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Is your coping strategy making you sick? (Vetaffairs Summer 2019)

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Dr Loretta Poerio

Dr Loretta Poerio,
Mental Health Adviser,
Department of Veterans’ Affairs

Avoidance is a type of coping strategy that most of us engage in, from distracting ourselves from a particular task to not leaving the house and, of course, fooling ourselves (not generally others) that everything is going great!

In its more extreme manifestations it is a result of post-traumatic stress disorder, anxiety, depression and, well, most mental health conditions. It is a strategy that has a range of unintended consequences, limiting our options, and leading to ongoing mental health issues.

It is a key feature of trauma, and involves avoiding certain thoughts, feelings or situations to minimise or prevent anxiety and reduce distress. It can take the form of not going into crowded places, not talking about particular topics, refusing to be part of groups, or becoming a workaholic.

Avoidance behaviour is perfectly understandable. It’s a way of protecting yourself when traumatic events overwhelm your ability to deal with situations. However, in the long term it often has profound impacts on your quality of life and that of the people around you. In fact, it perpetuates the very distress that you are trying to hide from.

This is partly because you spend enormous energy protecting yourself from the feared situation, thoughts and emotions, and this becomes your world. As you go into protection mode, you often cut out family, friends and opportunities to engage in new experiences and to learn. Your world can become a very small place.

This thinking and behaviour perpetuates a vicious cycle that reinforces avoidance as a strategy of choice, limiting your ability to take in new information that could change your perspective. Our thinking becomes skewed and we fool yourself into believing that everything is okay: ‘I just need to keep up the walls so that no one can get in. That will keep me safe. If I let my guard down then everything will come crashing down and I won’t be able to cope. I will let everyone down, my boss will think I’m a loser, my partner will leave me, my kids will think I’m a crap parent …’

It’s more helpful to face the fear and look at other strategies that are more effective. What if we ask ourselves, ‘How is this avoidance strategy working for me? Is it enabling me to meet my life goals?’

It is important to move towards the difficult memories and actively engage with the thoughts, emotions and situations related to the areas of your life that you are actively avoiding. This can open up possibilities for growth and healing.

Acknowledging that our avoidance has not worked and is taking up a lot of our energy is a fantastic step in the right direction as it opens up the possibility for change. How brave we are when we acknowledge our vulnerability and take the time to reflect: ‘How can things be different … What if I change how I think, feel and what I do?’

A pros and cons exercise is helpful. What are the benefits and the unhelpful consequences of continuing with this strategy? If you find that the unhelpful consequences outweigh the benefits and you are ready to change the situation, then the next step is to seek assistance. This may mean talking to a trusted family member or friend, a peer, or seeking professional assistance. The important thing to remember is to take small steps. Learning new coping strategies can take time and practice. They include challenging the conditions that have created and maintained the avoidance and reframing the situation, thoughts and emotions to create a more constructive approach.

If your mental health is being impacted by your avoidance strategy, and is affecting your mental health and wellbeing, I advise you to get professional assistance. This is available through Open Arms, or through a referral to a psychologist via your GP if you have a DVA White Card or Gold Card. Any kind of White Card entitles you to unlimited mental health care for life through Non-Liability Health Care (NLHC), whether or not your mental illness is related to service.

There are also apps that may be helpful in building more pro-active and helpful coping strategies to help navigate life’s twists and turns. For instance, DVA has developed High Res – visit highres.dva.gov.au or download the app (see below). It has tools and tips to build resilience.

Head to Health also has a range of tools and information including a veteran portal with specific information and tools for veterans and their families.

Remember, you just need to take the first step.

Resources

Open Arms: www.openarms.gov.au

NLHC: www.dva.gov.au/nlhc

DVA Health Cards

The High Res app is free and can be downloaded from the Apple Store - High Res and the Google Play store - High Res.

‘Veterans’ section of Head to health

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