Agoraphobia

New Website for Agoraphobia Help

2008-07-09T23:17:00.000-07:00

Need help with agoraphobia? If you haven't already, I would like to invite you to visit my new website for help with agoraphobia.

This new website features:

Free "Keys to Freedom" 7-Part Video Series in which I talk about the most powerful self-help techniques for recovering from agoraphobia.

Check out the new website and sign up for the free videos today! I care about your recovery from agoraphobia.

Beat Agoraphobia with Your Eyes Closed

2008-07-02T00:23:00.000-07:00

Have you noticed that people who have agoraphobia often have
powerful imaginations?

That's probably because it takes an extraordinary imagination to
create mental pictures that are vivid and fearful enough to
trigger panic attacks. Those of us who have panic attacks can
become quite good at scaring ourselves with what we see in our
minds.

When I had agoraphobia, I could bring on a panic attack just by
picturing myself in a classroom. I would imagine the doors and
windows of the classroom locking, and the air leaving the room.
Just imagining this left me feeling trapped, panicked, and
gasping for breath.

There is a positive side to having an imagination powerful enough
to trigger panic - its power can be harnessed and used as a tool
for recovery.

Your imagination has a major effect on your emotions because
visual images are housed on the right side of the brain. Brain
researchers say the right brain doesn't distinguish between real
and imagined experiences. For better or for worse, what you see
in your mind's eye is recorded in your brain as if it actually
happened.

This means that by simply closing your eyes and picturing
yourself successfully overcoming your fears, you can program your
mind and body to do so in actual life.

By practicing positive visualization, you can put the power of
your imagination to work for you and literally beat agoraphobia
with your eyes closed - or at least make tremendous progress
toward recovery.

Agoraphobia Story: Finding a Purpose Greater than Fear

2007-05-28T21:27:00.000-07:00

Since I recovered from panic disorder and agoraphobia, people often ask me what the major turning point in my recovery was. There were many turning points, but if I had to choose just one, I would pick the night I made a deal with God in one of my darkest hours of fear. That’s because it changed the orientation of my life.

I wasn’t sure if you can really make a deal with God, but I didn’t care. In complete and utter desperation, I prayed to God that if I could be freed from suffering and have my normal life back, I would use whatever abilities God gave me in the service of other people. I told God that if I were made well, my purpose in life would be to help others in times of suffering. Though I didn’t know it then, this change in purpose made all the difference.

To that point my life had all been about me. My life had been about doing whatever I needed to do to achieve everything I wanted for myself. Though I hadn’t realized it, the purpose I had given myself actually created fear – fear of failure.

When my life was all about meeting my personal goals, fear of failure always loomed in the back of my mind. I lived with the anxiety that I may not reach my goals or get what I want out of life – and then what would my life have meant? Constantly striving, fulfillment and satisfaction always seemed to be far away in the future.

In making this promise to God that I would live to do good for others, I let go of the anxiety over reaching my personal goals and found a new sense of purpose in giving to others. This new sense of purpose offers meaning and satisfaction along the way. I have since found that when the purpose of my life is to do good for others, I have a purpose greater than fear, including the fear of failing.

The need for purpose is one of the most basic human needs. A strong sense of meaning can be powerful in overcoming a fearful situation. German psychiatrist, Viktor Frankl, wrote about this in his book, Man’s Search for Meaning.

Dr. Frankl had the unique experience of living through the horrors of the Nazi death camps of World War II. Approximately one in twenty-six of Frankl’s fellow prisoners survived. From observation and interview, Frankl discovered that the main difference between those who lived and those who died was a deep sense of meaning or purpose in life.

Simply put, the men who lived were the ones who had the strongest reasons to live. The disproportionate survival of men who practiced religious faith intrigued Frankl greatly. He watched spiritual men of inferior constitution outlive more robust prison-mates. As a result, Frankl emerged from the prison camps firmly convinced that a sense of meaning or purpose in life is as vital to our existence as food, water or clothing.

I first read about Frankl’s experience when I had agoraphobia. When I read about his experience I related to the men in the Nazi death camps because I felt like I was in prison also, only my prison was a psychological one instead of a physical one.
Agoraphobia had turned my own home into a prison. The difference between my prison and a Nazi death camp was that I had a lot more control over my release. My prison was of my own making.

I decided that if a strong sense of meaning and purpose in life could sustain a man through the horrors of a Nazi death camp, then certainly a sense of meaning and purpose in life could carry me through to the other side of panic disorder and agoraphobia. I just needed a purpose in life that was greater than my fear, especially my fear of failure.

Personal Story: There is No Fear in Love

2007-02-10T12:14:00.002-08:00

Before I suffered from an agoraphobia many of my relationships were based on fear. I feared the disapproval and rejection of the people that mattered most. I was afraid of not meeting my parents’ expectations for me in the classroom. I was afraid of not meeting my own expectations in sports. I was afraid of not meeting the expectations of my peers and getting rejected at school. Worst of all, growing up in a religious family, I feared the disapproval and rejection of God.

When I was suffering from agoraphobia, hiding in my house every day, and afraid to go outside and suffering from relentless panic attacks, one night I turned to the Bible for help. It fell open to these words.

God is love. Whoever lives in love lives in God, and God in him.. There is no fear in love. But perfect love drives out fear, because fear has to do with punishment. - 1 John 4:16,18

These words helped change my life.

Like many agoraphobia sufferers, I was prone to feeling an excessive need to please others and an equally strong need to win their approval by living up to their expectations (or what I thought they expected of me). I feared losing relationships if I failed to meet certain expectations. Fear of losing relationships caused me a lot of anxiety.

To overcome the anxiety that comes with needing to please people and fearing rejection, I traded my fear-based relationships for relationships based on unconditional love.

When I first read the words of the Bible passage above, I took them at face value. Plainly and simply, they told me that God loved me and that if I let God love me there wouldn’t be so much room for fear in my life. I didn’t need to fear God’s judgment or worry about what God thought of me.

Please understand that this passage meant a lot to me because somewhere in my religious upbringing I had understood God as someone that could be angry with me and might punish me for something if I didn't do everything right.

God's unconditional love spilled over into my relationships with others. As I gained confidence that God loved me, I was able to love and accept myself. I became less needy for the approval of others. I still wanted to please others. I just wasn’t motivated by anxiety from a fear of being rejected. I was just motivated to share God's love.

I stopped feeling the anxiety of trying to get love from other people and started feeling the joy of giving love. With God's love in my life, there was plenty of love to go around.

Besides changing my orientation in relationships, I also made some changes in my closest, most significant relationships. I replaced fear-based relationships with relationships based on unconditional love. In some cases, as with my parents, I changed the nature of existing relationships. In other cases, I had to replace old relationships with new ones.

Feeling loved by God, loving myself, and loving other people was very freeing. I began to surround myself with people who really loved and accepted me for who I am, people for whom I didn’t have to constantly perform to earn their approval. My most significant relationships no longer produced anxiety.

Do you need to change your relationships?

If your relationships with others are based on fear of what might happen if you did not live up to their expectations for you, then it is time to make some changes.

You may need to have some serious talks with people in your life and tell them directly that you will no longer live according to their expectations for you. (Be nice when you do this). You may need to cut some people out of your life altogether. You may need to surround yourself with more loving and accepting people.

Ultimately, when I experienced unconditional love and build most of my relationships upon it, some funny things happened. I began living with the security of being loved no matter how I performed. I was free to trade the anxiety of trying to constantly win the love of others for the satisfaction of offering love to others.

When I focused on giving to others in relationships rather than trying to get it, I wasn't as needy, and my fears of disapproval and rejection faded away with my anxiety.

Here is a truth that has helped me live free from agoraphobia for nearly twenty years:
Where there is perfect, unconditional love, there is a lot less room for fear.

How to Offer Unconditional Love and Acceptance to Someone with Agoraphobia

2007-02-10T12:14:00.001-08:00

If you want to be an effective support person for someone with agoraphobia, your first job will be to establish a relationship of unconditional love and acceptance with the person who is suffering.

It can be tricky to offer a loving, accepting relationship with a friend or loved one with agoraphobia, even if you had a good relationship with them before.
However, It is important to build this type of relationship before you start trying to help someone with agoraphobia. A safe, supportive relationship of unconditional love and acceptance can be therapeutic, and is the vehicle through which real help can be offered.

Unconditional love and acceptance is much needed by those of us who suffer from agoraphobia because we are often self-critical and have a hard time accepting ourselves. Its even harder to accept yourself when you have agoraphobia and can't function normally. That is why it is so important to have people who accept us no matter what we do or go through. Experiencing the acceptance of others helps us to accept ourselves.Offering unconditional acceptance means being non-judgmental and non-critical.

It means not thinking of agoraphobia and the behaviors that go with it in terms of good and bad or right and wrong. It means not putting the person down or voicing disapproval when they do things you don't understand. It means letting the person know that you love them, care about them, and will not abandon them whether or not they recover from agoraphobia.

Offering unconditional acceptance means not only accepting the person with agoraphobia but accepting the condition of agoraphobia as well - at least for the time being. It means not trying to fix them all the time, refraining from constantly offering advice or suggestions, and not needing to always correct their irrational thinking. It means being able to relax and have fun with them - and talk to them about subjects other than what they need to be doing to get well. It means being willing to let the agoraphobic act agoraphobic - not that you don't want to help them get well - just that there is no pressure from you to hurry in doing so. Nobody wants to feel like a project or like they are letting someone down if they aren't getting better fast enough.

People with agoraphobia need people around them who accept them just as they are. Just like someone suffering from a physical illness or injury - it takes time to heal. If you are able to show your loved one with agoraphobia that you will love and care for them without conditions and will stand by them through the ups and downs - you will have taken a big, first step towards building a relationship with them that will contribute to their recovery from agoraphobia.

Note: Offering unconditional love and acceptance does not mean enabling someone. Part of your job as a support person is to help them find their own motivation to recover. To read more on this topic, click here.

Agoraphobia Recovery: What Does Love Have to Do With It?

2007-02-10T12:13:00.000-08:00

Actually, love has a lot to do with recovering from agoraphobia and there may be a biological basis for this. In a book entitled "A Complete Guide to Your Emotions and Your Health," Emirika Padus and the editors of Prevention Magazine suggest that when you feel loved, you experience a healthy biological reaction in your body's cells, similar to the effect of a good diet or exercise.

Dr. Bernard Siegel, who wrote "Love, Medicine, and Miracles," was quoted as saying "I am convinced that unconditional love is the most powerful known stimulant of the immune system. The truth is, love heals." Dr. Siegel is talking here about two kinds of unconditional love - both self-love and the love of another person. He believes that if you love yourself and are in a strong loving relationship, your chances of recovery are better and you can get through almost anything.

If you are a support person for someone with agoraphobia, your unconditional love may be the most powerful gift you can give someone who suffers from this dreadful psychological ailment. I am writing to encourage you by letting you know that your love and acceptance of a person with agoraphobia is vital.

As someone who recovered from agoraphobia, I know this firsthand. My parents, who were the support people who loved me through my disorder, were at times the only people I had contact with and my only link to the world outside the dark, isolated environment of the bedroom I hid in for the better part of two years.

Release-Only Muscle Relaxation

2006-11-13T07:11:00.000-08:00

Most people who have agoraphobia practice progressive muscle relaxation. That is the practice of tensing, holding, then releasing, each of your body's major muscle groups. The purpose of progressive muscle relaxation is not only to relax your muscles, but also to learn to feel the difference between what each muscle group feels like in the tense state versus the relaxed state. That may sound like an obvious difference, but tension can often be subtle, and many people with agoraphobia let tension creep into their body and become quite pronounced before they notice its presence.

Once you have learned to feel the difference between the tensed and relaxed state of your muscles, you are ready to move on to a shorter version of progressive muscle relaxation called "release-only relaxation."

In release-only relaxation, as the name suggests, you relax all of your muscles in progressive fashion but you skip the first step in traditional muscle relaxation. Instead of first tensing each muscle group before releasing, you relase each of the body's major muscle groups.

Relase-only relaxation allows you to practice progressive muscle relaxation in half the time.

In practicing release-only relaxation, the goal is to develop the mental concentration to be able to let all of the tension go from each muscle. Developing this ability will depend upon your ability to recongize the difference between the feel of a tense muscle and a deeply relaxed muscle.

How to practice release-only relaxation:

Sit or lie down in a comfortable position and in quiet place where you will not be disturbed. Loosen any tight clothing. You may close your eyes or leave them open if you wish.

Work through each of the following muscle groups each time you release-only muscle relaxation, concentrating on each muscle group and letting all of the tension go:

· Face
· Neck and shoulders
· Chest
· Back
· Stomach/abdomen
· Biceps
· Hands and forearms
· Buttocks
· Thighs and hamstrings
· Calves
· Feet

As you focus on each muscle group, practice deep, lower abdominal breathing. Breath in slowly through your nose, hold each breath for a few seconds, and then breathe out slowly through your mouth while picturing the tension leaving each muscle group with each exhalation. As you focus on each group of muscles, it may help to imagine them getting warm and heavy.

Although release-only relaxation may seem simpler than traditional progressive muscle relaxation, don't be fooled. It takes a lot more skill and concentration to release the tension from your muscles without tensing them first. You must also become acutely aware of what muscle tension feels like so that you do not let tension creep back into the muscles when you move on to focus on a new muscle group.

Here are some tips for successful practice of release-only relaxation:

1) Don't try to force your muscles to relax, just let go and let the muscles relax.

2) If you have any problems relaxaing a certain muscle group, just take a deep breath and try again. If you keep having trouble it's okay to skip it and move on, or come back to that muscle group later.

3) Don't be critical if you can't do this perfectly the first time. Most people take time to learn this skill.

4) Allow yourself at least two weeks with two practice sessions per day to master this skill. Keep practicing until you can relax your whole body in 5-7 minutes using release-only techniques.

5) Just as with traditional progressive muscle relaxation, you may want to record a script with soft relaxaing music in the background to guide you through your practice.

Learning to relax your entire body in a shorter and shorter amount of time is an important skill to learn in recovering from agoraphobia.

Hypnotherapy for Agoraphobia

2006-09-11T16:40:00.000-07:00

Some form of hypnosis has been used to help people overcome fears, problem behaviors, and illnesses throughout much of recorded history. Modern clinical hypnosis began in about 1773. Clinical hypnosis is the form of hypnosis used today to treat psychological and physical problems, including agoraphobia, in which the patient goes into an altered or relaxed state and is guided by a therapist’s suggestions.

Hypnosis is a method of harnessing the power of your subconscious mind to work for you in overcoming agoraphobia. How well hypnotherapy works for you will depend on how willing you are to be hypnotized and the degree to which your fear is rooted in your subconscious mind.

Hypnotherapists who treat agoraphobia believe that agoraphobic fear finds its roots in the subconscious. Proponents of hypnotherapy also believe the subconscious mind has tremendous power to influence the autonomic nervous system. They believe that if the subconscious mind perceives danger, it sets off the fight or flight response. In this context, panic disorder and, in some cases, agoraphobia occur when the subconscious mind gets confused about when to set off the fight or flight response and when not to.

The process of hypnosis resembles a very relaxed day-dreaming or a wakeful sleep. During hypnosis, your brain wave cycle rhythm lowers into a meditative state sometimes called the “alpha state.” During the alpha state, electrical impulses in your brain cycle at a rate of about ten cycles per second. In this state, you are fully aware of the messages and images in your subconscious mind.

When you are hypnotized, a therapist guides you through the reprogramming of your subconscious mind while in the alpha or meditative state. Negative subconscious thoughts and associations are replaced with positive ones.

It is important to undergo hypnosis in a safe and comfortable setting. Since people with agoraphobia naturally have trouble getting to and staying relaxed in a therapist’s office, many hypnotherapists make home visits for agoraphobics.

Agoraphobia Recovery Tip: Never Give Up!

2006-09-07T00:08:00.000-07:00

Setbacks can be one of the most discouraging things during your recovery from agoraphobia. They can make you feel like you have lost weeks, months, or years of hard-won progress and that you are back at square one. Fortunately, this is not the case. Don't give up when you experience a setback.

My recovery from panic disorder with agoraphobia didn't happen overnight. It was a hard fought battle with many setbacks. But it did happen, and today I am totally free from panic attacks and agoraphobia.

Your recovery may not happen overnight either, and your progress toward recovery may not all be forward. You may experience some tough setbacks along the way. I am writing you today to tell you not to make too much out of these setbacks.

I can remember working really hard with my desensitization program and getting to where I could go to four high school classes in a row before going home. It had taken me the better part of the past year to achieve this and I had started by going to only one class per day and slowly added classes over time.

Then one morning early in my junior year of high school, I had a major panic attack during first period and had to go home. I was devastated. I thought all of my hard work had gone down the drain and I would have to start my recovery over from scratch. I was so consumed by these thoughts that I didn't go to school at all for the next couple of days.Looking back, I am glad to be able to tell you that my thinking was totally wrong. This happened in September. By mid-November of that year I was playing on my school basketball team and attending almost a full day of school on a regular basis.

My encouragement to you is that all progress toward your recovery from agoraphobia may not be forward progress. There may be days when you experience so much panic or anxiety that it feels like you are right back where you started. But take heart, days like this do not mean you are starting your recovery over.

Each time you reach a new level in your recovery, you can get back to that level fairly quickly no matter what setbacks you face. It's best not to gauge the progress of your recovery from agoraphobia on a day to day basis. In most cases, recovery from panic disorder and agoraphobia is more like a marathon than a sprint. You can best measure progress toward your recovery over longer intervals of time.

Because of this, don't take setbacks too seriously no matter how bad they may feel. In fact, it might be better just to expect to have some setbacks along the way. In the end, if you persist in doing the things you need to be doing to recover, you will recover from agoraphobia and get your life back, no matter what happens on any given day.

Take it from someone who went through lots of setbacks but ended up overcoming a case of severe agoraphobia with panic attacks. Persistence wins in the end. I know this because I did it – and if I did it, so can you.

Always remember:

“Being defeated is a temporary condition. Giving up is what makes it permanent.” (Anonymous)

Never give up on your recovery!

Anxiety and Pregnancy

2006-09-04T19:07:00.000-07:00

If you have an anxiety disorder like agoraphobia while you are pregnant, does this mean that you are more likely to give birth to an unhealthy baby?

The answer is no - that is, according to a review of available data on this topic conducted by a team at the University Of Texas Medical Branch.

This is good news for pregnant women with agoraphobia or other anxiety disorders.

After reviewing 50 studies from a period of 39 years, the team concluded that there is no relationship between anxiety and pregnancy outcomes. In other words, if you have agoraphobia and are highly anxious during pregnancy, this does not increase your risk of birth complications such as having a low-birth-weight baby or longer labor.

These conclusions were presented recently at the annual meeting of the American Psychological Association in New Orleans."Pregnancy can be an emotional time for women and, for some, anxiety associated with the pregnancy can be compounded by pre-existing difficulties such as having an inadequate social support system," said Heather Littleton, the lead author of the team that conducted the literature review.

Even though anxiety didn't show any effect on birth outcomes overall, Littleton and her team members did acknowledge that more research is needed to be sure that their findings apply to people with the highest levels of anxiety, such as people who have been diagnosed with anxiety disorders.

In Littleton's own words, "This review of the literature clearly shows that additional research is necessary to completely understand how to best treat an anxious pregnant woman, and such work evaluating the mental and physical health of women during pregnancy could help to increase the number of healthy babies that are born."

Source: "No Direct Link Between Anxiety, Pregnancy Outcomes Women with symptoms have no increased risk for birth complications, researchers say" by Robert Preidt, Aug. 14 (HealthDay News)

E-Therapy for Agoraphobia?

2006-08-04T00:19:00.000-07:00

Can a software program treat agoraphobia as well as a live therapist?

Well, E-therapy for agoraphobia is now available. “Beating the Blues” is an interactive software program that provides cognitive-behavioral therapy for sufferers of anxiety and depression. “FearFighter” is another form of cognitive behavioral e-therapy for people with anxiety disorders and phobias.

To give you a quick review before describing the software, cognitive-behavioral therapy, or CBT, is the most effective treatment for agoraphobia according to research. It is a combination of cognitive and behavioral approaches to therapy.

Cognitive therapy focuses on identifying and correcting irrational thought patterns. In behavior therapy, a person with agoraphobia learns to face feared situations instead of avoiding them through one of two types of exposure therapy. The person can practice exposure to feared settings in small steps (as in systematic desensitization) or all at once (as in flooding).

Developed in the UK, Beating the Blues is designed to be a first-line treatment option for anxiety and depression, similar to live therapy. It is to be considered before medication. Right now it is not available for sale online, it is only available through health care professionals in the UK, US, Canada and Australia.

Beating the Blues uses interactive modules, animations and voice-overs to motivate and engage the user. A major feature is a series of filmed case studies of fictional patients who model the symptoms of anxiety and depression and help demonstrate the treatment by cognitive behavioral therapy.

During the 8-session program, users identify specific problems and realistic treatment goals. They work through cognitive modules which focus on the identification and challenge of automatic thoughts, thinking errors, distractions, core beliefs, and attributional styles.

Interwoven with these cognitive elements are problem-directed behavioral components where patients can work on any two of activity scheduling, problem solving, graded exposure, task breakdown, or sleep management according to their specific problems. The final module looks at action planning and relapse prevention.

FearFighter is available online, but only to users who are registered with health professionals in the UK. It offers cognitive-behavioral treatment for anxiety and panic disorders, phobias, obsessive-compulsive disorder, depression and post-traumatic stress disorder.

If you have agoraphobia, then e-therapy might be as effective (or more) than live therapy, or so a 2004 study suggested.

This study demonstrated the effectiveness of computerized cognitive-behavioral therapy (CBT) for treating anxiety and depression in a clinical setting.

For anxiety, computerized CBT was more effective than traditional CBT in more severe cases. The more severe the anxiety disorder, the more effective computerized CBT was in comparison with traditional CBT. Computerized CBT also led to greater satisfaction with treatment.

Pregnancy Risk Categories of Agoraphobia Meds

2006-08-01T20:08:00.000-07:00

In this post, I will share a rating scale used to assess the potential risks of medication during pregnancy and then let you know where various anti-anxiety medications used for agoraphobia fall on the scale.

The United Stated Food and Drug Administration (FDA) has assigned pregnancy risk categories to medications. The pregnancy risk category reflects the medication's potential to cause birth defects.

While it is not advisable to take medications during pregnancy, some people have to. The following rating system, designed by the FDA, is designed to help you decide which medications are a fairly safe risk and which are not.

Drugs in Category A are generally considered safe to use in pregnancy while drugs in category X should be avoided unless it is absolutely necessary to take them.

Category A: Adequate studies in pregnant women have failed to show a risk to the fetus.

Category B: Either one of two scenarios:

1) Animal studies haven't shown a risk to the fetus, but controlled studies haven't been conducted on pregnant women; or

2) Animal studies have shown an adverse effect on the fetus but adequate studies in pregnant women have failed to show a risk to the fetus.

Category C: Animal studies have shown an adverse effect on the fetus, but adequate studies haven't been conducted in humans. The benefits to pregnant women might be acceptable despite potential risks.

Category D: The drug may cause risk to the fetus, but the potential benefits of use in pregnant women may be acceptable despite the risks (such as in a life-threatening situation or a serious disease for which safer drugs can't be used or are ineffective).

Category X: Studies in animals or humans show fetal abnormalities, or adverse reaction reports indicate evidence of fetal risk. The risks clearly outweigh potential benefits.

Now, here's how various anxiety medications rate:

Xanax is in category D

Buspar is in category B (Buspar takes a few weeks to start taking effect in the body but is a much safer anti-anxiety medication than most).

