Safety Behaviors: Why We Do Them and How CBT Can Help!
written by: Samantha Myhre, PhD
Cognitive Behavior Therapy (CBT) suggests that our thoughts, feelings/emotions, and behaviors are all connected to one another and influence one another. CBT aims to identify and modify unhelpful thinking and behavioral patterns. One unhelpful set of behaviors targeted in the treatment of anxiety disorders are behaviors we refer to as “safety behaviors”. These are behaviors that are engaged in during times of anxiety in order to protect ourselves from whatever danger our anxiety is convincing us exists! You might be thinking “hey, the behaviors are serving us… why do we want to get rid of them?” Well, the problem lies in the long-term effect of engaging in safety behaviors. Sure, the immediate result of reduced or eliminated anxiety is great! BUT…the longer you engage in safety behaviors the more your brain thinks that is what you have to do in those situations. Over time you may feel that you need to engage in the safety behavior for longer or with greater intensity. At the same time, you become increasingly pulled away from the goals and values that are important to your life. This cycle is demonstrated below:
Safety behaviors can include forms of avoidance, distraction, preparing, and checking. Through CBT, individuals are taught how to engage in exposure therapy where they face the situations that typically bring about anxiety while refraining from engaging in safety behaviors. Sounds kind of scary, doesn’t it? That’s what we’re here for! With the help of a therapist, individuals design exposure hierarchies where they create a list of situations that bring about anxiety. Then they rank those situations from least to most difficult to approach through an anxiety or distress rating scale. Therapists will then model and guide individuals in how to approach these situations while dropping safety behaviors so that they can teach their brains a new way of responding in situations that previously required a safety behavior. Individuals work up to the more difficult items on their exposure hierarchy as they gain practice and confidence with lower rated items. The goal is to increase one’s ability to tolerate uncertainty and live a value-driven life! When we engage in safety behaviors, we are achieving short-term relief and in return experience long-term discomfort. Through exposure, we can achieve long-term relief by engaging in short-term discomfort!
Below are examples of safety behaviors in action:
- Sitting only in the back row of the classroom to avoid being noticed.
- Avoiding eye contact while grocery shopping and while going through the check-out.
- Wearing sunglasses while using public transportation (even on gloomy days).
- Over-preparing for presentations or meetings.
- Mentally rehearsing conversations before they happen.
- Carrying a bottle of anti-anxiety medication whenever outside of the home.
- Leaving the house only if accompanied by a trusted loved one.
- Creating an escape plan from any building entered.
- Checking the locks on the house or car door multiple times.
- Frequently checking or going on electronics during social interactions.
- Consuming alcohol, recreational drugs, or other substances to curb anxiety.
- Engaging in superstitious rituals before, during, or after situation that elicits anxiety.
- Avoidance of locations or situations that tend to increase anxiety.
- Having to carry a certain object in situations that tend to increase anxiety.
- Frequent visits to the doctor for slight changes in physical symptoms or sensations.
- Frequent checking of heart rate, blood pressure, or other vital recordings.
- Staying awake for long periods of time to ensure safety of home.
- Wearing excessive amounts of clothing when in public to avoid attention.
- Re-reading a text or e-mail multiple times before sending.
- Calling a loved one several times throughout the day to check on their safety or well-being.
If you think you might be engaging in safety behaviors to manage anxiety, reach out to us at Austin Anxiety and OCD Specialists. We have a qualified team of professionals who are trained in assessing and treating anxiety and related disorders. We would love to help you get back to a value-driven life that is not reliant on safety behaviors!