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PTSD: Understanding Avoidance

Picture of Sadaf Akhtar.,PhD

Sadaf Akhtar.,PhD

Mental wellbeing specialist at WellQo

PTSD: Understanding Avoidance

Avoidance refers to actions, be they psychological or behavioural, that serve to minimise or prevent exposure to stimuli that trigger distress associated with past trauma(s),  This can include internal stimuli, such as memories, thoughts or feelings.  Or it may be external stimuli, such as people, places, conversations, activities, objects or situations.  For example, a road traffic accident survivor may avoid driving on the same road, choose not to drive, or even avoid sitting in a car with others altogether.  In other situations, a person may try to distract themselves with excessive work, exercise or other external phenomena so as to avoid experiencing distressing mental, emotional or sensorial memories of past psychological injuries.  Other indicators of avoidance documented by research include:

  • Staying away from people or places that remind people of trauma
  • Withdrawing and self isolating
  • Using alcohol, substances or food to avoid memories and emotional pain
  • Excessively watching TV or playing video games 
  • Difficulty accepting that abuse or neglect occurred 
  • Excessively focusing on others
  • Perfectionism or high self-criticism

What is the purpose of avoidance?

Avoidance actions, often carried out unconsciously, can be a way for people to protect themselves and cope with stimuli perceived to be a threat or danger.  For example, a person may experience sexual harassment from a male perpetrator; after the distressing event(s), he or she takes actions to prevent being alone with men, or tries to minimise interacting with them because of a fear of having the same experience.  The trauma experience can be so intense that the mere thought of being around males causes fear and results in avoidant behaviour, even without recalling, or awareness of, the initial trauma.  This can occur because of the beliefs formed after encountering a shocking event, beliefs that are generalised to all or most situations.  If the avoidance continues, then the negative thought patterns become deeply embedded in the unconscious mind, thoughts then become automatic, and actions carried out without conscious awareness.  

Avoiding a toxic person or situation can be a healthy response.  However, the difficulty with avoidance is that it can occur in situations where people transfer the fear, or other negative emotions, that they experienced from one or more specific events, to all or most situations.  Take, for example, the road traffic accident.  This may be a single event, experienced at a very specific point in time, however, one goes on to avoid ‘that road’ at all times, even though it poses no danger.  This can happen because of a belief that ‘it’s not safe’ to travel that road, or it’s not safe to be around males because ‘all males are sexual predators’.  Thus, the belief is transferred to contexts beyond the specific incident(s), and to situations where it is safe.  

This is why it’s important to address symptoms of avoidance, because with time, it can lead to the development of negative core beliefs, and worsen other key symptoms of Post Traumatic Stress Disorder, such as re-experiencing and persistent perceptions of threat.  You can learn more about PTSD here.  

Getting treatment is essential

If your symptoms are very mild, then you may well be able to manage them effectively with self-care, and receiving compassionate support from family, friends or community members.  While self-care and support can be beneficial, I still recommend seeking therapy if they persist, even mildly.  This is because addressing the trauma that causes the symptoms can usually be done quite effectively with the right modality.  You need not suffer in an attempt to merely manage post traumatic stress, when the problem (i.e. the negative cognitions and emotions formed in response to the trauma) can be quite effectively healed.  If, however, you experience chronic distress that impairs your ability to function in daily life, then getting therapeutic support is essential.  Specific techniques can be applied to help you process the trauma memories so you can move forward and achieve a fulfilling life.  You can learn more about trauma therapy techniques here.

At WellQo I’ve had the privilege of working with numerous clients, helping them  to overcome past trauma(s), applying a holistic approach.  The techniques that I’ve applied work quickly and effectively to free people from the effects of psychological injury and promote mental wellbeing.  My approach is not the only way to heal from trauma, and there are many other effective strategies and therapists.  What I will emphasise, however, is that if you struggle with post traumatic symptoms, then it’s essential that you get support to address these immediately.  

Begin your journey of getting personalised therapy that addresses your unique needs; with the right modality, you can heal from the negative effects of trauma, and live a happy and fulfilling life.  

I hope you found this article useful.  If you have any further questions or to discuss treatment and support options, then feel free to get in touch.  

With warm wishes,

Sadaf

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