Ema has abdominal discomfort, she tells her husband: “My belly hurts a little, is it something serious? What do you believe?” Carlos approaches his house saying to himself: “Nothing has to have happened, it’s a normal day, everyone is going to be fine, but… what if not? What if someone came in and hurt my children? Enough, I can’t always think the worst.” Cecilia leaves work in a hurry, she notices that she forgot her water bottle, she returns quickly thinking: “No, I’m not going to leave without the water… it’s hot… I don’t want to faint.”
What do all these examples have in common? These are people carrying out avoidance behaviors and escaping their anxiety.
- Emma suffers health anxiety because he interprets the minor and normal sensations of his body as signs of serious illnesses; Therefore, she seeks reassurance from her husband to reassure herself.
- Carlos suffers from a generalized anxiety disorder, terrible and catastrophic images appear in your consciousness that generate a lot of anguish; He tries to calm himself with self-verbalizations, which end up turning into worries.
- Cecilia suffers from a panic disordershe fears that the heat will make her dizzy and, as a consequence, faint, so she always goes out with a bottle of water.
When we talk about anxiety, fear, anguish, or even when we use the word discomfort, we quickly tend to associate it with experienced emotional states, which is clearly correct… but incomplete. Indeed, millions of years of evolution did not take place just for modern human beings to experience a wide and colorful palette of emotions that we can translate into paintings, poetry and love stories; The latter may just be an accidental byproduct of the way our brains were shaped by natural selection to solve progressively more complex and novel, but also very pragmatic, challenges. Such challenges require behavioral interventions in a real, physical and social world, especially social. In this framework, rich and intricate emotional patterns have a behavioral edge that is as important or more important than the subjective emotional experience itself. Or, rather, emotions are also behaviors, just as are thoughts, physiological activation and subjective experience.
In the context of behavior analysis, negative emotions almost invariably lead to self-relieving reactions. In some simple cases, such as specific phobias, this mechanism is easy to observe; But in other more complex conditions, such as social phobia or generalized anxiety disorder, the process takes place in a more subtle way, following some generalities, but always with specific features of the person. Thus, although we can find some common denominators in the forms of avoidance and escape from emotional discomfort specific to each disorder, this type of analysis has an idiosyncratically established limit according to the learning history of each subject.
Below we take a look at some anxiety disorders and their most common behavioral manifestations of avoidance and escape.
If you value articles like this, consider supporting us by becoming a Pro subscriber. Subscribers enjoy access to members-only articles, materials, and webinars.
Simple phobias
This is probably the disorder where we most easily observe avoidance and escape behaviors. Generally, the phobic knows the situations in which the focus of his fear appears and directly avoids them. Thus, those who suffer from confinement phobia do not travel on subways or elevators, those who fear toads do not go to rural areas and those who fear heights do not look out of balconies. In these cases, these are simple and straightforward avoidances; We could define behaviors by their omission. In the event that the person suffering from the phobia is unexpectedly exposed to what he fears, then he escapes, that is, he moves away from the object, but not without some degree of disorganization in his behavior. For example, if someone is afraid of birds and suddenly a flock of birds approaches him, he will run in the opposite direction.
Beyond what has been said, even in this picture we see some complexities. For example, the storm phobic cannot escape if one of these is approaching. In this case, avoidance and escape behaviors usually consist of staying in certain places that are considered safer than others, or in the company of certain people who are believed to protect them.
Already in simple phobias, the functional analysis of the case acquires capital value. Thus, two people fear spirits and other entities from the afterlife that, of course, do not exist, which they both recognize. To alleviate his fear, one of them goes to bed and leaves several lights on, including the television or radio so that it generates noise and distracts him, but he does not get out of bed at night because he is afraid; he even leaves a portable urinal nearby so he doesn’t even go out to the bathroom. The other, who fears the same thing, is afraid that the spirit has hidden somewhere in the house; Therefore, at the slightest noise, he gets scared and therefore gets out of bed to check the bathroom and closets. Let’s observe that, faced with the same fear, different avoidance and escape behaviors occur: one stays still in bed while the other gets up to check.
panic disorder
The focus of fear in this painting is the bodily sensations themselves and, by extension, the environments in which they can be triggered. Thus, those who suffer from panic disorder fear their own tachycardia, rapid breathing, heat, and a feeling of dizziness; a sense known as proprioception or interoception. Given that these sensations are more likely to be triggered in some contexts such as the elevator, subway or on the street when alone, then the focus of fear generalizes to them.
