The Fear-Avoidance Feedback Loop

We all have our own methods and reasons to use avoidance as a coping skill. Still, most of us can also identify that using avoidance to reduce anxiety in the short term can also prolong our negative emotional experiences around the thing we are avoiding. What is less discussed, however, is that avoidance itself can actually cause and worsen the anxieties we seek to reduce.

Even if we never come into contact with the object of our anxieties, our mere avoidance of the things, people, or circumstances we feel anxious about can trigger a positive feedback loop in our brains that causes anxiety to grow. This feedback loop can exist in the absence of any actual interaction with the subject of our anxieties, since our brains are not especially skilled at discerning real threats from imagined ones. In other words, our avoidance reactions to something that makes us anxious is enough evidence for our brains to reinforce the validity of that anxiety. Our brains treat the future situations and imagined outcomes we avoid as real and present dangers in the context of our heightened anxieties around them.

Issue Avoidance Cartoon Comics

The relief our brains feel when we avoid a future situation further reinforces the “realness” of our anxieties and the usefulness of our avoidance. This process is exacerbated by the fact that avoidance prevents exposure to evidence that might contradict any anxiety-fueled predictions of the future. Additionally, our brains can develop the false belief that our anxious and avoidant behaviors actually helped to prevent a negative outcome.  

The habit of avoidance is developed through a neurobiological process that involves the interaction between the amygdala, a portion of the brain critical for learning about aversive stimuli, and the striatum, which is involved in reward-related processing. Through this avoidance-learning process, the brain essentially wires itself to favor avoidance reactions in the face of fear-inducing stimuli. To overcome our avoidance, we must retrain our brain’s neural pathways that have formed through the reinforcement of our avoidant behaviors. 

One way to rewire our brain’s learned avoidance responses is through exposure therapy, which is a proven method of treatment for anxiety. According to the model, effective treatment of avoidance (and anxiety in general) requires the activation of the brain’s “fear structure.” In other words, we have to practice putting ourselves in situations where anxiety and avoidance might arise. Activating the brain in this way creates opportunities for new information about safety to compete with existing beliefs. In my next blog post, I’ll get more into detail about how you can utilize techniques from exposure therapy in your daily life to build your confidence and break through your anxious-avoidant behaviors. 

Making Peace to Make Change

Finding compassion for the less savory parts of ourselves is an essential first step in personal growth.

Stuck. It’s a word that I hear all the time as a therapist. It’s thrown around in first sessions as clients articulate their presenting concerns. Myself and other clinicians often use the word on our websites to convey to clients our an understanding of the problems they may face. Oftentimes, the word “stuck” is used in the context of describing things we dislike about ourselves: stuck in a rut; stuck in the post-breakup blues; stuck in the a bad habit.

We all have parts of ourselves that feel stuck- parts of who we are that we feel frustrated about and that we feel constantly at war with. These habits, feelings, behaviors and fears feel like roadblocks that seem to impede wherever it is we are going in life.

We may repeatedly set an intention to change the aspects of ourselves that we feel so at odds with. We tell ourselves: “Get your life together.” “You ought to lose some weight.” “Can’t you drink less?” “And stand up to your bullies while you’re at it!” Again and again, we try and fail to force into submission the parts of ourselves we dislike. As we do so, the self-criticism and resentment we feel towards those aspects of our being grows.

Ironically, the self-criticism we harbor in our efforts to banish certain aspects of ourselves actually work against us. Not only do we have to push past our patterns and habits, we have to dodge the storm of negativity we project onto ourselves.

Although it may seem paradoxical, it is not until we make peace with the more challenging parts of ourselves that we are able to really make change in those areas. When we do so, we free up the mental energy that was once spent on self-loathing thoughts and negative emotions. As Carl Rogers said in his book On Becoming a Person, “The curious paradox is that when I accept myself just as I am, then I can change.”

I tell my clients that there is a reason that each part of them exists. Even our most frustrating habits serves (or has previously served) some purpose for us in life.  Part of the healing work in therapy is acknowledging and making peace with the reasons our various parts exist. We feel a burden lifted as we shift our focus away from judging our behaviors and patterns and as we begin to look instead towards what lies beneath.

Here’s the kicker: the true origins of our more challenging parts oftentimes lie in our unconscious mind and outside of conscious recognition. The parts of us that feel most “stuck” are oftentimes encoded in our brains early in life or in response to ongoing stress or traumatic events. The behaviors and beliefs that helped us persevere in these stressful times can become limiting as our brain attempts to deploy them later on in life. Meanwhile, our conscious brains may develop all sorts of blaming narratives for why we behave in self-limiting ways, although they oftentimes don’t have the full story.

This is where working with a trained mental health professional can be very helpful. In therapy, I help my clients recognize how their core and unconscious beliefs about themselves and about the world contribute to the their sense of feeling “stuck.” In doing that work of acknowledging, my hope is that my clients can foster more self-compassion and greater understanding for the parts of themselves they hope to change.

