PTSD - Avoidance

What is avoidance?

Avoidance is a common reaction to trauma. It is natural to want to avoid thinking about or feeling emotions about a stressful event. But when avoidance is extreme, or when it’s the main way you cope, it can interfere with your emotional recovery and healing.

What are the different types of avoidance?

Emotional avoidance is when a person avoids thoughts or feelings about a traumatic event. For example, a rape survivor may try to force herself to think about other things whenever thoughts about the rape arise. Or, she may stop herself every time she begins to feel sadness about the rape, or focus on something else that makes her feel less sad. She may say things to herself like, “Don’t go there,” or “Don’t think about it.”

Avoiding reminders of a trauma is called behavioral avoidance. For example, a combat Veteran may stop watching the news or reading the newspaper because of coverage of the war. Someone who lived in Manhattan might move out of the city after the 9/11 terrorist attacks. Assault survivors might go out of their way to stay away from the scene of their attack.

What are the consequences of avoidance?

Growing up, you may have heard advice like, “just try not to think about it” or “don’t dwell on it.” But if you avoid thoughts and feelings of the trauma all of the time, your symptoms may get worse. Using avoidance as your main way to cope can make it harder to move on with your life.

Is all avoidance bad?

Not all avoidance is bad. It can be helpful to learn ways to focus your thoughts and feelings on things that are not related to the trauma. Distraction is a useful skill that can help you to get on with your daily life after a trauma. It can allow you to go to school or work, or buy groceries, even in the face of difficult life events. Although distraction and avoidance can be helpful in the short-term, they should not be your primary way of coping.

How can you learn to cope with difficult thoughts and feelings?

You may be afraid that if you let yourself feel difficult emotions, they might overwhelm you. You may be afraid that if you start crying, you’ll cry forever. Or you may worry that if you experience the anger inside you, you might lose control. Therapy can help you learn to deal with your thoughts and feelings about the trauma instead of being afraid of them.