Given the threat system’s proneness to react with full-blown fight or flight response in response to trauma related cues, avoidance of places and activities that remind one of traumatic memories can be both an automatic response to triggers and an active attempt to cope with the impact of trauma. The questions is, how can we decide when is it a maladaptive response and when is it an understandable and relatively harmless attempt to cope?
The avoidance strategy can work for somebody. For example, someone who became involved in an accident overseas might decide not to go to that country again and found this sufficient to calm the threatened mind. An essential criterion to defining a disorder is whether the avoidance causes impairments to the person’s daily life and well-being. As long as the avoidance does not spill over to any other places or activities and not returning to the said country would not limit the person’s chances of personal advancement, the person can argue that they have sufficiently managed the emotional impact of the threatening event.
However, for the not so fortunate survivors, avoidance is not a solution. Rather, it creates new hurdles and damages one’s self-view when they find the list of “places and activities to avoid” expand never-endingly or when they realize that they have given up on the freedom to enjoy life to the fullest when they live a life constrained by the avoidance agenda. For example, to a victim of assault by another person, behavioural avoidance is often not limited to the actual place of assault. Instead, it can expand to all places that share similar physical characteristics or situations that involved interacting with someone of a similar profile to the assaulter. In such cases, taking steps to confront the avoidance behaviours can often be helpful and liberating.
However, we need to remember that unprepared confrontation with avoidance is not always therapeutic. Instead, it can have retraumatizing impact if one feels helpless and powerless in coping with the intense feelings triggered by the exposure to trauma related cues. Therefore, directly facing previously avoided cues is often only recommended after the initial stage of trauma therapy when one is armed with mindful compassion skills to cope with flashback and distress.
Goal setting is the next step to overcoming avoidance. In this stage, trauma survivors can identify tasks that they wish they could do when they were no longer constrained by the urge to avoid. Break down the goal into small, achievable steps like starting from (1) “have a coffee in the cafe near (the place one has been avoiding)” to (2) “have lunch in the café” and (3) “go to the park nearby for an hour walk”. Before carrying out these activities, prepare for potential occurrence of flashback and plan ahead what mindful compassion skills we can use should this happens
Most importantly, we do not have to achieve 100% of our goal when we find the situation overwhelming. Referring to the “have a coffee in the café near (the place one has been avoiding)”, just going near the café is one step closer to having a coffee in there. When we find the distress too much to handle, there is no shame to revising the plan and go back another day. Practice grounding skills, notice the thoughts going through our mind when we went near the café and use compassionate reframing skills to soothe our threatened mind.
Treat every step as a progress closer to the goal, show appreciation to ourselves, and continue to practice soothing the traumatized mind with mindful compassion skills. Consider overcoming avoidance triggered by trauma reaction as a journey rather than an all-or-none attempt. Remind ourselves that we can eventually reach the goal because we are learning to make peace with the past every time we try.
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