Safe behavior examples

Safe behavior examples DEFAULT

People with anxiety often perform "safety behaviors" during anxiety provoking situations. These safety behaviors make the person feel more comfortable in the situation by providing temporary relief from anxiety. However, safety behaviors have been described as the major cause of persisting anxiety and the reason why people don't feel relief during exposures (Wells, Clark, Salkovskis, Ludgate, Hackmann, & Gelder, ).

An example of a safety behavior in social anxiety is talking fast during a meeting. The person may feel temporarily better by speaking quickly and getting out of the situation. However, this behavior is basically telling the person's body that this situation is dangerous and he or she has to do something to remain safe. That is, whenever a person performs a safety behavior, he or she is reinforcing the idea that the situation is very dangerous. Here are some other examples of safety behaviors in social anxiety (safety behaviors occur across all anxiety disorders, but these examples focus mostly on social anxiety):

  • Asking the other person many questions when speaking with someone new (to keep the focus off of oneself).
  • Selecting a position in the situation to avoid excessive scrutiny (e.g., sitting in the back of the room)
  • Averting eye contact to avoid being noticed by others.
  • Taking on roles in social situations so that one does not have to interact (taking pictures or setting up equipment)
  • Drinking alcohol or taking drugs to feel less anxious before a situation
  • Wearing neutral clothing to avoid calling attention to oneself
  • Wearing turtlenecks or wearing hair in certain ways to cover blushing
  • Avoiding any substances or activiites that might induce anxiety or symptoms (e.g., caffeine, spicy food, physical exertion, warm clothing)

Multiple research studies have shown that safety seeking behaviors actually harm people's abilities to get past the anxiety in situations (e.g., Furukawa et al., ; Kim, ; McManus, Sacurda, & Clark, ; Wells et al., ). We have often heard many clients describe scenarios where they were 'exposed' repeatedly to situations that they fear, but they have not experienced a reduction in anxiety. For example, one client described being in meetings every day and feeling intense anxiety. However, he described standing in the back and leaving the room anytime that it was his department's turn to discuss items. These safety behaviors led his body to believe that the situation was much more dangerous than it actually was.

When we conduct exposures with people with social anxiety, we often start with situations where they use some safety behaviors. However, over time we ask people to reduce them more and more. As they start to feel success, we will often have them push the envelope and do the opposite of what their anxiety tells them ("If it feels bad, do it"). Their anxiety is telling them to play it safe, but to get past it, they must push themselves. For example, we often urge people to drink a sports beverage that contains caffeine and increases blood flow, so that the person can feel both shaky and flushed in social situations. We have them wear bright and outrageous clothing to call attention to themselves. When they do these 'opposite' behaviors, they are basically telling their body that there is nothing to fear and that they have the ability to cope on their own no matter what the circumstance.

Alden and Bieling () found that when people with social anxiety performed safety behaviors, they seemed more awkward and less likeable. Thus, by playing it safe, the person with social anxiety actually got what they feared most: negative evaluation. We often tell clients that they are doing a disservice to others by playing it safe. Others don't get to see their true self.

There is also a measure of Social Anxiety Safety Behaviors that you can complete (Pinto-Gouveia, Cunha, & Do Céu Salvador, ).

Alden, L. E., & Bieling, P. (). Interpersonal consequences of the pursuit of safety. Behaviour research and therapy, 36(1), 53–

Furukawa, T. A., Chen, J., Watanabe, N., Nakano, Y., Ietsugu, T., Ogawa, S., … Noda, Y. (). Videotaped experiments to drop safety behaviors and self-focused attention for patients with social anxiety disorder: Do they change subjective and objective evaluations of anxiety and performance? Journal of Behavior Therapy and Experimental Psychiatry, 40(2), – doi/j.jbtep

Kim, E. J. (). The effect of the decreased safety behaviors on anxiety and negative thoughts in social phobics. Journal of Anxiety Disorders, 19(1), 69– doi/j.janxdis

McManus, F., Sacadura, C., & Clark, D. M. (). Why social anxiety persists: An experimental investigation of the role of safety behaviours as a maintaining factor. Journal of Behavior Therapy and Experimental Psychiatry, 39(2), – doi/j.jbtep

Pinto-Gouveia, J., Cunha, M. I., & Do Céu Salvador, M. (). Assessment Of Social Phobia By Self-Report Questionnaires: The Social Interaction And Performance Anxiety And Avoidance Scale And The Social Phobia Safety Behaviours Scale. Behavioural and Cognitive Psychotherapy, 31(03), – doi/S

Wells, A., Clark, D. M., Salkovskis, P., Ludgate, J., Hackmann, A., & Gelder, M. (). Social phobia: The role of in-situation safety behaviors in maintaining anxiety and negative beliefs. Behavior Therapy, 26(1), –


Safety Behaviors: Why We Do Them and How CBT Can Help!

written by: Samantha Myhre, PhD

Cognitive Behavior Therapy (CBT) suggests that our thoughts, feelings/emotions, and behaviors are all connected to one another and influence one another. CBT aims to identify and modify unhelpful thinking and behavioral patterns. One unhelpful set of behaviors targeted in the treatment of anxiety disorders are behaviors we refer to as “safety behaviors”. These are behaviors that are engaged in during times of anxiety in order to protect ourselves from whatever danger our anxiety is convincing us exists! You might be thinking “hey, the behaviors are serving us… why do we want to get rid of them?” Well, the problem lies in the long-term effect of engaging in safety behaviors. Sure, the immediate result of reduced or eliminated anxiety is great! BUT…the longer you engage in safety behaviors the more your brain thinks that is what you have to do in those situations. Over time you may feel that you need to engage in the safety behavior for longer or with greater intensity. At the same time, you become increasingly pulled away from the goals and values that are important to your life. This cycle is demonstrated below:

Safety behaviors can include forms of avoidance, distraction, preparing, and checking. Through CBT, individuals are taught how to engage in exposure therapy where they face the situations that typically bring about anxiety while refraining from engaging in safety behaviors. Sounds kind of scary, doesn’t it? That’s what we’re here for! With the help of a therapist, individuals design exposure hierarchies where they create a list of situations that bring about anxiety. Then they rank those situations from least to most difficult to approach through an anxiety or distress rating scale. Therapists will then model and guide individuals in how to approach these situations while dropping safety behaviors so that they can teach their brains a new way of responding in situations that previously required a safety behavior. Individuals work up to the more difficult items on their exposure hierarchy as they gain practice and confidence with lower rated items. The goal is to increase one’s ability to tolerate uncertainty and live a value-driven life! When we engage in safety behaviors, we are achieving short-term relief and in return experience long-term discomfort. Through exposure, we can achieve long-term relief by engaging in short-term discomfort!

