Anxiety disorders and false safety behaviours.
Jason Brien.
Safety behaviours are actions that we consciously or unconsciously perform in response to perceived threats. Safety behaviours such as wearing a seat belt in a car, wearing a helmet whilst riding a bike or a wearing a condom during sex are genuine safety behaviours (GSB). By genuine I mean that there is a real, increased risk of potential harm if these safety behaviours are not implemented. Likewise, avoiding a raging house or bush fire is a safety behaviour as there is a genuine risk of harm or death if one were to run into the raging inferno.
Safety behaviours which are activated in response to anxiety and anxiety disorders are false safety behaviours (FSB). They are considered false because they are unnecessary. They are unnecessary because there is no real need for protection from either typical anxiety or atypical anxiety (anxiety disorders). Implementing FSB’s when there is no genuine threat or possibility of genuine harm will ultimately worsen anxiety. Implementing FSB’s unnecessarily will tell the brain “Oh look here’s a threat. Every time I see this threat from now on, I am going to induce anxiety”. FSB’s falsely prime the brain.
FSB’s fall across 4 broad categories; avoidance, checking, mental gymnastics and use of safety aids. Let’s look at avoidance first.
1.Avoidance FSB’s;
Avoidance FSB’s can come in many types. You might employ FSB’s which lead you to avoid certain places, events, situations or people that are related to your anxiety. You might also try and avoid bodily sensations such as the fear and anxiety that is induced when riding a rollercoaster even though it can be fun. You might even avoid caffeine as the effect resembles anxiety symptoms. You might even try and avoid the negative thoughts and memories associated with anxiety.
2.Checking FSB’s;
This involves unnecessary and conscious checking. Checking the stove once to ensure that the gas is turned off is a genuine safety behaviour. Checking twice shouldn’t really be necessary but maybe you were distracted the first time so a second check is warranted. Going beyond 2 times though is unnecessary and you are now engaging in an FSB. Likewise, it can be fairly normal to enter a restaurant and glance around your environment to kind of know where you’re at, but actively searching around for all possible bathrooms and exit doors is beginning to fall within FSB territory.
3.Mental gymnastics FSB’s;
These FSB’s involve employing mental strategies or techniques to ward of anxiety. When your anxiety appears, you might begin to overanalyse your situation or your surroundings. Any sudden change in bodily sensations is critically analysed. You might try convincing yourself that if you count to 23 then your anxiety will go away. There is a difference between employing strategies to prevent anxiety occurring and employing strategies to overcome and reduce anxiety.
4.Use of safety aids;
This one is pretty straight forward. It can involve carrying excess medication for example. Not excess as in just carrying a bottle of pills just because that’s the way the medication is stored. It is carrying excess medication based on the highly unlikely scenario that you have a car accident and you are stuck in the woods for three weeks. The same goes for carrying around excess food and water just in case it is needed. Safety aid FSB’s is quite commonly implemented by modern day ‘preppers’ who are preparing for the breakdown of society or an impending natural disaster etc.
False safety behaviours have the effect of drawing unwanted and unnecessary attention to anxiety symptoms. It’s kind of like with babies when they bump themselves for example. At first they may not notice any pain or even cry but once you start giving them attention “Oh my poor baby. Are you ok?” they ‘switch on’ and suddenly they are in pain and they are crying. FSB’s reduce anxiety in the short-term but they retain anxiety in the long-term. The types of FSB’s employed vary amongst the different types of anxiety disorders. Some false safety behaviours are disorder exclusive. Let’s look at FSBs within certain anxiety disorders.
Social anxiety disorder; Playing on phone, standing apart from others, preventing eye contact, staying ‘invisible’.
PTSD; Avoiding places associated with the trauma, self-medicating to avoid memories, feelings and thoughts.
OCD; Performing rituals designed to ward off unwanted thoughts or feelings. Constant checking and rechecking.
Panic disorder; Avoiding public places, overanalysing and exaggerating bodily sensations.
General anxiety disorder; Constantly seeking reassurance, avoiding people or places that invoke anxiety.
Like I mentioned earlier. There is a big difference between performing actions designed to ward off anxiety and performing actions designed to eliminate atypical anxiety and return the atypical anxiety to its typical state. Ward off means trying to prevent something from occurring. Trying to prevent the anxiety from occurring. This gives the anxiety much more power than it deserves. Anxiety in its typical state is nothing to be feared or avoided. Typical anxiety can be managed appropriately so that it doesn’t become overwhelming.
Resources.