Librium is in category D

Valium is in category D

Ativan is in category D

Serax is in category D

Now here are the ratings of some anti-depressants commonly prescribed for panic attacks:

Anafranil is in category C

Lexapro is in category C

Prozac is in category C

Paxil is in category C

Zoloft is in category C

I hope this information has been helpful. This info has been taken from the Nursing 2007 Drug Handbook. Always consult your doctor before taking any type of prescription medication.

The First Step to Offering Good Support for Someone with Agoraphobia – Learning About the Disorder

2006-07-28T00:08:00.000-07:00

Besides offering someone with agoraphobia your unconditional acceptance, a second vital key to offering good support is increasing your own knowledge and understanding.

In other words: Read all you can about agoraphobia and listen to the person who is suffering about their experience.

One of the problems people suffering from agoraphobia face when trying to find good support from others is that too many people overestimate their psychological knowledge. When I first decided to study psychology in college I had people say to me, "Isn't psychology all just common sense?" No one ever said that to my roommates who were studying bio-chemistry - yet psychological phenomena are just as complex.

If you had cancer or heart disease none of your friends or family members would presume to know what you should do for treatment. When you have an anxiety disorder like agoraphobia, everyone seems to think they know what you should do.

Psychology is not all common sense. Anxiety disorders like agoraphobia are just as complex as any medical problem. That is why it is important to read all you can to understand your friend or loved one with agoraphobia.

People with agoraphobia are likely to behave in ways that are hurtful or open to misinterpretation if you don't know what they are experiencing. For example, my family used to accuse me of not wanting to go to school, trying to mess up family vacations, or in general, thinking only myself and my own feelings. If you know someone with agoraphobia, chances are that you have probably thought of them as selfish or thoughtlesss at some point.

However, the more my family read up on agoraphobia - the more they realized that I wasnt trying to skip school or do anything intentionally to make the family miserable. They realized that I was suffering from a real disorder and wanted to recover, just as if I had been sick with cancer or a heart disease.

People with agoraphobia are famous for coming up with excuses to get out of things that scare them. They are also famous for becoming self-absorbed, in tune with their own emotions and out of tune with the feelings of others. The more you read up on agoraphobia, the more you will understand the reasons why and be able to support your friend or loved one with care and patience.

I can say from personal experience, your friend or loved one with agoraphobia probably doesn't want to be selfish or do anything to upset you, frustrate you, or hurt you. They are just sick and need you understanding and support to get better.

Remember, almost no one wakes up one day and decides they want to screw up their life. Most people with agoraphobia really do want to get better. They just need a little live and support from a few understanding people.

If you read up on agoraphobia - a little knowledge and understanding will go a long way in supporting your friend or loved one in their recovery from agoraphobia.

Why and How to Offer Unconditional Acceptance to Support Someone with Agoraphobia

2006-07-28T00:06:00.000-07:00

If you want to be a support person for someone with agoraphobia, your first job will be to establish a therapeutic relationship with the person who is suffering. It can be tricky to offer a safe, supportive relationship with a friend or loved one with agoraphobia, even if you had a good relationship with them before.

It is important to build a therapeutic relationship before you start trying to help someone with agoraphobia. Thats because a safe, supportive relationship is the vehicle through which real help can be offered.

Offering unconditional acceptance to someone who is suffering from agoraphobia is critical to building a healing relationship with them. Those of us who have had agoraphobia know that we are often self-critical and have a hard time accepting ourselves. Its even harder to accept yourself when you have agoraphobia and can't function normally. That is why it is so important to have people who accept us no matter what we do or go through. Experiencing the acceptance of others helps us to accept ourselves.

Offering unconditional acceptance means being non-judgmental and non-critical. It means not thinking of agoraphobia and the behaviors that go with it in terms of good and bad or right and wrong. It means not putting the person down or voicing disapproval when they do things you don't understand. It means letting the person know that you love them, care about them, and will not abandon them whether or not they recover from agoraphobia.

Offering unconditional acceptance means not only accepting the person with agoraphobia but accepting the condition of agoraphobia as well - at least for the time being. It means not trying to fix them all the time, refraining from constantly offering advice or suggestions, and not needing to always correct their irrational thinking. It means being able to relax and have fun with them - and talk to them about subjects other than what they need to be doing to get well. It means being willing to let the agoraphobic act agoraphobic - not that you don't want to help them get well - just that there is no pressure from you to hurry in doing so. Nobody wants to feel like a project or like they are letting someone down if they arent getting better fast enough.

People with agoraphobia need people around them who accept them just as they are. Just like someone suffering from a physical illness or injury - it takes time to heal. If you are able to show your loved one with agoraphobia that you care without conditions and will stand by them through the ups and downs - you will have taken a big, first step towards building a relationship with them that will contribute to their recovery from agoraphobia.

How to Be a Good Listener for Someone with Agoraphobia

2006-07-28T00:04:00.000-07:00

Being a good listener is another important quality in being a good support person for someone with agoraphobia. Being a good listener makes you someone the person with agoraphobia can share their feelings with. This is important because much of the anxiety someone with agoraphobia experiences could be coming from holding feelings in and not expressing them.

As someone who has suffered from agoraphobia I can tell you that one of the reasons people with agoraphobia (or anyone else for that matter) don't share their feelings with others is because most people are not good listeners and will just hurt your feelings even worse by not really listening or not validating them.

Probably the most crucial element to being a good listener for someone with agoraphobia or an anxiety disorder is being able to hear and validate someone's feelings or emotions by making reflective statements to let the person know that you heard and understood.

For example, if a friend with agoraphobia tellls you they are afraid they might have a panic attack and embarrass themselves if they go out on a date the best response would be:

"It sounds like you are really scared."

This lets the person with agoraphobia know that you heard their feelings. It lets the person know that you have heard their initial feeling and invites them to share more about it.

Some bad responses that do not show that you heard their feelings (and responses the average person would give) are:

"If you weren't so worried about having a panic attack you probably wouldn't have one."

"Maybe you won't have a panic attack and there's nothing to worry about."

These responses let people know that you think its silly for them to be worried about having a panic attack. They do not let the person know you have heard their feelings.

Hearing and making reflective statements about feelings is part of a skill called active listening. Active listening is a way of listening to someone that lets them know you care about them and are really hearing them. Since many people with agoraphobia say that what they need most in a support person is someone who will listen to them, here are some guidelines for active listening:

Be attentive. You have to make an effort to listen carefully. Don't daydream and don't talk.

Think about the main point the speaker is trying to make. Also, don't be thinking about what you are going to say the whole time the other person is talking.

Make reflective statments at first by paraphrasing or restating in your own words what the speaker is saying. Especially when they share a feeling (fear, anger, sadness, regret, guilt, etc.)Good phrases to use when making reflective statements are:"What I hear you saying is.....""It sounds like......""So in other words....."

Try to leave your own emotion out when you're listening. Try not to argue back in your mind. These things detract from what the speaker is saying. In other words, be objective and try not to let your own judgments and biases cloud what you are hearing from them. Try to really see things from the other person's perspective and wait to hear their whole message before forming a response.

Ask for clarification if you don't understand a point the speaker is making. Ask questions to invite them to elaborate on points that seem important.Avoid distractions. Sit close to the speaker, if possible.

Be aware of more than just the person's words. Look for body language, gestures, tone of voice, posture, etc. See if you think the persons non-verbal communication is congruent with what they are saying. (For example - some people smile when they are telling you they are upset). If the person's words and body language don't match, ask for clarification about what they are really feeling but be gentle about pointing out the descrepency.

When you do offer feedback, try to do so honestly but without passing judgment or expressing approval or disapproval of them as a person.As you can see, good active listening is more than just not saying anything and nodding. Good listening is a skill that may take some work to develop if you don't come by it naturally. However, developing good active listening skills will make you a good support person for your friend or loved one with agoraphobia.

Plus - being a good listener will help you in your other relationships, too, even with people who don't have agoraphobia.

How to Take Care of Yourself as a Support Person for Someone with Agoraphobia

2006-07-28T00:02:00.000-07:00

A person with agoraphobia may be prone to having a lot of needs or placing a lot of demands on the people they are close to. If you are going to be a good support person for someone with agoraphobia - then you may need to know where and when to draw the line. In other words, if you are going to support a friend or loved one with agoraphobia, you'll need to also be good at remembering to take care of yourself.Here are some things to do to take care of yourself:

1) Keep up with your friends. Don't let the person with agoraphobia isolate you to the point where they are the only person in your life.

2) Keep up with your job if you have one. Also keep your outside hobbies and interests. Although you may make lots of sacrifices to spend time with your friend or loved one with agoraphobia, its good to remain functional with your normal responsibilities and participate in recreation.

3) Get the sleep, nutrition and exercise you need to stay healthy. If you get too stressed then pamper yourself with a hot bath, a massage, or a good glass of wine. Don't feel like you have to be suffering all the time just because your friend or loved one with agoraphobia is suffering all the time. It doesn't help them if you let yourself get unhealthy.

4) Don't blame yourself or take responsibility for their condition or lack of progress if recovery is slow. Remember that it is their job to recover and your job to be there for support. If a bad day for them always means a bad day for you, you may be taking too much responsibility for their disorder.

5) Know your limitations and don't put unrealistic expectations on yourself to fix everything. Its ok to rest when you need to or ask for someone else's help in taking care of your friend or loved one with agoraphobia if you need a break.

6) Do something to express your own emotions and receive support for yourself. This could be in the form of a counselor, support group for people who support agoraphobics, or just a good friend you talk to often. Sometimes it can be almost as hard to watch someone you care about suffering as it is to suffer yourslf.

To use an analogy from lifeguarding - you are not going to be able to save someone from drowning if you start to drown yourself. This holds true if you are supporting someone with agoraphobia. To be a good support person, you've got to remember to take care of yourself.

How Do you Help Someone with Agoraphobia Practice Systematic Desensitization?

2006-07-27T23:58:00.000-07:00

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.

Agoraphobia Recovery Tip: Sharing Your Feelings with a Friend

2006-07-27T21:01:00.000-07:00

Many people with anxiety disorders like agoraphobia have a tendency to bottle up their emotions. Expressing your true feelings to a caring friend can bring short-term relief from anxiety.

Also, agoraphobia can leave you feeling lonely, and loneliness only increases anxiety. There is research to suggest that social support helps people reduce their anxiety levels. When you are feeling anxious, one of the best things you can do is to reach out and connect with a close friend or family member. Share what is bothering you. Share your anger, frustrations, worries and doubts.

Most of us assume that no one would want to listen to our feelings, but I am not suggesting that you talk someone's ear off with lots of whining or complaining. I am just suggesting that you let someone know what is really going on with you, then find out what is really going on with them.

Making an emotional connection with another human being is probably one of the most healthy responses to anxiety. It gives you an outlet for your emotions so they will not build up and cause more anxiety later. Plus, it helps you to focus outside of yourself and your circumstances as you listen to the other person.

Most of us turn to something when we feel anxious. Some people turn to destructive things like drugs, alcohol, or overeating. Next time you are feeling anxious, turn to a person. While this is not a long-term cure for agoraphobia, see if talking to someone and letting your feelings out doesn't relieve some anxiety in the meantime.

How to be a Good Listener for Someone with Agoraphobia

2006-07-25T14:21:00.000-07:00

(This post appeared in the 'Agoraphobia Newsletter' on July 18, 2006).

Being a good listener is an important quality in being a good support person for someone with agoraphobia. Being a good listener makes you someone a person with agoraphobia can share his or her feelings with. This is important because much of the anxiety someone with agoraphobia experiences could be coming from holding feelings in and not expressing them.

As someone who has suffered from agoraphobia, I can tell you that one of the reasons people with agoraphobia (or anyone else for that matter) don't share their feelings with others is because most people are not good listeners and will just hurt your feelings even worse by not really listening or not validating them.

Most people just try to fix you by pointing out what is irrational or wrong with your feelings. If you have agoraphobia, this just makes you feel stupid and/or misunderstood.

Probably the most crucial element to being a good listener for someone with agoraphobia or an anxiety disorder is being able to hear and validate someone's feelings or emotions by making reflective statements to let the person know that you heard and understood.

For example, if a someone with agoraphobia talks about being afraid of having a panic attack and being embarrassed when going out on a date, the best response would be: "It sounds like you are really scared."

This lets the person with agoraphobia know that you heard his or her feelings and invites the person to share more. Some bad responses that indicate you are not really listening to a persons feelings (and responses the average person would give) are:

"If you weren't so worried about having a panic attack, you probably wouldn't have one."

"Maybe you won't have a panic attack and there's nothing to worry about."

These responses let person know that you think its silly to be worried about having a panic attack. They do not let the person know you have heard his or her feelings.

Hearing and making reflective statements about feelings is part of a skill called active listening. Active listening is a way of listening to people that lets them know you care about them and are really hearing them. Since many people with agoraphobia say that what they need most in a support person is someone who will listen to them, here are some guidelines for active listening:

Be attentive. You have to make an effort to listen carefully. Don't daydream and don't talk.

Think about the main point the speaker is trying to make. Also, don't be thinking about what you are going to say the whole time the other person is talking.

Make reflective statements by paraphrasing or restating in your own words what the speaker is saying. Especially when the person shares a feeling (fear, anger, sadness, regret, guilt, etc.) Good phrases to use when making reflective statements are: "What I hear you saying is....." "It sounds like......" "So in other words....."

Try to leave your own emotion out when you're listening.

Try not to argue back in your mind.

These things detract from what the speaker is saying. In other words, be objective and try not to let your own judgments and biases cloud what you are hearing the person say. Try to really see things from the other person's perspective and wait to hear the whole message before forming a response.

Ask for clarification if you don't understand a point the speaker is making. Ask questions to invite the person to elaborate on points that seem important.

Avoid distractions. Sit close to the speaker, if possible. Be aware of more than just the person's words. Look for body language, gestures, tone of voice, posture, etc. See if you think the person's non-verbal communication is congruent with what he or she is saying. (For example - some people smile when they are telling you they are upset). If the person's words and body language don't match, ask for clarification about what the person is really feeling but be gentle about pointing out the discrepancy.

When you do offer feedback, try to do so honestly but without passing judgment or expressing approval or disapproval of the person.

As you can see, good active listening is more than just not saying anything and nodding. Good listening is a skill that may take some work to develop if you don't come by it naturally. However, developing good active listening skills will make you a good support person for your friend or loved one with agoraphobia. Plus - being a good listener will help you in your other relationships, too, even with people who don't have agoraphobia.

The Victim Mentality

2006-07-19T15:17:00.000-07:00

We all have people in our lives who have problems and are looking to blame them on someone else. This is called the victim mentality. People who are like this have usually been wounded early in life by a significant person or persons. As a result, they have adopted a passive approach to life and don't take responsibility for their own behavior or situation.

When you have agoraphobia, it is easy to slip into a victim mentality. It is easy to adopt a fatalistic mindset that you are powerless to do anything about recovery or making your life better. It is easy to start blaming other people for your condition.

Do not do this!

One of the keys to recovery from agoraphobia is taking responsibility for your own life. Maybe your parents scarred you emotionally. Maybe you have experienced a traumatic event that brought on panic attacks. Maybe you are in a relationship with someone who is abusive, overly controlling, jealous, or smothering.

No matter how someone has wounded you in the past, it is your responsibility to recover from agoraphobia and take control of your life. No one else can do this for you. You don't have to get other people to change to recover. It is your own thinking and behavior that you must change.

I would not be writing this if I had not suffered from agoraphobia myself - and recovered. Believe me, there are always people and circumstances to blame for your disorder - but no one has a perfect upbringing or perfect life circumstances. If you are in the mindset that someone else or something else needs to change for you to recover from agoraphobia, you may never.

Recovery is about acting on your environment - not allowing your environment to act on you. Recovery from agoraphobia is something that lies within your power, no matter how hopeless you may feel right now.

Its just about deciding to do the things that work (desensitization, changing irrational thinking, breathing and muscle relaxation exercises, visualization, etc..) , and doing them as if it were a second religion.

Nobody can do this for you but you.

Thoughts of an Agoraphobic on Independence Day

2006-07-05T11:20:00.001-07:00

I must admit that when I had agoraphobia, July 4th was not my favorite holiday. That's mainly because the thought of flashing bright lights in the sky followed by the sound of explosions didn't excite me in my overly-anxious state.

I hid in the house for at least two Fourths of July.

However, as I reflect on the Fourth of July that is coming up in a few days, I see it in a whole new way. As a recovered agoraphobic, I find inspiration from its themes of winning freedom and independence.

The Fourth of July is a time to celebrate the people who fought for our freedom and independence at all costs. They wouldn't settle for living their lives under an oppressive regime. Nobody offered them their freedom. Freedom was something they created for themselves.

That's how it was with my recovery from agoraphobia. Freedom was something I had to find for myself. It was a decision I made. I didn't find a magic pill or quick fix. I didn't wait for agoraphobia to go away on its own. I just decided that I could no longer live my life under its oppression.

You can make the same decision.

I can tell you from both experience and years of study that there is no easy way out of agoraphobia. The good news is, you can recover.

The journey to freedom from agoraphobia is often taken one hard step at a time. There may be setbacks and discouragements. There may be days when everything seems dark, and that you will never live a normal life free of anxiety again. I felt these things, and I am writing to tell you there is life on the other side.

I started the Agoraphobia Resource Center because I would like to be a partner in your journey to personal freedom. My goal is to improve the quality of life for people who suffer from agoraphobia.

As a recovered agoraphobic, I would like to bring you both information and inspiration to help you on your way to recovery.

I am still working on getting all of the information I would like posted on the site. I have shared my personal story with you in an e-book available in the resources section. Next, I am working on another e-book, "The Agoraphobia Treatment Guide" that will help you make informed decisions about your own recovery.

These things are just the beginning. If you have any ideas of how the needs of people suffering from agoraphobia could be better met online please let me know. You can email me any time at:
stephen@agoraphobia.ws

There is a link to the Agoraphobia Resource Center on the sidebar of this blog.

Here's to your freedom and independence. I wish you all my best this Fourth of July!

Sincerely,
Stephen A. Price
Recovered Agoraphobic

Breathing Away Anxiety

2006-07-03T10:43:00.000-07:00

On the road to full recovery from agoraphobia, sometimes we need ways to get short-term relief from anxiety just to get through a period of the day or even the next few minutes.

One of my favorite ways to get a short break from anxiety is by breathing it away. To do this:

1) Breathe in deeply through your nose.

2) As you breathe in, put one hand on your stomach and the other on your chest. Make sure the hand on your stomach rises first. This means you are breathing deeply and from the diaphragm.

3) Hold your breath for a slow count of five.

4) Breathe the air out very slowly. As you breathe out, make a slight sighing sound, as if you were trying to fog a mirror. Also, picture the tension leaving your body as you exhale.

5) Repeat these steps for a total of 10 breaths.

This simple technique should help relieve tension and anxiety because the way we breathe has a lot to do with how we feel. Quick, shallow breaths from the top of the lungs are associated with insecurity and anxiety. Deep slow breaths from the diaphragm are associated with confidence and well-being.

Could Amino Acids Provide a Natural Remedy for Panic and Agoraphobia?

2006-07-02T09:33:00.000-07:00

Natural Treatments Offer New Hope to Relieve Depression and Anxiety

by John Salerno, PH.D. and Lauren Salani (originally posted by Asbury Press, 6/15/06).

(Note: I have included this article because an imbalance in neurotransmitters, as discussed below, plays a role in the development of anxiety and agoraphobia).

Medical research has shown that fast foods, fast-lane living, inadequate sleep and genetics significantly affect the brain's ability to keep levels of neurotransmitters in adequate supply and balance.

Neurotransmitters, in specific amounts, are vitally important because they are the substances that create our moods, define our behavior, and establish the state of our overall health.

You may have heard some of their names. Serotonin, Norepinephrine, Epinephrine, GABA, Dopamine, Histamine and PEA are a few neurotransmitters with excitatory or inhibitory effects.
The brain extends communication to the organs of the body through nerve cells that "talk" with these substances.

The brain tells the heart to beat, the gastrointestinal system to digest, and the lungs to breathe.
Thus, the list of clinical conditions that could arise from neurotransmitter levels either being insufficient or exorbitantly high is extensive and includes both mental and physical health.

Addressing neurotransmitter imbalances may be the key to getting illness under control. The following is a list of commonly occurring neurotransmitter imbalance symptoms:

— Fatigue
— Chronic muscle and joint pain
— Inappropriate food cravings
— Irritability/hostility
— Inability to focus/concentrate
— Depression or agitation
— Excessive body fat
— Obsessive/compulsive behaviors
— Sleep disturbances
— Physical and emotional stress
— Recurrent diarrhea/constipation
— Headache/migraine

Many people are being treated with medications that either alter neurotransmitter release or imitate their function in the body.

Some medications such as Prozac, Paxil and Zoloft act to increase the time a neurotransmitter, such as serotonin, will stay in-between the nerve cells to increase the action.

Problems arise when serotonin levels are so low that the quantity is insufficient to make drug levels effective.

The study of the synthesis and metabolism of this and other neurotransmitters has led to the discovery of methods for detecting functional levels of these substances.

Subsequent treatment includes targeting the amino acids which are the building blocks of these excitatory/inhibitory neurotransmitters and providing these amino-acids at therapeutic levels so the body can start synthesizing its own supply and self-correct it's own imbalances.

This is very exciting news. Many patients seeking treatment for a variety of medical and psychological conditions are actually suffering from symptoms of an underlying neurotransmitter depletion or imbalance.

Discovering the root of the problem makes treatment efficient and true relief a reality.
John Salerno, Ph.D. and Lauren Salani, BCIA,C are members of the Behavioral Medicine and Psychophysiology Team at Physicians for Alternative Medicine, P.C.

Physicians for Alternative Medicine, P.C. offers free consultations to those who want to learn how natural medicine can best treat their medical and mental health problems. For more information about neurotransmitter (brain chemistry) testing or to make an appointment call (732) 542-2638.

Discover a Secret Weapon Against Panic Attacks

2006-07-01T12:46:00.000-07:00

I was watching a favorite movie just the other day and in one of the scenes, something peculiar happens. A man, armed with a gun, robs a bank. The police chase him up some flights of stairs and onto the roof of a twenty-story building where they corner him. In desperation, he kidnaps a girl (who just happens to be on the roof) and holds her for ransom. He threatens to shoot her if she doesn't do what he says.

Now here's the peculiar twist to the plot, the girl was about to jump off the roof and commit suicide when he found her. She doesn't care if she gets shot. In fact, she even begs him to go ahead and shoot her to save her the hassle of jumping.

Because the girl is so bold about inviting him to pull the trigger, the kidnapper can't scare her into doing anything.

This strange sequence in a movie scene illustrated the principle of non-resistance. Because the girl doesn't resist her kidnapper's threats, he has no power over her.

The principle of non-resistance, or using an opponent's strength against them, has long been a part of Eastern philosophy and the martial arts. This same principle can be your secret weapon against panic attacks.

You can use the principle of non-resistance to take away the power of panic attacks in your life.

If you stop resisting panic attacks and try to force yourself to have a panic attack instead, the panic will lose its power over you. I know it sounds strange, but just try it. More times than not, when you try to bring on a panic attack, you will find it nearly impossible to have a panic attack.

The strategy of non-resistance is so powerful that many psychologists offer it to overcome panic.

Next time you feel panic coming on you can try it. Go ahead. Try to hyperventilate. Try to get dizzy and faint. Try to sweat and get your stomach tied up in knots. Try to make your mind spin out of control.

Guess what? You probably won't be successful. Trying to bring on a panic attack is probably the best way to avoid having one.

So why does this work?

