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Avoidance as a psychological process is a self-protective strategy that keeps intolerable material at bay.

Avoidance itself can be unconscious so neither the pain nor the efforts to avoid pain are known.

Patients and therapists may find comfort in "thinking and doing" in ways that block therapeutic progress.

Beyond avoidance of people, places, or activities, avoidance as a psychological process refers to the various ways a person distances themselves from intolerable thoughts, feelings, memories, wishes, fantasies, etc. If the avoidance is very effective at its job, then the whole process may be kept out of a person's awareness for maximum self-protection. As a result, both patients and therapists are susceptible to avoidance dynamics in the therapy without recognizing it, especially if one or both individuals are in fact working very hard with good intentions, and therapy has the "look" of being productive. However, if the avoidance remains outside of awareness, that hard work will not lead to meaningful gains, leaving patient and therapist feeling stuck, confused, disappointed, and possibly resentful.

Thinking and Doing as Avoidance: The Patient

Therapy tends to include at least some elements of insight, psychoeducation, and supporting rational thought (thinking). Moreover, patients often benefit from various strategies like behavioral activation, engaging with fulfilling life activities, and maintaining physical activity (doing).

However, for some patients........

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