Challenging Avoidance

By Julie-Anne Peake, Clinical Psychologist

Avoidance feels like protection, yet it quietly strengthens the fears it tries to escape.

Avoidance is one of the most common and costly coping strategies in mental health. It temporarily reduces distress but maintains the very problems people are trying to escape. Whether it involves avoiding feared situations, difficult emotions, or painful memories, the short-term relief reinforces long-term suffering.

Avoidance sits at the heart of many disorders such as anxiety, depression, PTSD, OCD, and substance use. Instead of treating each disorder as distinct, a transdiagnostic perspective looks at shared processes that cut across diagnostic categories. Avoidance is one of these key processes, shaping how symptoms persist and interact.

Avoidance can take many forms:

• Behavioural avoidance: not going to places, events, or conversations that trigger discomfort.

• Cognitive avoidance: suppressing thoughts or distracting from distressing memories.

• Emotional avoidance: numbing, detaching, or using substances to block feelings.

Therapies such as Cognitive Behaviour Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Exposure Therapy share a common goal of helping clients face rather than flee their inner experiences. When avoidance is replaced with gentle, supported engagement, emotional processing can occur and flexibility grows.

Clinically, identifying avoidance means looking for what the client is not doing -what they avoid thinking, feeling, or saying. It often hides beneath rationalisations (“I just don’t have time”) or protective habits (“I prefer to keep busy”). Bringing awareness to these patterns allows for choice instead of reflex.

Working transdiagnostically, clinicians help clients to:

1. Recognise avoidance patterns across symptoms and contexts.
2. Develop tolerance for emotional discomfort through graded exposure and mindfulness.
3. Reconnect with valued actions and relationships rather than fear-based avoidance loops.

Final Thought

Avoidance protects in the short term but imprisons in the long term. Helping clients meet discomfort with compassion and curiosity is central to healing, regardless of diagnosis.

References

1. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. Guilford Press.

2. Barlow, D. H., et al. (2017). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Oxford University Press.

3. Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237.

4. Craske, M. G., Treanor, M., Conway, C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23.

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