Anxiety is a signal that danger is imminent.
When the danger is real, anxiety can help to keep us safe. The problem is that for many people, anxiety becomes a false alarm – and it can make someone feel just as threatened as if there were real danger ahead. Most of us are familiar with the physical sensations of anxiety, such as a rapid heartbeat or a sinking feeling in the stomach, and mental symptoms, such as racing and worrisome thoughts. In terms of behaviour, avoidance is the hallmark symptom of anxiety. Simply put, we avoid what we feel anxious about: if we are afraid of heights or snakes, we avoid skyscrapers or walking in tall grass. People who experience social anxiety often avoid social gatherings or situations where they might have to speak in front of people.
However, avoidance is not always possible, so people who have anxiety often develop behaviours to keep themselves feeling safe when they are unable to avoid a situation completely. These behaviours, known as ‘safety behaviours’, are a subtle kind of avoidance: one enters a feared situation without really facing the fear. In the above examples, somebody with a fear of heights might always hold on to a handrail on a balcony. People with a snake phobia might go hiking, but they’ll wear big boots and carry snake bandages and antivenom, even in places with no snakes. In the case of social anxiety, someone might wear sunglasses to avoid making eye contact with others or rehearse a speech repeatedly.
The problem with avoidance and safety behaviours is that, although they may reduce anxiety temporarily, they reinforce anxiety in the long term. Anxiety is characterized by exaggerated fears – e.g., I will fall off this balcony; I’ll be bitten by a snake; people will think I’m stupid – and safety behaviours prevent someone from learning whether the fears are true. Someone might mistakenly think the safety behaviours themselves stopped the feared situation from coming true. People with social anxiety who rehearses a speech dozens of times might assume that this repetition prevents them from making a complete fool of themselves.
Because avoidance and safety behaviours maintain anxiety over the long term, they are key targets in psychotherapy. The part of therapy that deals with them is called exposure therapy because it involves helping people to expose themselves to their feared situations gradually. Facing the situation helps them to learn not to fear the physical sensations of anxiety and to challenge their exaggerated predictions. Concerning safety behaviours, therapists and their clients work together to uncover all the unhelpful things clients do to try to feel less anxious in a feared situation. Then, the client will gradually drop these habits.
Unfortunately, disentangling unhelpful safety behaviours from helpful behaviours is not always as straightforward as it sounds. In many cases, making the distinction can be quite challenging.