The Concern We’re Avoiding
Michael is a 42-year-old executive known for being steady under pressure. He has built a reputation on composure, productivity, and emotional restraint. While the first two are celebrated, the third has created challenges. Michael had a volatile childhood – not "bad" by any specific measure, there was love, after all – but he grew up amid financial and emotional instability. As a boy, avoidance became an adaptive strategy. He learned to suppress fear amid conflict and never had the opportunity to fully process those moments. It allowed him to function in an unpredictable home. As an adult, however, that same strategy became automatic. Then harmful.
During a volatile market, Michael missed his sales quota. He responded by working longer hours, withdrawing socially, and at night, distracting himself with screens and alcohol. He said he was fine. He was not. Michael developed hypertension, trouble sleeping, and intermittent chest tightness. At work, he was crankier. His emotional distance eroded trust with his team. Still, he insisted he just needed to work harder, that the market would turn, and everything would be okay. He was right, at some level – but he had turned his back to his own wellness. Avoiding stress was creating more of it.
Eventually, after meeting with a qualified therapist, he recognized a pattern of avoidance and suppressing discomfort rather than processing it. Together, they worked on psychological flexibility – naming emotions, tolerating distress, and acting in alignment with values rather than reflexively. His sleep improved, his blood pressure stabilized, and workplace relationships reemerged. It did not happen overnight. But it could not have happened without recognizing the concern.
Avoiding a Public Health Concern
Denial is not a personality flaw. Decades of psychological research suggest something more complex. Denial and avoidance are frequently adaptive responses to overwhelming stress. They reduce immediate emotional intensity and allow a person to continue functioning. The problem develops when avoidance shifts from a coping strategy with potential utility to a default setting that causes unnecessary pain.
Experiential avoidance – attempts to escape or suppress unwanted internal experiences even when doing so causes harm – is well discussed in modern psychology (Hayes et al., 1996). When individuals repeatedly rely on avoidance as a primary coping strategy, it becomes automatic. The strategy that once limited threat might now create it. Consider the S.A.I.D. Principle: Specific Adaptation to Imposed Demand. Without exposure to a demand, adaptation is not possible. A marathoner who avoids running not only misses opportunities for growth, but atrophies in the absence of challenge. Avoidance is understandable, but self-limiting.
At scale, this pattern carries public health implications. Chronic stress, social isolation, and limited growth cluster together, and map onto mental health concerns. Psychological flexibility – avoidance's counterbalance – predicts mental health across a wide range of populations (Kashdan & Rottenberg, 2010). But flexibility is not possible without first acknowledging that a concern exists.
The Costs of Avoidance
Experiential avoidance is associated with anxiety disorders, depression, posttraumatic stress symptoms, and substance use disorders (Hayes et al., 1996; Chawla & Ostafin, 2007). People who habitually suppress emotions report lower social support and decreased relationship satisfaction (Gross & John, 2003). And while emotions are tamped down, the physiological strain remains. Suppression increases sympathetic nervous system activation compared to the more adaptive strategy of acknowledgment and cognitive reappraisal (Gross, 2002). Avoidance might reduce the outward display of stress symptoms without reducing distress itself. It is like sweeping dirt under the rug.
Unaddressed, chronic stress contributes to allostatic load – cumulative burden on the autonomic nervous system, the endocrine system, and the HPA axis – and predicts greater cardiovascular risk over time (McEwen, 1998; Chida & Steptoe, 2009). The rug might hide the dirt, but it does not remove it.
Compounding this, distraction is now immediate and accessible. Social media use driven by escape motives correlates with increased isolation and depressive symptoms (Primack et al., 2017). Screen use has become a socially acceptable version of a familiar effort: avoiding uncomfortable emotions.
Avoidance of challenging social situations limits social bandwidth over time. Without real-world proof that one can navigate difficulty, retreat deepens. Social isolation and loneliness are associated with increased mortality risk comparable to established health behaviors such as smoking (Holt-Lunstad et al., 2015). In avoiding pain, avoidance can exacerbate the risk of deeper pain.
In some individuals, unexamined stress pressurizes and presents as aggression – another presentation of the same instinct, driven by the same desire for safety (Roberton et al., 2012). When these strategies are normalized, communal trust erodes, and trust predicts community health outcomes and collective efficacy (Kawachi & Berkman, 2000).
An Approach to Progress
Three areas deserve prioritization:
Cultural destigmatization of vulnerability. Cultural scripts that equate vulnerability with weakness reinforce avoidance. Scripts that frame openness as a step toward strength expand behavioral options. Public health campaigns have reshaped norms before – more people wear seatbelts, fewer smoke cigarettes. Emotional literacy deserves similar attention.
Interventions that increase flexibility. Acceptance and Commitment Therapy and related approaches directly target experiential avoidance by cultivating willingness to experience internal states while pursuing valued action (Hayes et al., 2006). These are true life skills and should be integrated into primary care settings, educational systems, athletic programs, and workplaces – not learned exclusively in a therapist's office.
Promotion of physical health. Mind and body are inextricably connected. Sleep, exercise, and nutrition support systems involved in stress and emotion regulation, expanding the body's capacity to experience stress without becoming overwhelmed (McEwen, 1998; Ratey & Loehr, 2011).
Moving Forward
Avoidance can keep one safe for a moment, but healthy engagement can empower people for a lifetime. A public health framework that treats avoidance as a legitimate concern is an important step forward. No solution is possible without confronting the concern.