Below are examples of safety behaviors in action:

  • Sitting only in the back row of the classroom to avoid being noticed.
  • Avoiding eye contact while grocery shopping and while going through the check-out.
  • Wearing sunglasses while using public transportation (even on gloomy days).
  • Over-preparing for presentations or meetings.
  • Mentally rehearsing conversations before they happen.
  • Carrying a bottle of anti-anxiety medication whenever outside of the home.
  • Leaving the house only if accompanied by a trusted loved one.
  • Creating an escape plan from any building entered.
  • Checking the locks on the house or car door multiple times.
  • Frequently checking or going on electronics during social interactions.
  • Consuming alcohol, recreational drugs, or other substances to curb anxiety.
  • Engaging in superstitious rituals before, during, or after situation that elicits anxiety.
  • Avoidance of locations or situations that tend to increase anxiety.
  • Having to carry a certain object in situations that tend to increase anxiety.
  • Frequent visits to the doctor for slight changes in physical symptoms or sensations.
  • Frequent checking of heart rate, blood pressure, or other vital recordings.
  • Staying awake for long periods of time to ensure safety of home.
  • Wearing excessive amounts of clothing when in public to avoid attention.
  • Re-reading a text or e-mail multiple times before sending.
  • Calling a loved one several times throughout the day to check on their safety or well-being.

If you think you might be engaging in safety behaviors to manage anxiety, reach out to us at Austin Anxiety and OCD Specialists. We have a qualified team of professionals who are trained in assessing and treating anxiety and related disorders. We would love to help you get back to a value-driven life that is not reliant on safety behaviors!

Categories anxiety, Blog, OCDSours:
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In this video I explain one of the core concepts behind social anxiety: safety behaviors. Safety behaviors maintain social anxiety, because when we engage in them we are missing opportunities to learn from our success. Therefore, we continue to feel anxious and lose confidence.

In a recent testimonial, a user of our Overcome Social Anxiety program describes how stopping safety behavior has made major changes to his life! Our program creates a personalized formulation for each user. This includes identifying safety behaviors, and learning techniques for stopping them. You can learn more about the program here.


Fjola  Helgadottir, PhD, CPsychol, is a clinical psychologist, who has worked in Australia and at the University of Oxford in the United Kingdom. She is AI-Therapy’s director and co-creator of AI-Therapy’s Overcome Social Anxiety program and the creator of Flourish: Living happily while trying to conceive. Twitter: @drfjola

For my PhD I created an online social anxiety treatment for people who stutter or stammer. The results were fantastic. In fact, they were so good that Ross Menzies and I wanted to make the tool available for everyone with social anxiety, and that&#;s how AI-Therapy was born.

AI-Therapy now has hundreds of users from all over the world, and our results (technically known as the program&#;s &#;effect size&#;) have been just as strong as the original PhD version. Actually, they are even more promising as they are now based on a larger population of users.

Statistics aside, it&#;s also important to hear people&#;s stories. Unfortunately, the nature of social anxiety makes it difficult for those who suffer to speak openly about the problems. Therefore, I was extremely excited to (quite randomly) come across the following article:

How cognitive behaviour therapy helped me

It was written by a user of my PhD program, and talks about the impact CBT has had on his life. I found it humbling that the program I created made such a difference to someone who has lived with social anxiety for over 70 years.

Here are a few quotes:

The programme was one of the great events of my life. It acknowledged that people who stammer often have undesirable thoughts and beliefs and I was shown how to change these. The results were immediate. The major item I picked up from the programme was the dropping of safety behaviours.

Shortly after the course finished I attended a dinner with 25 people. Normally this would involve the minimum of social conversation from me. On this occasion I made use of the techniques I had picked up and talked just about non-stop and on several occasions I was told to stop talking and eat as everyone was waiting for me to finish my meal so they could have the next course served.

Each conversation that I approach I now face with determination and courage. No longer do I stand back and rehearse what I am going to say before saying it. I have become very outspoken and have no problem at all in speaking up at meetings to add to the discussion. People I have met since completing the CBT programme have no idea that I stammer and when I tell them they are amazed by my story of how CBT changed my life.

I highly recommend you read his whole story. As I mentioned, AI-Therapy&#;s Overcome Social Anxiety program has been enhanced to be suitable for anyone with social anxiety. I hope it continues to change lives.


Fjola  Helgadottir, PhD, CPsychol, is a clinical psychologist, who has worked in Australia and at the University of Oxford in the United Kingdom. She is AI-Therapy’s director and co-creator of AI-Therapy’s Overcome Social Anxiety program and the creator of Overcome Fertility Stress. Twitter: @drfjola

 I&#;ve just come back from the British Association for Behavioral and Cognitive Psychotherapies (BABCP) conference, which was held in Birmingham last week. The conference was excellent. One of my favorite talks was by my colleague Dr Clare Mein of Oxford University. She was presenting her PhD from the University of Western Australia, where she also trained as a clinical psychologist.

