PTSD and Avoidance

One of the topics that comes up often in PTSD is this idea of avoidance. Avoidance is the conscious or unconscious effort to push away painful thoughts, memories, and emotions, or to avoid people, places, or things that may remind you of past trauma. This makes sense right? If something is painful to think about or uncomfortable to do, we’ll want to avoid it. Sometimes this can be helpful to us. But in the context of PTSD, avoidance can give you a temporary relief but make things worse over time.

When we avoid, we get this little “fix” of temporary and false relief, just enough to get us believing that the only way to feel better is to keep avoiding. But remember this: if avoidance worked, no one would ever have PTSD. We’d just say “nope, that doesn’t bother us anymore” and we’d move on. The opposite, however (and unfortunately), is true. Avoidance allows symptoms of PTSD to grow deeper and stronger and take over more areas of your life. Before you know it, nearly everything can become triggering and you are avoiding more and more of your life.

Let’s say you’re in a grocery store. When you are in a crowded area, you notice your anxiety increasing. You notice a rapid heartbeat, feeling tense, feeling shaky, and the “fight or flight” response starts to kick in. Objectively, you may think, “I’m fine here”, but physiologically, there are alarms going off all over the place screaming at you to get out of there! So you leave. You leave and once you have a few minutes out of the situation, you notice your anxiety starts to come down. This is when your brain starts to make the connection, “hey, if i feel uncomfortable, I am not safe and must leave!”

But what happens the next time? Maybe you send a friend, family member, or spouse to get your groceries because you don’t feel up to it. Or, maybe you go for it but these feelings of anxiety start when you’re just walking up to the door so you head back to the car and hit up a drive through instead. Avoidance here, again. Nudging you saying, “you can’t handle it, just avoid it!” further increasing the likelihood you’ll keep avoiding in the future.

What if this goes on for weeks? Months? Years? It’ll spread beyond the grocery store. It can then go to any place there may be a group of people like lines, your kids sporting events, restaurants, etc. The emotional and physiological reactions intensify, needing very little to set them off. The avoidance has made way for these fears to manifest and take over more and more…..and as diminished the power and control you have over your own life.

Helping people to get back to living life is a big part of PTSD treatment! It’s not just about going and doing those things you’ve been avoiding and suffering through, but being able to master them and feeling confident competent again. The amount of relief someone feels when they are able to do these things comfortably (key word!) is invaluable.