Agoraphobia Thought Replacement, The Alternative To A Lobotomy

When you've got agoraphobia and are thinking in all of the irrational ways I've described in recent posts, then you've got to take one of two options if you want to stop anxiety-producing thought patterns:

A) Get a Lobotomy

B) Practice Thought Replacement

Since option B is the most practical, I am going to discuss the practice of thought replacement in today's post. Thought replacement is referred to as "cognitive restructuring" by most psychologists and is the most basic form of cognitive therapy. Thought replacement is basically just trading your old irrational, anxiety-producing thoughts for more rational ones. The good news is that you can practice it at home by yourself without the supervision of a psychologist.

After having agoraphobia and studying psychology through to the graduate level, I've read quite a few books on cognitive therapy for anxiety disorders and agoraphobia. They all prescribe the same three steps so here is my version (the three R's):

1) Record
2) Replace
3) Rehearse

First, record your irrational thoughts. Being able to recognize your irrational thinking is the first step to changing it. This means tuning into your self-talk on a regular basis and journaling. Each time you notice yourself feeling more anxious than usual, ask yourself what thoughts are causing the anxiety and write them down as one or two line belief statements.

Example: "I have to be liked and accepted by everyone to be a worthwhile person. Since Joe does not seem to like me, there must be something wrong with me."

Do this for about a week and at the end of the week, prioritize between five to ten thought statements to work on. Pick the thoughts that either arise the most frequently or cause you the most anxiety. If you can, decide why they qualify as irrational and categorize them according to the ten categories (check other posts from this month to see defintions and examples of each):

1) catastrophic thinking
2) black-or-white thinking
3) magnifying the negative
4) overgeneralizing
5) emotional reasoning
6) personalizing
7) negative mind reading
8) rigid expectations
9) fatalistic thinking
10) accepting an unreliable authority

The above example falls into the categories of rigid expectations and personalizing. (Some irrational thoughts may fall into more than one category, the idea is just to become aware of how your thoughts are irrational).

Second, replace each irrational thought statements with more rational ones.

Example: "I have to be liked and accepted by everyone to be a worthwhile person" can be replaced by "It's ok if everyone does not like and accept me. Even the best people have a few people that don't like them."

List all of your replacement thought statements and keep a copy with you at all times so you can rehearse them.

Third, rehearse each replacement thought on a regular basis. Pull out your list of replacement thoughts at leat ten times per day and review each one. You can also use these statements as affirmations when you are doing breathing or muscle relaxation exercises. Once you have learned to identify irrational thoughts for what they are and create replacement thoughts that are more rational, confront your irrational thinking in the moment it occurs. Each time you catch yourself thinking an irrational thought that you have rehearsed, immediately say the replacement thought to yourself several times.

Thought replacement does not happen overnight, but if you practice this over a few months your thought patterns will be retrained and will not produce so much anxiety. Remember, cognitive therapy on its own is not nearly as effective as it can be when combined with behavioral therapy (like cue-controlled relaxation, systematic desensitization, and flooding).

If you have agoraphobia, I wish you all the best in your recovery.