Think about it - panic attacks rely on tension and anxiety to fuel them. Those of us with agoraphobia have a lot of panic attacks just because we are afraid of having them. In other words, panic attacks rely on tension between you and the panic to occur.

On the other hand, there are some steps to ensure that you will have a panic attack:

1) Worry incessantly about having a panic attack.2) Avoid all places in which you are afraid you might have a panic attack.

3) Set the goal of never, ever having another panic attack again no matter what.

4) Try to ignore any tension in your body that feels remotely like panic.

5) Try really hard to brace yourself against panic and actively fight off a panic attack through sheer will and determination when you feel one coming on.

If you do these things, you are sure to increase the number of panic attacks you have because you are increasing the tension between you and the panic.

To stop having panic attacks, don't resist them. If you start feeling panic just go with it. Accept what is happening. Face up to the symptoms and just let some time pass. Whatever you do, don't put up a fight against it.

When you give up the fight against panic, paradoxically, it will lose its power over you.

What Does Love Have to Do With Agoraphobia?

2006-06-26T11:58:00.000-07:00

I just read an interesting few paragraphs in a boook this afternoon that I have to share. I was reading Karen Williams' book entitled "How to Help Your Loved One Recover from Agoraphobia" and I came across a part where she writes about the power of being loved by others and loving yourself when it comes to recovering from agoraphobia.

I thought this was interesting because I attribute a great deal of my recovery from agoraphobia to changing the nature of my close relationships - from relationships based on fear (of disapproval, rejection, etc...) to relationships based on unconditional love.

To read more, go to the Agoraphobia Resource Center website, click on "articles" and look for one called "The Power of Love for Healing Agoraphobia."

EMDR Treatment for Agoraphobia

2006-06-25T09:20:00.000-07:00

Eye Movement Desensitization and Reprocessing (or EMDR) is a relatively new form of therapy, sometimes used to treat agoraphobia, that focuses on removing emotional triggers associated with childhood abuse or trauma.

In other words, if you have experienced a traumatic event that has caused you to associate fear or anxiety with a certain place, this therapy focuses on removing that fearful or anxious association.

Though some mental health professionals claim that they have had positive results using EMDR to help agoraphobics, there is not a body of research to support its effectiveness with agoraphobia.

EMDR is only recommended after the more proven cognitive-behavioral approaches have been tried or in cases where agoraphobia develops from post-traumatic stress.

Who Should Try EMDR for Agoraphobia?

2006-06-25T09:18:00.000-07:00

EMDR is only recommended after the more proven cognitive-behavioral approaches have been tried or in cases where agoraphobia develops from post-traumatic stress.

For some individuals, a traumatic life event such as an auto accident, mugging, rape, abuse, or childhood trauma can lead to the development of agoraphobia. Usually the person will develop another disorder first, like post-traumatic stress disorder.

After having some panic attacks associated with the initial disorder (at the scene of the trauma in some cases), the person develops fearful associations with certain places or situations. At some point, the fear generalizes to all places and situations except for a safe place (or a few safe places) and that's when the person has developed agoraphobia.

Individuals who develop agoraphobia in this manner are the most likley to benefit from EMDR.

Good Quote for Agoraphobia

2006-06-20T10:31:00.000-07:00

Good Quote for Agoraphobia:

"Being defeated is a temporary condition - giving up is what makes it permanent."

- Anonymous

What is Agoraphobia?

2006-06-19T21:49:00.000-07:00

What is Agoraphobia?

Recently, I have been writing articles for e-zines on the topic of agoraphobia. I am fast confirming a previous notion I had that there are not many people writing internet articles on agoraphobia and there are many people who don't know what agoraphobia even is.

That's funny to me because the average person is familiar with most phobias. Take for instance, social phobia, claustrophobia, arachnophobia, etc. Also, the average person has heard of most anxiety disorders. I mean who hasn't heard of panic disorder, obsessive-compulsive disorder, or post-traumatic stress disorder?

So why isn't agoraphobia getting its share of the ink? Even at the local bookstore, there are many self-help books with anxiety disorder and panic disorder in the title, but often there are few or no books specifically dedicated to agoraphobia. If you are an agoraphobic you have to read about your disorder in sections of these other books.

Well, I came up with a theory as to why agoraphobia seems to be a dark horse among anxiety disorders and phobias. It may well be because it doesn't fit neatly under either category, nor is easily recognizable by its name.

Among the anxiety disorders, agoraphobia is the only one without "disorder" in the name.

Among the phobias, agoraphobia puts a word in front of "phobia" that no one has ever heard of (unless you are Greek). What exactly does it mean to be afraid of the "agora."Most of us would get that hyrdophobia is fear of water or that insectophobia is fear of insects - but agoraphobia - that leaves a lot of people guessing.

Why Cue-controlled Relaxation Works

2006-06-17T10:58:00.000-07:00

To many people with agoraphobia, learning to relax on cue sounds too simple to be possible. However, this technique is based upon a well-known phenomenon called “classical conditioning.” In everyday language, classical conditioning is just teaching yourself to respond to a cue in a certain way. This is done by pairing that cue with something that causes the response you want.

Need an example?

Classical conditioning emerged from an experiment done by Russian Psychologist, Ivan Pavlov, in the 1890’s. Pavlov trained a dog to salivate at the sound of a bell. He did this by ringing a bell right before the dog received food. After doing this enough times, the dog started salivating at the sound of the bell because it associated the bell with food.

In the same way, you can teach yourself to relax when you say a cue word, provided you learn to associate that word with a deep state of relaxation through repeated practice.

Cue-controlled Relaxation for Agoraphobia

2006-06-16T17:31:00.000-07:00

Learning to relax on cue will help you stop the panic attacks that come with agoraphobia.

Two skills are fundamental to learning to relax on cue; deep breathing and deep muscle relaxation. To develop a relaxation cue, you will use both of these skills to put your body in a state of complete calm while in a safe, non-threatening environment. As you are reaching a complete state of calm in your body, you will slowly repeat any word you choose to be your key word. For example, your cue word might simply be “relax.”

After practicing deep breathing and deep muscle relaxation on a regular basis while repeating a cue word, your mind will learn to associate the cue word with a profound state of calm and relaxation. Then, when you feel anxiety or panic coming on, you can just speak your cue word and your body will start to relax.

What Does Pavlov's Dog Have to Do with Agoraphobia?

2006-06-13T14:54:00.000-07:00

Remember Pavlov's dog from psychology class. Just in case you missed it, this is the dog that salivated every time it heard a bell. This is because the owner (Psychologist, Ivan Pavlov) rang a bell just before feeding his dog so many times that the dog associated the bell with the food.

Well, some psychologists think that this process called "classical conditioning" accounts for the development of agoraphobia.

I read a journal article that supports this idea. This study found the presence of panic disorder and agoraphobia to be about 20% in heart patients with pacemakers (which is way above the normal population). When the patients with panic disorder and agoraphobia were interviewed, it seemed like they had been conditioned just like Pavlov's dog.

They got anxious about shocks from the pacemaker and later associated that anxiety with the places or situations they were in when they got shocked.

You can read more details about this study on My Agoraphobia Resource Center Wesite (see link on the sidebar).

My Friend the Pharmacist

2006-06-12T18:03:00.000-07:00

My best friend, Don, is a pharmacist. He is mentioned a few places on the Agoraphobia Resource Center Website.

I grew up with Don here in the Fresno, California area and have known him since the fourth grade. We went to grade school, junior high, high school, and college together. We have played together on school basketball teams and shared an apartment when we went to University of California at Davis. Though Don does not have an anxiety disorder, he has known me through all of my experience with agoraphobia.

After college, Don went to pharmacy school and became a pharmacist. Actually, he is a pharmacy manager now. Any time I have a question about a medication I am on, I give Don a call.Don has been a supportive friend to me for most of my life, and he and his wife have encouraged me in writing my first e-book and doing a website on Agoraphobia.

Just as Don has helped me, Don would like to help you.There are a lot of doctors out there that don't know that much about psychological disorders and are not as careful as a mental health professional might be about what they prescribe for anxiety. Don would like to be a resource for you on my website, and is here to answer your questions about medication.

Even if you are going to see a psychologist or psychiatrist - you are the one who knows your body - and you should be an active participant in any decision made about the medications you take.

I know from knowing Don that it is good to have a friend who is a pharmacist to discuss your medication options with. That's what Don will do for you. If you have questions about medications you are taking for anxiety or agoraphobia, please feel free to email my friend, Don, at:

doctordon@agoraphobia.ws

Its good to learn all you can about any medication you even consider taking for agoraphobia.

Agoraphobia Treatment Guide

2006-06-06T20:33:00.000-07:00

I have just posted my first e-book, "Goodbye Anxiety" on the Agoraphobia Resource Center Website. This is a book about my own recovery in which I share strategies to help you that are based on my personal experience. Now I am working on a second e-book called "The Agoraphobia Treatment Guide." This will be a book to help you learn everything you need to know about agoraphobia to make informed decisions about your recovery.

Below, in quotes, is the introduction for the book that I just wrote tonight.

"If you have agoraphobia then you have probably experienced something like this:

You start feeling uneasy a lot of the time but you don’t know why. You feel a little dizzy sometimes, a little lightheaded, or it gets just a little bit harder to breathe. Sometimes your heart seems to be beating just a little bit faster or you feel like you are sweating a little bit more than usual. For as long as you can, you try to ignore these symptoms.

Then the day comes when you can’t ignore them anymore. That’s because they hit you all at once and at a much higher degree of intensity. You feel like your heart is about to pound right through your chest like a hammer. You are literally gasping for breath. Your body shakes all over and your hands and feet get cold and clammy. Your vision blurs and you get so dizzy and lightheaded you are afraid that you might pass out. You feel like your body is truly in danger, as if you are having a heart attack or stroke. The longer these dreadful symptoms persist, the more you become afraid that you may die.

Not knowing what is happening to you or why, you feel the urge to run but don’t know where to run to. Maybe you call someone for help. Maybe you call 911 and end up in the emergency room. Whatever the case, when you leave the place where you felt these terrible sensations, your body relaxes and you feel a whole lot better. If you went to the emergency room, they tell you there is nothing wrong. Though you are temporarily relieved, in the back of your mind lurks the fear of having another unexplainable experience just like this one.

Days, weeks, or months may pass, but eventually your worst nightmare comes true. All of these dreadful symptoms hit you once again when you are least expecting it, forcing you to flee to a “safer’ place. You start avoiding the places where you have these unexplainable experiences, but at the same time you have these unexplainable experiences in more and more places. The list of places you fear going gets longer and longer as the list of places you feel safe gets shorter with each passing day.

Eventually your world narrows to the point that you have to admit to yourself that something isn’t quite right. You consult a doctor and after examining you, the doctor assures you that nothing is wrong. Perplexed, you see another doctor for a second opinion and then another. Every doctor tells you the same thing, that there is nothing wrong with you. Maybe one or two of them tell you that you are just experiencing the symptoms of stress and to take it easy for a few days. To you, your symptoms seem like more than that. Taking it easy a few days doesn’t do the trick. You continue to have these debilitating episodes of unexplainable symptoms that scare you out of your mind.

You world gets smaller and smaller. You go fewer and fewer places. Eventually you only go out of the house when you absolutely have to.

Finally, after a desperate search for answers, you find a doctor that gives you a diagnosis. You find out you have agoraphobia and the unexplainable experiences are called panic attacks. The best the doctor can do for you is to prescribe some pills to make you feel better temporarily. Though the pills make you feel relaxed, you know you can’t stay on pills forever. You need to find a way to stop having panic attacks, to get out of your house again, to go to work or school again, and to enjoy a normal life.

Not knowing how or where to begin the recovery process, you log onto the internet and type “agoraphobia” into Google. There are hundreds and thousands of references to agoraphobia but none of them give you the information you really need. Clicking through the agoraphobia links that come up, you find definitions, bits of information here and there, a discussion board or two, and some lists of treatments with a line or two about each one. If you are lucky, you find a whole paragraph. After surfing the internet, your questions are left mostly unanswered.

You want to know things like:

How do I know that what I have is really agoraphobia?

Do I need to seek professional help or is this something I can work through with a good self-help program?

If I choose to seek professional help, what type of professional should I see? A counselor, a psychologist, or a psychiatrist?

What credentials should my therapist have?

What questions should I ask the therapist when I get in the office?

What treatment options should I discuss with the therapist?

Are there some effective treatments for agoraphobia that are supported by research?

How long should I expect to be in therapy and how do I know if it is working so I don’t waste my money?

Are there some good books I could be reading that would help me?

Would a support group help, and if so are there some criteria I should use to choose one?

What are my chances of recovery? Do people really get well from agoraphobia?

What causes agoraphobia anyway and how many people suffer from it?

Are there some natural remedies that I might try in place of prescription medications?

These are the kinds of things you will want to know if you have agoraphobia. However, you will have to do a lot of homework to find answers to all of these questions. When you have agoraphobia or any anxiety disorder for that matter, it can be hard to focus on undertaking a major research project when you are so desperate for symptom relief.

Wouldn’t it be nice if someone did all this homework for you?

Wouldn’t it even be nicer if that person were someone who recovered from agoraphobia and who had a background in psychology also?

Well, that’s why I wrote the Agoraphobia Treatment Guide.

My name is Stephen Price. I have masters degrees in psychology and counseling and have published original research on the topic of anxiety. I also know exactly what it is like to find out you have agoraphobia and not know where to turn. That’s why I have done your homework for you. I have compiled information from a variety of sources to offer you everything you need to know to get started on the road to recovery. The Agoraphobia Treatment Guide will answer all of the questions listed above and more.

Basically, I wrote the book I wish I had when I first got agoraphobia. Reading this book would have cut at least a year off the time it took me to recover.

In the agoraphobia treatment guide, I will help you understand agoraphobia and consider your treatment options from an educated perspective in easy-to-understand language.

I will help you know if you really have agoraphobia, what might have caused it, and what you can do about it. I will give you the knowledge you need to decide if you need professional help or can recover on your own. I will also give you sound criteria for choosing the best therapist for you should you seek professional help.

What’s more, I will explain every type of therapy that is commonly used to treat agoraphobia and tell you what current research says about the effectiveness of each type of treatment. I will also provide you with information about all the different types of medication that are used for anxiety and panic, giving you the information you need to determine which medication you might talk to your doctor about.

Also, I will help you save money by warning you what to watch out for in therapy. I’ll not only tell you what types of therapy have been proven most effective in research, I will also tell you about how to know if a particular therapy is working for you and how long it should take for you to start seeing results.

After reading the Agoraphobia Treatment Guide, you will be able to approach recovery with the confidence of knowing your treatment options and have informed discussions with mental health professionals about your condition.

In addition to helping you understand the possible courses of treatment for agoraphobia, I’ve included three bonus sections. The first bonus section will help your friends and family members understand how to be a good support people during your recovery. The second will give you a list for further reading that includes book reviews of what I consider to be the best books for agoraphobia sufferers on the market, including the books I used in my own recovery. Finally, a third bonus section will include scripts to help you practice deep breathing, progressive muscle relaxation, and positive visualization on your own at home.

No one resource could better prepare you to make informed decisions about your recovery. I have written this book for you. I wish you well on your road to recovery."

Now its time to get to work on writing the actual book.

Do You Know Anyone In Greensboro, NC?

2006-06-01T13:53:00.000-07:00

I am looking for someone in Greensboro, North Carolina that might be a friend to someone who is housebound with agoraphobia.

If you know anyone, please let me know.

Email me at:

stephen@agoraphobia.ws

or comment on this blog

Thanks,
Stephen

Taking Responsibility for Everything

2006-05-25T19:01:00.000-07:00

The summer after I graduated from high school, I took a job stacking boxes of fruit at a packing house. Basically, I would stand at the end of a converyer belt with two to three other guys. Each time a box would come to us on the belt we would stack it. About the only mentally engaging part of the job was making sure that boxes of peaches were stacked with peaches, plumbs with plumbs, and so forth.

During some parts of the day the boxes came slow and we could easily get them stacked. At other times, the boxes came to us on the conveyer belt at a pace that forced us to work faster. During fast times, if we didn't get all the boxes stacked in time some would fall off the end of the conveyer belt leaving peaches or plumbs to spill out of the box and roll everywhere.

The problem was, when the boxes came faster, everyone didn't work faster. Some guys worked as if they were content just to let the boxes fall. Others of us worked harder to pick up the slack. We took responsibility for not letting the boxes fall no matter how slow the other guys worked.

I was one of the guys that picked up the slack for others.

Looking back, I would guess it was the guys who didn't speed up that never had a panic attack or anxiety disorder in their life.

The guys that picked up the slack for everyone, like me, were probably the ones most prone to having panic attacks - or developing agoraphobia.

How I Developed Agoraphobia

2006-05-12T14:53:00.000-07:00

Panic first struck me hard, unexpectedly, and out of nowhere. I was an eighth grader playing right field in a baseball game one night when suddenly everything seemed unreal. My body felt like someone else’s and I felt light enough to float away into the sky. I started breathing fast, as if sucking in lots of air would make me heavy enough to stay on the ground but I was afraid that I might keep getting lighter and lighter until I floated away like a helium balloon.

The stronger this fear became, the more my breathing sped out of control. Pretty soon I felt like I was choking, or maybe even drowning, as if I couldn’t get any air.

That’s when panic kicked in. I had that same dreadful feeling that you get when you have been underwater too long, your lungs are about to burst, and you look up and realize that the surface is high above.

That inning was the longest inning of baseball I can remember playing in my life. I could never slow down my breathing and looking in from where I stood in right field, the batters seemed fuzzier and fuzzier to me. Eventually my arms and legs got tingly and I felt weak all over. My feet went numb in my shoes and my hand felt dead inside the leather interior of my glove.

I didn’t understand what was happening to me and was completely terrified. It was all I could do to stay out in right field and sweat out each pitch, just waiting for the inning to come to a merciful end. By the time it ended, I was so dizzy and weak I could hardly jog off the field.

Back in the dugout, I finally caught my breath. That’s when the feeling returned to my arms and legs, and my vision cleared up. The panic went away, too, but I still felt uneasy. I was afraid that if I went back onto the field it would happen again. I also felt like I couldn’t tell anyone about my experience because they might think I was going crazy.

Because these unpleasant sensations came over me that night in the absence of warning or logical explanation, I felt extremely vulnerable in the following days. I was afraid the experience might revisit me at any time.

Both spring and summer passed that year with thoughts of this waking nightmare lurking in the back of my mind like a foreboding specter. I didn’t feel safe. No matter what I did or where I went, the experience hung over me. I prayed to God it would never happen again.

My prayer wasn’t answered. At least not in the way I wanted it to be. Those same sickening feelings I had felt on the baseball field came back. They broke in on my education and rudely disrupted my life on the Monday morning of my third week of high school. It was my fifteenth birthday.

During my first period algebra class, I lost all sense of security and well-being. My heart’s heavy pounding grabbed my attention first. My chest tightened, and I had trouble catching my breath. It was like I was suffocating from a lack of air in the room.

Almost gasping, my vision blurred as I lost my sense of balance. Desks, chairs, and even the other students seemed to swirl all around me. My disorientation and dimming sense of sight triggered intense waves of panic.

For several minutes of this, I suppressed my terror, in hopes that the symptoms would just go way. Instead, they only got worse and a terrible nausea came over me. I could feel drops of sweat falling onto the cloth of my shirt. I didn’t know what was wrong and hoped I wasn’t having a heart attack. Finally, when I couldn’t sit at my desk another minute, I raised my hand and asked for a pass to see the nurse.

I ran all the way across the campus to the nurse’s office and dialed home with shaky fingers. Waiting for my mom to pick me up seemed like forever even though it was probably only ten minutes. Since I thought I was sick, I went to bed as soon as I got home. For some reason, once I was under the covers, all the bad feelings went away and I felt fine. I was totally exhausted from and confused by the experience, but felt pleasantly relaxed.

The experiences I just described, which I can now identify as panic attacks, started happening closer and closer together after that day in algebra class. Since at first they mostly happened in classrooms I got in the habit of staying home from school to avoid them and continued going everywhere else. However, I eventually had panic attacks in other places and the fear slowly generalized. I had panic attacks at church, in the mall, at friends’ houses, and so on. I stopped going to every place I had experienced panic for fear that I might have another attack.

My world slowly shrank until I hardly left home anymore.Though I didn’t have many full-blown panic attacks at home, fear did not leave me alone to rest there. The physical sensations I felt during panic attacks left me with questions about my health. Since I didn’t even know what panic attacks were, I thought something was physically wrong with me. When I stayed home from school, often I lay in bed most of the day scanning my body. I put my hand over my heart to make sure it was still beating. I blew air into the palm of my hand to make sure my lungs were still expelling air. I worried that I had some hidden tumor, an enlarged liver or spleen, or some rare unexplainable disease.

Fear of the unknown hung over me every day and I had way too much time to think. I found myself turning into a hypochondriac. That’s when I started going to the doctor.

Actually, I didn’t just go to one doctor. I went to many. When I told my general practitioner I was having difficulty breathing and thought I had an irregular heartbeat, he took x-rays of my heart and lungs. Everything checked out fine and he told me it was all in my head. Neither I nor my parents could accept this diagnosis.

You have to understand that my dad was a school psychologist at the time. His job was diagnosing the problems of other people’s kids. In his mind, there was no way his own son could have a psychological problem like agoraphobia or panic disorder.

Most of all, it was I who could not accept that I had a psychological problem.I come from an intelligent, educated family. People like me, I thought, don’t have psychological problems. I saw myself as too smart, too healthy, too young, and overall way too normal to have a mental disorder.

I thought psychological problems were only for “screwed-up” people from dysfunctional families, and I knew there had to be something wrong with me that was real. When I say real, I mean something physical and tangible. I couldn’t see myself as someone who would be staying home from school just because I couldn’t get a mental grip on school or life.

Needless to say, I felt totally insulted by what the doctors told me and vowed that no doctor would make me doubt my sanity. I got a second opinion, and a third and a fourth. Every doctor’s opinion was the same. They all told me there was nothing physically wrong. Though I eventually gave up on learning anything from the doctors, denial kept me from seeking psychological help.

As spring of the next year approached outside, my indoor world had gotten pitifully small. When I tried to go back to school, my knees would get so shaky that I would freeze for fear of falling down. When I attended church with my family, I would feel all the air being sucked out of the sanctuary and run outside just to breathe.

When I went walking through the shopping mall, the ceiling would appear to be so high it would leave me feeling weightless and airy, like I was slightly out of my body and just barely being held down by gravity. When I tried to find a doorway out, everything looked bright and blurry and I found myself walking hurriedly and wildly through an endless and dizzying maze of colorfully-dressed, slow moving people. I started running panicked out of grocery stores, restaurants, and even the baseball card shop where I used to hang out on Saturdays. I felt especially trapped and helpless in moving automobiles. Almost every situation threatened me, stimulating a strong impulse to flee. I didn’t know what to do or where to turn for help, so I got into the habit of retreating home where it felt safer.

I had learned to fear the panic itself. The dreadful anticipation of the next panic attack left me forever uneasy. Though I spent long days at home, sometimes I couldn’t even get comfortable there. The television flashed pictures of public places and scenes before my widened pupils. The stories of shootings in the newspaper left me fearful and ill. Video games became too violent and the rock music I once loved became an intolerable assault on my senses. Even small amounts of sensory stimulation overwhelmed me, throwing me into violent panic attacks.

I woke up tense and nauseous every morning, and I went to sleep each night only after endless pacing around the house, worrying. I kept worrying that my heart would stop. I kept worrying that my lungs would collapse. I even worried that my skeletal system would fall apart, or that my muscles would all freeze. In short, I had no faith that my body would keep itself alive and constantly checked my heartbeat, pulse, and respiration.

