Anxiety and Avoidance - Blog#11 - 29 March 2019

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Bridge Phobis - 2010

Let’s follow up on our earlier blog on death anxiety by addressing anxiety in general. To understand and manage anxiety, we must also pursue its relationship with avoidance. As with other emotions, there are healthy and unhealthy versions of anxiety. The healthy version of anxiety alerts us to potential real threats, dangers, and issues, allowing us to plan and to alter our behavior to manage such threats. Likewise, there are healthy versions of avoidance (e.g., avoiding a man with a gun; taking time out to calm down during a marital dispute). But we can also manufacture threats and anxiety, and resort to chronic, self-sabotaging avoidance behavior.  Avoidance is a defense against anxiety, which provides short-term relief from anxiety. But a basic rule in learning psychology is that a reward increases the strength of the behavior preceding the reward. Thus, the reward, anxiety reduction, reinforces and strengthens the avoidance habit. And by avoiding the source of the anxiety, we lose opportunities to learn how to directly deal with and conquer the anxiety. Thereby, we often end up with long-term maintenance or escalation of both the avoidance and the anxiety. Defenses (such as avoidance) yield a short-term plus but a long-term minus, whereas coping skills (approaching difficult situations and feelings) increase immediate negative feelings (especially anxiety), but if handled well, yield long-term benefits, growth, and reduced anxiety.

Anxiety is often misunderstood, and is sometimes confused with depression or frustration. Anxiety is a feeling whose meaning is similar to fear, tension and nervousness. It is a tense feeling that arises when we fear something negative will happen in the near future. The anticipated crisis may be external, such as being ridiculed for a lousy presentation in front of coworkers later today, or internal, such as the danger of a suppressed memory of abuse surfacing, or fear that our anger will get out of control. Anxiety is different from depression, but often coexists alongside depression. Anxiety is a feeling, which can develop into various anxiety syndromes (Generalized Anxiety Disorder, Social Phobia, OCD, PTSD, etc.). Depression is a syndrome rather than a feeling, but often involves sadness as a primary feeling. Sadness typically involves a significant loss (e.g., loss of a loved one, rejection by a lover, loss of health, our job, etc.), and is often focused on the past, whereas anxiety is focused more on real or imagined threats in the future. Anxiety and depression commonly coexist, particularly as the consequences of anxiety and avoidance escalate into losses (e.g., social anxiety > avoidance > loneliness). Anxiety and frustration both involve tension, but anxiety typically involves worrying about what could happen in the near future, whereas frustration is about blocked expectations or desires during events that have already occurred.

Anxiety and fear live in the same neighborhood, but are not identical. Fear, and its extreme version, panic, are innate, automatic and adaptive survival responses to immediate danger. They precipitate a fight-or-flight response mediated by our Autonomic Nervous System (ANS, which controls automatic physical processes such as breathing and heart rate), and propel us toward immediate self-protection before it is too late. If your genetic ancestors were too mellow in their reactions to threats, you probably would not be reading this paragraph. Compared to panic, anxiety is a less intense but sometimes more chronic state of mind. It includes anticipation of, and worry regarding potential threats in the future, not just reactions to an immediate threat in the present. It involves a state of tension and apprehension, rather than a surge of panic. Some of us find ourselves in a relentless, self-defeating habit of constantly anticipating and preparing for a variety of future threats, both real and imagined.

Thus, on a cognitive level, constant preoccupation with potential threats will manufacture and multiply anxiety. For example, constant worrying can produce a generalized anxiety disorder. Negative thinking typically contributes to anxiety, and it is therefore important to monitor our thoughts to see if we engage in excessive worry, catastrophic "What if?" thinking, or obsessing. Worrying is simply a milder version of catastrophic thinking. It is not a feeling, but rather a type of thinking which produces the feeling of anxiety. Just as excessive expectations produce frustration, and blaming creates anger, worrying is a cognitive process which predictably produces its own feeling, anxiety. So what are the options if you are a worrywart? If we want to control our feelings, specifically our anxiety in this case, we need to learn how to control our thinking. One method for controlling worry involves utilization of a core resource in 12-step programs, the Serenity Prayer (“God grant us the serenity to accept the things we cannot change, courage to change the things we can, and wisdom to know the difference"). The profitable use of the Serenity Prayer first requires its third component, wisdom, followed by either acceptance or courage. The wisdom to determine what we can control or change, and what we cannot, is essential. It tells us which fork in the road to take, the path toward acceptance, or toward courageous, committed action. Reliance on the Serenity Prayer can markedly reduce frustration as well as worrying, because it directs us to let go of the unrealistic expectations that often fuel frustration.

Our behavior and lifestyle can also create anxiety. For example, anxiety can be created by relentlessly rushing around, during the time-managed lifestyles we are invited to lead in our modern industrialized society. If we can just cram five pegs into four holes during our three-hour outing, we can declare today a victory, and take our blood pressure meds later tonight. Physical factors, such as excessive caffeine, and poor nutrition or sleep, can also contribute to anxiety. Internally, unresolved issues, both past and present, can create or maintain anxiety. The anxiety becomes a signal, helpful feedback from inside, that something is wrong and should be attended to.

Sometimes our anxiety is more social in origin. Persons with a social phobia, the term sometimes used to describe social anxiety, typically function fairly comfortably and spontaneously in one-on-one situations with friends, since they typically know how their friends feel about them. However, with strangers, and particularly groups of strangers, especially if stuck in the spotlight of the group's attention, severe anxiety and even panic attacks may paralyze them. Fighting is obviously inappropriate, and therefore the fight-or-flight options associated with panic are reduced to flight (or freezing, which is also problematic in social situations). The problem in these situations is evaluation apprehension, that is, excessive concern and negative thinking regarding the impression one is making on other persons. In my view, there are four dominoes involved in social anxiety. Social phobics typically harbor low self-esteem, and engage in very negative internal self-talk about themselves. Then, they project their negative self-appraisals, and imagine (typically without evidence) that others are thinking negatively about them. This causes anxiety, which is then reduced by avoiding the people that are supposedly judging you so negatively. But the reduced anxiety is a reward that reinforces the avoidance behavior, which deprives us of the opportunity to interact with people and learn social skills, leaving us alone, lonely, and perhaps depressed. The healthy solution is to target our negative self-talk and projections rather than avoiding. To reduce social anxiety, we need to learn how to esteem ourselves, assess evidence rather than assuming others are judging us, and gradually approach rather than avoid people.

Anxiety is a broad topic, and we have only scratched the surface, delving mostly into generalized and social anxiety. For more, check out Chapter 27: “Anxiety and Avoidance Behavior,” in my recently published book, Beyond Atheism – A Secular Approach to Spiritual, Moral, and Psychological Practices. Available in print or e-Book on Amazon. Chapter Highlights for Beyond Atheism may be found at www.edchandlerandbeyond.com. And if you’d like, share your own perspective on anxiety and avoidance in the comments section below. Thanks for listening.

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