Staff Perspective: Don’t we all just want to be safe?
If you would ask any stranger on the street if they like to feel safe, it is likely that they respond “Yes”. This is nothing new or surprising. In fact, most young children can articulate this concept. It is clear that the need for safety is innate. It makes sense then that we all yearn for a sense of safety. Every one of us has people, places, or things that contribute to our sense of safety. We see the need for safety all around us. We see it in the infant reaching out to his caretaker when feeling scared. As early as infancy, safety signals can include a “blanky,” a stuffed animal, or any other transitional object. In other words, we give ordinary objects, extraordinary power!
As we age, safety is inherent in our preventive behaviors, such as taking vaccinations, or keeping a first aid kit nearby. In the field of psychology, the importance of safety has long been recognized with a great deal of literature emphasizing the importance of safety within the therapeutic relationship, as well as in the therapeutic milieu. Even Maslow, identified safety as the second most important need, subsequent to physiological needs required for human survival.
Learning to successfully differentiate safety from danger is a vital skill for survival. Fear helps us to prepare for potential danger by triggering the fight-flight-freeze response. It is biologically engrained in animals and humans. Studies have uncovered neurological links to safety. For example, decreased activity in the medial prefrontal cortex (mPFC) is associated with fear generalization in animals and humans. In other words, anxiety causes our fear response to act as a smoke alarm. Although a smoke alarm can protect us from a fire, it can sometimes be too sensitive leading it to go off even in the absence of a fire.
Many people, when experiencing anxiety, try to find ways to self-sooth and ameliorate the anxiety. We tend to respond to these false smoke alarms in ways we think might help to protect from threat. These behaviors are referred to as Safety Behaviors. Safety behaviors provide temporary relief from anxiety and can manifest in various ways.
For individuals with social anxiety, safety behaviors may include speaking quickly or quietly, avoiding eye contact, positioning oneself not to be noticed (i.e. sitting in the back of the room), appearing preoccupied, or having a planned excuse to leave a social situation. Individuals with Panic Disorder often carry with them safety aids such as water, cell phone and/or medication. In Generalized Anxiety Disorder (GAD), safety behaviors can include reassurance seeking, making lists and overprotective behaviors. In Obsessive Compulsive Disorder (OCD), the most common safety behavior is checking behavior. For individuals with health anxiety, fear is focused on illness, mortality, and physical symptoms. As a result, safety behaviors can include avoidance of places and/or situations (i.e. avoiding hospitals or visiting a sick friend), reassurance seeking from doctors and/or frequent medical checkups, and avoidance of activities that cause physiological changes (i.e. sex, exercise, and caffeine).
Safety behaviors foster an illusion of protection from danger. In reality, however, they maintain a fear response in the absence of danger. Take for example a fear of dogs. If I was afraid of dogs, I might decide to cross the street every time I saw a dog. Every time I cross the street, I might think to myself “I did not get bitten by the dog because I crossed the street”. In other words, I learn that crossing the street has, in fact, kept me safe from harm. What's more, I learn that dogs are dangerous. In reality, the likelihood of getting bitten by a dog is quite low and it is very possible that the dog would not have bitten me even if I remained on the same side of the street. The problem with crossing the street is that it robs me of the opportunity for new learning – the possibility of learning I can be safe even in the presence of the dog. In this way, crossing the street reinforces my belief that dogs are dangerous and keeps my fear alive over time.
Safety behaviors are problematic in a number of ways:
- Safety behaviors prevent the disconfirmation of unrealistic/inaccurate beliefs about events and their outcomes. This is because individuals will attribute non-occurrence of the feared event to engaging in the safety behaviors. In other words, engaging in safety behaviors prevents you from having the opportunity to acquire corrective information about a threat, by shifting attention from potentially disconfirming information and promoting misattribution of safety.
- Safety aides and behaviors keep you from actually experiencing the anxiety during the exposure experience. Thus it robs you from the opportunity to learn that you can, in fact, cope with the challenging situation and resulting emotions.
- Using safety aids and safety behaviors present a constant reminder of the “danger”.
- Safety behaviors can actually increase the anxiety symptoms. For example, gripping a glass tightly will often lead to increased hand trembling. Similarly, wearing multiple layers of clothing to prevent others from seeing your armpits sweat can ultimately lead to increased sweating due to the added heat.
- Safety behaviors may result in negative results from others.
Unfortunately, there is a clear relationship between the safety behavior and the feared consequence. For example, individuals with social anxiety may avoid any pauses in speech. However, avoiding pauses in speech will inevitably lead others to perceive one to be anxious. More importantly, safety behaviors can diminish self-esteem and lead to a very unsatisfying life by restricting engagement in pleasurable activities. Ultimately, one needs to confront their fears in order to overcome them. There are many ways to do this. Whether it be flooding or graded exposure, the ultimate goal is to create the freedom of choice in one’s life!
Keep reading our blogs, more on exposure techniques to come…
Sharon Birman, Psy.D., is a CBT trainer working with the Military Training Programs at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.
