A man is walking down the street and sees another man waving his arms, up and down repetitively in a flying motion. He observes the man’s behaviour and then approaches him to ask what he is doing. The man answered, I am waving my arms to keep the dragons away. The man was amazed by the answer and said but there are no dragons. To that replied the man, see it works….
Anxiety is the body’s way of responding to danger. Anxiety emerges when threat is felt, yet the source is external and ambiguous. The threat can be perceived as existential regardless if it is real or not. Anxiety triggers worries and preoccupation with emotional or physical danger. Averrill (1988) describes individuals, who suffer from anxiety, as people, who cannot verbalize what they are anxious about and what they should do about it. An anxious person suffers from exaggerated expectation of harm, rejection and humiliation. The need to escape towards safety is great.
Safety behaviours play an important role in the vicious cycle of anxiety. Safety behaviours are obvious or hidden behaviours that one does as an attempt to minimize the anxiety felt in certain situations. The act provides comfort and a sense as if the situation is suddenly made safer. Example for such behaviours could be drinking alcohol to boost confidence, using cigarettes, drugs or food to calm ourselves, avoiding certain social activities, repetitious checking of something, having a certain lucky routine before a game, asking people to do things for you etc. Safety behaviours can also consist of a specific repetitious thought pattern or a certain object that brings comfort such as a lucky charm. When an individual becomes dependent on their presence, he will be even more distressed and anxious when they are not available to him. Another type of safety behaviour is the use of immediate escape from the situation such as immediately getting off the train or walking away from confrontations. This is often chosen by individuals who experience difficulty breathing, as if they are suffocating and need to literally search for air. By escaping the individual will never know that he is competent enough to cope with the anxiety felt.
Safely behaviours usually start when an individual feels anxious in a certain situation and has the feeling that something really bad will happen; a catastrophe that he has to stop from occurring. The individual then acts in a certain way and once the catastrophe does not occur then he attributes that specific behaviour to the triumph. That specific behaviour is thus continuously repeated in future situations under the belief that it will prevent the catastrophe from happening. Anxiety is thereby reduced as the individual finds comfort in the belief that the safety behaviour will protect him. The same behaviours that intend to reduce anxiety can also indirectly cause more anxiety. For example, others may observe the behaviour, criticize, laugh or even reject the individual for acting that way, which will only increase the anxiety felt in social situations and ultimately the level of loneliness and social isolation.
Safety behaviours are held as reality reflecting and are constantly used by the anxious individual. The hypothesis that that specific behaviour actually does save from harm is blindly trusted and believed without actually gathering any evidence that supports it. In the same manner no evidence is collected that disconfirms the belief. The individual prevents himself from realizing or learning that it can be different or that he is capable of handeling the anxiety felt. In this manner the individual also never learns that his fears, might not come true or that better coping strategies exist. Safety behaviours may be a short term relief but they reinforce anxiety and the vicious cycle.
CBT‘s focus is to identify the safety behaviours which maintain the symptoms. Furthermore, the client needs recognize their dysfunction, which is done by challenging and experimenting with the behaviors. The intention is evidence gathering and testing out the validity of the predictions. The individual then learns to replace them with healthier coping behaviors/strategies. There are various methods in which this can be done, which also includes graded exposure. Gradually, repetitively and structurally facing the feared situations over a period of time will enable the practice of newly learned skills, the confrontation of anxiety and increase self-efficacy which in turn will reduce the anxiety felt and the need in such unhealthy behavioral patterns.
Averill, J. R. (1988). Disorders of emotions. Journal of Social and Clinical Psychology, 6, 247-268.
Maser, J. D., & Cloninger, C. R. (1990).Co morbidity of mood and anxiety disorders. WashingtonDC: American psychiatric press.
Millon, T., Blaney, P. H., & Davis, R. D. (1999). Oxford textbook of pathology. New York: Oxford university press.