Elaine’s Note: Avoidance & Safety Strategies
If you clicked this, it’s because your assessment suggested avoidance and safety strategies are keeping your health anxiety cycle going.
This is a tender one, because avoidance often looks like self-protection:
- “I’m just being careful.”
- “I’m managing my stress.”
- “I don’t want to trigger it.”
But clinically, avoidance is one of the biggest reasons health anxiety becomes chronic — because it removes learning.
What avoidance can look like in health anxiety
- avoiding exercise because increased heart rate feels dangerous
- avoiding travel or being far from help
- avoiding medical shows/news/hospitals
- avoiding appointments due to fear of bad news
- avoiding being alone
- avoiding certain foods or situations “just in case”
Safety strategies can be:
- carrying meds/items for reassurance
- always needing an exit
- always needing someone with you
- staying in “safe zones”
Why avoidance maintains health anxiety
Avoidance reduces anxiety immediately — and that’s why it’s so reinforcing.
But the long-term effect is:
- your brain never learns: “I can handle this.”
- your brain never learns: “That sensation is tolerable.”
- your world shrinks
- the threat system stays sensitised
Avoidance also makes triggers feel bigger over time, because each avoided situation becomes “unproven.”
The aim: graded approach, not forcing
The goal is not “throw yourself in the deep end.”
The goal is:
- stepwise exposure
- gently reducing safety behaviours
- building behavioural evidence for Theory B
What helps (how I’d do it with you)
1) Pick one avoided thing
Not ten. One.
Example:
- short walk raising heart rate slightly
- watching one health trigger without Googling
- driving 10 minutes from home
- going out without checking first
2) Decide your “safety drop”
A key part is reducing a safety behaviour by 10–20% while doing the activity.
Example:
- walk without checking pulse before/after
- go out without carrying the “just in case” item
- watch the trigger without Googling afterwards
3) Stay long enough for the wave to shift
Avoidance trains panic. Staying trains recovery.
Even 5–10 extra minutes can teach your nervous system:
- “This rises and falls.”
- “I don’t need emergency behaviour.”
4) Repeat (this is the medicine)
Exposure works because repetition rewires predictions.
A 7-day “expand the safe zone” plan
- choose one avoided activity
- do it 3 times in 7 days
- reduce one safety behaviour by 10%
- record: “What did I predict? What happened?”
Course support
Avoidance work is powerful, but it’s easiest with structure.
My Health Anxiety Reset Course guides you through:
Related reading: understanding health anxiety; CBT for health anxiety.
- graded exposure planning
- reducing safety strategies safely
- nervous system regulation during exposures
- keeping momentum without overwhelm