My world at home kept narrowing. Every day I surrendered ground. Each panic attack and each terrifying sensation would leave me afraid of one more chair, one more corner, one more lamp stand, or one more room. The fear eventually backed me into my bedroom where I learned to spend long hours alone in quiet darkness, lying prone, and wrapped safely in bed sheets.

At the point of utter defeat, I admitted that the doctors might be right and I finally went to see a psychologist. As you might suspect, I was diagnosed with Panic Disorder with Agoraphobia.

No Overnight Cure for Agoraphobia

2006-05-08T11:11:00.000-07:00

If you are looking for a way to recover from Agoraphobia, don't be fooled by all of the ads on the internet that promise an overnight, never-before-heard-of cure if you'll just buy a series of books or CDs for anywhere from 50 to 500 dollars.

Believe it or not, we live in a world where opportunists will try to take advantage of suffering and desperate people who would do anything to get better. I know that when I had agoraphobia, it was so awful that I desperately sought an answer to my problems and would have done anything to recover. But I will tell you this from personal experience - you will save a lot of time in your recovery (and money) if you do not let yourself fall for ads for "quick fixes."

Think about it:

If there were a miracle, sure-fire, quick cure for agoraphobia wouldn't psychologists and mental health professionals everywhere be using it?

The best thing to do if you have agoraphobia is to get informed and then seek professional help if you need it. You can get informed by reading credible books and research articles on the subject - which I am working hard to try to summarize for you on the Agoraphobia Resource Center Web site.

From one agoraphobic to another - don't get taken advantage of by people selling the "quick fixes."

Get real information and qualified professional help if you need it.

Why You Think You Recovered From Agoraphobia Really Matters

2006-05-06T11:45:00.000-07:00

I was up late last night reading some research that's been done on agoraphobia and came across a study with some information I had never considered before:

Why you think you recovered from agoraphobia really matters.

That's right, even if you are just improving toward recovery, it really matters what you attribute your improvement to.

Research was conducted at the Institute of Psychiatry in Denmark Hill, London, involving people with agoraphobia who improved using a combination of Xanax and psychotherapy (either relaxation or exposure). The ones that relapsed were the ones that credited Xanax for their improvement.

The people who credited themselves, and their hard work in therapy, for improvement were the ones who were least likely to relapse.

The moral of the story is - don't give Xanax or any other medication too much credit. Also, don't rely on medication too much in your recovery. Use it when you are practicing exposure or during particularly tough times, but always keep in mind that drugs quit working when you quit taking them.

Its the hard work you put in toward your recovery that can lead to real improvement that lasts a lifetime.

Check out the study and get the details in the articles section on the Agoraphobia Resource Center website. The article is called "Why You Think You Recovered From Agoraphobia Really Matters."

What in the world is agoraphobia?

2006-05-05T13:32:00.000-07:00

Most people have heard of most phobias. Mention claustrophobia, social phobia, or arachnophobia and everyone pretty much knows what you are talking about. Mention agoraphobia, and most people will just shake their heads.

Because of this, many people who get agoraphobia often take a year, and in some cases, many years, just finding out what is wrong with them. Since the panic and anxiety symptoms that come with agoraphobia are so physical, people who get agoraphobia commonly visit a succession of doctors trying in search of a diagnosis. Since medical doctors are not usually trained to diagnose agoraphobia, let alone anxiety disorders, agoraphobia has had time to become deeply rooted in most people before they know enough about the disorder to seek the proper treatment and being recovery.

In light of this, here are some basics about agoraphobia:

Agoraphobia is "anxiety about, or avoidance of, places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having a panic attack or panic-like symptoms.” (DSM-IV)

Agoraphobia is a type of anxiety disorder. The term “agoraphobia” comes from the Greek words “agora”, meaning “marketplace,” and “phobia”, meaning “fear.” Literally translated as “fear of the marketplace,” people with agoraphobia are afraid of open or public spaces.

In reality, most people with agoraphobia are not so much afraid of open and public places as they are afraid of having a panic attack in these settings, especially settings in which there may be no one to help in the case of a panic attack or actual emergency.

The most common symptoms of agoraphobia are:

1) Panic Attacks: Periods of intense fear, usually lasting about ten minutes or so (but sometimes longer).

2) Avoidance Behavior: Avoiding places and situations that are hard to escape from or that might be embarrassing to have to suddenly leave. Most commonly, this is because they fear having a panic attack or unexpected catastrophe and not being able to get help or get away.

3) Developing "Safe" People: People with whom the agoraphobic is highly familiar with and feels emotionally close to. “Safe” people are usually parents, spouses, children, or close friends and relatives.

4) Developing "Safe" Places: Places in which the agoraphobic feels psychologically comfortable. The most common safe place for someone with agoraphobia is his or her own home.

5) Scanning: Obsessive monitoring of one's own body for strange or unusual symptoms.

6) Fear of being alone: This is related to the fear of having no one to help in the case of a panic attack or real emergency.

If you suspect that you or someone you know might have agoraphobia, don’t waste any time in learning about the disorder. Research has shown that the sooner you start the recovery process the more likely your chances of a successful recovery are.

You can learn more about agoraphobia online at the Agoraphobia Resource Center website. The site was started by a recovered agoraphobic with the intention of helping others learn about and recover from agoraphobia. The link to the Agoraphobia Resource Center Website can be found on the sidebar of this blog.

What You Need to Know About Xanax

2006-05-02T17:01:00.000-07:00

A review of the literature in Germany showed Xanax to be the most effective benzodiazepine (or anti-anxiety agent) for panic disorder with agoraphobia (Bandelow, 1999). In other words, there were more controlled studies with positive results for Xanax published than other anti-anxiety agents.

Because it has been proven effective in studies since it was approved by the United States Food and Drug Administration in 1981, I thought I would write a little about Xanax, what it is and how to use it right so it will help you and not hurt you.

First of all, what is Xanax?

Xanax (Alprazolam) is a benzodiazepine, or anti-anxiety agent, prescribed mainly for temporary relief of mild to moderate anxiety, nervousness, or tension associated with anxiety disorders. It has also been used effectively for panic attacks. In some cases, it has been used to treat stress-related illnesses such as irritable bowel syndrome (IBS).

Xanax comes in two forms - Xanax and Xanax XR. What's the difference? Xanax XR is just the extended release version of the original Xanax which, if you are taking Xanax daily, lets you just take one dose per day rather than three or four.

What's the best way to use Xanax for panic disorder with agoraphobia?

Since Xanax, like most anti-anxiety agents, causes the body to develop tolerance and can be addictive, the best way to use it for panic disorder with agoraphobia is to keep it in your pocket and take it only as needed to get through rough spots, times of unusually high anxiety, or when you are practicing desensitization or exposure therapy.

It's important to remember that no pill will cure agoraphobia. Not even Xanax. Pills only work as long as you are taking them. That's why Xanax is best used as part of a larger recovery plan for agoraphobia that includes a long-term solution like psychotherapy.

So how fast does Xanax work?
Xanax offers pretty quick relief for most some anxiety patients. In healthy adults, it may take an hour or two to take effect.

Is there anything you shouldn't eat or drink when taking Xanax?
Yes. Tell your doctor about any other medications you are taking so he or she can make sure you won't experience a bad interaction. Also, you shouldn't mix alcohol with Xanax or any other benzodiazepine because it amplifies the effects.

Can you take Xanax if you are pregnant or nursing?
It's not recommended. You should definitely not tak Xanax in the first twelve weeks of pregnancy under any circumstances.

How will Xanax effect your daily routine?
It may make you really drowsy, so don't be driving or operating dangerous machinery on Xanax until you test it out and see how it effects you.

If you feel Xanax stops working, should you just take more?
Never. under no circumstances should you increase your dose without talking to your doctor, even if you think it's not working and you need more. This is because even when used as recommended, Xanax can cause emotional and/or physical dependence. In other words, you can get extremely addicted to it.

Can you just stop taking Xanax if it's not working?
No again. It is not safe to just stop taking Xanax cold turkey. Do not even decrease your dose without talking to your doctor. If you stop taking Xanax or decrease your dose too abruptly you are likely to experience serious withdrawal symptoms. Many of the withdrawal symptoms are similar to the panic and anxiety you probably started taking Xanax for in the first place. In the worst case, you can have a seizure if you try to stop taking Xanax too suddenly.

What about side effects?
If you are going to have side effects from Xanax, you will probably have them right when you start taking it. In many cases, initial side effects subside if you keep taking it. Most common side effects are drowsiness, fatigue, impaired coordination, irritability, light-headedness, memory impairment, insomnia, and headache.

Hopefully after reading this, you can use Xanax to help you and not hurt you if you have panic disorder with agoraphobia.

Press Release for Agoraphobia Resource Center

2006-04-30T23:04:00.000-07:00

I am submitting the following press release to PR Web to be sent out on May 2. I had never written a press release before, but here is what I wrote:

Recovered Agoraphobic Launches New Informational Website to Help People with Agoraphobia

Clovis, CA (PRWEB) May 2, 2006 -- A recovered agoraphobic has launched a new informational website featuring a free newsletter to help people learn about and recover from agoraphobia. Agoraphobia is the fear of having a panic attack in open spaces or public situations.

Stephen Price, who since recovering from agoraphobia has earned a masters degree in psychology and published original research on anxiety, created the Agoraphobia Resource Center (found on the web at www.agoraphobia.ws) to help others who suffer from agoraphobia.

The Agoraphobia Resource Center offers its visitors a variety of information on the causes, symptoms, and treatments for agoraphobia along with summaries of the latest research on the disorder. The site also includes informative articles, written from Stephen’s study of and personal experience with agoraphobia.

Visitors to the site may sign up for the free Agoraphobia Newsletter, a bi-monthly, online newsletter written specifically to help people learn what they need to know to recover from agoraphobia. Agoraphobics may also share their personal experiences on the site’s discussion board.

“I created the site I wish I had when I was suffering,” says Stephen. “The way I see it, the Internet is the best way to communicate with people who are afraid to leave their homes. There are 3.2 million Americans with agoraphobia at any given point in time, and my goal is to offer them a sense of community and hope through the Internet.”

Stephen is currently writing two e-books which should be available on the site by summer. One will be called “The Agoraphobia Handbook” and provide a comprehensive information source on the disorder. The other will be called “Goodbye Anxiety” and contain principles for recovery illustrated by the author’s personal success story.

Understanding agoraphobia is a major obstacle for most people in recovery. Many people have agoraphobia for a year or more before they even know what is wrong with them. Sufferers commonly visit a succession of medical doctors, many of whom are not trained to diagnose psychological disorders. The purpose of the Agoraphobia Resource Center is to remedy this situation.

“People have heard of most phobias, like claustrophobia and social phobia,” Stephen says, “but if you mention agoraphobia, people just shake their heads. My goal is create awareness so people will know how and where to get help if they or someone they love shows signs of having agoraphobia.”

No Hopeless Cases of Agoraphobia

2006-04-28T00:21:00.000-07:00

I believe hopelessness is a myth when it comes to agoraphobia.

If anyone was a hopeless case then I was. For two years I could hardly leave my home without being totally overwhelmed by debilitating panic. During the daytime, I fought a constant battle to keep from hyperventilating and scanning my body to make sure all my vital organs were working. At night I paced around the house, worrying that I might stop breathing and die at any moment.

Each morning, I awoke to the sounds of acid churning in my stomach. Just taking a shower exhausted me and I could hardly swallow food at breakfast. I couldn't go to school, work, or church. I couldn't even go visit a friend and I was terrified when the telephone would ring and I though it was for me. I had panic attacks even when I was at home and at times I was confined to one "safe" room by my fear.

I tried therapy, a support group, and medications - but nothing seemed to help me. I thought about giving up and seriously questioned the value of my life. But I did recover. Many people with agoraphobia believe that if therapy, support groups, and medication don't help them then nothing can help them. There are many agoraphobics like I was who go through times of thinking they are a hopeless case.

There were two major turning points in my recovery: 1) Doing reading on my own to get educated about my disorder. 2) Meeting someone who had made a personal recovery from agoraphobia with panic attacks.

When I met someone who had experience with recovering from panic disorder and agoraphobia, not only could she understand what I was going through from her own experience – she knew what to do to get better. I could have confidence in her suggestions because she had made a complete recovery from agoraphobia and panic attacks herself.

Meeting someone who had recovered from the same thing I was going through was like being lost in a forest and meeting someone with a map who could show me the way out.

You are Not Alone with Agoraphobia

2006-04-27T12:31:00.000-07:00

Most people who get agoraphobia feel like they are the only one. Unless you have looked into the statistics, it is easy to feel like you are the only person going through what you are going through. You may feel like no one else experiences the kind of panic or anxiety that you do or that no one could ever understand you.This belief can be isolating and work against your recovery. It can lead to hiding your problem, not sharing it with anyone, and not getting the support or help you need to get better.

I will admit that my case of agoraphobia made me feel like some kind of a freak for a while. I felt like I must be the only person in the world that couldn't leave my house without hyperventilating and getting weak and dizzy. I felt alone and isolated in my suffering, as though no one else has experienced the type of things I was experiencing.

Going to a support group didn't help these feelings of isolationat all. Though the people at my support group all said they had anxiety disorders and some even said they had agoraphobia, they could all sit through the whole group session without leaving. I, on the other hand, could only stay about five or ten minutes without being overwhelmed with panic and walking hurriedly to the door – and I was on lots of valium.

So I felt like the freak, even among a support group of other people with anxiety disorders. The truth is, you are not alone if you suffer from agoraphobia. In fact, you are in good company. About 3.2 million Americans suffer from agoraphobia at any given time (Anxiety Disorders Association of America, 2005). That's a lot of people who share your experience!

They are not necessarily losers or societal outcasts either.

There are some pretty big names among these 3.2 million agoraphobia sufferers, too. Former NFL football star and Heisman Trophy winner, Earl Campbell, has suffered from debilitating agoraphobia at times, as has Oscar Award winning actress, Kim Basinger.

I said all of this to say that if you have agoraphobia, it might be helpful to find someone else who has been through agoraphobia and recovered. The best support and help may come from someone who understands your disorder from their own experience - and can share what they did to get their life back.

Setbacks Don't Have to be Setbacks in Your Recovery from Agoraphobia

2006-04-26T11:30:00.000-07:00

Setbacks can be one of the most discouraging things during your recovery from agoraphobia. They can make you feel like you have lost weeks, months, or years of hard-won progress and that you are back at square one. Fortunately, this is not the case.

Don't give up when you experience a setback. My recovery from panic disorder with agoraphobia didn't happen overnight. It was a hard fought battle with many setbacks. But it did happen, and today I am totally free from panic attacks and agoraphobia.

Your recovery may not happen overnight either, and your progress toward recovery may not all be forward. You may experience some tough setbacks along the way. I am writing you today to tell you not to make too much out of these setbacks.

I can remember working really hard with my desensitization program and getting to where I could go to four high school classes in a row before going home. It had taken me the better part of the past year to achieve this and I had started by going to only one class per day and slowly added classes over time. Then one morning early in my junior year of high school, I had a major panic attack during first period and had to go home. I was devastated. I thought all of my hard work had gone down the drain and I would have to start my recovery over from scratch. I was so consumed by these thoughts that I didn't go to school at all for the next couple of days.

Looking back, I am glad to be able to tell you that my thinking was totally wrong. This happened in September. By mid-November of that year I was playing on my school basketball team and attending almost a full day of school on a regular basis.

My encouragement to you is that all progress toward your recovery from agoraphobia may not be forward progress. There may be days when you experience so much panic or anxiety that it feels like you are right back where you started. But take heart, days like this do not mean you are starting your recovery over.

Each time you reach a new level in your recovery, you can get back to that level fairly quickly no matter what setbacks you face. It's best not to gauge the progress of your recovery from agoraphobia on a day to day basis. In most cases, recovery from panic disorder and agoraphobia is more like a marathon than a sprint. You can best measure progress toward your recovery over longer intervals of time.

Because of this, don't take setbacks too seriously no matter how bad they may feel. In fact, it might be better just to expect to have some setbacks along the way. In the end, if you persist in doing the things you need to be doing to recover, you will recover from agoraphobia and get your life back, no matter what happens on any given day.

Take it from someone who went through lots of setbacks but ended up overcoming a case of severe agoraphobia with panic attacks. Persistence wins in the end. I know this because I did it – and if I did it, so can you.

Agoraphobia Online Newsletter

2006-04-25T01:13:00.000-07:00

While there are a number of newsletters on anxiety and panic disorders on the internet, I have decided to start a newsletter that is specific to agoraphobia. I am happy to say that people have already been signing up since I began advertising it Saturday night.

Articles that will be featured in the first issue issue (May 1) include:

- Top 10 Ways to Panic-Proof Your Life (A recovered agoraphobic's perspective).

- Can You Assume That Your Psychologist Will Use the Most Effective Treatments for Agoraphobia? What Does Research Say?

- Some Simple Guidelines For Choosing a Good Therapist.

Sign up for the newsletter on the Agoraphobia Resource Center website. The link is found on the sidebar of this blog.

New Agoraphobia Website

2006-04-22T13:27:00.000-07:00

I had agoraphobia before the internet became so widely used. Looking back, I wish there had been a helpful website or two with information about agoraphobia. Since I couldn't leave my house very easily, the internet would have been the perfect place to learn about agoraphobia.

Recently, I have started the website I wish I had when I suffered from agoraphobia. The information I am putting on the site would have saved me about a year or so of my life. I spent over a year just trying to figure out what was wrong.

Anyway, the link to my website is posted on the sidebar of this blog.

Check it out today and sign up for my free, bi-monthly newsletter. Oh, and I am calling the site the Agoraphobia Resource Center.

Causes of Agoraphobia

2006-04-20T20:16:00.000-07:00

There is no single cause of agoraphobia, nor is there any one factor that has been proven to be present in all cases. However, here are a list of factors that commonly contribute to the development of agoraphobia:

Family Factors
Growing up in a family with rigid rules or belief systems
Having an anxious parent as a role model
Having an overly critical parent that demands perfection or has unrealistic expectations
Having an overprotective parent
Receiving performance related approval as a child
Being abused as a child either physically or emotionally
Growing up with alcoholism in the family

Personality Factors
Oversensitivity to emotional stimuli
High levels of creativity and imagination
Black-and-white thinking
Perfectionism
High need for approval
High need for control
Suppressing or denying feelings
Tendency to disregard physical needs or acknowledge connection between the body and emotions.

Biological Factors
Oversensitivity to adrenalin
Oversensitivity to hormone changes
Oversensitivity to medication
Oversensitivity to physical stimulus (lights, sounds, temperatures, bodily sensations, etc.)
Large amounts of sodium lactate in the bloodstream

Usually a number of these factors contribute together to the onset of agoraphobia.

How to Provide Support for Someone with Agoraphobia During a Panic Attack

2006-04-17T21:38:00.000-07:00

If you are with someone with agoraphobia and they start to have a panic attack, you can be a major help or a major hindrance. Here are some tips on how to be a major help.

First, ask ahead of time what the person would prefer you to do during a panic attack. Some people like to be left alone to concentrate on using their own strategies to get through it. Some people like to be talked to or touched. Knowing your friend or loved one's preferences is the first step toward being able to help during panic.

If the person with agoraphobia would like you to talk them through a panic attack, ask them specifically what types of things he or she would like you to say. If they cannot tell you, here are some good ideas:

1) Validate their emotions. Tell them that you are sorry they are experiencing the anxiety or panic. Let them know that you are acknowledging how they feel without judging them. Whatever you do, don't try to use logic or reason to tell them why they shouldn't be anxious. This is the opposite of validating someone's feelings and can make the other person feel stupid for feeling anxious and lets them know you don't get it.

2) Let them know you will stay with them. The presence of a "safe" person with whom the person is familiar and trusts is very comforting to most people during a panic attack. Sometimes its not what you say to the person having the panic attack, but just that you are there with them that makes the difference.

3) Remind them that panic, hyperventilation, and the other physical sensations felt during panic are not dangerous and that they are sure to live through the panic attack. Its good if you read up on the different sensations people feel during panic so you can address them. For example, a person may say they are feeling tingling in their hands and feet during a panic attack and ask if you should take them to a doctor. Knowing ahead of time that tingling sensations are a common physiological response to hyperventilation might give you the confidence to let them know what they are feeling is normal during panic - and keep you from wondering if your friend or loved one might be having a heart attack, stroke, or something dangerous.

If your friend or loved one with agoraphobia says they like to be touched during panic attacks then putting a hand on their shoulder or back, or even holding their hand until the panic subsides can be of great comfort.

Another idea is to lead the person away from the situation or place that triggered the panic and help them get somewhere safe. This may mean guding them out of a crowded restaraunt and helping them get to the car to calm down. It might mean leaving an event in the middle and driving them home.

People with agoraphobia really appreciate it when someone understands enough to help them out of the feared situation and get to a safe place without criticizing, judging, trying to talk them out of the panic, or asking lots of questions.

When you are helping someone with agoraphobia out of a situation that has induced a panic attack it is best to hold your comments and questions until later. Most people cannot think during a panic attack and having to listen to someone else's opinions or being faced with questions will only annoy the person having the panic attack, or cause them to start arguing with you.

Like I said before, trying to talk them out of the panic with reason or logic will just invalidate their feelings. Its unrealistic to expect a person having the panic to think rationally.

Whatever happens, stay calm and try to practice the things I just discussed. Speak in low, soothing tones and move using gentle, slow motions. The best thing a person can have during a panic atack is the presence of a calm role model who cares for them.

Agoraphobia Support: Ten Things Not To Do

2006-04-14T08:02:00.000-07:00

Here are ten things not to do if you are trying to be a good support person for a friend or loved one with agoraphobia:

Don't:

1) Try to fix their problems with reason or logic

The anxiety and panic that come with agoraphobia come from irrational fear. Trying to use reason or logic to help will only make your friend or loved one with agoraphobia feel like you think he or she is stupid. If reason and logic worked, most people with agoraphobia would be better already. If a person with agoraphobia is sharing irrational thoughts with you, try active listening (hearing and making reflective statements about their feelngs) to let the person express emotions.

2) Try to force them to try any one recovery method

You may think you know best what they should be doing, but trying to force your way will only undermine the recovery process. Part of recovery has to do with the person gaining a sense of mastery or empowerment in his or her own life - and taking responsibility for oneself. You might suggest options, offer incentives, but don't try to force your way on someone with agoraphobia. Never use words like "should" or "shouldn't." Feeling trapped into having to so something with no other options is one of the psychological contributors to agoraphobia in the first place.

3) Try to solve all of the person's problems for them

If you try to do everything for someone with agoraphobia that he or she is afraid to do for himself or herself, you are just enabling the person and making the disorder too convenient for them. In extreme cases, the person will start enjoying the care and attention you are giving them and lose incentive to recover. The idea is to encourage, but let the person with agoraphobia take responsibility for his or her own life.

4) Question the person's desire to recover

Most people with agoraphobia want to recover. Most people would not choose to live through the nightmare that agoraphobia can be. Though the avoidance behavior and paralysis from anxiety might make someone look like they aren't trying or don't really care about recovering - believe me, they do. Questioning this is only hurtful and humiliating. Someone with agoraphobia doesn't need to be spending energy convincing others of their desire to recover. They will need all of their energy for the recovery effort.

5) Set time limits for their recovery

Let the person come up with his or her own goals. Setting recovery goals for a person with agoraphobia that are set in time only puts them under added pressure and stress. For instance, don't tell your spouse she has to get well by summer or she will ruin your vacation to the Bahamas. People need to be internally motivated to recover, not pressured by someone else.