Dr Mein demonstrated in series of experiments how social anxiety can affect social situations. In particular, she found that people with social anxiety interact differently during conversations. For example, think about the last time you got lost in a conversation with someone who you are not anxious around (best friend, partner, etc). You got lost in the moment, and the conversation went smoothly. However, it&#;s very different when you feel socially anxious, isn&#;t it? When we are anxious there are many thoughts going through our head unrelated to the conversation itself. These are often related to impression management. Here is an example:



The research showed that these thoughts are one reason why people with social anxiety don&#;t get &#;lost in the moment&#;. Unfortunately, it also showed that the conversational partner typically notices this, making the overall experience worse for both people.

Dr Mein conducted an experiment with people who have low scores on social anxiety measures.  She asked these participants to count the number of words starting with the letter &#;T&#; while having a conversation. The results showed that the when the participants were distracted by the counting they weren&#;t fully engaged in the conversation. Furthermore, the conversation partners felt less connected. In the same way, people with social anxiety are often focused on something else (i.e. how they present themselves), having a negative impact on the conversation.

People with social anxiety often have a collection of impression management strategies that they&#;ve acquired over the years. One goal of treatment, such a with a therapist or an online programs like AI-Therapy, is to identify and let go of these behaviors. This frees you to focus on the conversation. The good news is that if you successfully overcome social anxiety you&#;ll be able to enjoy high quality social interactions with everyone, not just your friends and family.


Fjola  Helgadottir, PhD, CPsychol, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy, a developer of online CBT treatment programs.

A lot has been written about the use of smartphones in social situations &#; it is the pet peeve of many. People often find it irritating to have a conversation (or eat a meal, watch a film, etc.) with someone who is constantly tapping away at their phone. In this blog I will look at the issue from a slightly different perspective. For those with social anxiety, smartphone use may actually be maintaining their problem.

AI therapy Woman With Smart PhoneA safety behavior is an action taken to manage one&#;s anxiety by exerting (perceived) control over a social situation. It is a behavior or action that is taken in order to prevent the core fear &#; being negatively judged by other people. Checking your smartphone is a perfect example that seems to be becoming increasingly common. People may do it to avoid something they fear: uncomfortable conversations, meeting new people, awkward silences, etc. In many cases they are worried that they won&#;t be able to &#;perform&#; in the social situation. In other cases, they may want to look important by being online and connected 24/7.

The problem with safety behaviors is that they tend to make the problem worse. On one hand, since it is an avoidance behavior, anxiety is maintained since it is never challenged. Sometimes uncomfortable conversations turn into interesting ones, sometimes awkward silences are followed by deep and meaningful comments, and sometimes when you meet new people you find a friend for life. Being on a smartphone can take away these opportunities. Also, if the social situation goes well despite being on a smartphone, one might wrongly attribute the positive outcome to the smartphone!

To illustrate another point, consider the following scenario:

Alice goes to a party where she doesn&#;t know many people. She is very anxious, and is worried that the other people at the party will not like her. She spends a lot of time sending text messages, as she hopes this will demonstrate that she is a social person with a wide group of friends.  The other people at the party make no effort to engage with Alice, as it looks to them like she has no interest in being there.

As you can see, the safety behavior (checking the phone) is the very reason why people are judging Alice negatively.

I should note that not all smartphone use in social situations is a safety behavior, as it depends on the reason why people are using their phone. There are many other reasons why someone may use their phone, such as bad habit or addiction (I will save that for another blog).

Our social anxiety treatment program can help you identify and challenge maladaptive safety behaviors. I encourage you to think about your actions, and try turning your smartphone off next time you are at a party. Not only are you less likely to be perceived as uninterested in the social situation, I guarantee you will have a richer experience, and you are a lot more likely to make a good impression on other people!


Fjola  Helgadottir, PhD, CPsychol, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of, an online CBT treatment program for overcoming social anxiety

It seems like every time I open Facebook or LinkedIn I see some tips from celebrities or entrepreneurs how to be more confident or successful. In reality, a little talent, a lot of hard work, and some lucky breaks are the key ingredients to success. Yet, successful people have a tendency to attribute their trajectories to a handful of tricks people “must do” in order to succeed. Unfortunately, these tips aren&#;t always as helpful as they seem. In fact, they can even lead to safety behaviors. If social anxiety is a problem for you, it is important to learn about the role of safety behaviors, and see if you are using them to “play it safe” socially.

This blog post is the first in a series where I will give some common tips, and explain why they are actually counterproductive.

Tip 1. Pretend to be interested in other people

The self-improvement writer Dale Carnegie recommends that people pretend to be interested in what others are saying during conversation. While this may sound reasonable when we are trying to impress someone, it can actually backfire. First, the other person might sense a lack of genuine interest in the topic, and find it uncomfortable that the listener is pretending to be interested. Second, if the social interaction results in a positive response, the pretender is likely to attribute the success to their pretense of being interested, not that they were liked for who they are. Third, this sort of behavior can maintain unhelpful thoughts people have about themselves, such as “I’m so plain and boring”. Every social interaction is an opportunity for people to disconfirm these types of unhelpful thoughts. However, every time safety behaviors are used, an opportunity is missed.

Tip 2. Read over your emails at least 5 times

Many of us overemphasize the importance of wording in our emails. Whilst this may seem reasonable, it simply isn&#;t always helpful. In fact, some of the most successful people I have corresponded with send me emails full of spelling mistakes (probably due to auto spelling) and no formal structure. Life is too short to read emails more than a couple of times. Try sending emails without proofing them: it&#;s difficult at first, but then it becomes liberating. It becomes easier to respond from your phone or tablet, and can save you from thinking about the emails when you are doing something else!


In other news, I just had a peer reviewed paper on safety behaviors accepted in the Journal of Speech, Language and Hearing Research. Once it is in press, I will blog about this as well!



Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of, an online CBT treatment program for overcoming social anxiety

Last night I went to see Captain Phillips (not a blog-worthy experience in itself, but the movie was very good). One of the advertisements was for the latest Google Nexus 7:

This ad has been viewed millions of times on YouTube, not including all the views on TV and in movie theaters. The fear of public speaking has been a research topic within psychology for at least two decades,  and major advancements have been made. In particular, it is now known that cognitive behavior therapy (CBT) is the most successful way to decrease fear and anxiety. Furthermore, the elimination of safety behaviors is a crucial component in tackling this problem. In this advert, it looks as if one simply needs to prepare (and being Google, &#;preparation&#; is watching YouTube speeches with a Nexus tablet). Obviously, there is much more to it than this. In fact, over-preparation is a behavior that can actually maintain social anxiety in the long term. In other words, sometimes the things we do to cope with short term anxiety are the very reason why the anxiety persists in the long run.

I am not saying it is unhelpful to watch clips of great speakers &#; we can all learn a lot from the masters. Also, being adequately prepared is important. However, real life can be more of a struggle than it is presented in commercials, and true gains are the result of hard work, not a fancy new tablet.


Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of, an online CBT treatment program for overcoming social anxiety

I&#;m a huge fan of the show &#;Parks and Recreation&#; by Amy Poehler. In fact, I even wrote a blog about how much we can learn from the main character (Leslie Knope), who has a fantastic outlook on life. However, I was pretty disappointed when I came across this video of Amy Poehler giving hints about how to deal with social anxiety:

Most of this sounds like common sense advice. However, if you are a regular reader of my blog you will have noticed that all she is doing is promoting &#;safety behaviours&#;. She recommends the following:

  • Breathe
  • Reach out to a friend (e.g. text message or phone call)
  • Find a place where you feel more comfortable, such as a corner or couch
  • Remember that you can always leave without telling anyone

These are classic examples of safety behaviours. Yes, it&#;s true they may help you get through a particular social event, but the risk is that these behaviours are maintaining the underlying anxiety in the long run. It would be much better to target the thoughts and behaviours that are causing the anxiety in the first place (for example, using CBT).

Don&#;t get me wrong &#; I know that Amy Poehler means well, and I&#;m still a huge fan. However, we have to remember that there is a difference between advice that &#;makes sense&#;, and advice that has been proven effective in carefully controlled experiments. Unfortunately, just because you&#;re a brilliant actress, it doesn&#;t mean you are up to date with the latest findings in evidence based clinical psychology. Let&#;s make a deal Amy &#; you keep rolling out those episodes of Parks and Rec, and we&#;ll keep an eye on the psychology journals.

For those who are not regular readers of my blog, here are a few that mention safety behaviours:





Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of, an online CBT treatment program for overcoming social anxiety


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Safety behaviors (anxiety)

Safety behaviors (also known as safety-seeking behaviors) are coping behaviors used to reduce anxiety and fear when the user feels threatened.[1] An example of a safety behavior in social anxiety is to think of excuses to escape a potentially uncomfortable situation.[2] These safety behaviors, although useful for reducing anxiety in the short term, might become maladaptive over the long term by prolonging anxiety and fear of nonthreatening situations.[1][3] This problem is commonly experienced in anxiety disorders.[4] Treatments such as exposure and response prevention focus on eliminating safety behaviors due to the detrimental role safety behaviors have in mental disorders.[5][6] There is a disputed claim that safety behaviors can be beneficial to use during the early stages of treatment.[7]


The concept of safety behaviors was first related to a mental disorder in when the “safety perspective” hypothesis was proposed to explain how agoraphobia is maintained over time.[3] The “safety perspective” hypothesis states that people with agoraphobia act in ways they believe will increase or maintain their level of safety.[3] In , the use of safety behaviors was observed in people with panic disorders.[1] Later studies observed the use of safety behaviors in people with other disorders such as social phobia,[5]obsessive compulsive disorder,[8] and posttraumatic stress disorder.[9]

Theories about effects[edit]

Safety behaviors directly amplify fear and anxiety.[4]

  • The use of safety behaviors promotes the monitoring of anxiety symptoms. For example, people with panic disorders tend to monitor themselves for symptoms of anxiety and respond to these symptoms with avoidant behaviors.[10] This over analysis of physical sensations results in detection of symptoms that may not lead to panic attacks but are perceived as panic-inducing symptoms.[10]
  • People with social phobia withdraw themselves from social situations by quietly speaking, reducing body movement, and preventing eye contact with other people.[5][11] These behaviors are meant to reduce the chances of receiving criticism from other people.[5][11] Instead, safety behaviors result in more criticism because people with social phobia are seen as aloof and unwelcoming people.[5][11]

Safety behaviors reduce anxiety in feared situations but retain anxiety in the long term.[4]

  • When a person uses safety behaviors to reduce anxiety and fear in a threatening situation, the anxiety and fear may subside.[4] The user will then believe that the safety behaviors caused the emotional decrease and continue to use safety behaviors in future situations.[1] However, the decrease in anxiety and fear may be due to other factors such as time.[1]
  • The decrease in anxiety and fear may also be due to the situation itself.[1] Situations that seem severely threatening, such as giving a presentation, are not actually very harmful.[1] By avoiding the situation through the use of safety behaviors, the user is unable to realize that the situation is harmless, allowing the cycle of anxiety and behavior to continue.[1]


Safety behaviors can be grouped into two major categories: preventive and restorative safety behaviors.[12]


These behaviors are also known as "emotional avoidance behaviors".[13][14] These behaviors are aimed to reduce fear or anxiety in future situations.[12] Examples include:

  • Completely avoiding situations in which the threat might occur[4]
  • Relying on safety signals such as inviting companions to social events for support[4]
  • Subtle avoidance behaviors such as avoiding physical contact[4]
  • Compulsive behaviors such as checking doors before leaving[4]
  • Preparations for potentially encountering these situations[4]


These behaviors are aimed to reduce fear or anxiety in a currently threatening situation.[12] Examples include:

Associated conditions[edit]


