February 12, 2021

Avoidance and Exposure

Mental Health & Wellbeing

I’m sure the words, “avoidance,” and, “exposure,” are both common enough that you probably have a pretty good working definition for each. What I’m hoping to do with this blog post is to explore what those ideas mean, how they’re related, and how they come up in therapy. Because believe me, they come up in therapy!


It’s likely that we all know what avoidance is, and can probably give plenty of examples of it from our own lives. Growing up, I avoided basically anything performative. Public speaking, music solos, sports events, etc. I’d avoid doing homework or having tough conversations. As an adult, lots of those things are still true- I procrastinate (avoid!) doing my paperwork, I catch myself avoiding the occasional confrontation or public engagement. These are things that I don’t like, or that make me anxious. So my natural solution? Avoid it!

The problem with that solution, though, is that it doesn’t last. Eventually, I have to turn in my paperwork. Eventually, I have to confront that person and have the difficult conversation. Thankfully, solos in band are behind me, but I will still occasionally have to speak in front of a group or deliver a presentation. And while avoiding those things for the moment might give me a few minutes or days reprieve, when those deadlines approach and I do have to face the thing I’ve been avoiding, my anxiety is usually much worse because it’s been building and building with each decision to avoid. The worrisome event is looming and seems to only get scarier the more I put it off.


“Exposure” is a more obscure term for me. It conjures up images of developing film, or sunburns, or, at the moment, the coronavirus. The basic definition of exposure is, “to come into contact with something.” In the above examples, film comes into contact with light, your skin with (too much) sunlight, and our bodies to viral germs.

So, when we look at the idea of exposure in relation to avoidance, I’m referring to “contact” with the event, person or experience we are avoiding. I might avoid exposure to public speaking engagements. If I’m scared of spiders, I likely avoid exposure to spiders. The exposure refers to coming into contact with, for the sake of this blog, the thing we are avoiding.

I’ve loosely tied those words together- so, how does this fit into therapy?

In Therapy

Is avoidance and/or exposure part of therapy? Yes! Not always, but oftentimes in therapy it can be helpful to take a look at your own patterns of avoidance. Avoidance is often a key factor for any of us struggling with anxiety, PTSD, or a phobia, etc. Even if you’re at peak wellness, there are probably still things you tend to avoid. It’s natural. In the context of therapy though, it can be helpful to identify what kinds of things you are avoiding and why. And then, because we know avoidance might help short-term but ultimately hurts long-term, it’s helpful to start addressing that avoidance with – you guessed it – exposure!

If you have to speak publicly for your job but it brings up anxiety, one way to conquer it is exposure. Practice. Practice speaking and speaking publicly, over and over and notice the way you adapt. You build your capacity for the skill, and it gradually becomes less distressing to you. The more healthy exposure you get, the more likely you are to experience a big decrease in anxiety. Once you stop that pattern of avoidance by confronting the worrisome event with exposure, you start to see change.

Use it wisely

There are ways that you can challenge and encourage yourself to stop avoiding and start confronting your fears. However, it’s much easier said than done. This is a very brief overview of a part of therapy that I have found to be very effective, but it is incomplete, difficult and potentially dangerous to try on your own. If you are struggling with any kind of avoidance, know that there are therapists who can walk you through this process in a safe and structured way. There are even specific, “exposure therapies,” developed for this kind of work!

If you’re interested in learning more about exposure work or in starting the process of therapy, give our office a call. We’d love to walk with you through it!

Written by therapist Clair Miller

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