14/05/2013 07:21 BST | Updated 13/07/2013 06:12 BST

Avoidance and Anxiety: Why Avoiding What You Fear Doesn't Help

When you are anxious about something, the most natural thing in the world is to avoid it. It's common sense: if something seems frightening, unpleasant or overwhelming, your first impulse is to escape it. If you're phobic about dogs, you cross the street every time you see one coming. If you're worried about public speaking, you go to great lengths to avoid presentations, speeches or contributing to meetings. If you're scared of needles, it's unlikely you will be first in the queue to give blood.

Once you understand why we feel anxiety, this makes even more sense. Anxiety, like anger, is an 'arousal emotion', inextricably linked to the fight-or-flight response that kicks in whenever you feel under threat. When you get angry, your brain is telling you: 'There's a threat, so go and fight it!' So you get hostile, aggressive or even violent to deal with the threat.

When you are anxious, your brain is saying, 'There is a threat, but it's too dangerous to fight - run away!' In hunter-gatherer times, that threat would have been a wild animal or marauding enemy tribe. These days, it's more likely to be a gang of hoodies or a 'psycho-social' threat like a driving test or first date with someone you really like, but that same primitive response kicks in every time.

But just because avoidance makes perfect sense, that doesn't mean it's helpful. In fact, in cognitive behaviour therapy (CBT) it's called a 'safety behaviour', which is something you do to make yourself feel better but that has unintended consequences. If you are anxious/avoidant, the first of these is never disproving your negative beliefs. So if you are phobic about dogs, and spend your life avoiding them at all costs, how will you disprove the belief that all dogs are dangerous? If you were able to approach a few friendly-looking dogs, you would quickly realise that the worst you will get is a friendly lick.

Another consequence is that you turn your feared object into a big, scary monster. The more you avoid something, the more you are convinced that you are only safe because you are avoiding it - this inevitably makes the thing seem more scary. Again, by approaching it (perhaps with the help of someone like me, if the anxiety is too much to overcome on your own) you realise that awful thing you have been avoiding for years isn't so bad after all.

To misquote the title of a rather famous self-help book, overcoming anxiety means feeling the fear and doing it anyway.

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