Anxiety avoidance spiral

Anxiety is an essential part of the human experience. Awareness of danger helps us take action to stay safe. Elevated stress levels when we merge into traffic on a busy highway help us be more alert. Avoiding anxiety does not make us more relaxed. Paradoxically, avoidance makes us more anxious. 

Avoidance behaviors make anxiety worse

The edginess that anxiety brings can help us meet challenges. Feeling nervous about making a presentation, for example, might give us an extra push to prepare for the meeting.

Anxiety, in limited doses, is powerful. Anxiety that persists over long periods, and anxiety that keeps us from meeting our goals, is often disabling. When we adopt avoidance tactics to try and escape from an anxiety-provoking situation, we unintentionally reinforce the belief that the situation is dangerous or risky. Avoiding anxiety creates a negative loop where increased avoidance triggers elevated levels of anxiety the next time we face the situation.

Event

An event you encounter initiates anxiety

Anxiety

Hyperawareness arises that leads to an avoidance of situations or triggers.

Avoidance

You avoid the perceived threat as a means of coping.

Temporary relief

Avoidance offers temporary relief, yet leads to increased avoidance and more anxiety over time.

Intensified anxiety

You become more anxious and you avoid more situations over time. The anxiety-avoidance cycle.
Infographic from Therapy with Brooke on the Anxiety-Avoidance Spiral, showing a cycle from contemplating a decision, experiencing anxiety, choosing avoidance, feeling temporary relief, to increased anxiety.
Hover over the ❔ symbol for details about anxiety-avoidance.

A situation is perceived as a threat or danger, triggering anxiety.

You become hyperaware of the anxiety and begin to avoid anxiety-provoking situations.

Avoidance delivers temporary relief, training your brain that avoidance is a good response, leading to increased avoidance over time.

Avoidance leads to lower confidence and a diminished sense of mastery, fueling more avoidance and exacerbating your anxiety.

You become more restricted, avoid more situations, and become increasingly isolated. This is the anxiety-avoidance cycle♻

Anxiety avoidance tends to get worse over time

To avoid feeling stressed or anxious, do you skip social occasions or avoid speaking up at work or school? These are examples of avoidance behaviors. Unfortunately, the short-term relief provided by avoidance behaviors comes at a cost: reinforcing anxiety in the long run. By avoiding anxiety-provoking situations — anything from going on a date to asking for a new project at work, to taking a plane — you are training your mind that these situations are dangerous.

The next time that the situation arises, your brain is going to present even greater resistance to taking part. You may go to greater lengths to avoid the trigger. Avoidance leads to isolation from relationships, exacerbates anxiety, is associated with depression, and can suck you into a downward spiral of difficult emotions and behaviors.

Breaking the cycle is possible

It is difficult to break the anxiety-avoidance cycle. It is also feasible.

The first step is to recognize how anxiety avoidance plays out in your own life. What avoidance behaviors have you adopted?

The second step is to understand the role that avoidance behaviors play in maintaining and aggravating your anxiety. Understanding will give you the motivation to break the cycle.

The third step is to challenge your avoidance behaviors. An important evidence-based approach is exposure therapy. By experiencing a gradual exposure to anxiety-provoking situations your mind can learn (or relearn) that the situation need not be avoided. Recent research has shown that Virtual Reality Exposure Therapy (VRET) can be effective. This might be used, for example, to create a virtual reality experience of flying on an airplane for an individual with a fear of air travel.

A therapist who understands anxiety and avoidance behaviors can help you develop effective coping strategies to manage anxiety.

References and further reading

Bennett, M.P., Roche, B., Dymond, S., Baeyens, F., Vervliet, B., & Hermans, D. (2020). Transitions from avoidance: Reinforcing competing behaviours reduces generalised avoidance in new contexts. Quarterly Journal of Experimental Psychology (2006), 73, 2119 – 2131.

de Jong, R., Lommen, M.J., van Hout, W.J., de Jong, P.J., & Nauta, M.H. (2020). Therapists’ characteristics associated with the (non-)use of exposure in the treatment of anxiety disorders in youth: A survey among Dutch-speaking mental health practitioners. Journal of anxiety disorders, 73, 102230.

Lemmens, A., Smeets, T., Beckers, T., & Dibbets, P. (2020). Avoiding at all costs? An exploration of avoidance costs in a novel Virtual Reality procedure. Learning and Motivation.

Reeves, R., Curran, D., Gleeson, A., & Hanna, D. (2021). A Meta-Analysis of the Efficacy of Virtual Reality and In Vivo Exposure Therapy as Psychological Interventions for Public Speaking Anxiety. Behavior Modification, 46, 937 – 965.