6) Set goals for or evaluate the person's progress toward recovery

Remember, they are recovering for themselves, not you. Guide them to make their own evaluations but don't make it about pleasing you. People pleasing is already a problem and source of anxiety for most people with agoraphobia. Whatever you do, don't compare their progress with someone else's. Every case of agoraphobia is different and to a different degree. Feeling the need to compete with others in recovery just adds needless anxiety.

7) Try to get them to be spontaneous or do something unexpectedly

For someone with agoraphobia, this is highly likely to trigger panic or at least an escalation in anxiety. One of my worst memories as an agoraphobic was when my parents tried to get me to take a trip out of town on short notice. I felt suddenly overwhelmed and out of control.

8) Accuse them of wanting to have agoraphobia for selfish reasons

Having your motives questioned is the worst if you have agoraphobia. My parents used to accuse me of wanting to be sick to be able to stay home from school. I can tell you from experience that no one would decide to suffer from the horrors of agoraphobia to stay home from school, work, or anything else. Questioning motives humilates the sufferer and put the focus on having to convince others of something rather than the recovery process.

9) Psychoanalyze

No one likes to hear someone else's speculations about what's wrong with them. Keep your guesses to yourself, especially if you are not a psychologist or mental health professional. Its ok to help the person in the process of self-discovery or listen to a person analyze himself or herself, but under no circumstances act like you've figured them out. Sufferers of agoraphobia don't need more advice. They will get that from everyone who tries to fix them. The best thing you can offer them is understanding - that's what they really need from you as a support person.

10) Criticize

People with agoraphobia are already too hard on themselves and are usually perfectionistic. being critical only promotes this sort of thinking. Only criticize if you are doing it constructively and the person knows it is because you care.

Oh, and one more thing.......never, ever, ever give up on them. Your friend or loved one with agoraphobia needs you to keep believing in them, even during times when they lose confidence in themselves.

Top Ten Ways to Support Someone with Agoraphobia

2006-04-12T14:39:00.000-07:00

Here are ten ways to be a healthy support person for someone with agoraphobia (written by a recovered agoraphobic):

1) Offer unconditional acceptance

This means being non-judgmental and non-critical. It means not thinking of agoraphobia and the behaviors that go with it in terms of good and bad or right and wrong. It means not putting the person down or voicing disapproval when they do things you don't understand. It means letting the person know that you love them, care about them, and will not abandon them whether or not they recover from agoraphobia.

2) Practice active listening

Hear and validate the person's feelings or emotions by making reflective statements to let them know that you heard and understood.

3) Increase your knowledge and understanding by reading about agoraphobia

Read all you can about agoraphobia and listen to the person who is suffering about their experience. Don't assume you know what they are going through.

4) Help the person find a motivation to recover

Help them find a purpose greater than their fear. This is one of the most important factors in anyone's recovery - discovering a reason for living that makes fear irrelevant. Discuss their dreams and fantasies with them. Draw out their desires. Engage them in discussions about their skills and interests and what would bring them the most satisfaction in life.

5) Reward their progress and accomplishments no matter how small

Recovery is usually made in a lot of little steps. Sometimes it takes a lot of work to gain just a little ground and its easy for someone with agoraphobia to get discouraged at the pace of recovery. Verbal praise and other rewards for taking even small steps forward can be very encouraging and keep a person motvated to keep pressing forward.

6) Show patience when the person makes mistakes or suffers a setback

Setbacks are a part of almost every recovery and are not intentional on the part of the sufferer. Setbacks, no matter how bad they seem are usually temporary. In most cases, setbacks only become major or prolonged when the person with agoraphobia blows them out of proportion in his or her mind (catastrophizing) and perceives them as worse than they are. By showing patience and not getting upset when your friend or loved one experiences a setback (and by not blaming them), you can help them perceive setbacks as minor and keep them from slowing down the person's recovery more than necessary.

7) Respect the person's autonomy.

If you are helping guide someone's recovery from agoraphobia, make suggestions and offer options, but always leave the decisions to the sufferer. Giving the person freedom to choose will help him or her gain a sense of control over his or her own life - which is so desperately needed to recover.

8) Keep your word always

Let the person with agoraphobia know what they can expect from you and follow through at all times. The sufferer really needs to trust you and feel safe in your presence. Agoraphobia is all about fear and people with agoraphobia and panic attacks are usually very insecure. Having a safe person they can trust helps build the security they need. So don't promise more than you can do and always keep your word.

9) Show confidence in their ability to handle their own life

Don't get into doing everything for a person with agoraphobia. Challenge them to try things they think they can't do. The more you show confidence in the person's ability to handle things, the more likely they are to gain confidence of their own.

10) Take care of yourself

To be a good support person, you need to stay rested and model good self-care habits. Don't make your whole life revolve around the person with agoraphobia. Keep up with interests, social activities, and relationships that don't have anything to with helping your friend or loved one recover from agoraphobia. Learn your limits and don't try to do more than you can do. Be able to say no when you aren't able to help anymore and don't be afraid to ask someone else to help you when you need to rest so your patience and energy need to be revitalized.

Helping Someone with Agoraphobia Want to Recover

2006-04-07T23:29:00.000-07:00

You'd think that everyone with agoraphobia would want to recover, but as I discussed in my last post, some people have some deeply ingrained reasons to cling to their disorder.

One of the best things you can do to support a friend or loved one with agoraphobia is to help them find the desire, motivation, or will to recover if they cannot find it within themselves. What you do to accomplish this should probaby depend on their reasons to stay ill. But in general:

Assure them that they will not lose your attention if they get better, that you would still love and care for them and want to be close to them should they recover from agoraphobia.

Don't let them get away with putting the responsibility for their problem on other people - especially on you. Lovingly confront them when they start to do this and don't get involved in conversations about how someone else is to blame for their problems.

Also, do not be an enabler and cater to their every whim. If you start doing everything for them (shopping, communicating with people, doing the things they are afraid to do for themselves) you are taking responsibility for their disorder and making it convenient for them to stay in their agoraphobic state.

Treat them like the worthwhile person that they are and remind them they are worthy of a better life. Stay positive about who they are, be encouraging and don't get involved in conversations about why they are a bad person or deserve to have agoraphobia.

Most of all - help them find a purpose greater than their fear. This is one of the most important factors in anyone's recovery - discovering a reason for living that makes fear irrelevant.

Discuss their dreams and fantasies with them. Draw out their desires. Engage them in discussions about their skills and interests and what would bring them the most satisfaction in life.

People who are driven to action by a heartfelt cause seldom worry about what might happen if they fail. People who have a reason for living are seldom afraid of freedom, choices, or change. Their focus is usually on making a difference in the world rather than on being afraid of what dreadful thing might happen to them.

In the most extreme cases, people with a strong sense of purpose do not even show fear in the face of death.

Why Some People Don't Want to Recover From Agoraphobia

2006-04-06T15:51:00.000-07:00

You would think that someone with agoraphobia would want to get better. This may not necessarily be true.

Believe it or not, some people with agoraphobia (or other anxiety disorders) would rather not recover. Although they might not admit this consciously, some part of them just doesn't want to let go of agoraphobia so they cling to the disorder like a dear friend.

Some people with agoraphobia enjoy the attention and care they receive from others. They might not have experienced the same level of attention and care before they got agoraphobia or may fear losing it should they recover. This attention and care could come in the form of financial or emotional support among other things.

Other people with agoraphobia might fear getting well because it would mean making changes. They may not feel confident that they would be able to cope with or handle the responsibilities of a normal life and the idea of recovery leaves them feeling unsure and overwhelmed.

Still others with agoraphobia may inherently feel like they don't deserve a better life. They may feel guilty about something and feel like they deserve to suffer. Agoraphobia for these people could be like a prison they have put themselves in to serve out a sentence they feel like they have coming.

Some people with agoraphobia might not feel responsible for their disorder and get a psychological benefit in blaming it on other people. In other words, having a psychological problem like agoraphobia provides a way of getting back at someone (like their parents) whom they wish to make feel guilty.

Some people with agoraphobia might fear freedom. They may not trust their impulses or they may doubt their level of self-control . They might be afraid that they would go out of control in some way (emotionally, physically, financially) if they were to get well and be faced with new freedoms.

Some people with agoraphobia may simply be unmotivated. They know that recovering from agoraphobia would be a lot of work and they don't have any reason to put out the effort. They may not have a sense of purpose for their lives, and so they have no reason to work towards getting well.

Some people with agoraphobia may have other people who are reaping a psychological benefit from their illness. Their close friend or family member might derive a sense of self-worth having someone with agoraphobia being totally dependent on them. That person could be sabatoging their recovery, enabling them instead of challenging them to face their fears and get better.

Whatever the case - some people with agoraphobia might have more reasons to stay sick than get well. To recover, they really need to find a reason to get well.

As a support person for agoraphobia, you can help someone find a reson to get well. I'll share some ideas about that later.

What Makes Someone Vulnerable to Agoraphobia?

2006-04-04T14:02:00.000-07:00

I just read an interesting article in the January 2006 issue of American Psychologist on the subject of how anxiety disorders including agoraphobia develop. Allow me to share the mian points.

First, the authors acknowledge that the going theory of how anxiety disorders like agoraphobia develop is through conditioning. They describe two types of conditioning:

Exteroceptive conditioning: learning to associate external cues like sights, sounds, smells, etc. with anxiety and panic.

Interoceptive conditioning: basically learning to fear the fear. Associating lower levels of anxiety sensations with full blown panic. This is when you are conditioned to notice minor sensations and feelings in your body and relate them to high levels of panic - so that these smaller anxiety-related sensations actually start to trigger panic attacks.

Second, the authors pose the question:

"If simple conditioning explains the cause of panic disorder and agoraphobia then why do some people who experience panic attacks go on to develop panic disorder and agoraphobia and some don't?"

In reviewing the literature, the authors answer this question by saying that what is known as "contemporary learning theory" explains why some people are prone to being conditioned into panic disorder and agoraphobia and others are not.

In other words, someone's genetics and prior learning history can make them vulnerable to developing full-on panic disorder or agoraphobia if they experience a single panic attack. Here are the factors that have to do with your genetics and learning history that put you at risk for developing panic disorder and agoraphobia:

1) Genetic personality traits like neuroticism and trait anxiety.

2) History of learning experiences in which you learn to perceive yourself as helpless or lacking control.

3) Being rewarded for engaging in sick role behavior when experiencing anxiety or panic. (The article says that adults who experience panic attacks are more likely to have grown up in households where they witnessed chronic illness and learned to perceive any unusual bodily sensations as dangerous).

To summarize the author's points, initial panic attacks set the stage for internal and external conditioning that could lead to panic disorder and agoraphobia but.......

people with the above risk factors having to do with genetics and learning are more vulnerable to being conditioned into panic disorder or agoraphobia.

Part of the significance of this finding is that by using this "contemporary learning theory" model to understand how panic disorder and agoraphobia develop, it might be possible to identify people who are at risk for these disorders because of their personality and help them unlearn their helplessness and playing the sick role before they get conditioned for panic disorder and agoraphobia.

By the way, the title of the article is "A Contemporary Learning Theory Perspective on the Etiology of Anxiety Disorders." The authors are Susan Mineka and Richard Zinbarg from Northwestern University.

The article covers the development of specific phobias, social phobia, obsessive compulsive disorder, port-traumatic stress disorder, and generalized anxiety disorder in addition to panic disorder and agoraphobia.

Agoraphobia Support: To Be A Good Support Person You Have To Take Care of Yourself

2006-04-03T00:01:00.000-07:00

A person with agoraphobia may be prone to having a lot of needs or placing a lot of demands on the people they are close to. If you are going to be a good support person for someone with agoraphobia - then you may need to know where and when to draw the line. In other words, if you are going to support a friend or loved one with agoraphobia, you'll need to also be good at remembering to take care of yourself.

Here are some things to do to take care of yourself:

1) Keep up with your friends. Don't let the person with agoraphhobia isolate you to the point where they are the only person in your life.

2) Keep up with your job if you have one. Also keep your outside hobbies and interests. Although you may make lots of sacrifices to spend time with your friend or loved one with agoraphobia, its good to remain functional with your normal responsibilities and participate in recreation.

3) Get the sleep, nutrition and exercise you need to stay healthy. If you get too stressed then pamper yourself with a hot bath, a massage, or a good glass of wine. Don't feel like you have to be suffering all the time just because your friend or loved one with agoraphobia is suffering all the time. It doesn't help them if you let yourself get unhealthy.

4) Don't blame yourself or take responsibility for their condition or lack of progress if recovery is slow. Remember that it is their job to recover and your job to be there for support. If a bad day for them always means a bad day for you, you may be taking too much responsibility for their disorder.

5) Know your limitations and don't put unrealistic expectations on yourself to fix everything. Its ok to rest when you need to or ask for someone else's help in taking care of your friend or loved one with agoraphobia if you need a break.

6) Do something to express your own emotions and receive support for yourself. This could be in the form of a counselor, support group for people who support agoraphobics, or just a good friend you talk to often. Sometimes it can be almost as hard to watch someone you care about suffering as it is to suffer yourslf.

To use an analogy from lifeguarding - you are not going to be able to save someone from drowning if you start to drown yourself. This holds true if you are supporting someone with agoraphobia. To be a good support person, you've got to remember to take care of yourself.

Agoraphobia Support: Guidelines for Good Listening

2006-04-02T14:01:00.000-07:00

Being a good listener is another important quality in being a good support person for someone with agoraphobia. Being a good listener makes you someone the person with agoraphobia can share their feelings with. This is important because much of the anxiety someone with agoraphobia experiences could be coming from holding feelings in and not expressing them.

As someone who has suffered from agoraphobia I can tell you that one of the reasons people with agoraphobia (or anyone else for that matter) don't share their feelings with others is because most people are not good listeners and will just hurt your feelings even worse by not really listening or not validating them.

Probably the most crucial element to being a good listener for someone with agoraphobia or an anxiety disorder is being able to hear and validate someone's feelings or emotions by making reflective statements to let the person know that you heard and understood.

For example, if a friend with agoraphobia tellls you they are afraid they might have a panic attack and embarrass themselves if they go out on a date the best response would be:

"It sounds like you are really scared."

This lets the person with agoraphobia know that you heard their feelings. It lets the person know that you have heard their initial feeling and invites them to share more about it.

Some bad responses that do not show that you heard their feelings (and responses the average person would give) are:

"If you weren't so worried about having a panic attack you probably wouldn't have one."

"Maybe you won't have a panic attack and there's nothing to worry about."

These responses let people know that you think its silly for them to be worried about having a panic attack. They do not let the person know you have heard their feelings.

Hearing and making reflective statements about feelings is part of a skill called active listening. Active listening is a way of listening to someone that lets them know you care about them and are really hearing them. Since many people with agoraphobia say that what they need most in a support person is someone who will listen to them, here are some guidelines for active listening:

Be attentive. You have to make an effort to listen carefully. Don't daydream and don't talk.
Think about the main point the speaker is trying to make. Also, don't be thinking about what you are going to say the whole time the other person is talking.

Make reflective statments at first by paraphrasing or restating in your own words what the speaker is saying. Especially when they share a feeling (fear, anger, sadness, regret, guilt, etc.)

Good phrases to use when making reflective statements are:

"What I hear you saying is....."

"It sounds like......"

"So in other words....."

Try to leave your own emotion out when you're listening. Try not to argue back in your mind. These things detract from what the speaker is saying. In other words, be objective and try not to let your own judgments and biases cloud what you are hearing from them. Try to really see things from the other person's perspective and wait to hear their whole message before forming a response.

Ask for clarification if you don't understand a point the speaker is making. Ask questions to invite them to elaborate on points that seem important.

Avoid distractions. Sit close to the speaker, if possible.

Be aware of more than just the person's words. Look for body language, gestures, tone of voice, posture, etc. See if you think the persons non-verbal communication is congruent with what they are saying. (For example - some people smile when they are telling you they are upset). If the person's words and body language don't match, ask for clarification about what they are really feeling but be gentle about pointing out the descrepency.

When you do offer feedback, try to do so honestly but without passing judgment or expressing approval or disapproval of them as a person.

As you can see, good active listening is more than just not saying anything and nodding. Good listening is a skill that may take some work to develop if you don't come by it naturally. However, developing good active listening skills will make you a good support person for your friend or loved one with agoraphobia.

Plus - being a good listener will help you in your other relationships, too, even with people who don't have agoraphobia.

Support for Agoraphobia: A Little Understanding Can Go A Long Way

2006-04-01T11:24:00.000-08:00

How to Offer a Healing Relationship to Someone with Agoraphobia: Unconditional Acceptance

2006-03-30T23:22:00.000-08:00

If you want to be a support person for someone with agoraphobia, your first job will be to establish a therapeutic relationship with the person who is suffering. It can be tricky to offer a safe, supportive relationship with a friend or loved one with agoraphobia, even if you had a good relationship with them before.

It is important to build a therapeutic relationship before you start trying to help someone with agoraphobia. Thats because a safe, supportive relationship is the vehicle through which real help can be offered.

Offering unconditional acceptance to someone who is suffering from agoraphobia is critical to building a healing relationship with them. Those of us who have had agoraphobia know that we are often self-critical and have a hard time accepting ourselves. Its even harder to accept yourself when you have agoraphobia and can't function normally. That is why it is so important to have people who accept us no matter what we do or go through. Experiencing the acceptance of others helps us to accept ourselves.

Offering unconditional acceptance means being non-judgmental and non-critical. It means not thinking of agoraphobia and the behaviors that go with it in terms of good and bad or right and wrong. It means not putting the person down or voicing disapproval when they do things you don't understand. It means letting the person know that you love them, care about them, and will not abandon them whether or not they recover from agoraphobia.

Offering unconditional acceptance means not only accepting the person with agoraphobia but accepting the condition of agoraphobia as well - at least for the time being. It means not trying to fix them all the time, refraining from constantly offering advice or suggestions, and not needing to always correct their irrational thinking. It means being able to relax and have fun with them - and talk to them about subjects other than what they need to be doing to get well. It means being willing to let the agoraphobic act agoraphobic - not that you don't want to help them get well - just that there is no pressure from you to hurry in doing so. nobody wants to feel like a project 0r like they are letting someone down if they arent getting better fast enough.

People with agoraphobia need people around them who accept them just as they are. Just like someone suffering from a physical illness or injury - it takes time to heal. If you are able to show your loved one with agoraphobia that you care without conditions and will stand by them through the ups and downs - you will have taken a big, first step towards building a relationship with them that will contribute to their recovery from agoraphobia.

Agoraphobia: Unhealthy Family Reactions

2006-03-28T19:36:00.000-08:00

Once a person has tried to help a family member or spouse with agoraphobia by offering logic and reason and sees that it doesn't help, he or she will usually get frustrated and do one of the following:

1) Give up and emotionally detach from the person with agoraphobia
2) Become and enabler
3) Provide healthy support

The first two options are polar extremes - taking zero responsibility for helping and taking all of the responsibility. Both are unhealthy responses to agoraphobia.

Those who give up and emotionally detach from their family member or spouse with agoraphobia may start to say things like, "Well I guess I'll just let this be your problem since you won't let me help you" (putting the blame on the person with agoraphobia for not being receptive to help) or simply "I've tried everything I can, there's nothing I can do to help." Either way, they start detaching emotionally.

The people who emotionally detach from a family member with agoraphobia are not usually trying to be mean. In most cases, they just can't handle caring and feeling powerless to help or fix the problem.

Those who become enablers start trying harder to help when their first efforts fail. They may start doing everything for the family member or spouse like going shopping for them, communicating with others for them, driving them, entertaining them, fixing their meals, or in short, making their whole life about helping the family member or spouse with agoraphobia.

At first the enabler may seem kind and caring but in the long run they do the loved one with agoraphobia more harm than good. They, in effect, shield their loved one from having to face up to their fears or take any initiative toward recovery. A good enabler can make it too convenient for the agoraphobic not to work toward getting well. In some cases the person with agoraphobia enjoys the all the added love and attention they are getting from their spouse or family member so much that it actually gives them a reason not to get well.

Both giving up and detaching and becoming an enabler are unhealthy responses a spouse or family member can have to someone with agoraphobia. The most helpful response is to provide healthy support.

Providing healthy support means offering consistent encouragement and care without assuming responsibility for the disorder, or making it too convenient for the person with agoraphobia to stay sick and not his or her fears. (I realize agoraphobia is never convenient - but you know what I mean).

I will talk more about how to be a healthy support person for someone with agoraphobia in a later post.

Agoraphobia: Don't Expect Your Family To Get It

2006-03-25T10:46:00.000-08:00

When I say don't expect your family to get it, I don't mean that agoraphobia is not contagious. What I mean is that most families do not understand agoraphobia, at least not right away.

In my case, I was the son of a psychologist, and he didn't understand what was going on with me for over a year.

When someone gets agoraphobia, the first stages of common family reactions are as follows:

1) Denial

When you first get agoraphobia, most parents, husbands, wives, or children will not understand what is happening even if you tell them. They are most likley to shake their heads in disbelief as to why you can't do the normal things you used to do.

They may think you are making the symptoms up.
They may accuse you of being lazy, unmotivated, or purposely trying to avoid some responsibility.
They may try to use logic or reason to try to help you.
They may try to talk you out of your feelings
They may say things like "there's nothing really wrong with you" or "there's nothing to be afraid of."

2) Frustration

When their logic and reason don't help you, family members are likely to get extremely frustrated. Most people will want to fix you, and if they can't fix you they may start blaming you for not trying hard enough to get better or be normal.

I remember my dad got mad at me once and said, "Come on, any fool can breathe." That was right during a massive hyperventilation spell. I knew he just wanted to see me get better, but comments like this can really hurt.

Eventually, family members see that all of their logic and simple solutions will not solve your problem. They will have to quit denying the problem or trying to fix it. They will be forced to admit you have agoraphobia, a psychological disorder. They will have to admit they can't help you so easily. They may even have to admit that they have contributed to the development of your problem.

When family members get to the level of frustration that forces them to admit reality - they will have a big choice to make.

They can respond to your disorder in a healthy, helpful way.

Or they can respond to your disorder in an unhealthy, unhelpful way.

I will talk more about family responses to agoraphobia in the next post.

Agoraphobia Treatment: How Can You Tell It Is Working And How Long Should It Take?

2006-03-24T22:13:00.000-08:00

How do you know if your therapy for agoraphobia is working?

Your therapy is working as long as you keep seeing forward progress no matter how slow. Another good sign is if you still feel encouraged and still have your sights set on the goal of recovery. Its also a sign that therapy is working if you are feeling connected with your therapist in a therapeutic way and you feel the two of you are working together as a team to reach your recovery goal. In sum, as long as there is some momentum and forward progress, no matter how little, the therapy is working.

How long should you try a type of therapy before you decide its not working?

You should see some major progress in 12-16 weeks. If in this amount of time, you still feel frustrated and at a standstill, its time to change treatment plans or therapists, or so says the Anxiety Disorder Association of America.

A support group for agoraphobia meeting downtown?

2006-03-23T23:30:00.000-08:00

When my mom first showed me an ad for an agoraphobia support group in the newspaper, I thought it was a total joke. The group met downtown and I couldn’t see how anyone with the type of panic disorder and agoraphobia I had getting downtown. Go figure.

I attended the group a few times and it just affirmed how bad my case was compared to others. To get to the group’s meeting place downtown I had to knock myself out with Valium and lie on the floor of a van facedown while my dad drove me. Once there, sitting in a metal folding chair facing a circle of people was a lot harder than lying on the shrink’s couch. I could only stay in my seat about five minutes without feeling on the verge of a collapse from hyperventilation. I had to leave a lot to catch my breath outside in the van.

