The avoidance of reality is merely an avoidance of present time.
An individual who will not look at the physical universe must look either ahead of it into the future, or behind it into the past. One of the reasons he does this is because there is insufficient action in the present to begin with; and then this thirst for action develops into an inability to have action, and he decides that all must be maintained in a constant state, and he seeks to prevent action. This also applies to pain. People who are somewhat out of present time have a terrible dread of pain; and people who are truly out of present timeas in a psychotic statehave a revulsion towards pain which could not be described. A person entirely within present time is not much concerned with pain.