What Are Safety Behaviors?

Salkovskis (1997) argues that anxiety poses a paradox: “Why do people suffering from anxiety fail to benefit from the repeated experience of surviving anxiety-provoking situations unharmed?”. Put another way, why does someone “continue to fear a catastrophe that repeatedly fails to materialise?” (Seligman, 1988). 

Safety-seeking behaviors (‘safety behaviors’) are actions that people take in response to a real – or perceived – threat. When a threat is real, safety-seeking behaviors are helpful (adaptive). Stepping out of the way of a speeding car, leaving a burning building, or attending hospital when faced with a medical emergency are all actions which can save your life. However, if a misinterpretation leads an individual to perceive a threat in the absence of real danger, safety-seeking behaviors can prevent the anxious individual from learning about the (true) absence of danger: 

“Inappropriate seeking of safety can prevent the anxious person from discovering that their fears are groundless. After an episode that should have established that the feared consequence did not happen, persons engaged in active safety behaviors may believe they had a lucky escape because they did things that prevented the feared catastrophe from occurring.” (Salkovskis, 1997). 

Safety-seeking behaviors are prevalent in many clinical problems. The chosen safety strategy is closely linked to the individual’s concern, and acts to maintain the threat-related belief:

• Someone suffering from panic might carry a bottle of water when traveling by train to prevent the feared catastrophe of choking. The non-occurrence of choking might be attributed to the use of water. (e.g.,“My throat didn’t close up because I kept taking sips of water.”)
• Someone struggling with social anxiety might stay silent to avoid the feared catastrophe of ridicule. The non-occurrence of humiliation might be attributed to their use of silence. (e.g., “Nobody laughed at me because I kept myself to myself.”)
• Someone suffering from PTSD might prevent the feared catastrophe of inviting another personal attack by avoiding eye contact with men. Non-occurrence of attack might be attributed to their safety strategy. (e.g., “I wasn’t attacked because I was careful.”)
• Someone suffering from OCD might prevent the feared catastrophe of infecting their family with HIV by being careful to avoid anything that looks like dried blood. The non-occurrence of the feared infection might be attributed to this caution. (e.g., “My family are safe because I was careful”.)

Understanding safety-seeking behaviors has important treatment implications. Rather than relying on exposure (which can be made less effective by the use of safety behaviors) to provide disconfirmation of a threat, behavioral experiments can be designed to provide experiences which directly disconfirm threat beliefs. For example, someone who panics that they would choke on the train can be encouraged to take a train journey without their bottle of water, in order to find out whether their throat will close up. A person fearing ridicule in a lecture can be encouraged to ask a question, to test whether it will happen. Similarly, a person with PTSD can be encouraged to make eye contact when speaking to a stranger, to test whether it provokes an attack.

• Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic: a cognitive account. Behaviour Research and Therapy, 19(1), 6-19.
• Salkovskis, P. M. (Ed.). (1997). Frontiers of cognitive therapy. Guilford Press.
• Seligman, M. E. P. (1988). Competing theories of panic. In: S. Rachman & J. D. Maser (Eds.), Panic: Psychological perspectives (pp. 321–329). Lawrence Erlbaum Associates, Inc.