Guide to Avoiding Avoidance

Melanie's life was shrinking like a cheap blouse in an overheated dryer. At 30 she'd developed a fear of flying that ended her dream of world travel. Within a year, her phobia had grown to include—or rather, exclude—driving. After the World Trade Center attacks, Melanie became terrified to enter the downtown area of any city. She quit her job as an office manager (the potential for mail-based terrorism was too big) and called me hoping I could help her devise a way of earning money from home. "Everybody tells me my fears aren't realistic," she said. "But I think I'm the most realistic person I know. It's a dangerous world—I just want to be safe."

There was only one thing for which Melanie would leave her apartment. Once a month, she walked to a rundown neighborhood to meet her drug dealer, who sold her Xanax and OxyContin of questionable purity. I insisted that Melanie see a psychiatrist before I'd work with her, and the worried shrink called me before the impression of Melanie's posterior had faded from his visitor chair. "She's taking enough medication to kill a moose," he told me. "If she slipped in the shower and knocked herself out, withdrawal could kill her before she regained consciousness."

Ironic, n'est-ce pas? Safety-obsessed Melanie was positively devil-may-care when it came to better living through chemistry. This made no sense to me—until I realized that Melanie's objective wasn't really to avoid danger but to prevent the feeling of fear. Melanie was using a strategy psychologist Steven Hayes, PhD, calls experiential avoidance, dodging external experiences in an effort to ward off distressing emotions. It wasn't working. It never does. In fact, to keep her tactics from destroying her, she would have to learn the antidote for experiential avoidance—and so must the rest of us, if we want our lives to grow larger and more interesting, rather than smaller and more disappointing.