What I heard spoken in group was not inspiring at all. After several visits, I lost my motivation to go back. Most of the group members had been suffering from anxiety disorders for longer than I had been alive.

They had formed a cozy little sub-culture around their pathology with inside jokes and the whole bit. It seemed that illness had become an identity for some. It was their ticket into the sub-culture where they found a sense of belonging.

Though my symptoms were far worse than anyone’s, I wasn’t about to join the club. I didn’t want to make a life out of my anxiety disorder. I just wanted to get well. It didn’t seem healthy to spend too much time with people who seemed content with being sick.

Also, comparing myself with others discouraged me. Especially with people who claimed to have panic disorders or agoraphobia but sat through the whole group on a hard folding chair without having to leave. Maybe they were taking lots of drugs or something, but I didn’t stick with the group long enough to find out.

How to find a support group for agoraphobia

2006-03-23T19:23:00.000-08:00

Here are some places to look for information about agoraphobia support groups in your area:

1) In the your local telephone book under a section called "Community Services." It may be in the white or yellow pages. Once you find the community service section look under the category of "Mental Health."

2) If you cannot find any support groups in this section look in the yellow pages under "psychiatrists," "psychologists," "marriage and family counselors," "social workers," or "mental health clinics." If any therapists or clinics say they specialize in anxiety disorders or agoraphobia, call and ask if they know of any local support groups for agoraphobia.

3) Sometimes support groups put ads in the newspaper in the classified ads section. That's where I found the one I went to nwhen I had agoraphobia.

4) Finally, if you cannot find a local support group, The Anxiety Disorders Association of America helps people organizing local support groups through their network of people who specialize in working with anxiety disorders. You can check their website or contact them by phone or mail at:

Anxiety Disorders Association of America
6000 Executive Boulevard, Suite 513
Rockville, MD 20852
(301) 231-9350

How to choose a good support group for agoraphobia

2006-03-23T19:11:00.000-08:00

Support groups can be helpful in recovering from agoraphobia. Going to a support group can help you to know that you are not alone in your suffering and give you a chance to build relationships with people who are going through the same thing and will understand what you are going through. At support groups, agoraphobia sufferers can share their successes with one another and give each other encouragement.

There are basically two types of support groups:

1) Professionally led
2) Peer led

If you are thinking about finding a support group, here is what you should expect from each type of support group:

A professionally led group should offer professional training in cognitive and bahavioral recovery methods, the latest information on agoraphobia related to recovery, referrals for medication as needed, opportunities for support/counseling for the sufferer and for close friends or family.

A peer led group should offer insight from people's personal experiences in recovery, self-help recovery methods, a supportive atmosphere of care and confidentiality, and information on agoraphobia, treatments, and medications.

Peer led support groups should also promote the use of research proven recovery methods (cognitive and behavioral) and encourage sufferers to be disciplined in the practice of facing their fears using these methods. Peer led support groups can also be a good source of accountability for setting goals and actively striving to meet them.

Finally, peer led support groups should be free of charge. Only pay for a support group if it is led by a professional.

How to know when to seek help for agoraphobia

2006-03-23T14:25:00.000-08:00

When I had agoraphobia I went for a long time without treatment. That's because I was busy going to doctors and couldn't admit I had a psychological problem.

Once you recongize you are having agoraphobia symptoms, the question is "How do you know when it's time to seek outside help?"

Here's a general rule of thumb:

If your symptoms are interfering with the regular flow of your daily life it's time to get help. This is when the symptoms are hindering you at work, school, social events, or in your relationships with family or friends.

When you decide you need help, the next question is "what type of help?"

Here's another rule of thumb:

The type or level of help you need should depend on the degree of avoidance behavior. If you are just anxious and have no or mid avoidance behaviors then you probably don't need to see a professional psychologist. In this case, giving yourself a good education on agoraphobia through reading or consulting others who nay have experience with agoraphobia is a good idea. In getting a good education on agoraphobia you will probably be able to learn and use anxiety management techniques to keep the symptoms at bay and function in your normal life.

However, if you are showing signs of severe avoidance behavior that is disrupting your life (like missing work or school) you probably need to find a good individual therapist to guide you or get involved in group therapy.

What Causes The Personality Behind Agoraphobia?

2006-03-21T22:10:00.000-08:00

The agoraphobia personality I described in the last post isn't just genetic. A number of factors might conspire to create it. If you have agoraphobia, check out the list below and see if you can relate:

1) A parent who models anxiety. Role modeling by a paret can have a powerful influence on a child. If a parent models the anxious personality traits, the child is likely to devlop them as well.

2) Critical parent. If a child has an overly critical parent that places unrealistic expectations on them, this can lead to the child developing a perfectionistic personality.

3) Overprotective parent. An overprotective parent shields their child from life's hardships, acting as if their child couldn't handle life on their own. Overprotection on the part of the parent teaches the child that taking risks in life is too dangerous and that risks should be avoided. It also teaches the child that he or she is fragile and not equipped to face challenges independently. As a result, children of overprotective parents are likely to fear taking risks ad feel anxiety and unsure of themselves in the face of a challenge.

4) Approval based on peformance. Parents who only show approval for their child when he or she does something that pleases them. This type of parent does not make a distinction between what the child does and the child's worth as a person. Children with parents like this may also grow up failing to make that distinction, and feel they must always perform well to be a valuable person. This leads to the anxiety that comes from always having to strive to achieve something to maintain a sense of personal worth. Perfectionistic parents who only give approval based on performance are even worse. Not only do their children learn that they have to perform well to be loved, they must perform perfectly. When a child feels like his or her worth is riding on being perfect, this can lead to a lot of performance anxiety and fear of losing the love and approval of significant others.

5) Rigid family rules. Children who grow up in families with overly strict rules tend to become black-and-white thinkers. As adults, they may end up creating their own set of rigid rules about the way things "should" be, and feel anxiety when these standards are not met.

6) Rigid belief systems. Children who grow up in families that hold rigid belief systems also tend to become black-and-white thinkers becuase parents with rigid beliefs usually model this type of thinking.

7) Surpression of feelings. When children grow up in families where they are taught that it is not ok to express feelings (example: being told not to cry or not to feel a certain way) , they are prone to holding their feelings in as adults. Parents may teach a child that it is not ok to express feelings in several ways: 1) telling the child directly not to feel a certain way, 2) ignoring the child's feelings, 3) reacting with violence or anger when the child expresses feelings. All of these cases lead to adults with bottled up emotions that could cause anxiety or panic.

8) Alcoholism, physical abuse, or emotional abuse. Children from homes with alcoholism or abuse tend to feel anxiety from the insecurity of having an unstable emotional environment. They grow up to become ustable emotionally as adults and are more prone to having an anxiety disorder.

9) Sepration from parents. Children who are separated from their parents for long periods of time without knowing why develop anxiety over separation and loss. This may happen if a parent is sick or in the hospital for a long time, goes on a long business trip, ignores their child for lon periods, gets divorced, or dies.

10) Having to play the parent role too early. When children who are forced into the parent role too early due to a parent being sick, busy, or absent they may develop a a rigid set of rules for themselves in order to survive. This may be the only way they can cope with having adult responsibilties before they are developmentally prepared to handle them. In adulthod, this can lead to many of the agoraphobia personality traits; black-and-white thinking, a high need for control, perfectionism, and unrealistic expectations.

I'm not saying that these factors cause agoraphobia in all cases, but the more of these factors a person experiences in life, the more likely they are to develop the personality traits of agoraphobia.

The Personality of Agoraphobia

2006-03-21T00:17:00.000-08:00

Tonight I would like to write about a set of personality traits that are common among people with agoraphobia. These personality traits are not likely to cause agoraphobia alone, but usually conspire with other factors in a person's life to cause the disorder. Still, people with agoraphobia or who are highly anxious will typically have many of these anxiety-producing personality traits:

1) Oversensitvity to emotional stimuli. It takes less stimuli for a person with agoraphobia to respond with feelings of sadness, anger, hurt, rejection, or loneliness, than it does the average person. On the other hand, it also takes less stimuli to make them feel excited, joyful, elated, passionate, or affectionate. People with agoraphobia not only feel emotions more readily, but they also feel emotions throughout their entire bodies (hence, the capacity for panic attacks). The are more likley to have physical responses to emotion than other people. In addition to being overly sensitive to their own needs, they are also highly sensitive to the needs of others.

2) Highly creative and imaginative. People with agoraphobia usually have vivid imaginations and lots of creativity. This can be a blessing or a curse. Imagination and creativity are both great virtues, but with an anxiety disorder like agoraphobia the ability to create powerful visual images of dreadful possibilities can really work against you. People with agoraphobia can come up with an infinite number of negative possibilities to worry about in a given situation. They can also imagine a catastrophic event like having a panic attack in a feared setting so vividly that they can start to hyperventilate because the imaginary experience feels so real.

3) Rigid Thinking. People with agoraphobia tend to perceive everything in extremes or absolutes. Things are black or white, right or wrong, good or bad, fair or unfair. They also have a strong tendency to think in terms of what "should" or "must" be. When they experience events, people or life circumstances to be different from how they think they "should" be, they are easily upset or get anxious.

4) High need for approval. People with agoraphobia are often people pleasers. Because they have a low sense of self-worth, they rely on the approval of others to feel valuable or significant. Because they need the validation of others so much, they are sensitive to criticism and have an extreme fear of rejection. They also have trouble saying no and avoid conflict or confrontation for fear of losing the approval of others. This extreme need for approval can combine with their high levels of sensitivity, causing them to feel responsible for other people's problems and feelings.

5) Perfectionism. People with agoraphobia have a tendency to set unrealistic expectations for themselves and then fear not living up to them. Because they are people pleasers, they also worry about meeting the expectations they perceive others have set for them. Since they consider anything less than perfect a failure and they have an extreme fear of failure, the constant striving for perfection causes people with agoraphobia a lot of worry and stress.

6) Need for control. People with agoraphobia have a high need for events to be predictable and to be able to exert large amounts of control over their environment or circumstances. In many cases, they even feel the need to control the feelings and behaviors of others. They live in fear of losing control and after the onset of agoraphobia, feel a lot of anxiety over hiding their condition to appear to be in control to others.

7) Inhibition of feelings. People with agoraphobia feel a lot of anxiety over trying to hide or supress negative feelings. This may be because they fear losing the approval of others, fear losing control, or feel like they "shouldn't" be feeling a certain feeling. Whatever the case, holding in feelings over a long period of time cause them to build up inside the person. Then when the person gets under stress, they are likely to feel all of their bottled up feelings all at once which causes panic or anxiety.

8) Neglecting physical needs. People with agoraphobia often show the tendency to ignore their bodies needs for rest or proper care. This may be because they are constantly striving towards unrealistic expectations. They are usually only aware that they are tired and need to rest when they become completely exhausted.

Tomorrow I will talk about where these personality traits behind agoraphobia come from.

Why Do Most People with Agoraphobia Take a Year or More to Figure Out What's Wrong and and Even Longer to Start Recovery

2006-03-17T16:02:00.000-08:00

Agoraphobia is the fear of having a major panic attack in public or open spaces.

Understanding agoraphobia is the first step toward recovery. However, the average person with agoraphobia takes at least one full year to get diagnosed and even longer to learn enough about agoraphobia to start recovering.

Here are four reasons why:

1) Most people don't know what is wrong with them at first. The symptoms of agoraphobia, especially during panic attacks, feel like those of a physical illness. For example, when you are hyperventilating it is easy to suspect something is wrong with your lungs. When your heart is racing it is easy to think something is wrong with your heart. When you are sick at your stomach day after day it is easy to think something is wrong with your digestive system. Plus, one symptom of agoraphobia is to "scan" your body for physical symptoms and worry about every little twinge as if it may be a major life-threatening illness.

2) Many doctors don’t know how to diagnose agoraphobia. People with agoraphobia commonly visit a succession of doctors trying to find a diagnosis. Most doctors will listen to physical complaints and run tests. They will report that the tests are negative, but often fail to suggest the presence of agoraphobia due to a lack of training. Doctors who can tell that your symptoms are caused by a panic attack may still not be able to tell what type of anxiety disorder you have or provide information about it.

3) Most people go through a period of denial. If finally faced with a diagnosis of a psychological disorder like agoraphobia, the human reaction is to throw up defenses and deny it. Most of us don’t think of ourselves as the type of person who would have a "mental problem" or "psychological disorder." Psychological problems carry a stigma in society that physical illnesses and injuries do not.

The average person tends to consider a psychological disorder as personal weakness or lack of will power. People are more likely to treat a psychological disorder like agoraphobia as your fault than they would in the case of a physical illness or injury. If you were diagnosed with cancer, no one would stand over your bed during chemotherapy and question your will power, work ethic, or desire to go to work or school. But try having agoraphobia. People will do exactly that. Since no one wants to be viewed that way, it is hard for most people to admit to anyone they have agoraphobia.

4) Most people are reluctant to seek treatment for a psychological disorder because of the stigma. Even people who are able to admit to themselves that they have a psychological disorder might still have trouble admitting it to anyone else. It’s hard enough to try to explain irrational fear and panic attacks to your friends and family, and even harder to seek out professional help.

A word to the wise - the best course of action to take if you start experiencing panic attacks or the symptoms of agoraphobia is:

- See a doctor to rule out medical problems.
- Consult a mental health professional to get a diagnosis and/or begin treatment.
- Learn everything you can about your disorder.

Knowledge is the first step to recovery and the sooner you get started on your recovery from agoraphobia the faster it will be.

On the flip side, the longer it takes you to get diagnosed and admit that you have a disorder - the more agoraphobia has a chance to take root, and the more difficult your recovery may be.

If you suspect that you or someone you know might have agoraphobia, don’t take a year to start learning everything you can about it. Start today. You can learn more by reading or asking questions at:

www.agoraphobia.ws

Is Agoraphobia the Same as Panic Disorder?

2006-03-16T22:33:00.000-08:00

Since people with agoraphobia usually suffer from panic attacks, people often ask me if agoraphobia is the same as panic disorder.

The answer is no, but....

Agoraphobia and panic disorder usually come hand-in-hand. Over 95% of people diagnosed with agoraphobia actually have panic disorder with agoraphobia.

Panic disorder (with or without agoraphobia) is defined by:
- frequent panic attacks
- persistent worry about having panic attacks
- worry about the implications or consequences of the panic attacks (like losing control, having a heart attack, or going crazy).
- Significant changes in behavior related to the panic attacks.

Looking at the features of panic disorder, you can probably see why people with panic disorder commonly develop agoraphobia also. Worrying about panic attacks and their consequences can easily lead to fear of being out in public or open spaces and cause one to retreat to “safe” and familiar places.

Less than 5% of people with agoraphobia have what is called “agoraphobia without history of panic disorder.” People in this category fear public and open spaces because of panic-like symptoms but don’t meet the full criteria for panic disorder (according to the DSM-IV). In other words, they may fear going out in public because they are afraid they may get dizzy, faint, or fall helpless to the ground – but do not experience full on panic attacks.

Insight Therapy for Agoraphobia

2006-03-15T22:10:00.000-08:00

If you have agoraphobia, insight therapy can either help you make a major breakthrough or turn out to be an expensive trap. Insight therapy has not been proven by research to be as effective as the cognitve-behavioral approach, but some therapists do practice it. If you are going to try insight therapy, it's good to know something about it.

Insight therapy comes from Freudian Psychoanalysis which was popular in the early 20th century. In this type of therapy, the patient talks at length about his or her thought and feelings, and the therapist analyzes them. The goal of insight therapy is to figure out the deeper reason behind why you are suffering from a particular psychological disorder. In the case of agoraphobia, the goal would be to figure out what about your life is behind all the fear.

Before you go to a therapist, it might be worth it to try to figure out what is behind your fear on your own. Ultimately, the answer will come out of you, with or without the therapist. Therapists are trained to help you figure it out if you can't do it on your own.

Here are three questions to ask yourself to gain insight into your fear:

1) What life circumstances coincide with your fear?

To answer this question it might be helpful to journal. Recall the times in your life when you have felt the most fear and anxiety, and struggled the most with agoraphobia. Write down what was going on in your life during each of these times and then look for themes.

Many people with agoraphobia discover that their symptoms are the worst during times when they
- felt stuck in a bad situation they couldn't get out of
- felt like they really needed to or should do something but felt helpless or powerless to do it
- felt like they were being negatively affected by circumstances beyond their control
- felt like they were never good enough for themselves or for someone else they could not please

2) What emotions went along with these circumstances?

The answer to this question could be one of a myriad of negative emotions. You may have felt angry, frustrated, sorrowful, sad, ashamed, anxious, nervous, guilty, weak, helpless, overwhelmed or simply out of control.

3) What type of fear did your circumstances or emotions lead to?

Some possibilities would be:

- fear of failure
- fear of insignificance, or lack of purpose
- fear of losing control
- fear of loss
- fear of identity or role loss
- fear of losing approval
- fear of abandonment or isolation

The idea behing insight therapy is that once you can answer these questions you can start to do something about getting free from agoraphobia. You can exert power to change your circumstances once you know what is leading to the fear. Cognitive-behavioral therapy offers a faster road to recovery from the symptoms of agoraphobia, while insight therapy offers the possibility of slowly removing the psychological roots of the fear so it won't come back.

Put another way, cognitive-behavioral therapy may help you get well, and insight therapy can help you stay well.

Here is an example of how insight therapy can be used on your own to recover from agoraphobia:

A young boy grows up with parents who put immense pressure upon him to perform in school, but he is more interested in sports. Though he makes b's in the classroom, he excels in sports. The b's are not good enough for his parents and he is scolded and punished for doing so "poorly" in school every time he brings home a report card. When he begins high school, he starts falling behind in classes because sports are taking so much of his time. After receiving poor grades on his first tests, he starts having panic attacks every time he goes to class. he becomes afraid to go to school because of the panic attacks and its not long before he is housebound with agoraphobia.

Although he "recovers" and finishes high school, he experiences panic attacks and hyperventilation two more times in his life. One time is when he is in a job with boss he can not please no matter what he does. The other time is during a relationship with and engagement to a woman whom he can never please either.

After journaling about the times in his life when he experienced panic atttacks, he comes to the realization that they all had one thing in common - they occured when he was caught in a relationship of some form with someone significant he felt unable to please. This made him feel helpless and nervous and led to fears of failure and loss (loss of approval, a job, and a fiancee).

After choosing to work for and be in relationships with people whom he could please, his anxiety lessened and he quit having panic attacks.

Of course, this example is overly simplified, but it illustrates how insight therapy can work.

Sometimes it is not so easy to get insight. In some cases your feelings may be unknown to you or lurking at a subconscious level. That's when it might be helpful to consult a therapist, but if you do you should proceed carefully and follow a few guidelines:

1) Tell the therapist what your goal is - that you are recovering from agoraphobia and that you need help discovering the life circumstances and feelings that are behind your fear.

2) Make sure the therapist is willing to share direct and honest conclusions with you.

3) Agree on how many sessions the therapy is expected to last. Make sure the therapy can be done in no more than 5-6 one-hour sessions. An experienced therapist should be able to provide the insight you need within that length of time.

Following these guidelines will keep you out of an expensive trap with a therapist who takes forever leading you to your own conclusions. If you pay for professional help, you are paying for the therapist's insights and you don't want to get caught in a never-ending therapy program where you are expected to keep coming to therapy until you make your own.

Also, it's easy to get too comfortable with therapy or attached to the therapist if it goes on too long. Especially if you are isolated, lonely, and need someone to talk to. Remember that if you have agoraphobia, your goal is to get well, not to settle into a comfort zone and get content with just talking about your illness with a friendly, caring person.

Your life is too valuable to spend suffering from agoraphobia.

Coping with Agoraphobia: Enjoying The Present Moment

2006-03-13T16:52:00.000-08:00

One time when I had agoraphobia my therapist asked me what I was worried about. I told her I was really anxious over the idea of trying to go back to school at the end of the summer and being trapped sitting in crowded classrooms.

My therapist brought up a good point, that it was still summer vacation. She reminded me that since school was not starting the next day or anything, to practice enjoying the present. Enjoying the present moment, as she called it, would distract me from worrying about the future and thinking catastrophically.

Enjoying the present moment is a good way to cope with daily life when you have agoraphobia. This is not necessarily a recovery technique, but a way to cope with anxiety about the future while you are recovering.

If you have agoraphobia then you probably feel some level of anxiety most of the time, even if you are in your safe place and are not having a panic attack. That's because most of us with agoraphobia experience some degree of anxiety about the future all the time. Learning to focus on the present moment is an effective way to cut down on free-floating, anticipatory anxiety that comes with agoraphobia.

To focus on enjoying the present moment, it is important to use all of your senses and treat whatever you are doing, or whatever is around you like it is the most important thing in the world.

For example, you can enjoy the present moment when you are eating:

- slow down and take a look at your food before taking a bite.
- become aware of how the food is aranged on your plate.
- take notice of the colors, textures, and shapes of the food
- put a small bite on your fork or spoon and take time to smell its aroma before putting it in your mouth.
- put your food on your lips first, and then on the tip of your tongue to taste it.
- when you put it all the way in your mouth, wait a moment to bite down.
- chew the food every slowly and thoroughly, noticing small changes in tastes and textures with every bite.
- move the food to different parts of your tongue, noticing subtle differences in tastes.
- when you swallow, concentrate on how the food feels going down your throat.
- repeat these suggestions, savoring every bite, and take at least 20 minutes to finish the meal.

You can also enjoy the present moment when you are taking a walk outside, although this may be a little more difficult at some stages of agoraphobia. But if you can feel safe taking a walk through your neighborhood:

- stand still and breathe deeply and quietly five times before starting your walk.
- for the first few minutes, notice every sensation in your leg muscles as you walk, focusing on your things, calves, and then your ankles.
- then, for the next few minutes, notice how the bottom of your feet feel as they touch the ground. Notice how the heel makes contact with the ground first, then the foot rools, and then you push off with the ball of your foot and toes.
- focus on the rythym of your walking, feeling the pace of your legs and swinging your arms. Continue to do this for a minute or two.
- now focus on the rythym of your breathing, focusing on how the air flows into your nose and to your lungs, Exhale each breath through your mouth.
- now move your attention betweem your feet, legs, walking rythym and breathing, focusing on each for a few minutes at a time.
- if troubling thoughts come into your mind, simply take notice of them. Watch them as you would watch clouds float by overhead and let them float right out of your mind.
- practice meditation for about five minutes during each walk, focusing on something pleasant. If your mind starts to stray from your object of meditation, gently bring it back.

The more you learn to focus on what you are doing in the present moment, the less you will focus on being anxious about the futre. Its that simple. Living in the moment is a great technique to use to get through the day if you have agoraphobia.

Agoraphobia Strategy: Getting Your Imagination To Work For You Part 2

2006-03-12T22:20:00.000-08:00

Besides dreaming up a secret place when I had agoraphobia, I used my imagination to create positive visualizations of myself being anxiety-free in real life.

I pictured myself sitting calmly in a classroom at school surrounded by other students. I saw myself coming up to bat in a baseball game and getting a game-winning hit. In the same way, I pictured myself shopping in the mall, sitting in church, or having fun with friends.

In each of these visualizations, I was careful to create added sensory details with my mind. I would not only see each image, but also hear it, smell it, and touch it.

For example, when I pictured myself sitting in the classroom, I saw the faces of the students around me and words written on the chalkboard. I heard the sound of my teacher’s voice as she gave the lecture. I felt the texture of the surface of the desk I sat in, and of the pages in my notebook. I felt the pen in my hand as I took notes. I spent time picturing each scene and let my mind fill in every detail I could think of.