Mind you- we don’t have to like the parts of ourselves that we want to change. And I am not promoting permissiveness towards harmful behaviors or patterns. I will, however, encourage you–just as I encourage my clients–to mull over the idea that there is a valid reason why the various parts of your being exist. Your brain is working hard to utilize all of its parts to make it through the day, and you owe it to yourself to acknowledge that truth.

This is Your Brain on Friendship

Why we function best when we feel connected to others

In 1987, American television viewers were first introduced to the slogan “This is your brain on drugs.” As those words rang out from TV sets across the country, the commercial’s narrator sternly cracked an egg into a hot frying pan and displayed to viewers the scrambled mess he had made. The scene was part of an advertising campaign funded by the Partnership for a Drug Free America.

Its intent was to shock viewers into comprehending the deleterious effects that substance use could have on our brains. Of course, the scare tactics like these that were part of the War on Drugs were declared largely a failure, and the research on medicinal drug use has complicated the conversation about Our Brains on Drugs.

The effects of drugs on the brain aside, this commercial also serves as a reminder that our human brains are malleable–and thus vulnerable. Our brains need certain elements to be present in our body and in our environment for it to grow, to learn, and to function optimally.

Two of the most important of these elements are friendship and connection to others. In fact, “Your Brain on Friendship” looks and feels as different from that now-famous egg in a frying pan as one could imagine.

The experience of social inclusion and connection among humans feels like winning a neurological jackpot. According to one study, the brain reactions to feeling loved and cared for by pumping our neural networks with Oxytocin, the neurotransmitter responsible increasing warm and fuzzy feelings and decreasing stress and anxiety. In short, our brain treats and rewards social pleasure equivalently to physical pleasure.

The brain also releases more endorphins-a pain relieving and pleasure inducing neurotransmitter- when activities are done in group settings compared to in isolation. Many humans even display a lesser response of the stress hormone cortisol during interaction with adverse stimuli when a friend or loved one is present.

Moreover, social connection has even been proven to be a predictor of longevity. According to a longitudinal study of individuals from 1938 to the present day, those who reported the most satisfaction in relationships at age 50 were the healthiest (and most likely to be living) at age 80. The study posits that secure relationships protect the brains of elderly individuals from decline and that the stress of isolation can contribute to early memory decline. Another related study found that social isolation was a more important risk factor for death than inactivity and obesity.

In addition to serving as a strong predictor of emotional well-being, social attachment and connection are important ingredients to another central task for the human mind: forging a sense of self.

Our big, fat, social brains take stock of who we are based largely on how others react to us. Descriptive words like “timid” and “bossy” and “vivacious” and “grouchy” lack meaning outside of the social context and interactions which shape those terms. Similarly, the student who receives an 85% on an exam has limited information about how to feel about their score outside of the context of his peers’ reactions and feelings and outside of the context of societal expectations placed on students.

Moreover, the feelings we hold about ourselves as individuals are shaped in large part by the feelings we learned others held of us early in life. In his book Wired for Love, author and psychologist Stan Tatkin states:

“Human beings don’t start by thinking anything about themselves, good or bad. We learn to love ourselves precisely because we have experienced being loved by someone. We learn to take care of ourselves because somebody has taken care of us.”

In short, we know ourselves because others know us. We spend our lives defining and redefining ourselves in concordance with (or in reaction to) our experiences (or lack thereof) with other people.

However, Americans today are finding it more and more difficult to sustain friendship and connection, despite the evidence pinning it as an important element of mental health and wellness. According to a study by researchers at UC San Diego, 3 out of every 4 Americans experience moderate to high levels of loneliness.

There are a myriad of reasons we could point to as potential causes for this cultural loneliness. Probably high on the list is the replacement of in-person social networks with virtual ones. For some, loneliness stems from experiences with mental illness that interferes with our brains tendency towards social responsiveness. For others, loneliness may come as a result of trauma and other emotional wounds that result in a sense of isolation. Regardless of the reasons, loneliness is a universal human experience that comes part and parcel with our brain’s wiring for social connection.

For times when you feel lonely or simply want to increase those good feelings that come along with social inclusion, here are some tips to follow:

  • Take Stock: When we feel isolated, our brains lack those feel-good chemicals I mentioned earlier. This can cause us to spiral into some pretty bleak thoughts about our (lack of) options for social connection. Be curious and questioning in the face of those thoughts. Play detective and see what’s really available in your social network.
  • Reach Out: You wouldn’t wait for your plants to water themselves. Don’t wait for your social life to tend to itself either. Pro-social behaviors like reaching out to a friend in need can feel even better than being on the receiving end of help, one study shows.
  • Meet Up: Online and in-person meetup groups are abundant and are (rightfully) becoming more normalized by the day. These structured events might be a great option if you notice you have anxiety about meeting new people, as you can often research them ahead of time and know what to expect.
  • Seek Help: Sometimes we run up against sticking points in our brain that feel too big to tackle on our own, and it’s very common that these points often relate to how we relate to others. Doing some work with a therapist to better understand your experiences and to change your relationship with these sticking points can be very helpful in making changes in your life.