Main article: Agoraphobia

People may increase their risk for agoraphobia when they use safety behaviors to avoid potentially dangerous environments even though the danger may not be as severe as perceived.[15] A common safety behavior is when a person with agoraphobia attempts to entirely avoid a crowded place such as a mall or a public bus.[16] If the affected person does end up in a crowded area, then the person may tense his or her legs to prevent collapsing in the area.[15] The affected person may also attempt to escape these crowded situations.[15] People with agoraphobia then attribute the lack of feared symptoms to the safety behaviors instead of to the lack of danger itself.[15] This incorrect attribution may lead to persisting fears and symptoms.[15]

Generalized anxiety disorder[edit]

Main article: Generalized anxiety disorder

People with generalized anxiety disorder (GAD) view the world as a highly threatening environment.[17] These people continuously search for safety and use safety behaviors.[17] A common safety behavior used by GAD sufferers is seeking reassurance from a loved one to reduce the excessive worry.[17] The affected person may also attempt to avoid all possible risks of danger and protect others from that danger.[17] However, these behaviors are unlikely to significantly reduce anxiety because the affected person often has multiple fears that are not clearly defined.[17]


Main article: Insomnia

People with insomnia tend to excessively worry about getting enough sleep and the consequences of not getting enough sleep.[18] These people use safety behaviors in an attempt to reduce their excessive anxiety.[18] However, the use of safety behaviors serves to increase anxiety and reduce the chances that the affected person will disconfirm these anxiety-provoking thoughts.[18] A common safety behavior used by affected people is attempting to control the anxiety-provoking thoughts by distracting themselves with other thoughts.[18] The affected person may also cancel appointments and decide not to work because the person believes that he or she will not function properly.[18] The affected person may take naps to compensate for the lack of sleep.[18]

Obsessive-compulsive disorder[edit]

Main article: Obsessive-compulsive disorder

People with obsessive-compulsive disorder (OCD) use safety behaviors to reduce their anxiety when obsessions arise.[19] Common safety behaviors include washing hands more times than needed and avoiding potential contaminants by not shaking hands.[19] However, when people with OCD use safety behaviors to reduce the chance of contamination, their awareness of potential contamination increases.[19] This heightened awareness then leads to an increased fear of being contaminated.[19]

Checking rituals, such as checking several times to determine if all of the doors to a house are locked, are also common safety behaviors.[20] People with OCD often believe that if they do not perform their checking rituals, others will be in danger.[20] Consequentially, people with OCD often perceive themselves as more responsible for the wellbeing of others than people without the disorder.[20] Therefore, people with OCD use safety behaviors when they believe that other people will be in danger if these behaviors are not used.[20] Continuous checking reduces the certainty and vividness of memories related to checking.[6] Exposure and response prevention therapy is effective in treating OCD.[6]

Posttraumatic stress disorder[edit]

Main article: Posttraumatic stress disorder

People with posttraumatic stress disorder (PTSD) believe that their general safety has been compromised after a trauma has occurred.[21] These people use safety behaviors to restore their general sense of safety and to prevent the trauma from happening again.[21] A common safety behavior used by affected people is staying awake for long periods of time to make sure that potential intruders do not attempt to break into their homes.[21] The person may also attempt to avoid potential reminders of the trauma such as moving away from the place where the trauma occurred.[21] These behaviors may lead to persistent fears because the behaviors prevent the affected person from disconfirming the threatening beliefs.[21]


Main article: Schizophrenia

People with schizophrenia may have persecutory delusions.[22] These people use safety behaviors to prevent the potential threats that arise from their persecutory delusions.[23] Common safety behaviors include avoiding locations where perceived persecutors can be found and physically escaping from the perceived persecutors.[23] These behaviors may increase the amount of persecutory delusions the person experiences because the safety behaviors prevent the affected person from disconfirming the threatening beliefs.[23]

Social anxiety[edit]

Main article: Social anxiety disorder

Generally, people use social behaviors to either seek approval or avoid disapproval from others.[24] People without social anxiety tend to use behaviors that are designed to gain approval from others, while people with social anxiety prefer to use behaviors that help to avoid disapproval from others.[24][25][26]

Safety behaviors seem to reduce the chances of obtaining criticism by drawing less attention to the affected person.[11] Common safety behaviors include avoiding eye contact with other people, focusing on saying the proper words, and other self-controlling behaviors.[11]

Exposure therapy alone is mildly effective in treating social anxiety.[5] There are larger decreases in anxiety and fear when people are also told to stop themselves from using safety behaviors during therapy than when people are encouraged to use safety behaviors.[5] These decreases are largest when people are told to stop using safety behaviors and disconfirm the thoughts that the threatening situation will most likely not happen even if the safety behaviors are stopped.[11] This combination of techniques is used in exposure and response prevention therapy for social anxiety.[5]

Assessment measures[edit]

Several assessments have been developed to measure the amount of safety behaviors used by people with specific psychological conditions. Two examples of assessments developed to measure safety behaviors performed by people with social anxiety are the Social Behavior Questionnaire and the Subtle Avoidance Frequency Examination.[2][27] An assessment developed to measure safety behaviors performed by people with panic disorder is the Texas Safety Maneuver Scale.[28]

Social Behavior Questionnaire[edit]

The Social Behavior Questionnaire (SBQ) is an assessment of safety behaviors in social anxiety that was developed in [27] The frequency at which a behavior is performed is rated from “never” to “always.”[27] Examples of safety behaviors recorded in this assessment include “avoiding asking questions” and “controlling shaking.”[27] The SBQ has been shown to distinguish between people with strong from people with weak fears of being negatively evaluated by others.[29]

Subtle Avoidance Frequency Examination[edit]

The Subtle Avoidance Frequency Examination (SAFE) is an assessment of safety behaviors in social anxiety that was developed in [2] The frequency at which a behavior is performed and the total number of safety behaviors utilized is rated from “never” to “always.”[2] Examples of safety behaviors recorded in this assessment include “speaking softly” and “avoiding eye contact.”[2] This measure has been shown to distinguish between people with clinical levels of social anxiety and those without.[2][30] This assessment has also been shown to support other measures of social anxiety such as the Social Phobia Scale.[2][31]

Texas Safety Maneuver Scale[edit]