In principle, what the individual will try to avoid are his own bodily sensations. Thus, we find people who do not do physical activity, try not to make vigorous movements or even have sexual relations, since all these activities increase proprioception. In other cases, avoidance is more subtle, such as having a bottle of water on hand so you never feel dry in your throat, or getting out of bed slowly so as not to experience dizziness.
Now, just as fear generalizes from sensations to the contexts that trigger them, so do avoidances. In this way, those who suffer from panic tend to avoid places that, in an idiosyncratic or conventional way, have been associated with triggering proprioception: subways and elevators (since there is a fear of lack of air) or places where it is hot (since it is believed that this leads to dizziness and, therefore, potential fainting). Sometimes he avoids the mere fact of being alone, because in case the much-feared sensations are activated, there is no one available to help.
Social phobia
In this case, the focus of fear lies in the potential negative evaluation and rejection by others. In this way, the social phobic fears that “they will think badly of me”, “make a mistake and look bad”, “look like a fool”, among other negative evaluations from others. Given that what the individual fears can only happen in situations of potential social scrutiny, this objectifies the first and most obvious avoidance behavior: not attending social events with people outside the intimate circle. But there is more…
Almost no one can completely avoid staying in environments with strangers or even having some degree of interaction with them, which is why avoidance and escape behaviors are taking on other forms. Probably, what comes next in order of frequency and complexity is staying still, silent, and going as unnoticed as possible. Thus, in classrooms or meetings where I am forced to remain, I can prevent them from “thinking badly of me” if I remain silent and only interact as little as necessary. But this same attitude of silence and stillness can also attract attention: “Won’t others think that I’m a fool who stays silent all the time because I don’t know what to say?” These types of cognitions trigger a third level of avoidance and escape behaviors, even more subtle.
In social situations where I am forced to stay, for example, I can pretend to respond to messages on my cell phone so that, eventually, others will believe that if I do not speak it is because I am too busy with a matter that I cannot postpone. In this way, they will not believe that “I don’t speak because I am a fool who doesn’t know what to say”, but rather they will think that “I don’t speak because I am too busy answering my social networks”.
Finally, there are social situations in which not only people are forced to remain but also to interact. For example, when we arrive at certain faculty subjects in the first class, we have to introduce ourselves or, at some point, we must present a practical work that we have prepared in front of all our classmates. On such occasions, there is usually the fear that my voice will become thin and I will not be able to speak, in which case a frequent avoidance behavior consists of faking hoarseness and coughing; Thus, if it happens that I have difficulty speaking, others will attribute it to my medical condition and not to my fear. And if I’m afraid of turning red and sweating, I can stay warm when it’s hot, so that if I blush, other people will think it’s because I’m hot and not because I’m embarrassed. Some people fear being asked a spontaneous question to which they will have to improvise an answer; Therefore, they prefer to speak first, give their opinions and points of view initially because they feel that they have gotten the problem out of their hands and it is less likely that someone will ask them to intervene again.
As can be seen, the range of avoidance and escape behaviors becomes more complex in social phobia; it is no longer about leaving the situation, but rather carrying out behaviors that have a personal meaning. Reinsurance behaviors are called avoidance and escape behaviors that are not frank and open but, being more subtle and sophisticated, avoid anxiety based on some personal belief, such as those mentioned about faking hoarseness or covering up on a hot day. . As we will see below, the greater the complexity of the psychopathology, the more specific and convoluted the avoidance and escape behaviors.
Generalized anxiety disorder
In the case of this disorder, things are a little more complicated because, as its name suggests, the focus of fear can be almost anything: from getting sick or being fired from my current job to losing a future job ( which I have not yet accessed), or that the grandson (which I do not yet have) may one day have an accident. Indeed, the issues of concern of generalized anxiety not only refer to current potentially problematic situations but also reach imaginary scenarios that in the future…