Anxiety and Avoidance Explained

Anxiety and Avoidance: What You’re Actually Avoiding (And What You’re Not)

If you are struggling with an anxiety disorder, you have probably been told that avoidance makes things worse. You’ve heard it from therapists, read it in articles, seen it on social media. Avoidance is the enemy. Stop avoiding. Face your fears.

But there’s a lot of confusion in the anxiety community about what avoidance actually means. And if you’re confused about what you’re avoiding, you’ll have a very hard time working on it. So I want to clear this up.

The Question That Keeps Coming Up

People ask me some version of this all the time: if I’m learning to not engage with my scary thoughts, to let my anxiety symptoms be there without reacting, to not argue with my intrusive thoughts or try to prove them wrong, isn’t that avoidance? Isn’t that just ignoring the problem?

It’s a fair question. And the answer is no. What you’re describing is not avoidance. But to understand why, you need to understand the difference between content and process.

Content vs. Process

The content of your anxiety is the specific thing that triggers you. For someone with OCD, it might be an intrusive thought about harming a loved one, or doubts about a relationship, or fears about identity. For someone with health anxiety, it’s the particular disease that has the brain’s attention right now, or the physical sensation that seems to signal something is terribly wrong. For GAD, it’s whatever worry feels most urgent today, the career, the family, the finances, the sense that something important is being missed. For panic disorder, it’s the racing heart, the dizziness, the feeling that the body is about to give out. For agoraphobia, it’s the highway, the supermarket, the distance from home.

That content is real to you. I’m not dismissing it. But the content is not what you’re actually avoiding.

What all of those experiences have in common is that they create discomfort. Fear, anxiety, uncertainty, the sense that something terrible is about to happen, the feeling that you cannot handle what is unfolding inside you. That discomfort is the process. And the process is what matters.

Avoidance is everything you do to make that discomfort stop.

What Avoidance Actually Looks Like

If you have OCD and an intrusive thought fires, avoidance looks like looping through the thought to make sense of it, arguing with it to try to prove it wrong, seeking reassurance from someone else that you would never act on it, mentally reviewing past events to establish that you’re a safe person. You’re not avoiding the thought. You’re avoiding the discomfort the thought produces, and those behaviors are the attempt to escape it.

If you have GAD and a worry takes hold, avoidance looks like overthinking, over-planning, mentally rehearsing every possible outcome so that you can feel more certain and therefore less afraid. You’re not solving a real problem. You’re trying to manage how uncomfortable the uncertainty makes you feel.

If you have panic disorder or somatic anxiety and your body starts doing something that scares you, avoidance looks like checking your pulse, Googling your symptoms, going to the emergency room, calling someone so they can tell you you’re okay, or constantly trying to physically control the sensation. You’re not diagnosing a medical emergency. You’re trying to get away from the fear that the sensation causes.

If you have agoraphobia, avoidance looks like turning around and going home when anxiety spikes on the highway. You’re not actually avoiding the highway. You’re avoiding the discomfort that driving on the highway produces. That’s a critical distinction.

What Is Not Avoidance

Letting a scary thought be there without responding to it is not avoidance. Feeling a physical sensation that frightens you and not doing anything to fix it is not avoidance. Not engaging with a worry, not arguing with an intrusive thought, not seeking reassurance, not checking, not doing the compulsion: none of that is avoidance. That is, in fact, exactly what recovery requires.

People get tripped up here because it feels like you’re ignoring a real problem. The OCD thought seems like a real problem. The worry about your kids seems like a real problem. The somatic sensation that feels like suffocation seems like a real problem. But if you’ve been dealing with this for any length of time, you’ve noticed that the content changes. What OCD latched onto a year ago is different from what it’s fixated on now. The theme that health anxiety chose six months ago has probably shifted. The content is a moving target because the content was never the point. The process is the point.

Why This Distinction Matters

This is the difference between anxiety and anxiety disorders. People with non-disordered anxiety feel anxious in response to external things, real problems in the real world, and that anxiety motivates them to deal with the external situation. People with anxiety disorders feel anxious in response to internal experiences, thoughts, sensations, emotions, and then spend enormous energy trying to control, escape, or eliminate that internal experience. The anxiety becomes self-sustaining because avoidance temporarily relieves the discomfort while making the whole system worse in the long run.

When you understand that the avoidance is the response to the discomfort, not the avoidance of the content, the work becomes clearer. The question to ask yourself is: what triggers me into a state of distress, and what do I do to try to get away from that distress? Whatever the answer is to the second question, that is your avoidance behavior. That is what you have to practice not doing.

Letting the discomfort be there is the work. It’s simple and it’s hard. It’s counterintuitive because every part of you is saying the content is the problem. But the content was never the problem. Your relationship with the discomfort the content creates, that’s the problem. And that is what anxiety treatment, done well, is actually addressing.

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This post was previously published on The Anxious Truth.

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