The Texas Safety Maneuver Scale (TSMS) is an assessment of safety behaviors in panic disorder that was developed in [28] The frequency at which each behavior is performed is measured on a five-point scale from “never” to “always.”[28] Examples of safety behaviors recorded in this assessment include “checking pulse” and “avoiding stressful encounters.”[28] This assessment has also been shown to correlate with agoraphobia measures such as the Fear Questionnaire.[28]

Objections to treatment[edit]

Some researchers have claimed that safety behaviors can be helpful in therapy but only when the behaviors are used during the early stages of treatment.[7] For example, exposure therapy will appear less threatening if patients are able to use safety behaviors during the treatment.[7] Patients will also feel more in control in the threatening situations if they are able to use their safety behaviors to reduce anxiety.[7] The studies testing this claim have shown mixed results.[4]

See also[edit]


  1. ^ abcdefghSalkovskis, P. M. (). The importance of behaviour in the maintenance of anxiety and panic: A cognitive account. Behavioural Psychotherapy, 19(1), 6– doi/S
  2. ^ abcdefgCuming, S., Rapee, R. M., Kemp, N., Abbott, M. J., Peters, L., & Gaston, J. E. (). A self-report measure of subtle avoidance and safety behaviors relevant to social anxiety: Development and psychometric properties. Journal of Anxiety Disorders, 23(7), – doi/j.janxdis
  3. ^ abcRachman, S. (). Agoraphobia—A safety-signal perspective. Behaviour Research and Therapy, 22(1), 59– doi/(84)
  4. ^ abcdefghijklmnopqrHelbig-Lang, S., & Petermann, F. (). Tolerate or eliminate? A systematic review on the effects of safety behavior across anxiety disorders. Clinical Psychology: Science and Practice, 17(3), – doi/jx
  5. ^ abcdefghWells, A., Clark, D.M., Salkovskis, P., Ludgate, J., Hackmann, A., & Gelder, M. (). Social phobia: The role of in-situation safety behaviors in maintaining anxiety and negative beliefs. Behavior Therapy, 26(1), – doi/S(05)
  6. ^ abcvan den Hout, M., & Kindt, M. (). Obsessive–compulsive disorder and the paradoxical effects of perseverative behaviour on experienced uncertainty. Journal of Behavior Therapy and Experimental Psychiatry, 35(2), – doi/j.jbtep
  7. ^ abcdRachman, S., Radomsky, A. S., & Shafran, R. (). Safety behaviour: A reconsideration. Behaviour Research and Therapy, 46, – doi/j.brat
  8. ^Salkovskis, P. M. (). Understanding and treating obsessive—compulsive disorder. Behaviour Research and Therapy, 37, SS doi/S(99)
  9. ^Ehlers, A., & Clark, D. M. (). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), – doi/S(99)
  10. ^ abEhlers, A., & Breuer, P. (). Increased cardiac awareness in panic disorder. Journal of Abnormal Psychology, (3), – doi/X
  11. ^ abcdefKim, E. J. (). The effect of the decreased safety behaviors on anxiety and negative thoughts in social phobics. Journal of Anxiety Disorders, 19(1), 69– doi/j.janxdis
  12. ^ abcRachman, S., & Hodgson, R. (). Obsessions and compulsions. Englewood Cliffs, NJ: Prentice Hall.
  13. ^Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (). Experiential avoidance and behavioural disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, – doi/X
  14. ^Salters-Pedneault, K., Tull, M. T., & Roemer, E. (). The role of avoidance of emotional material in the anxiety disorders. Applied and Preventive Psychology, 11, 95– doi/j.appsy
  15. ^ abcdeSalkovskis, P.M., Clark, D.M., Hackman, A., Wells, A., & Gelder, M.G. (). An experimental investigation of the role of safety-seeking behaviours in the maintenance of panic disorder with agoraphobia. Behaviour Research and Therapy, 37, – doi/S(98)
  16. ^Mayo Clinic Staff. Agoraphobia. Mayo Clinic. Retrieved from
  17. ^ abcdeWoody, S., & Rachman, S. (). Generalized anxiety disorder (GAD) as an unsuccessful search for safety. Clinical Psychology Review, 14, – doi/(94)X
  18. ^ abcdefHarvey, A. G. (). A cognitive model of insomnia. Behaviour Research and Therapy, 40(8), – doi/S(01)
  19. ^ abcdDeacon, B., & Maack, D. J. (). The effects of safety behaviors on the fear of contamination: An experimental investigation. Behaviour Research and Therapy, 46(4), – doi/j.brat
  20. ^ abcdSalkovskis, P.M., Wroe, A.L., Gledhill, A., Morrison, N., Forrester, E., Richards, C., Reynolds, M., & Thorpe, S. (). Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behaviour Research and Therapy, 38, – doi/S(99)
  21. ^ abcdeDunmore, E., Clark, D. M., & Ehlers, A. (). Cognitive factors involved in the onset and maintenance of posttraumatic stress disorder (PTSD) after physical or sexual assault. Behaviour Research and Therapy, 37(9), – doi/S(98)
  22. ^American Psychiatric Association. (). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.
  23. ^ abcFreeman, D., Garety, P. A., Kuipers, E., Fowler, D., Bebbington, P. E., & Dunn, G. (). Acting on persecutory delusions: The importance of safety seeking. Behaviour Research and Therapy, 45(1), 89– doi/j.brat
  24. ^ abSchlenker, B.R., & Leary, M.R. (). Social anxiety and self-presentation: A conceptualization and model. Psychological Bulletin, 92, – doi/
  25. ^Arkin, R. M. (). Self-presentation styles. In J. T. Tedeschi (Eds.), Impression management theory and social psychological research (pp. –). New York: Academic Press.
  26. ^Arkin, R. M., Lake, E. A., & Baumgarder, A. H. (). Shyness and self-presentation. In W. H. Jones, J. M. Cheek, & S. R. Briggs (Eds.), Shyness: Perspectives on research and treatment (pp. –). New York: Plenum Press.
  27. ^ abcdClark, D. M., Wells, A., Hackmann, A., Butler, G., & Fennell, M. J. U. (). Social behaviour questionnaire. Unpublished. Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford.
  28. ^ abcdeKamphuis, J. H., & Telch, M. J. (). Assessment of strategies to manage or avoid perceived threats among panic disorder patients: The Texas Safety Maneuver Scale (TSMS). Clinical Psychology & Psychotherapy, 5(3), –
  29. ^Spurr, J. M., & Stopa, L. (). The observer perspective: Effects on social anxiety and performance. Behaviour Research and Therapy, 41(9), – doi/S(02)
  30. ^Moscovitch, D. A., Rowa, K., Paulitzki, J. R., Ierullo, M. D., Chiang, B., Antony, M. M., & McCabe, R. E. (). Self-portrayal concerns and their relation to safety behaviors and negative affect in social anxiety disorder. Behaviour Research and Therapy, 51(8), – doi/j.brat
  31. ^Rapee, R. M., Gaston, J. E., & Abbott, M. J. (). Testing the efficacy of theoretically derived improvements in the treatment of social phobia. Journal of Consulting and Clinical Psychology, 77(2), doi/a

