Enabling through Accomodating

One of the Common Anxiety Myths listed on the Anxiety Disorders Association of America's (ADAA's) informative website is that "A never-ending supply of compassionate reassurance from family and friends and assistance in avoiding stress are good for someone with anxiety problems." The writers go on to explain that friends and loved ones usually feel compelled to offer frequent reassurance and soothing to the person in their life suffering from acute anxiety. Without a more informed understanding of how human behaviors are extinguished or reinforced, they mistakenly believe that taking it easy on the anxious person by helping him or her to avoid things is the best way to help relieve the person's anxiety. Helping an anxious person to avoid something he or she fears tends to work beautifully in the short term. The term for this is accommodating the person's avoidance. A mother quits her job to home school a child with acute social and separation anxiety. The boyfriend of a girl with agoraphobia agrees to only spend time with her at her house because venturing out overwhelms her with the fear of panic attacks. But what works so well to reduce anxiety in the short term has the insidious longer term effect of deepening and retrenching the anxious person in their life-depleting condition.

On the other hand, it is not a family member or friend's responsibility to be a behavior therapist for their anxious loved ones: creating fear hierarchies and guiding them through rigorous exposure and response prevention. That's what CBT therapists are for. Similarly, no one wants to abruptly force their anxious loved one into situations where he or she will have an emotional breakdown, or berate them, or make unrealistic demands to simply "get over it" that will cause someone struggling with a serious anxiety disorder to feel entirely unsupported.

So what is the best stance for family and friends of an anxious person to take? The answer is for family and friends to try to provide compassionate and kindly encouragement to move through the anxiety rather than avoiding it. To not accommodate the fears, but lovingly encourage a person to engage in the activity he or she is nervous about by reminding him that he is a strong and resilient person and can handle it and even find enjoyment in it. Of course, there are times when a person's fear of an activity is so intense that loving encouragement will not be enough to unlock his or her willingness to do it. When a person's life is too entrenched in and disrupted by acute fears, that is when professional CBT therapy is needed. But in cases where willingness to face fears is there, it can be unlocked by patient encouragement and resolutely pointing out the life costs of anxious avoidance. This is something that many family members and friends can provide, to the great long term benefit of their acutely anxious loved one.