Most importantly, I pictured myself sitting there in my desk calmly breathing, slowly and deeply, totally free of any worry or panic. In this way, I was able to experience the success of recovery and leading a normal, anxiety-free life before I actually recovered. The more I was able to see it in my mind, over and over, the more these images of success became a reality.

How to Pair Visualization with Relaxation Exercises

One of the more effective things I did was to pair visualization with my breathing and muscle relaxation techniques. Over time, this developed a mental association between positive mental imagery and a deep sense of calm in my body.

I started each relaxation session with deep breathing first. Then tensed and relaxed each muscle group until my body felt limp. Once my breathing was slow and deep and the tension in my muscles was released, I visualized myself at my secret place. This added a visual component to my relaxation response. Then whenever I started to feel anxious in public and said my cue word to trigger relaxation (see chapter seven), I could close my eyes and add a visual dimension. I did this by picturing my secret place which I had also learned to associate with a deep sense of calm.

Another way I used mental imagery was to visualize successes in real life while doing my relaxation routine. For example, I pictured myself being calm in public while doing deep breathing or muscle relaxation exercises. Then when I found myself in a setting that usually caused anxiety, like school, I associated that setting with deep relaxation after having pictured it so many times in my head when I was relaxing at home.

Practicing positive visualization, places I used to associate with panic became associated with deep experiences of peace and relaxation. Even though I only imagined these experiences of calmness and success, my mind started building positive associations related to places and situations I once feared. These new positive associations were as powerful as if I had experienced each imagined success in reality.

How to Put Together a Successful Visualization Program

Here’s a summary of how you can harness the powers of your imagination and make them work for you in your recovery from agoraphobia:

1) Develop a secret place and write out a script that you can record or have someone read to you. Then if you can’t find a place you feel safe and relaxed in real life, you will have one in your mind. You can always close your eyes and let your mind take you far away.

2) Practice positive visualization at least twice a day. Practice at least once in the morning and once in the evening before bed.

3) Combine positive visualizations of being calm in feared settings with deep breathing and muscle relaxation exercises. This way, positive visualization becomes part of your overall relaxation response and you can learn to visually associate relaxation with places you once feared.

I know from experience that if you can picture a new reality in your mind, you can eventually experience that reality in real life. Even if it feels like reversing the flow of a mighty river at first, by reversing the current of your creative powers to get them flowing in a positive direction, your imagination will become an asset for you in your recovery from agoraphobia.

Agoraphobia Strategy: Getting Your Imagination To Work For You

2006-03-12T21:51:00.000-08:00

Most people with agoraphobia have a great imagination. People with agoraphobia are able to imagine the most terrible possibilities in any circumstance and their catastrophic imaginings are vivid enough to produce fear and panic.

One key to recovering for agoraphobia is getting your imagination to work hard for you instead of against you. The cognitive strategy that has been developed to do this is commonly called "positive visualization."

I turned a major corner in my recovery from agoraphobia when I could visualize situations that evoked pleasant emotions as clearly as I could visualize situations that evoked fear. Through practicing positive visualization at least twice per day, I put my creative powers to work for me.

I used the power of my imagination to help me in two ways. First, I used it to create a place of tranquility in my mind. I could always retreat to this place when I started to feel anxious or visualize something negative. Second, I used it to picture myself being calm while sitting in class among other students, going to the shopping mall, playing in school sports, or attending church again. These visualizations let me practice feeling calm in anxiety-producing situations without going anywhere.

Using my imagination in my favor, I was able to experience and feel as if I had recovered from the anxiety disorder in my mind before I actually did. Once I was able to feel and see recovery in my mind’s eye, my reality was soon transformed.

How can you create a private retreat in your mind?
Harry Truman once said, "I have a foxhole in my mind." This meant he had created an imaginary place where he could go to escape the pressures of the outside world. I read about this when I had my anxiety disorder and thought it was a great idea. I figured if this worked for the 33rd President of the United States, then it might work for me.

I used my imagination to create a secret place in my mind where only I would go. I carefully imagined what it might look like, and what sounds and smells I might experience there. Once I imagined this secret place in minute detail, I wrote out a script that described it. I recorded this script on tape so that I could either listen to it myself read it or have my mom read it to me. My script went something like this:

"Lie back, close your eyes and imagine you are entering a place of ultimate relaxation that no one knows about but you. You are walking along a dirt path in a forest beside a stream of cool running water. The water is clear and you can see the forms of rocks below the stream’s currents. Tall trees are all around you providing shade from the sunlight that peeks through their branches. You can hear birds chirping and see butterflies fluttering through the air.

After you walk for a while you stop to lie down in some grass by the stream. As you lie back in the grass you close your eyes and focus on the sound of water gently flowing by. The gurgling of the stream and the chirping of the birds brings you a deep sense of peace as you relax alone, surrounded by nature. You can also smell the fragrant aroma of the pine trees wafting trhough the air.

You don’t have to do anything or be anything here. No one will ask you to do anything or expect anything of you. In fact, no one will ever find you here. You are completely free to lie down and relax for as long as you want to stay here. You feel your body go limp as you lie on your back in the grass without a care in the world."

My script was actually longer than this but you get the idea. I shared this much to encourage you to write your own.

Your imaginary retreat doesn’t have to be in nature. It can be a palace on a cliff overlooking the ocean. It can be a monastery in the middle of the desert. It can be a warm, sunny day at the beach. It can be anything or any place you want it to be.

The important thing is that you create a place in your mind that you can visit any time just by closing your eyes. Then when you are in an anxiety-producing situation, you can close your eyes and take a trip to your personal place of tranquility.

Here are some things to remember when creating a secret, imaginary place in your mind:

1) Have fun with the process and enjoy yourself. Treat it like planning a real vacation.

2) Let your imagination run wild. Use your creativity to come up with a place that would feel the most iviting and relaxing to you.

3) Include details that involve all the senses if you can. Include, touch, taste, smell, sounds and sights.

4) Add as much description as possible to make it real. Use a thesaurus to come up with adjectives if you need to.

5) Make your script long enough to give your body time to get into a deep state of relaxation. You might want to create a script that takes at least 15 or twenty minutes if read slowly.

6) Record your script in a soft voice with relaxing music in the background. You might even ask a familiar person who has a voice that relaxes you to read it for you.

7) Include statements that suggest relaxation like "Your body feels calm and relaxed from head to toe" or "Here in this place, you have nothing to worry about, no one you have to please, and no obligations to fulfill."

Positive visualization works because our subconscious mind doesn’t always distinguish between the real and the imagined. Our thoughts and what we see in our minds has great influence on our emotional state, even if it is pure fantasy. Creating an inner life gives your mind a break from thinking about all of the stresses that may be bombarding you.

If you have agoraphobia, then you probably have a powerful imagination that will make it easy to imagine a secret place. Creating a private retreat in your mind will be the first step toward harnessing the power of your imagination and making it work for you in your recovery from agoraphobia.

Agoraphobia Strategy: The Principle of Non-Resistance

2006-03-12T18:31:00.000-08:00

Here is a strategy to use your mind to overcome the panic attacks that are part of agoraphobia:

Practice non-resistance by trying to have a panic attack.

Go ahead. Try to hyperventilate. Try to get dizzy and faint. try to sweat and get your stomach tied up in knots. Try to make your mind spin out of control.

Guess what? If you actually try to bring on a panic attack you probably won't be able to. Trying to bring on a panic attack is probably the best way to avoid having one.

So why does this work?

Think about it - panic attacks rely on tension and anxiety to fuel them. In the case of agoraphobia, a lot of the reason people with agoraphobia have so many panic attacks is because they fear having them so much. In other words, panic attacks rely on tension between you and the panic to occur.

Here is how to ensure that you will have a panic attack:

1) Worry about having a panic attack.
2) Avoid all situations where a panic attack might happen.
3) Set the goal for yourself of never, ever having another panic attack no matter what.
4) Try to ignore any tension in your body that feels remotely like panic.
5) Try really hard to brace yourself against and actively fight off a panic attack through sheer will and determination if you start to feel one coming on.

If you do these things you are sure to increase the number of panic attacks you have because you are increasing the tension between you and the panic.

To stop having panic attacks, its better not to resist them. If you start feeling panic just go with it. Accept what is happening, face up to the symptoms, and just let some time pass. Whatever you do, don't put up a fight against it. When you give up the fight against panic, paradoxically, it will lose its power over you.

I was watching a movie the other day where a man with a gun tries to kidnap a girl and hold her for ransom. He threatens to shoot her if she does not come along with him. Ironically, she was about to commit suicide when he found her, so she does not care if the kidnapper shoots her. She even asks him to go ahead and shoot her to save her the work of jumping off the roof of the building. Because the girl actually wants to die and is inviting him to shoot her, the kidnapper cannot scare the girl into following him by threatening to shoot her. In effect, he has no power over her.

That's how it is with panic. If you stop resisting panic attacks and try to force a panic attack on yourself instead, the panic will loose its power over you. I know it sounds strange and you may be very skeptical, but try it. More times than not, when you try to bring on a panic attack, you find it absolutely impossible to have a panic attack.

When panic loses its power over you, you are one giant step closer to overcoming agoraphobia.

More Agoraphobia Thought Stopping: Focusing

2006-03-12T18:11:00.000-08:00

If you have agoraphobia, a technique most recovery books call "focusing" is another way to stop irrational thoughts before they turn into anxiety or panic.

Most good athletes perfect this technique to block out possible distractions and anxiety in situations where the pressure is on. A baseball pitcher may see only the catcher's mitt. A basketball player may see only the rim as he shoots. A kicker in football may see only the goalposts. None of these athletes, when focusing, will hear the noises of the crowd, or see banners waving that are meant to distract them, or even pay attention to their own internal doubts and insecurities about their performance. They are lost in the moment and focused on what matters.

If you have agoraphobia practice focusing to shut out irrational thinking that leads to anxiety and panic. As soon as you catch yourself thinking an irrational thought, willfully focus your thoughts on something else as if it were of utmost importance. You can focus on anything, and the more senses you can engage the better.

A good example of focusing is in Albert Camus' The Stranger, where the main character does not hear a judge speaking his death sentence because he is caught up in enjoying the colors on his lawyer's tie.

You can choose anything to focus on:
1) Try to remember what you did last weekend.
2) Sing the lyrics of a favorite song.
3) Try to estimate the temperature in the room.
4) Guess what material a chair or piece of furniture is made out of.
5) Count the number of ceiling tiles.
6) Put your hand on your wrist and take your pulse.
7) Feel the thickness of two books and try to decide which one has more pages.

The more you can learn to focus on things from your immediate environment and focus as if your life depended on it the better. The main thing is that you distract yourself from whatever irrational thought has come into your mind and to keep it from staying around long enough to cause anxiety, panic, or another symptom of agoraphobia.

Agoraphobia Thought Stopping

2006-03-12T17:53:00.000-08:00

For people with agoraphobia who are trying to defeat the irrational thinking that causes unneeded anxiety, one alternative to thought replacing (see earlier post) is thought stopping.

Thought stopping was one of the first types of cognitive therapy. The technique of thought stopping is just what it sounds like. Once you learn to identify your irrational thinking, you can say the word, "stop" out loud or to yourself every time you catch yourself thinking an irrational thought. You can even add a visualization like picturing a big red stop sign, a bright red traffic light, or flashing red lights at a railroad crossing right before a train comes.

Saying "stop" and visualizing something will distract you just long enough to take your focus away from the irrational thought. If you don't think this works then try it. You will be surprised at how this simple exercise can cut off irrational thinking right after it starts, and before it turns into anxiety, or full-on panic.

Agoraphobia Thought Replacement, The Alternative To A Lobotomy

2006-03-12T01:50:00.000-08:00

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.

Agoraphobia Thoughts: Rigid Expectations, Fatalistic Thinking

2006-03-11T20:22:00.000-08:00

Here are two more irrational thought patterns that people with agoraphobia often practice - holding rigid expectations about how things "should" be and feeling like they have no control over their circumstances.

Rigid Expectations: Thinking of personal preferences, wants, or choices in terms of absolute rules. Rigid expectations are usually expressed with words like “should,” “ought to,” “have to,” and “must.”

This type of thinking leads to anxiety because you end up focusing on something you think is wrong and are likely to becomne critical of whoever or whatever is not meeting the rigid expectation. Because in many cases, the rigid expectations are applied to yourself, this type of thinking tends to promote a lot of self-criticism.

When you hold rigid expectations, you think of anything that falls short of the inflexible standard you have set as totally unacceptable. In effect, you have entered an idealistic fantasy world where everything is supposed to be exactly how you think it should be or you feel anxiety.

Examples of rigid expectations:

“I should be liked and accepted by everyone or I am not a worthwhile person.”

“I have to be able to finish my workout before 7 AM every morning or it won’t be a good day.”

Fatalistic thinking: Thinking of yourself as powerless to make choices or affect the outcomes of your own life. Fatalistic thinking is holding the belief that the forces that govern your life circumstances lie completely beyond your control. This is a way of not taking responsibility for your decisions and behavior.

For people with agoraphobia, it is also a way of avoiding responsibility for doing things that might cause anxiety. People who engage in fatalistic thinking often say “I can’t” when they really mean “I don’t want to,” “I am afraid to,” or “I won’t.:

Examples of fatalistic thinking:

I am supposed to go to a conference for work, but it will mean flying in a plane to get their and I am afraid to fly. I say to a co-worker, “I can’t go to the conference because the company can’t really afford to send another person.”

I don’t want to go to class because I am afraid to take a test. I tell my parents, “I can’t go to school today because I feel too sick.”

Fatalistic thinking may start out as consciously making excuses for things someone with agoraphobia would be afraid to do, you event. However, people who talk this way often start believing that their life circumstances really are out of their control. When you perceive the important outcomes of your life as in the hands of fate, you are setting yourself up for feelings of powerlessness, fear, and anxiety.

For most people with agoraphobia, fatalistic thinking gets combined with rigid expectations to cause even more anxiety. That’s because when people holding rigid expectations for themselves succumb to fatalistic thinking, they live in a world caught between what they “should” do but “can’t” do.

An example of this “should but can’t” thinking would be if someone with agoraphobia experienced the death of her mother and the funeral was to be held out of town and would require a drive of several hours. This person might think to themselves, “I really should make the funeral or I am not being a good daughter. Missing my own mother’s funeral would be absolutely unthinkable. But I can’t make it because I can’t drive. What if I had a panic attack and got into a major wreck.”

The person in this example is caught in the classic bind between rigid expectations and fatalistic thinking. There is something she “should” do but feels like forces beyond her control will prevent her. She is likely to feel guilty about missing her mothers funeral and anxious because she doesn’t think she can do anything about it. She is likely to compound her anxiety with self-criticism.

Most people with agoraphobia experience these binds all the time, and live in a near constant state of self-criticism and anxiety as a result.

Agoraphobia Thoughts: Overgeneralizing, Emotional Reasoning

2006-03-11T06:46:00.000-08:00

Since agoraphobia is something everyone hasn't heard of, I want to make sure that anyone reading knows that in my recent posts I have been going through the different types of irrational thinking that someone with agoraphobia would do. Plus, I am putting in some posts about how to get free of these types of thinking.

What I have been calling "Agoraphobia Thoughts" are not actually symptoms of agoraphobia. They are more or less just thought patterns that most people with agoraphobia have, and that contribute to the anxiety someone with agoraphobia feels.

No one type of irrational thinking is fully responsible for agoraphobia. But together they cause enough anxiety to make someone start having panic attacks and hiding in their home.

So anyway, here are a couple more types of thinking that go with agoraphobia - overgeneralizing and emotional reasoning.

Overgeneralizing: Assuming something that happened one time in one place or situation (usually a negative event) will continue to happen in all places and situations. If you have agoraphobia, you will be familiar with overgeneralization because overgeneralizing after your first panic attacks is probably what led to agoraphobia.

Examples of overgeneralizing:

I have my first panic attack and think to myself, “If I had a panic attack at work then I am in danger of having panic attacks every time I go to work or anywhere else.”

I fail one important test and think to myself, “If I failed this I will always fail.”

Emotional reasoning: Using emotions, or how you feel, as evidence to back up irrational thinking. Doing this can lead to inappropriate emotional responses to events or circumstances (such as panic or anxiety) as well as self-defeating behaviors. Emotional reasoning is sometimes done in the face of objective evidence to the contrary.

Examples of emotional reasoning:

I go to a party and don’t see anyone I know. I have trouble getting a conversation started with the first few people I talk to. After a while, I feel self-conscious and anxious. Instead of trying a little harder to be friendly, I start to withdraw and think to myself, “I shouldn’t really be here. I don’t really fit in and the people here would never like me or accept me.”

I approach an attractive woman at a social event. As I start to talk to her I feel shaky inside and like my heart is about to jump out of my throat. Even though she smiles and responds to me politely, I respond to my inner feelings and tell myself, “She really doesn’t like me or find me attractive. She is just being friendly but she is way out of my league. I shouldn’t have approached her in the first place. What was I thinking?” I make short work of the conversation and excuse myself to talk to someone else.

Emotional reasoning compliments overgeneralizing and plays a key role in the development of agoraphobia. Most people who develop agoraphobia interpret the place or situation where they have their first panic attack as dangerous because they don’t recognize what is really happening. As a result, they practice avoidance behavior and stay away from the scene of the panic attack. Once they have experienced multiple panic attacks and deemed an increasing number of places as dangerous, they overgeneralize these feelings and start to believe that it is dangerous to go anywhere besides a few safe places.

Agoraphobia Strategy: The "South Beach" Diet for Your Mind

2006-03-10T15:44:00.000-08:00

After talking about the different ways people with agoraphobia think that creates anxiety, I'd like to share the strategy for "restructuring" (replacing) agoraphobic thoughts that worked for me.

This strategy has to do with changing your self talk. Your self-talk is not only a reflection of your thoughts, it can be a tool to change how you think. You can use this strategy to change any of the irrational thought patterns associated with agoraphobia.

Self-talk is the diet of the mind. Whether or not we’re aware of it, all of us are constantly talking to ourselves. Though we can do this with spoken words, much of our self-talk comes in the form of thoughts. The message of this internal dialogue is the nutrition on which our mind feeds.

If you have agoraphobia, ask yourself:

What kind of diet is your mind eating? Is it healthy for you or is it junk?

Just as some diets can make you sick and other diets promote your health, so it is with the nature of your self-talk. Negative messages are destructive to the mind while positive messages heal. Whatever type of messages your mind constantly chews on and digests will lead either to positive or negative cycles in both your thinking and in your life circumstances.

Consider the following suggestions to be like putting yourself on the "South Beach" Diet for your mind.

Tune into your self-talk

Self-talk can be like a radio frequency. There are always radio waves in the air around us, but we don’t hear them unless we tune into them with a radio. My suggestion is to tune into the channel of your thoughts and find out what you are telling yourself all day. You first need to first become aware of the messages that are going into your mind before you can change them.

It might help to set an alarm on your watch to remind you to pay attention to your thoughts. Set the watch to go off at one hour intervals. Each time you hear the alarm, focus in on what your mind is thinking and write it down. Then, at the end of each day, you can go back and read your journal to see what thoughts are accumulating in your head over time.

Personally, I found that a lot of my self-talk was subconscious and was escaping my notice. I heard messages such as:

“You can’t be among other people five minutes without hyperventilating.”

“The house is the only safe place for you.”

“You have to be perfect to be accepted by others.”

It’s not like I was walking around all day purposely telling myself I was a fearful, nervous person who would be scared by most everything. However, when I paid closer attention to ongoing thoughts, I realized I was doing this subconsciously.

Take responsibility for what you are telling yourself

Once you become aware of your self-talk, you can take responsibility for the messages you are sending yourself. This means telling the difference between the messages others are sending you and the messages you are sending yourself.

This was the hardest step for me because I liked to blame my anxiety on others. For instance, once I realized that anxiety over school performance was related to my disorder, I wanted to blame my mom for putting so much pressure on me in school.

My mom didn’t always put pressure on me in words. She usually did it non-verbally through disapproval, implication, and through praising my brother for his academic performance. She displayed our report cards on the refrigerator each quarter which made it obvious that my brother made straight A’s and I did not. In any event, the message I received from her was that in order to be a capable, responsible and lovable person, I needed to take the most advanced classes for my grade, turn in every homework assignment on time, make A’s on all the tests and, of course, an A in every class.

For a while, I thought if only my mom would ease up on her expectations for me in school I would get better and have fewer panic attacks. That was putting the responsibility for my anxiety symptoms on her and handing her control of my mental health.

I eventually discovered that it wasn’t the messages I received from my mom that kept me so anxious about school. It was the messages I sent to myself!

Sure, my mom let it be known that she expected something near perfection from me in school, but I had bought into her way of thinking and was telling myself the same thing! If she had gotten off my case altogether, I would still have been telling myself that I was not a capable responsible or lovable person because my performance in the classroom wasn’t as perfect as my brother’s.

I had even added something to the message. I was not only telling myself that I needed to be near perfect in school, but that I needed to please to my mom to feel good about myself. Listening to my self-talk helped me take responsibility for my own feelings and admit I was putting unrealistic expectations on myself.

Replace self-defeating thoughts with positive ones

Once I identified my self-talk and took responsibility for sending myself the messages that were shaping my beliefs, I started to replace each self-defeating message with a positive one.

For example, I told myself that I was a responsible, capable, lovable person even if I didn’t take all advanced classes, do every homework assignment, and make A’s on everything. I told myself that I could be just as responsible and capable while dividing my time between schoolwork and sports, being truer to my own interests and goals.

I also told myself that I didn’t need to please my mom to feel good about myself or be lovable. Sure, I loved my mom and wanted to see her happy, but not at the cost of the anxiety I felt trying to live up to her standards for me.

Once I replaced my negative self-talk with a diet of more encouraging messages, I was able to form new beliefs about what it meant to be capable, responsible, and lovable. I felt a lot less anxiety about my schoolwork and about pleasing my mom and felt a lot better about myself.

I had to identify and replace a lot of negative messages during my recovery from agoraphobia, more than just the ones about my performance at school. I replaced negative messages I was sending myself about my athletic ability, my appearance, and what God thought of me.

So here are three steps for replacing negative thoughts with positive ones:

1) After you have journaled your thoughts at intervals for a day or two, list the top four or five negative statements you are telling yourself.

2) Next to each negative statement, write a positive statement that is the exact opposite of the negative one.

3) Make it a habit to tell yourself each of the positive statements at least ten different times during the day.

4) Keep repeating the positive statements to yourself until the negative statements fade away. This could take weeks, months, or even years. The important thing is to persist until the negative thoughts are totally extinguished and you are completely free from their influence.

If you have agoraphobia, changing your negative thoughts will go a long way in reducing your anxiety.

Agoraphobia Thoughts: Perfectionistic Thinking

2006-03-10T15:05:00.000-08:00

Today I will share two more ways that most people with agoraphobia think that sort of compliment each other.

Black-or white thinking (also called all-or-nothing thinking): Viewing everything in terms of absolutes or extremes. Things are either right or wrong, good or bad, with no in between.

Perfectionism goes hand-in-hand with all or nothing thinking. People who think this way are often perfectionists, putting themselves under a great deal of unnecessary pressure with unrealistic expectations, which increases anxiety and fear of failing. If their unrealistic expectations are not met, they tend to label themselves as “bad” or a failure.”

Examples of black-or-white thinking:

I get a chance for a promotion at work and think, “If I don’t get this promotion at then I am a total failure in my career.”

I find out a friend has lied to me one time and I think to myself, "I should have known he really was a bad person all along."