Examples safe behavior

Dropping ‘Safety Behaviours’

Examples of safety behaviour

  • Sitting or lying down / Leaning against a wall
  • Going out ‘for air’ / Getting a glass of water
  • Leaving a situation
  • Asking for someone&#;s help / Phoning someone
  • Sitting near an exit
  • Avoiding crowds
  • Carrying your mobile phone &#; or a ‘good luck charm’
  • Only visiting friends with whom you feel ‘safe’
  • Only going to places you feel ‘safe’
  • Never going out alone (bringing a ‘safety person’)
  • Opening a window (indoors or in car)
  • Making sure we eat a certain food or supplement
  • Making sure we get the ‘exact’ amount of sleep
  • Wearing loose clothing / avoiding warm rooms
  • Avoiding physical exertion (for fear of increased heart rate)
  • Distraction &#; turning up the TV, radio, humming loudly, engaging in some activity to try to block out the panic
  • Practising relaxation or deep breathing in a frantic attempt to ‘get rid of’ the panic

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Workplace Safety Training Video - Behavioral Safety Safetycare Behavioural DVD - free preview

Safety-Seeking Behaviors / Safety Behaviors

What Are Safety Behaviors?

Blakey et al. () review safety behaviors from an inhibitory learning standpoint and argue that safety behaviors interfere with safety learning in three ways:

  • they could prevent the violation of expectancies by attenuating the discrepancy between what the patient predicts will occur during an exposure task (i.e., catastrophe) and what actually occurs (i.e., no catastrophe);
  • safety behaviors might obstruct the generalization of safety-based associations by restricting safety learning to specific contexts;
  • they could impede the development of distress tolerance by obstructing patients from learning that they can persist in challenging tasks despite elevate levels of distress.

Although safety behaviors are labeled ‘behaviors’ they can also be internal processes or cognitive strategies, such as using distraction during an episode of panic, or rehearsing what you are going to say in social phobia. Helbig-Lang and Petermann () give a two-dimensional account of the function and strategy of safety behaviors:

StrategyBehavioralSituational avoidance

Relying on safety signals

Subtle avoidance

Compulsive behavior carried out to prevent an increase in anxiety


Use of safety signals

Compulsive behavior carried out to decrease anxiety

Reassurance seeking



Thought suppression

Disorders That May Be Maintained by Safety-Seeking Behaviors

Harvey et al. () propose that safety-seeking behavior is present in:

  • panic disorder with or without agoraphobia
  • specific phobia
  • social phobia
  • post-traumatic stress disorder (PTSD)
  • obsessive compulsive disorder (OCD)
  • body dysmorphic disorder
  • eating disorders
  • insomnia
  • psychosis

Helpful Questions for Assessing Safety-Seeking Behaviors

Some helpful questions for assessing safety-seeking behaviors include:

  • How do you respond when you feel threatened?
  • In situations where you feel anxious but can’t or don’t escape, what do you do to cope?
  • What are the short-term effects of coping in that way?
  • What would happen if you stopped using that safety behavior?

Treatment Approaches That Target Safety-Seeking Behaviors

The traditional approach to the treatment of anxiety is to expose the patient to the feared situation or stimulus with encouragement to drop the use of safety-seeking behaviors. Recent research has questioned whether the judicious use of safety behaviors might make exposure tasks more acceptable to patients, and might facilitate approach behaviors. Current evidence is mixed, with the authors of a trial concluding:

“… therapists may not need to be concerned if their patient is unwilling to immediately eliminate their safety behavior(s) as long as the patient explicitly tests their fear-based negative expectancies through direct and sustained confrontation with feared situations/​stimuli and also understands they should eliminate their use of safety behaviors as soon as they are willing” (Blakey et al., ).


  • Blakey, S. M., Abramowitz, J. S., Buchholz, J. L., Jessup, S. C., Jacoby, R. J., Reuman, L., & Pentel, K. Z. (). A randomized controlled trial of the judicious use of safety behaviors during exposure therapy. Behaviour Research and Therapy, , 28–
  • Clark, D. M. (). Anxiety disorders: Why they persist and how to treat them. Behaviour Research and Therapy37(1), S5.
  • Harvey, A. G., Watkins, E., Mansell, W., & Shafran, R. (). Cognitive behavioural processes across psychological disorders: A transdiagnostic approach to research and treatment. New York: Oxford University Press.
  • Helbig-Lang, S., & Petermann, F. (). Tolerate or eliminate? A systematic review on the effects of safety behavior across anxiety disorders. Clinical Psychology: Science and Practice, 17(3), –
  • Salkovskis, P. M. (). The importance of behaviourin the maintenance of anxiety and panic: A cognitive account. Behavioural and Cognitive Psychotherapy, 19(1), 6–

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When faced with a dangerous animal, what do we do?  We get away as fast as we can, fight the animal if we cannot get away, or become still and hope the animal will not notice us.

