Mental health articles

avoidance behavior symptoms You don’t have to be a behavior therapist to recognize the clinical signifi cance
of maladaptive behaviors. And of all the maladaptive patterns of anxious and
depressed students, perhaps the most widespread is avoidance. Anxious students
shy away from confronting specifi c objects or situations (as seen with
simple phobias and PTSD), interacting with classmates (social phobia), or
talking in class or giving a speech (performance anxiety). Panic suff erers
avoid situations associated with their attacks, and some agoraphobics literally
won’t leave their room or apartment. Depressed students may languish
at home rather than visit friends, try out for the swim team, or ask a tutor for
help. More subtly, students who have generalized anxiety disorder and OCD
are avoiders as well, expending time and energy on their worries or rituals
rather than taking constructive action.
Avoidance is detrimental in any number of ways. Many challenges are
more diffi cult in imagination than in reality, but avoiding them makes them
seem scarier, like peering down and hesitating on the proverbial high diving
board. What’s more, putting off challenges can in fact increase their diffi
culty, whether it’s catching up with classroom assignments, breaking into
a friendship circle, or paying off credit card debt. Avoidance causes embarrassment
and shame, too, which leads to more avoidance; a hypersensitive
student may feel too mortifi ed aft er failing to fi nish an assignment to show up
again in class. Avoidance also frees up mental energy that can easily be channeled
into more worries, anxieties, and pessimism. Rather than doing, avoiders
have time on their hands to dwell on the worst. Avoidance turns off other
people. Shy or demoralized students are oft en dismissed as snobs or misfi ts
by their classmates or viewed as unmotivated by their professors. In a larger
sense, avoidance is the enemy of psychological development. Successfully oneself, not running for cover.
For all these reasons, treating anxiety and depression won’t get very far
until students stop running away and begin to face up to their challenges. But
students don’t always see it this way, instead identifying their symptoms as
the problem and avoidance as a by-product. First cure my fear, they say, and
then I’ll talk in class. Restore my motivation, and then I’ll study or go out with
friends. One of our main jobs as therapists, therefore, is to sell avoidant students
on the merits of taking constructive steps. “I know you’re reluctant, but
it’s very important to your treatment that you get moving again.” A popular
saying captures the point: It’s a lot easier to act your way into a new way of
feeling than to feel your way into a new way of acting. Alcoholics Anonymous
puts it more concisely: “Fake it till you make it.”
As for where to begin with constructive behavior, solution-focused therapy’s
sagely commonsense advice is to build on positive exceptions, the times
when students are already doing a little of the right thing (Walter & Peller,
1992). Even the most socially withdrawn student likely says hello to somebody,
and the most despondent student engages in some productive activity.
Th ese are the behaviors to reinforce. To fi nd instances of constructive behavior,
students can be given a monitoring homework exercise: “Notice the times
during the week when you feel even a little less depressed [or frightened or
worried]. What are you doing then to make this possible?” (Th e very act of
assigning homework sends the uplift ing message that students can do something
concrete about the problem, and right away.) Assuming that students do
the homework (they may avoid it!) and fi nd constructive examples, the assignment
for the following week should be to do even more of the same.
In a similar spirit, the behavioral strategy of graded assignments has students
tackle behavioral challenges sequentially, starting with the least anxiety
provoking and working up to bigger challenges. Th erapists can ask students,
“What small goals seem most feasible for you to do this week? What would be
a fi rst step telling us you’re moving in the right direction?” If students draw a
blank, it may be necessary to off er suggestions: “Can you imagine smiling at one
person?” “Would it be possible for you to start studying again for at least a half
hour at a time?” Since striving and accomplishments are inherently rewarding,
even small positive changes can provide a big boost. Th is get-them-movingagain
approach, like a psychological First Law of Motion, posits that people at
rest (avoiders) tend to stay at rest, whereas people in motion (doers) tend to stay
in motion. Once started, a student feels inspired to tackle harder challenges.

Tags: symptoms