How Do you Help Someone with Agoraphobia Practice Systematic Desensitization?

Before helping someone with agoraphobia practice systematic desensitization, there are a couple things to learn.

First, get familiar with the anxiety scale. Ask the sufferer to rank their anxiety level at periodic intervals during practice and under no circumstances encourage them to persist in confronting a feared situation if their anxiety level gets beyond a three. While discomfort is necessary for desensitizing themselves to a feared setting, feeling anxiety beyond a level of three is likely to reinforce the very associations between the feared setting and anxiety feelings that the sufferer is trying to break. Staying below level three during practice will help the sufferer form new associations between the setting and lower anxiety levels.

Second, learn the following steps, referred to as five R’s, as a framework for guiding the sufferer through the systematic desensitization process. These steps are recommended by Dr. A. B. Hardy in Karen Williams’ book, How to Help Your Loved One Recover From Agoraphobia:

React: Confront fearful situations until the anxiety reaction is slightly uncomfortable, a #3 (or below) on the anxiety scale.

Retreat: Back away from the fearful situation. Walk toward the door, take a few steps away, or turn around and face the other way.

Relax: Distract mind and let self relax and calm down.

Recover: Completely recover from the anxious reaction.

Repeat: Approach the fearful situation again, repeating the five R’s process.

Here are some suggestions for preparing the agoraphobia sufferer for practice, adapted from Karen Williams’ book:

· Find out what the agoraphobia sufferer would like you to do if they get highly anxious or panic. Different people have different preferences. Some people will like for you to talk them through it or touch them. Others will like you to be silent and stand back while they work through it on their own.

· Remind the agoraphobia sufferer that risk-taking and discomfort are a necessary part of the recovery process and that you will be with them no matter what they experience.

· If the agoraphobia sufferer starts to back out of practicing and give excuses, confront the excuses with encouragement to go ahead and practice. If the sufferer absolutely refuses to follow through with practicing, don’t force them, but lead them to set another time and place for practicing in the near future.

· If practicing is going to take place in a social setting among others, agree upon a signal for leaving that the agoraphobia sufferer can use to communicate with you if they get too anxious and need to leave. This will prevent the agoraphobia sufferer from getting trapped in a situation in which their anxiety gets beyond a three and from embarrassing themselves or having to explain anything in front of other people.

· Don’t set any preconceived expectations for what the agoraphobia sufferer will accomplish during any one practice session. Allow for bad days and for progress to go up and down. Let the sufferer set their own goals for each practice session and never say anything to make them feel like they are letting you down if they don’t meet their goal for that day.

· Make some encouraging comments to give the person with agoraphobia your vote of confidence before beginning. Tell them you believe in them.

· Also let the person with agoraphobia know you will be there for them no matter what happens and that they are in control. Tell them they will be in control of the situation at all times and that you are simply there to help. State that when they want to leave, you will.