In the “How It Works” series, I’ll dig into the science, research, and theory behind our psychology.
Part 1 of How It Works: Avoidance introduced the model of avoidance, and Part 2 explored the impact of “little-a” avoidance, or the safety nets we employ to help deal with distress.
In Part 3, we’ll dive into exposure therapy, the gold standard evidence-based treatment for tackling avoidance.
By now, hopefully three things are clear:
Most of us deal with distress, including anxiety and fear, by trying to get rid of it quickly.
We do so by avoiding the distressing thing all together, or by creating a system of safety nets that make the distressing thing feel more manageable in the moment.
Both big- and little-a avoidance are highly rewarding in the short-term, so we reach for them over and over again. But, over time, avoidance messes with our self-confidence, leaves us feeling incompetent, and makes our lives smaller and scarier.
Solution, please.
First, it’s important to realize that what goes up, must come down. Emotions cannot sustain at 100% unendingly. That’s why panic attacks, which people often describe as feeling like a heart attack, typically peak in intensity after ~10 minutes. If these symptoms continued to worsen indefinitely, they might actually be heart attacks.
I don’t say this to minimize the intensity of a panic attack or to deny that people can experience extremely heightened emotional pain for days, months, or even years on end.
Rather, it’s meant to illustrate that our belief that we can only handle a certain amount of distress is another trick that fear plays on us.
So, what would happen if we pushed past our peak distress?
This is the premise of exposure therapy. This evidence-based treatment consists of repeated exposure to the things that you have been avoiding. By allowing yourself to push past the avoidance, your mind learns a few critical lessons:
You can handle more distress than you think you can.
The thing you’re worried will happen is not actually that likely to happen.
Even if something bad does happen, it turns out you can handle that, too.
Now, nothing about working on our mental health is easy, and avoidance is a particularly challenging one. So I’ll give it to you straight:
You will feel worse before you feel better. If you’re pushing past the avoidance (ie, past the point of your “peak” distress), well… you’re going to feel more distress. (I’m really not one for sugarcoating.) Remember, though, that the goal is not to feel relief in the moment. The goal is to learn that you can handle a higher level of distress, and that. . .
The distress will eventually come back down again. It’s not instantaneous (or else you wouldn’t have needed to avoid in the first place). But, your distress will come back down again. Your brain needs the opportunity to learn this because, when you avoid, your brain operates from the lens of, “I can’t handle anything more than this. If it gets worse, the floodgates will open and I’ll never recover.”
Now, it’s not all doom and gloom, or else I wouldn’t provide this therapy (I’m not a sadist). The benefits?
When the distress does come down again, it won’t bring all the messy stuff with it. Rather than feel guilt, shame, regret, or disappointment for avoiding, you’ll actually feel a sense of accomplishment or pride.
And the next time around, you won’t feel as afraid. Because, this time, you actually know what to expect, and you know you can get through it without the safety nets. The scientific term for this is habituation, which simply means that we get used to something over time. The 20th time you ride a bike isn’t going to feel as scary as the first time; the 20th time you give the same talk isn’t going to be as nervewracking.
Even better? As the exposures get easier and easier, you’ll also experience so many more benefits than just the removal of fear. You feel more sure of yourself. And you start living again, possibly in ways you never could have imagined.
The fear no longer controls you.
I often say that exposure therapy is the closest thing to therapy magic. I’ve seen it quite literally change the course of people’s lives in a few months.
One of the things I love the most about it is that you’re doing the work, and I act as more of a coach who eventually steps away so you can take the helm of your own life.
And if you’re the one who got yourself better, then no one can take that away from you.
*A note on the importance of seeking ethical exposure therapy with an expertly trained professional:
Exposure therapy absolutely can be provided incorrectly, and misinformation has found its way to social media (eg, “rejection therapy”). Avoidance fights very hard to survive in the brain, and it is extremely good at doing so.
If you’re completely honest with yourself, do you tend to storytell in your therapy sessions rather than talk about what’s really causing you pain? Do you talk openly about past trauma because you know that you’re supposed to, but you feel completely numb when doing so? Maybe you focus on more manageable traumas rather than the big one? Do you laugh when the thing you’re talking about actually devastates you?
Every time your therapist does not draw attention to things like that, they are complicit in your avoidance. To unearth safety behaviors wherever they may be hiding, call out avoidance in the room, and not give into our own avoidance requires a highly skilled exposure therapist.
*Please note that information shared in this newsletter is for educational and common interest purposes only. It is not a substitute for mental health treatment, and is not intended to be used for diagnosis or individualized clinical advice. Reading this newsletter does not establish a therapist-client relationship.
If you are experiencing a mental health crisis, you can call 988 or text 741741. If you are interested in learning more about evidence-based therapy or starting therapy, you can reach out for a free consultation call.