Avoidance, by itself, isn’t negative. It makes people think it isn’t a big deal. But imagine how many missed opportunities for growth or connection, in time, add up to a lost relationship or what may have encompassed a substantial life change. What feels neutral, like one more cigarette, is false security, a slowly corroding possibility.
Avoidance exists in many forms, one of which is the pursuit of information. Due to the recent and widespread election anxiety, patients around the country sought out the aid of their therapists for comfort about the future. They looked for answers regarding the likelihood of a particular candidate winning to avoid fear. Cognitive behavioral therapy, which offers help in exploring the likelihood of a negative belief or prediction, was used to help quell anxieties about climate change, social unrest, corruption, and exploitation. Unfortunately, in hindsight, while CBT may have been effective, its likely reframes, based on general sentiment and early polling, were often wrong. (I’m guilty as well.) Now, many are left wondering: How good are we at predicting?
CBT is limited due to this. But, many continue to avoid making choices, learning skills, and taking risks while collecting data; some even desperately search for root causes. To fix a problem is to first understand it, but what if we spend too much time analyzing, and too much time feeling as though we can and should know more? I tell my patients that while it’s good to develop strong analytical skills, it’s also best to not only prepare for worst-case scenarios but to live life, which includes practicing coping with one’s mistakes. “Who am I really?” “What do I actually want?” These questions frequently arise in therapy, with an almost as frequent obsessive preoccupation with certainty. The belief is that we can only become happy once we’ve settled on an obvious option. In a similar vein, this question comes up: “Can I be sure about the future?” Finally, some believe that discovering the root causes of their ailments will automatically engender insight into a cure. Yet, despite the burning, and almost suffocating, desires for answers, life offers few.
It’s challenging for me to sit with a patient and say, “I know both of us want to develop a strong belief based on the evidence, but we still have to leave room for being wrong.” It feels like I’m failing, as though my critical skills are degrees below those sought after by my client. I start to feel useless. Like many of us grasping for political forecasts from the experts, I grasp for thought exercises, worksheets, and arguments, forgetting that, sometimes, worrying is, in part, good because it’s necessary. Anxiety can arouse as much as it can stifle. It can create possibilities better than those before. We hate fear, yet, at times, may love its fruits. Many times, I’ve heard patients say, “I hate that experience but am glad it happened.”
A Common Refrain
However, “I won’t be able to handle it” is a common refrain in therapy. So, in addition to exploring probabilities, we ask, “Why are you so terrified of uncertainty?” Obsessive-compulsive disorder is referred to as the disease of self-doubt, which is why patients struggling with it chronically seek out reassurance. But rather than developing skills and or belief in their abilities, some prefer to know that they won’t need them. And, I, as a therapist, as a person better yet, try to avoid emotional crises as well; by, at times, helping to soothe my patients, I also aid myself, which, in turn, fails to support either, at least in the long run. Clinically, delusions are understood to be mostly negative. We accept that we have to live with some delusions because human beings can’t tolerate too much reality, but we should minimize them as much as possible. Living in reality allows us to grieve what’s lost and accept our possibilities for how we choose to create our lives. Avoidance, especially in the context of propping up what’s revealed in time as false, is a curse.
Additionally, because worst-case scenarios sometimes come true, we don’t have the time and space to embark on the road to the root cause. Perfectionists tend to want answers to all of their questions, but, sometimes, doing is enough. We learn to live with and to some extent appreciate our mistakes. We learn our limitations in fixing ourselves and the world. We learn to accept uncertainty because we aren’t soothsayers, no matter how assured we feel. Maybe we “won’t be able to handle it” or maybe we will. Maybe our communities are strong, or maybe our anxiety indicates the need to strengthen them. In a world that hates to feel its feelings, sometimes those that result from difficult circumstances give us the space to become more than we were, even if better just means better at managing our feelings.
We are the hope.
In some sense, in one way or another, everything will be all right. Persistence, confidence, and community are the keys. I speak with young therapists about navigating business-related problems in the profession, including issues with health insurance companies, and warn them of the difficulties, but I also tell them: As long as you have the drive, you’ll often overcome your struggles. This is my message. We don’t have to continually soothe ourselves. We have to learn to live with uncertainty. Fundamentally, we have to learn how to live. The other option isn’t better.