If you would ask any stranger on the street if they like to feel safe, it is likely that they respond “Yes”. This is nothing new or surprising. In fact, most young children can articulate this concept. It is clear that the need for safety is innate. It makes sense then that we all yearn for a sense of safety. Every one of us has people, places, or things that contribute to our sense of safety. We see the need for safety all around us. We see it in the infant reaching out to his caretaker when feeling scared. As early as infancy, safety signals can include a “blanky,” a stuffed animal, or any other transitional object. In other words, we give ordinary objects, extraordinary power!
As we age, safety is inherent in our preventive behaviors, such as taking vaccinations, or keeping a first aid kit nearby. In the field of psychology, the importance of safety has long been recognized with a great deal of literature emphasizing the importance of safety within the therapeutic relationship, as well as in the therapeutic milieu. Even Maslow, identified safety as the second most important need, subsequent to physiological needs required for human survival.
Learning to successfully differentiate safety from danger is a vital skill for survival. Fear helps us to prepare for potential danger by triggering the fight-flight-freeze response. It is biologically engrained in animals and humans. Studies have uncovered neurological links to safety. For example, decreased activity in the medial prefrontal cortex (mPFC) is associated with fear generalization in animals and humans. In other words, anxiety causes our fear response to act as a smoke alarm. Although a smoke alarm can protect us from a fire, it can sometimes be too sensitive leading it to go off even in the absence of a fire.
Many people, when experiencing anxiety, try to find ways to self-sooth and ameliorate the anxiety. We tend to respond to these false smoke alarms in ways we think might help to protect from threat. These behaviors are referred to as Safety Behaviors. Safety behaviors provide temporary relief from anxiety and can manifest in various ways.
For individuals with social anxiety, safety behaviors may include speaking quickly or quietly, avoiding eye contact, positioning oneself not to be noticed (i.e. sitting in the back of the room), appearing preoccupied, or having a planned excuse to leave a social situation. Individuals with Panic Disorder often carry with them safety aids such as water, cell phone and/or medication. In Generalized Anxiety Disorder (GAD), safety behaviors can include reassurance seeking, making lists and overprotective behaviors. In Obsessive Compulsive Disorder (OCD), the most common safety behavior is checking behavior. For individuals with health anxiety, fear is focused on illness, mortality, and physical symptoms. As a result, safety behaviors can include avoidance of places and/or situations (i.e. avoiding hospitals or visiting a sick friend), reassurance seeking from doctors and/or frequent medical checkups, and avoidance of activities that cause physiological changes (i.e. sex, exercise, and caffeine).
Safety behaviors foster an illusion of protection from danger. In reality, however, they maintain a fear response in the absence of danger. Take for example a fear of dogs. If I was afraid of dogs, I might decide to cross the street every time I saw a dog. Every time I cross the street, I might think to myself “I did not get bitten by the dog because I crossed the street”. In other words, I learn that crossing the street has, in fact, kept me safe from harm. What's more, I learn that dogs are dangerous. In reality, the likelihood of getting bitten by a dog is quite low and it is very possible that the dog would not have bitten me even if I remained on the same side of the street. The problem with crossing the street is that it robs me of the opportunity for new learning – the possibility of learning I can be safe even in the presence of the dog. In this way, crossing the street reinforces my belief that dogs are dangerous and keeps my fear alive over time.
Safety behaviors are problematic in a number of ways:
- Safety behaviors prevent the disconfirmation of unrealistic/inaccurate beliefs about events and their outcomes. This is because individuals will attribute non-occurrence of the feared event to engaging in the safety behaviors. In other words, engaging in safety behaviors prevents you from having the opportunity to acquire corrective information about a threat, by shifting attention from potentially disconfirming information and promoting misattribution of safety.
- Safety aides and behaviors keep you from actually experiencing the anxiety during the exposure experience. Thus it robs you from the opportunity to learn that you can, in fact, cope with the challenging situation and resulting emotions.
- Using safety aids and safety behaviors present a constant reminder of the “danger”.
- Safety behaviors can actually increase the anxiety symptoms. For example, gripping a glass tightly will often lead to increased hand trembling. Similarly, wearing multiple layers of clothing to prevent others from seeing your armpits sweat can ultimately lead to increased sweating due to the added heat.
- Safety behaviors may result in negative results from others.
Unfortunately, there is a clear relationship between the safety behavior and the feared consequence. For example, individuals with social anxiety may avoid any pauses in speech. However, avoiding pauses in speech will inevitably lead others to perceive one to be anxious. More importantly, safety behaviors can diminish self-esteem and lead to a very unsatisfying life by restricting engagement in pleasurable activities. Ultimately, one needs to confront their fears in order to overcome them. There are many ways to do this. Whether it be flooding or graded exposure, the ultimate goal is to create the freedom of choice in one’s life!
Keep reading our blogs, more on exposure techniques to come…
Sharon Birman, Psy.D., is a CBT trainer working with the Military Training Programs at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.