Avoidance
A National Center for PTSD Fact Sheet
by Laura E. Gibson, Ph.D., The University of Vermont
Why have a fact sheet on avoidance?
Avoidance is a common reaction to trauma, and it can interfere
with emotional recovery and healing. It is understandable that individuals who
have experienced stressful events want to avoid thinking about or feeling
emotions related to those events. Research with a wide variety of populations
(e.g., survivors of sexual abuse, rape, assault, and motor vehicle accidents)
indicates that those individuals who try to cope with their trauma by avoiding
thoughts and feelings about it tend to have more severe psychological symptoms.
Because the research clearly suggests that avoidance can interfere with
recovery and healing, this fact sheet provides an overview of this common
reaction to trauma.
What does emotional avoidance mean?
Emotional avoidance in the context of trauma refers to
people’s tendency to avoid thinking or having feelings about a traumatic event.
For example, a rape survivor may try to suppress thoughts about her rape by
forcing herself to think about other things whenever the thoughts arise, or by
simply trying to push away thoughts about the rape. She may use emotional
avoidance by stopping herself every time she begins to feel sadness about the
rape, or by bringing her attention to something that makes her feel less sad.
She may say things to herself like, “Don’t go there,” or “Don’t think about it.”
What does behavioral avoidance mean?
Behavioral avoidance generally refers to avoiding reminders
of a trauma. An extreme example of behavioral avoidance would be for someone
who lived in Manhattan to move out of the city after the 9/11 terrorist attacks
to avoid reminders of the trauma. Less extreme examples might involve remaining
in Manhattan but making sure to avoid Ground Zero to avoid difficult emotional
reminders. Other examples would include individuals who try to avoid driving
after they have been in car accidents, or assault survivors who go out of their
way to avoid the scene of their attack.
Doesn’t avoidance help people cope with trauma?
Not when it is extreme or when it is the primary coping
strategy. Many people were raised hearing advice like, “just try not to think
about it,” “try to think about positive things,” or “don’t dwell on it.” These
suggestions seem very logical—especially if you grew up hearing them regularly.
However, although the desire to turn one’s attention away from painful thoughts
and feelings is completely natural, research indicates that the more people
avoid their thoughts and feelings about difficult life stressors, the more
their distress seems to increase and the less likely they are to be able to
move on with their lives.
Is all avoidance bad?
No, not all avoidance is bad. If you have experienced a
traumatic event in your life, it can be extremely useful to learn ways to focus
your thoughts and feelings on things that are not related to the trauma. This
is typically referred to as “distraction.” Distraction is a useful and
necessary skill that allows us to get on with our daily routines even when we
are feeling very distressed. If it weren’t for our ability to distract
ourselves, we would have difficulty getting on with our lives after traumatic
life events. Our ability to use distraction skills allows us to go to school or
work, buy groceries, etc.—even in the face of difficult life events.
While distraction and avoidance can be very useful in the
short-term, they become problematic when they are the primary means of coping
with trauma. When we caution against the use of avoidance, we are really
cautioning against the use of avoidance or distraction as the primary means of
coping with a trauma. If an individual were to avoid thinking about or having
feelings about a trauma all of the time, they would likely have a much harder
time recovering from the trauma.
“But if I let myself experience my emotions, I would be overwhelmed by
them…”
One common reaction to the suggestion that people should
allow themselves to feel difficult emotions is a fear that those emotions
will overwhelm them. Sometimes people are afraid that if they start crying,
they’ll cry forever. Other people worry that if they let themselves experience
the anger inside them, they will lose control. Attending therapy with someone
who is knowledgeable about trauma can be very useful for individuals who harbor
these fears. For suggestions on how to locate a therapist in your area, go
to the FAQ page below. This page contains information about contacting specialists
and support groups for PTSD.
Related Fact Sheets
Coping with
PTSD
Provides information for PTSD survivors on positive techniques for dealing
with PTSD
FAQ about PTSD
Answers to frequently asked questions about PTSD
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