More and more, I am hearing about the idea of distraction in some form as the answer to overwhelming thoughts and feelings such as anxiety. For me, distraction has never really worked, so I also never push it with clients. Learning Exposure & Response Prevention first brought the concept of avoidance as not only being undesirable but actually part of the problem itself when it comes to many mental health issues. TEAM-CBT (@DavidDBurnsMD) embraces the idea that negative thoughts won’t be helped by distraction since the way to enlightenment is through crushing negative thoughts and seeing the truth rather than the “con” of anxiety and depression, as Burns so eloquently puts it.

In ACT (Acceptance and Commitment Therapy), this battle is seen as another layer of the problem, and that is why some don’t do well with countering negative thoughts. In ACT, distraction is a means of avoidance, and they call this Creative Hopelessness. It simply means that to really get better, your agenda cannot be to avoid. This is similar to Burns’ concept of the Acceptance Paradox.
This all begs the question in my mind: is distraction always avoidance? I would have probably said yes until today when I was attempting to “Anchor” by stretching and really feeling the physical pain since both emotional and physical pain come from the same part of the brain. Sometimes, I will imagine a non-specific client asking a question, and in this case, it was, “But isn’t that distraction by forcing yourself to feel the physical pain and not the emotional?”. And I stumped myself because how is that any different than someone who self-harms?
So, if you are distracting yourself from anxiety because you have, say, a major presentation to give, it might be worth distracting yourself. But if you are just home on a Tuesday night thinking of every presentation you’ve done and how it could have been better, distraction is not the answer. So what is the answer? That does depend on each person, but there is a technique for everyone. It’s just a matter of what works for each individual. For myself, I find the IFS (Internal Family Systems) “Unburdening” technique is a game-changer and I would recommend it to anyone who feels unfairly treated or unheard by people close to you.

For more info on this, ACT has many studies that compare outcomes with CBT, and in those studies, ACT shines in areas where the goal is not necessarily aimed to directly reduce symptoms but rather to improve psychological flexibility and values-based living. So next time you see an article that says to count to five or picture a red stop sign, remember that most times, distraction is avoidance.

You can also view this article on CEO and CBT Therapist Daniel Linehan’s official X account here.