According to Daniel Goleman, in Vital Lies, Simple Truths, (1995, Simon & Schuster), when we avoid thinking about or doing that which makes us anxious, our brains reinforce us  with really pleasant chemicals. Thus we have epidemics of procrastination and avoidance.

    With this in mind, I've developed several strategies for my avoidant and procrastinating clients. I tell them to:

  1. Make a list of your favorite avoidance behaviors (computer games, cookies, tv, shopping, addictions, etc.)
  2. Whenever you start thinking of doing the behavior, or actually doing it, ask yourself, "What am I avoiding?"

  3. Think about the avoided thing. Then notice what you're feeling. (Anxiety, frustration, daunted, shame, anger, etc.) Stay with the feeling.

  4. Then, just do it! If you can do it right away, great. If not, make a definite plan for a definite time. Feel the anxiety. And do the deed.

  5. Apply positive reinforcement when it's done. You can use the harmless things on the avoidance list as reinforcers, after the task is complete.

I often use Jim Knipe's subversive Level of Urge to Avoid with the hard-core cases. He has clients think of how good it would feel to do the avoidance behavior, instead of the thing avoided. Then he has them do EMDR bilateral stimulation while they think about avoiding the task. The clients usually start feeling worse and worse. He subverts the "inappropriate positive affect" until they begin to think about doing the task. Then he point the EMDR Standard Protocol at the anxiety tied to doing the task. Then he has people imaginally rehearse doing the task with more EMDR. It works wonderfully. (In "Targeting Positive Affect to Clear the Pain of Unrequited Love, Codependence, Avoidance, and Procrastination". EMDR Solutions: Pathways to Healing. 2005, Norton)

In my mind, avoidance is all about affect tolerance. My most anxious clients have the most affect to avoid, and are the most avoidant. If their anxiety is a 9 on a scale of 10, they have more endorphin payoff for not working on their taxes/confronting their s.o.s/starting project X. If I can get them to feel their distress, and work it through, then they get the deeds done. The more they get done, the less good they feel about avoiding.