Avoidance and PTSD

Avoidance is a common reaction to trauma. It feels natural to want to avoid thinking about or feeling emotions related to a traumatic event.  Avoidance is one of the main symptoms of PTSD and C-PTSD. It often maintains the other symptoms of PTSD. Over time avoidance generalises as a way cope. Your life can become shutdown due to avoidance. It can stop people attending trauma focussed therapy to get better. It can stop people forming relationships. It can stop them from working, from getting a job.

What Are the Different Types of Avoidance?

Emotional avoidance

Emotional avoidance is when a person avoids thoughts or feelings about a traumatic event. This type of avoidance is internal to the person; others around you may not know what you are avoiding and why. For example:

A sexual assault survivor may try to create distance from unpleasant emotions, like fear, when reminded of the trauma. Other unpleasant emotions may be avoided, such as anger, and sadness. The person experiencing this may seem shut down and even zoned out.

A first responder may try to shut down feelings of sadness about the  tragic events they have had to attend.

A bushfire survivor may drink alcohol to numb out. Effectively shutting down feelings that come up when reminded.

Behavioural Avoidance

Avoiding reminders—like places, people, sounds or smells—of a trauma is called behavioural avoidance. For example:

Assault survivors might go out of their way to stay away from the location of their attack or places that remind them of the assault.

Sexual assault survivors might avoid people that look like their assailant. Such as a survivor assaulted by a man avoiding men or places men may frequent.

Car accident survivors may avoid driving near the accident site. They may not drive at all.

Avoiding pubs because the smell of alcohol reminds the trauma survivor of the event

Many survivors stop watching the news or using social media because of stories or posts that are reminders.

What Are the Consequences of Avoidance?

Even though avoidance might look like a good choice on paper eg.

Reminder of Trauma – Bad Feeling Happens Because of Reminder – Stay Away from Reminder – Bad Feeling Goes Away.

When avoidance is part of PTSD it can grow to become the way, you live your life. Spending time to go out of your way to avoid thoughts, feelings, and reminders of the trauma. Avoidance makes PTSD symptoms worse.

Can You Learn to Cope with Difficult Thoughts and Feelings?

You may be worried that if you let yourself feel difficult emotions or think about the trauma. It might overwhelm you. You may be afraid that if you feel sad, you’ll become depressed. Or you may worry that if you let yourself feel angry, you might lose control.

At the Centre for Clinical Psychology, we use Cognitive Processing Therapy (CPT) which is an effective PTSD treatment. CPT can help you learn to cope with your thoughts and feelings about the trauma instead of being afraid of them. Instead of avoidance.