Wednesday, June 27, 2012

Avoidance and Exposure

Try to face your fears rather than avoid them. Even though uncomfortable, this will limit the growth of fear.

A paradox occurs when you avoid what you fear, because your fear then grows. This is counterintuitive, because when you avoid for a short time, your fear does decrease. Over a longer period, however, avoidance allows the anxiety to flourish.
You have to work against avoidance, even though it seems to make you feel better. Exposure means facing what makes you feel anxious. By exposing yourself to anxiety-provoking sensations, you become habituated to them, and your anxiety will eventually diminish.
The following types of avoidance contribute to anxiety:
Escape behavior
Avoidant behavior
Safety Behavior
All these forms of avoidance are ineffective methods of dealing with anxiety because they keep you from habituating to that which makes you anxious. Avoidance makes it next to impossible to learn to overcome the anxiety. Once you begin avoiding, it’s difficult to stop. Avoidance is difficult to avoid for the following reasons:
It works to reduce fear for a short amount of time
The more you engage in avoidance, the harder it is to resist in the future because it becomes a habit.
There is a superficial logic to avoidance, such as, “Why shouldn’t I avoid something that makes me anxious?”
You get a secondary gain from it, like extra care, because people around you are sympathetic.
By engaging in avoidance you stir up the “worry circuit” in the brain. The worry circuit stitrs up the amygdala, which increases your sense of fear, and the overactivity of the amygdala preoccupies the Orbital Frontal Cortex which tries to figure out why you feel anxious. The extreme version of the worry circuit occurs with people who suffer from OCD, a condition in which the worries become obsessive.
The key to breaking this vicious cycle is to make sure you expose yourself to what you were fearful of in the past. By keeping your behavioral options to what made you anxious in the past, you can learn to recondition yourself and habituate to the situation. When you apply detached attention to your worries, another paradox occurs: the worry circuit calms down. This technique is used in mindfulness meditation.
However, be aware, even after you succeed in habituating to your anxiety-producing situations, you are never completely “cured” as such. You will not extinguish the fear forever, it will recur in old or new forms, especially in times of stress, in which case you must expose yourself once again.

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