Avoidance and PTSD

Many people with post traumatic stress disorder (PTSD) view avoidance as a coping method but it is actually a symptom of PTSD, not a means of coping.  Essentially, saying that avoidance is coping is the same as saying that difficulty concentrating, nightmares or flashbacks is coping.  Avoidance maintains the stress disorder.  As you may have noticed, although avoidance works temporarily, long-term avoidance prevents the processing of the trauma that is needed for recovery from PTSD.

Consider the following examples of avoidance and how much you resonate with each:

Examples of Avoidance

Avoiding thoughts that are related to trauma

Isolation

Drinking and drug use

Aggression

Self-harm/self injurious behaviors

Excessive tattoos

Obsession with sports or politics

Binge eating

Avoiding places that are reminders of trauma

Avoiding people that are reminders of trauma

Avoiding emotional experience

Avoiding emotional expression

Ignoring physical needs (hunger, thirst, fatigue, pain)

Social withdrawal

Withdrawal from activities

Overworking

Over-scheduling

Obsession with the news

Addiction to food, sex, gambling, etc.

Oversleeping

Avoiding intimacy (emotional and/or physical)

Avoiding intense emotions in others

Excessive internet use

Excessive video game playing

Canceling therapy appointments to avoid processing trauma

Avoiding doctors appointments

Avoiding sleep

Infidelity

Avoiding hygiene and/or self-care needs

Reassurance seeking

About 50% of the symptoms of PTSD are avoidance behaviors. As therapists, our job is to recognize your avoidance behaviors that have maintained PTSD and point them out to you so that you can change.  We cannot emphasize enough how important it is to learn to address avoidance and find other ways to manage difficult thoughts, emotions and/or situations. For most people, this is the biggest (and most anxiety-inducing) hurdle.  If you find yourself wanting to avoid, remind yourself that you are still struggling with traumatic events because you have learned to avoid and ask us how you can do things differently.