Why we avoid & what we can do about it

We human beings are well-practiced in the art of avoidance–those moments of emotionally and mentally checking out, the times when we phone it in on our efforts to connect with others, and those instances when it feels much more comfortable to sink deep into ourselves and to hide among our insecurities than it does to take the plunge into something unfamiliar. Avoidance can be subtle and can even feel benign at times–allowing our minds to drift to social media while we write a tough email, for instance.

Our brain’s penchant for avoiding the uncomfortable parts of our life boils down to an effort at self-protection and self-preservation. However, avoidance can easily beget further avoidance, and falling into the habit of avoiding can leave our brains less primed to stay present and engaged for those important moments in our life that do throw us out of our comfort zones.

When we avoid, we aren’t doing so because the alternative activity we seek out is more appealing (although it may feel at the time like we are actively choosing to play video games late into the evening, to drink a few extra beers, etc.). Our brains are not actively seeking joy in our avoidance strategies so much as they are attempting to minimize pain and discomfort. These strategies are rooted in the parts of our brain that function automatically (and mostly unconsciously) to make sure our level of emotional arousal stays within our “window of tolerance.”

Avoidance can feel very automatic and out-of-control because the mental process the underlies it (i.e. our brains’ efforts to assuage our discomfort) is indeed automatic. Moreover, the more frequently our brains utilize strategies like avoidance to temper our emotional arousal, the lower our tolerance for highly emotional experiences becomes. Just like the muscles in our arms and legs, our brains work on a use-it-or-lose-it basis. When we do not give our brains enough exposure to emotionally vulnerable and challenging experiences, our brain’s intuitive understanding of emotional equilibrium begins to fade, and we begin to experience a feedback loop of greater and greater emotional avoidance.

This process of compounding avoidance is at the heart of people’s experiences of phobias and anxiety, as the act of avoidance results in the exchange of one type of emotional pain for another. When we avoid, we are left with a lowered tolerance for emotionally arousing experiences in the long term. In the short term, we feel the uncomfortable cognitive dissonance that presents when we avoid something we know to be important. Coping with that cognitive dissonance may even require us to employ even further avoidance, and thus the avoidant feedback loop continues.

Although avoidance is the product of our brain’s automatic efforts to keep our emotional arousal at a tolerable intensity, we as human beings have the capacity to shape both how our brain copes with uncomfortable emotions and to expand the amount of emotional intensity our brains can tolerate.

Here are a few of my favorite strategies for owning and dealing with avoidance:

1. Make nice with the avoidant part of your brain
Remind yourself that the avoidant part of your brain is doing everything it can to keep you safe and to help avert you away from intolerable experiences. Oftentimes, we learn our strategies of avoidance in childhood, when big emotions were comparatively even larger within our small bodies and when our brains were not yet fully formed in their emotion-processing capacities.

Practice having gratitude and compassion for the work that this avoidant part of your mind has put in for you over the years. For example, perhaps it kept you from having to be present for some tough fights at home growing up, or maybe it allowed you to compartmentalize some difficult emotions in order to finish up your last semester of college. The more you can make peace with this part of your mind, the less tumultuous your efforts to utilize alternative coping strategies will be.

2. Make an avoidance list
This tip is based on a concept named by Psychiatrist Dan Siegel in his parenting book The Whole Brain Child. In the book, Siegel writes about the strategy of “Name it to Tame It” to describe the process of helping children gain a sense of calm about uncomfortable and out-of-control emotional experiences. According to Siegel, applying words and labels to emotional experiences helps to engage our brain parts in ways that lower the intensity of emotional arousal.

In other words, whatever we are avoiding feels a lot bigger and scarier when it is floating around in our mind, untethered to the present reality. When we write down (or even speak out-loud) our avoidances, we label them and put parameters on them. We can own them, acknowledge them, and begin to have self-compassion about why we might be feeling avoidant. We might even notice that we feel more prepared to tackle the items on our list.

3. Have an attitude of “Let’s See”
So often, the emotional distress we feel around avoidance is compounded by our own judgement towards the things we’re avoiding. Consider your self-talk around some things you avoid. (Maybe it’s something along the lines of “I’m being lazy for not exercising four days a week,” or “I’m socially incompetent and need to put myself out there more.”) Instead of forcing expectations onto yourself, play around with what I like to call a “Let’s see” attitude in those situations where you can identify avoidance. “I’m lazy and need to get in shape” becomes “Let’s see how much exercise I can get this week,” and suddenly the judgement and shame that surrounds much of our avoidance of exercise begins to melt away.

Transforming our self-talk can transform our attitude and approach to the things in life we avoid. In shifting our self-talk, we begin to open ourselves up to experiences that disconfirm our notions of what our brains can tolerate. We begin to create the habit of showing up and being present without judgement or expectations, and we can gradually begin to loosen the hold grip of avoidance on our minds.