.gov/articles/PMC5879019/
BrightPoint. (2025, February 10). What is exposure therapy for anxiety disorder – How can it help? BrightPoint Medical. https://www.brightpoint-md.com/anxiety-treatment/what-is-exposure-therapy-for-anxiety-disorder/
American Psychological Association. (n.d.). Cognitive–behavioral therapy for clients with anxiety and panic [Video]. APA Psychotherapy Video Series. https://www.apa.org/pubs/videos/4310884
Hunter, L. E., & Gillan, C. M. (2020). Anxiety, avoidance, and sequential evaluation. Current Opinion in Behavioral Sciences, 34, 49–54. https://pmc.ncbi.nlm.nih.gov/articles/PMC8143038/
Tompkins, M. A. (2013). Anxiety and avoidance: A universal treatment for anxiety, panic, and fear. New Harbinger Publications.
Healthline. (2023, March 15). Anxiety avoidance: Causes, treatment, and support. https://www.healthline.com/health/anxiety/anxiety-avoidance