While this may have been a common occurrence in prehistoric times when humans lived in jungles with predatory animals, today we live in a human ‘jungle’ with human beings who have opinions and judgements. For an individual with social anxiety, the world seems like a jungle filled with mostly judgmental people who can attack with their negative judgement. People seem just as dangerous as the predatory animals and they find themselves responding as if they lived in a jungle.

Playing safe

It is not surprising that people who experience anxiety in social situations try their best to avoid, escape and not attract the judgmental gaze of others. These behaviors are termed as safety behaviors. Safety behaviors are adopted in response to thoughts stemming from beliefs that informs the socially anxious person that he/she is at risk. Adopting the safety behaviors however only seems to confirm that the social situations they are avoiding and escaping are indeed dangerous. In addition, their use also reinforces the belief that one would be at risk if it were not for the use of safety behaviors.

Using safety behaviors help people feel less anxious in the moment. In the long run, however, safety behaviors impose many limitations on individuals and operate as a trap that prevents them from living their life fully. Thus, socially anxious individuals often experience dissatisfaction with themselves and their lives. Safety behaviors offer short term relief, but in exchange they have long term discomfort. The behaviors that keep them ‘safe’ prevent them from learning that not everyone is judgmental, and even if some people are judgmental nothing devastating happens and it has no major implications. They never learn that they can stand up to unfair judgments and criticism and that constructive judgement/criticism can be beneficial, too.

Commonly used safety behaviors

Below are examples of safety behaviors in action:

  • Selecting a position in social situations that will allow the person to avoid excessive scrutiny (e.g. sitting in the back of the room).
  • Taking on roles in social situations so that one does not have to interact (staying busy behind the scenes, like helping in the kitchen or setting up equipment).
  • Avoiding eye contact to avoid interaction or being noticed by others.
  • Over-preparing for presentations or meetings to ensure there will be no opportunity for negative judgment.
  • Mentally rehearsing conversations before they happen, and scripting what to say next during a conversation.
  • Always having a trusted friend or family member by one’s side so responsibility for social engagement becomes limited and scrutiny is also less.
  • Frequently checking or going on electronics during social interactions as a means of limiting the interaction.
  • Consuming alcohol, recreational drugs, or other substances to curb anxiety.
  • Avoidance of social situations that increase anxiety by refusing invitations to most social events.
  • Wearing very neutral or excessive amounts of clothing when in public to avoid attention.
  • Talking fast during a meeting or other social situations to be able to leave situations quickly after saying what has to be said.
  • Asking the other person many questions when speaking with someone to keep the focus off oneself.
  • Wearing high necked clothing or styling hair in certain ways to cover blushing.
  • Behaving and appearing in as perfect a manner as possible.
  • Being pleasing and not doing anything to displease for fear of judgement and rejection.

Breaking free of safety behaviors with cognitive behavior therapy (CBT)

Safety behaviors operate like protective parents who whisk their child away from the playground for fear that their child will fall and get hurt. The child unwittingly learns that the playground is dangerous and it is best avoided, just as the socially anxious person learns that people are judgmental and best avoided.

The only way for the child to learn that the playground is not dangerous and that he/she can deal with the challenges and ultimately have fun would be to go to the playground and explore it in stages. Similarly, the socially anxious person will learn that not all people are so dangerously judgmental only if he/she were to face anxiety provoking social situations and forgo the safety behaviors.

This is where it would be helpful to seek the help and guidance of a cognitive-behavioral therapist (CBT). The therapist would work with the client to build a hierarchy of socially anxious situations that are ranked from the least to the most difficult (based on the distress related rating given to each situation). Therapists will then support individuals through the process of approaching these situations while dropping safety behaviors in stages.

The process results in experiential learning that the situations that had been identified as unsafe and requiring the use of safety behaviors to survive are not unsafe and they can be dealt with successfully. This learning prompts diminishing anxiety. The safety behaviors become easier to give up and they are no longer needed over time. It is like recognizing that a tiger they feared was actually a paper tiger all along!

In addition to exposure, CBT therapists will also work with the socially anxious client to help them develop skills to cope with the anxiety that is typically triggered before and during the exposure exercises. Cognitive restructuring work is also carried out to help modify the anxiety provoking thoughts and self-critical ruminations that commonly occurs.


Learning about social anxiety disorder and how it can be treated is the first step. Finding a good therapist that one feels comfortable with would be the next. Chipping away at the social anxiety may cause one discomfort initially but the rewards are well worth it. Keep in mind the long term reward of living a value-laden life that is unfettered and free as you move forward in your journey to break free from the silken bonds of safety behaviors.

How to Get Help for Social Anxiety

The National Social Anxiety Center is a national association of regional clinics with certified cognitive therapists specializing in social anxiety and anxiety-related problems. We have compassionate therapists who can help you to reduce social anxiety. Currently, we have regional clinics in San Francisco, District of Columbia, Los Angeles, Pittsburgh, New York City, Chicago, Newport Beach / Orange County, Houston / Sugar Land, St. Louis, Phoenix, South Florida, Silicon Valley / San Jose, Dallas, Des Moines, San Diego, Baltimore, Louisville, Philadelphia, Montgomery County, Maryland / Northern Virginia, Long Beach, Staten Island, North Jersey, Brooklyn, and Santa Barbara. Contact our national headquarters at () or visit our Regional Clinics contact page to find help in your local area.

Written by,
Suma Chand, Ph.D.
NSAC &#; St. Louis

This entry was posted in Anxiety, Blog, Cognitive Behavior Therapy, Evidence-Based Treatment, Social Anxiety, Uncategorized, Uncertainty and tagged anxiety, cognitive therapy, cognitive-behavioral therapy, exposure therapy, safety behavior, social anxiety, social anxiety counseling, social anxiety disorder, social anxiety St. Louis, social anxiety therapy, social phobia. Bookmark the permalink. Sours:

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