Magnifying the negative: This type of thinking is a close cousin to black-or-white thinking. Magnifying the negative means dwelling on the negative aspects of something and making it seem much larger than the positive aspects. You will often hear people who think this way making statement that start with "yeah, but."

Examples of magnifying the negative:

After winning a baseball game I think, “Yeah, but since I made an error I really didn’t play a very good game.”

Someone tells me they really enjoyed an article I wrote and I say, "Yeah, but I wrote that in a hurry and there were several mistakes in it. I wish I had a chance to edit it better. Next time I will be a lot more careful."

Magnifying the negative compliments black-or-white thinking. If you are a perfectionist who does both, then you are always able to point out a flaw in yourself, your performance, or a situation, which gives you justification for labeling everything as "bad," "flawed," "disappointing," or otherwise short of perfection.

People with agoraphobia lived trapped between the need to reach perfection and the sheer inability to ever perceive anything as such. As you might guess, the tension between these two is part of what fuels the anxiety that underlies agoraphobia.

Agoraphobia Strategy: Worst Case Scenario Method

2006-03-09T22:55:00.000-08:00

Got agoraphobia, panic disorder or some other anxiety disorder?

Need to get over catastrophic thinking? Then get comfortable with the very worst thing that could happen to you.

When I had agoraphobia and used to worry about panic attacks all the time, my dad taught me this simple mind trick (or cognitive strategy).

One night when I was telling my dad about my fear of sitting in classes at school, he asked me what I thought was the worst thing that could happen. When I told him I was afraid my lungs would stop working or my heart would stop beating, he asked, “What then?”

To that I responded that I might collapse and either pass out or die in front of everyone in the class. Then my dad asked me if I really thought that could happen. I thought about all of my panic attacks and had to admit that I had never even passed out before. I had been through some pretty intense panic so it was unlikely I would ever really pass out. I certainly would not die.

My worst fear was really being so uncomfortable that I needed to leave the class and would be embarrassed in front of my classmates. My dad asked me if I could live with that. I said it would be hard, but it wouldn’t be the end of my life or anything. I eventually reasoned that there was no danger of dying from a panic attack. Once I left high school whatever happened in class wouldn’t really matter.

The more comfortable I became with having a panic attack in front of my classmates, the less anxiety I had about going to class. Ironically, I was able to focus more during class as well. I found that surrendering my mind to the very worst thing I thought could happen freed my mind from worrying so much about it and allowed me to focus on the present moment. Also, once I got used to the worst case scenario I found that most experiences, even the worst panic attacks, did not live up to the worst scenario I could imagine. They seemed less threatening by contrast.

I don't know if this technique officially qualifies as cognitive therapy - but this was one of the methods that helped me to stop having panic attacks and get over agoraphobia.

Agoraphobia Personal Story: Losing Sleep Over a Hot Girl with a Dead Grandmother

2006-03-09T22:32:00.000-08:00

After I wrote that last post on catstrophic thinking and negative mind reading I went to the gym. While I was working out tonight, I thought of a time right before I had agoraphobia and did both. Here's the story:

As an eighth grader in first period algebra class, I sat behind an attractive girl I will call Kimberly. Though I had trouble getting up the confidence to talk to Kimberly, she had to acknowledge my presence twice a day. Once when we passed our completed homework up the rows and another time when we passed the new homework back down the rows. Even though we didn’t talk, she at least knew I was sitting there behind her.

One morning when I felt more confidence than usual because of a school basketball game I had played in the night before, I came to class planning to talk to Kimberly. Much to my disappointment, when we passed our homework to the front that day, she reached back for the papers without turning around or looking at me. When the new homework was passed down the rows, she just held the papers over her shoulder without turning around again. This shot what little confidence I had and my heart sank. I left class that day without talking to her once again.

I felt anxious for the rest of the day and had trouble sleeping that night. I was preoccupied with what Kimberly thought of me and why she didn’t turn around to pass me the papers in class. I thought maybe I had done something to make her mad.

The next morning when I arrived at algebra class, I could feel my heart pounding. I waited anxiously for Kimberly to arrive. She never did. I lost more sleep that night.

When Kimberly returned to school a day later, my anxiety over her behavior overrode my fear of talking to her. I found out that a grandmother who was close to her had died. She had missed a day of school to attend the funeral.

I felt relieved and stupid all at once. I felt relieved that she hadn’t purposely ignored me in class and that her behavior had nothing to do with me. I felt stupid that I had forfeited so much peace of mind wondering.

There could have been a million possible explanations why that girl didn't turn around in her seat. But leave it to an agoraphobic like me to think she was mad at me. I didn't know what I was doing back then, but I was not only "negative mind reading" according to the agoraphobia books, but I was also catastrophizing.

Looking back, I can see that this story was probably one of many omens that I would develop panic disorder with agoraphobia by the start of the next school year.

Agoraphobia Thoughts:Catastrophic Thinking and Negative Mind Reading

2006-03-09T18:32:00.000-08:00

I would like to share some "cognitive restructuring" strategies that will be helpful in reversing the flow of negative thinking that fuels agoraphobia. First, I'd like to write a few posts to explain some of the cognitive mistakes people with agoraphobia commonly make (and that need restructuring). Then I will share some ways to change faulty thinking that will help you recover from agoraphobia.

Probably the biggest and most common cognitive mistake made by people with agoraphobia is catastrophic thinking.

Catastrophic thinking: Blowing negative events or feelings way out of proportion. Turning small mistakes or minor setbacks into major catastrophes through exaggerated thinking. The magnification of negative events leads to a magnification of fear, anxiety, or panic experienced as a result.

Examples of catastrophic thinking:

I get turned down after auditioning for a part in a play and I think, “This is so awful and embarrassing. I am a terrible actor and had no business even auditioning.”

I am having trouble understanding a math assignment in school and I think, “I am such an idiot who cannot understand anything. I probably won’t make it through college or be able to get a good job.”

Another cognitive mistake made by people with agoraphobia (and other anxiety disorders) is negative mind reading.

Negative mind reading: Assuming that other people are thinking and feeling negative things about you without any real evidence to support your assumption. Some people with agoraphobia live as though they were psychic, always assuming the worst case scenario when interpreting other people's comments, expressions and behaviors. People with agoraphobia suffer from a lot of unnecessary anxiety that comes from always assuming the worst when it comes to how other people might be perceiving them and wondering what they might be doing wrong to cause such negative reactions from others.

Examples of negative mind reading:

I pass someone I know in a crowded shopping mall and try to catch her attention to say hello. She walks right on by and do not even glance my way. I think to myself, "She must be mad at me about something. I wonder what I could have done to make her angry?"

I turn in a report to my boss at work that I have put a lot of effort into and anxiously await his feedback. A week passes and my boss says nothing about the report. I think to myself, "I guess he really didn't like my work. I wonder if he is not talking to me because he is trying to think of a way to fire me?" I go into work every day thinking that it may be my last.

Of course, anyone reading these can probably think of a lot of different explanations for someone passing by in a mall and not seeing you - or a boss at work taking some time to give you feedback about a report. People in crowded shopping malls just might not hear or see you and a boss could be too busy to review a report right away.

People with agoraphobia tend to focus on one possible explanation - the worst one.

Plus, negative mind reading can be compounded by catastrophic thinking as in the example with the boss and the report. Thinking the boss might not be pleased with a report might turn into the certainty of being fired in the mind of someone developing agoraphobia or related anxiety disorder.

Agoraphobia: Why Cognitive Therapy Helps

2006-03-09T18:22:00.000-08:00

Cognitive therapy is effective in treating agoraphobia and other anxiety disorders because of the link between thoughts and feelings. Cognitive therapy is based on the principal that thoughts can lead to feelings, and feelings can lead to physical symptoms.

To give an example, let’s say I was going to an interview for a new job. If I were to start thinking self-defeating thoughts such as, “I probably don’t have the skills to be successful in this new position” or “I will probably be asked questions that I won’t be able to answer” then I would be likely to worry more and feel anxious before the interview. The more anxious and worried I felt before the interview, the more likely I would be to experience physical symptoms like being jittery, having butterflies in my stomach, or freezing up during the interview.

At the same time thoughts can lead to feelings and accompanying physical symptoms, feelings and physical symptoms can reinforce thoughts. Going back to the interview example, if I felt anxious and froze up during the interview, my failed interview could reinforce thoughts that I don’t have what it takes to succeed in a new job. Thoughts, feelings, and physical symptoms can form a vicious cycle of negativity.

People with agoraphobia get caught in these negative thought-feeling-behavior cycles all the time.

Cognitive therapy stops this vicious cycle by challenging “cognitive distortions” and correcting them through a process called “cognitive restructuring.” Put in everyday language, cognitive distortions are just faulty ways of thinking that lead to the irrational fear behind agoraphobia. Cognitive restructuring is just changing the way you think, replacing fear-producing thought patterns with more rational, healthy thinking. Replacing fear-producing thoughts with healthy ones helps to relieve the symptoms of agoraphobia.

More Agoraphobia Drugs

2006-03-08T23:32:00.000-08:00

Benzodiazepines and anti-depressants are the most commonly prescribed drugs for agoraphobia. Tonight I'd like to talk about a few others that some doctors or psychiatrists might prescribe.

The first will be the anti-convulsants which include Valproic Acid and Gabapentin. These medicines were originally developed to treat people with epilepsy because they can control seizures. Later, they were discovered to be good mood stabilizers and were used to lessen the mood swings of people with bipolar disorder.

Very recently, they have been tested on people with panic attacks with some success. Valproic Acid and Gabapentin have both been shown by studies to be helpful in reducing the frequency and intensity of panic attacks.

Valproic Acid has more potential side effects of the two. The most commonly reported adverse reactions are nausea, vomiting and indigestion. Other potential side effects include interfering with blood clotting and liver functioning. There have also been reports of acute pancreatitis occurring in association with Valproic Acid therapy.

Gabapentin has a smaller risk of side effects plus it has been shown by some studies to reduce anticipatory anxiety in people with generalized anxiety disorder. If Gabapentin can both prevent panic attacks and reduce anticipatory anxiety - then it could emerge as the drug of choice for people with agoraphobia.

However, research on the use of anti-convulsants to treat agoraphobia is fairly new and some doctors and psychiatrists will not prescribe them until more studies are done.

Finally, a drug called Buspar has been used to treat agoraphobia and is in a class by itself. It is an anti-anxiety medication but is not a benzodiazepine. It also does not create the same tolerance or cause the same withdrawal symptoms as benzodiazepines.

The only problem with Buspar is that it takes so long to work - that is, if it works at all. You might have to take a prescribed dose for a week or more to start feeling the effects. Some people don't ever feel any effects. But since Buspar does not have dangerous side effects it might be worth a try. Especially if you find out it does work for you.

However, as I said before, I am not a proponent of using drugs as a long-term solution for agoraphobia. I recommend following a recovery program that challenges you to grow as a person and helps you get free of the underlying anxiety that feeds agoraphobia.

In the long run I think you will want to live with the confidence that you would not be totally debilitated by agoraphobia, anxiety and panic if you stopped taking your pills.

Agoraphobia Drugs: Anti-depressants

2006-03-07T23:52:00.000-08:00

At this point, I should say that I am not personally an advocate of using medication to overcome agoraphobia or an anxiety disorder. I did use a little Xanax to help me in my recovery, but the pills mostly stayed in my pocket as a safety measure.

But...If you are taking the chemical route to treat agoraphobia and you are misfortunate enough to have panic disorder with agoraphobia, then anti-depressants might just be your drug of choice over benzodiazepines.

That's because, unlike benzodiazepines, anti-depressants put a stop to panic attacks pretty effectively (in addition to treating depression).

There are several main classifications of antidepressants:

1) MAOIs (Monoamine Oxidase Inhibitors)
2) TCAs (Tricyclic Anti-depressants)
3) SSRI's (Selective Serotonin Reuptake Inhibitors) and
4)SSNRI's (Selective Serotonin and Noreprenephrine Reuptake Inhibitors).

First off, forget MAOIs. Almost no one prescribes them anymore anyway. They have way too many potential side effects like dry mouth, blurred vision, drowsiness, dizziness, decreased sex drive, skin rash, and weight gain or loss. Plus you can't eat smoked, fermented, or pickled foods or drink certain beverages if you are taking MAOIs (which rules out wine and cheese). MAOIs also have a bad reaction with a lot of other medications and can cause high blood pressure if you mix them with the wrong thing.

Tricyclic Anti-depressants used to be a popular choice but have the same potential side effects as MAOIs. TCAs include drugs like Elavil, Norpramin, Tofranil, and Pamelor. For the most part, since the advent of SSRIs starting with Prozac, TCAs are being used less and less by medical and mental health professionals.

SSRIs became popular partly for their effectiveness and partly because they don't have as many potential side effects. The side effects of SSRIs are manageable for most people and are usually limited to indigestion and/or a reduced sex drive. SSRI's currently in vogue are Prozac, Paxil, Zoloft, Celexa, Luvox, and Lexapro. Besides countering the effects of depression, these all are known to reduce the number of panic attacks a person has.

One of the reasons that SSRIs are so widely prescribed by doctors and psychiatrists is because you can't use them to kill yourself by overdose. This is obviously a good thing because prior to SSRIs, one of the most common forms of suicide was to overdose on the very antidepressants which were meant to cure the depression.

However, there are two serious drawbacks with SSRIs:

1) SSRIs are risky to combine with other drugs. For example, SSRIs can be lethal when taken with MAOIs.

2) Even though you can't use them to kill yourself by overdose, SSRIs have actually been proven to increase suicidal thinking.

A close cousin to SSRIs which have also become popular are SSNRIs. SSNRI's include Effexor and Serzone. The main difference between these drugs and SSRI's is that they effect the brain's levels of noreprenephrine in addition to serotonin and aren't as likely to produce sexual side effects.

The bottom line is that if you are going to take an anti-depressant to stop panic attacks, try one of the newer ones (SSRIs and SSNRIs). Since there are so many choices, you may have to shop around and try several before you find the one that works for you. As you know, different drugs work differently on different people.

Paxil is the favorite of some doctors because they say it makes people a lot calmer than some of the other SSRIs. But there are so many different SSRIs and SSNRIs that if you try one that doesn't work for you, just keep trying until you find one that does.

Agoraphobia Drugs: Benzodiazepines

2006-03-06T23:30:00.000-08:00

Tonight I am going to begin talking about one way of treating agoraphobia - using medication. The most common type of medication prescribed for agoraphobia is a class of medicines called benzodiazepines.

Benzodiazepines is basically just a fancy way to say tranquilizers and sleeping pills. You have probably heard of some of the most common types of benzodiazepines which are Xanax, Valium, Restoril, Ativan, Halcion, Dalmane, and Serax.

When prescribed for agoraphobia, the purpose of benzodiazepines is to relieve anxiety symptoms and/or help you sleep. Most will calm you down within a half hour although some may take up to two hours. This can also depend on how sensitive you are to medication.

Benzodiazepines mainly reduce anticipatory anxiety (or catastrophic thinking). They don't usually stop panic attacks. However, the less inhibitory anxiety you experience, the less likely you are to have a panic attack.

The reason benzodiazepines work so well for agoraphobics and other anxiety sufferers is that they enhance the action of a neurotransmitter called GABA (Gamma Amino Butyric Acid). This neurotransmitter inhibits excitement and calms you down.

Benzodiazepines are divided into short, medium, and long acting categories based on how long they stay active in the body:

Dalmane is long acting and stays in the body for days. Valium is also long acting and can stay in the body for over a day. Restoril and Ativan are considered to be medium acting and stay in the body for about one half to a full day. Halcion, Xanax, and Serapax are short acting and stay in the body for only a few hours.

If it were not for side effects, benzodiazepines might be considered an effective cure for agoraphobia and other anxiety disorders. They work really well for most people. The problem is that benzodiazepines can only be taken safely for brief periods of time. If you take them over long periods of time, you are likely to become tolerant and/or dependent. Tolerance means that over time it takes bigger and bigger doses to get the same calming effect.

Besides the problem of developing tolerance and becoming dependent, possible long-term side effects caused by taking benzodiazepines include cognitive impairment, loss of balance, respiratory problems, problems with blood pressure regulation, and sleep disturbance.

Another downside to benzodiazepines is that you experience withdrawal when you try to get off. This is because your body has made adjustments to compensate for the continual presence of the drug. Paradoxically, the withdrawal symptoms are similar to the symptoms of agoraphobia and other anxiety disorders. So when the drug ceases to be effective due to tolerance you can’t just stop taking it easily– and you might end up worse off than when you started because the side effects might be worse than the original anxiety.

Agoraphobia, anxiety, and panic attacks are actually listed among the most common withdrawal symptoms in pharmaceutical literature. Other withdrawal symptoms include breathing difficulties, blurred vision, depression, dizziness, lethargy, feelings of unreality, heart palpitations, hypersensitivity to light, indigestion, insomnia, irritability, loss of concentration, loss of balance, loss of memory, nausea, nightmares, rapid mood swings, severe headaches, sweating, and tightness in the chest. In short - withdrawing from benzodiazepines can have the same symptoms as an anxiety disorder or agoraphobia.

Because of these withdrawal symptoms, getting off cold turkey is strongly warned against. People who need to get off benzodiazepines should do so gradually. A recommended program for getting off benzodiazepines is as follows:

1) stabilize on a normal daily dose an make sure the dose is taken regularly throughout the day.

2) change to short or medium acting benzodiazepine to a long acting one.

3) reduce to a small amount of one dose (10-20% of the overall dose).

4) stabilize on the reduced dose for at least two weeks

5) reduce the dose again

6) take rests during the reduction process if the symptoms become too severe or during a stressful time.

In summary, the most advisable use for benzodiazepines is to help you through a particularly difficult situation. A benzodiazepine may help you get through a stressful event that you couldn't face otherwise. In this way, benzodiazepines are useful for treating agoraphobia when combined with cognitive and behavior therapy because they give the user a window of opportunity to practice entering feared places and situations with a lessened chance of anxiety building up.

The best and safest use for benzodiazepines is carrying them in your pocket. This can give you the security of knowing that you can stop anxiety if you absolutely had to. Just having them at your disposal can give you the confidence to venture out into unsafe territory on your road to recovery from agoraphobia.

Ultimately, benzodiazepines are a useful tool for recovery from agoraphobia when used wisely, and in moderation.

Agoraphobia, Anxiety and Medical Problems

2006-03-06T11:11:00.000-08:00

People ask me a lot about the relationship between stress-related medical problems (ulcers, high blood pressure, migraines, etc.) agoraphobia, and anxiety disorders.

Generally, people with anxiety and/or panic disorders, including agoraphobia often want to know if their disorder is physically dangerous and if these stress-related medical problems are caused by or are symptoms of their anxiety disorder.

I decided to take the time to post some answers.

First - Neither anxiety disorders or panic attacks are physically dangerous. To my knowledge, no one has died or been put in critical condition from anxiety or a panic attack.

But -if you have an anxiety disorder or experience panic attacks you should get checked out by a doctor. That's because some medical problems have symptoms that are similar to anxiety and panic symptoms, and if your problem has a physical basis then you should treat it as such. Also, you want to make sure that your anxiety or panic attacks do not aggrivate a physical condition that you already have.

Second - Although anxiety and panic disorders are not known to cause stress related medical problems, many people with anxiety and panic disorders (including agoraphobia) also suffer from stress-induced illnesses. One doesn't cause the other. But stress-induced medical problems can be caused by the same factors that cause anxiety and panic. In other words, they are physical and emotional effects of a similar cause.

Personally, I suffered from ulcerative colitis after I thought I had recovered from agoraphobia. I eventually realized that the same factors that led to agoraphobia were later being expressed as ulcers.

That's why its important to deal with the root cause of agoraphobia, an anxiety or panic disorder and not just take drugs or do relaxation exercises to mask the symptoms.

When I've got more time, I'd like to talk about the factors that I think caused my agoraphobia and colitis. They have to do with things like genetics, personality, family relationships, life circumstances, and so on.

More later - I have to take a phone call.....

Agoraphobia Treatments

2006-03-03T16:17:00.000-08:00

Today I just want to introduce the major forms of therapy for agoraphobia. Basically, psychologists and psychiatrists are most likely to combine three types of treatment for agoraphobia:

1) Behavioral Therapy: Focuses primarily on changing avoidance behavior that results from anxiety.

2) Cognitive Therapy: Focuses primarily on changing anxiety-producing thought patterns.

3) Medication: Focuses on changing physical processes on the brain through chemical intervention.

So which treatment for agoraphobia is most effective according to research?

Although research results on the effectiveness of each form of therapy varies from study to study, behavioral therapy has proven to be the most effective treatment on its own. Cognitive therapy has not been proven successful when used alone, but agoraphobia patients who undergo behavioral therapy increase their chances of recovery when cognitive therapy is added.

In fact, studies have demonstrated that the combination of behavioral and cognitive therapies (or cognitive-behavioral therapy) is up to 90% successful in reducing the occurrence of panic attacks associated with agoraphobia.

Medication, of course, is also highly effective in reducing the occurrence of panic attacks and the other anxiety symptoms of agoraphobia. The problem with medication, however, is that the symptoms are only reduced while you are taking it. In other words, medications only mask the symptoms of agoraphobia and are not a real cure or long-term solution. Also, some medications can be addictive or have negative side effects.

Due to the drawbacks of medication, most psychologists and psychiatrists prescribe medicine as a temporary means of reducing agoraphobia symptoms while cognitive-behavioral therapy is practiced. Once a person begins to feel successful with cognitive-behavioral therapy, the goal is to gradually reduce reliance on the medication for anxiety relief.

I will talk more about my experience with each of these types of therapy in later posts. Plus, starting a running program really helped me overcome agoraphobia, too.

More Agoraphobia Symptoms

2006-03-02T12:05:00.000-08:00

After writing about the symptoms of Agoraphobia I thought of two more. At least they are symptoms I had.

One is fear of being alone. I was totally afraid to be without a safe person even if I was in a safe place. I had sort of a dependence on being near someone I thought could help me if I had a panic attack or medical emergency. My safe people wer basically my parents.

The other symptom is called "scanning." That just means being hyper-aware of your body and its sensations, foevere looking for strange symptoms. A lot of agoraphobics suffer from a degree of hypochondria. We are afraid we will get the symptoms of just about any disorder we hear about - which causes more anxiety.

I could lie in bed for quite a while focusing on my body and trying to notice strange symoptoms. I would feel my chest to see if my heart was still beating or beating in the correct rythm. I would also blow into my palm just to make sure I was still breathing and my lungs were still working.

I was totally afraid either my heart or lungs would stop if I didn't monitor them. I am sure other people with agoraphobia focus in on other things.

Anyway, those are two more agoraphobia symptoms I missed last time. Next I'll write about some ways agoraphobia is treated.

Agoraphobia Symptoms

2006-02-23T23:13:00.000-08:00

In my last post I talked about how important it is to be able to identify agoraphobia early so it doesn't have as long to take root in you. For anyone who thinks they may have agoraphobia, here are the major symptoms to help you know for sure:

1) Panic attacks

Most (but not all) people with agoraphobia experience frequent panic attacks. A panic attack is period of intense fear, usually lasting about ten minutes or so (but sometimes longer), in which you have at least four of the following symptoms:

palpitations, pounding heart, or accelerated heart rate
sweating
trembling or shaking
sensations of shortness of breath or smothering
feeling of choking
chest pain or discomfort
nausea or abdominal distress
feeling dizzy, unsteady, lightheaded, or faint
feelings of unreality or being detached from oneself
fear of losing control or going crazy
fear of dying
numbness or tingling sensations
chills or hot flashes

It should probably go without saying that panic attacks are a torturous emotional and physical experience, and most people who have a panic attack even once will go to any length to avoid having another one.

2) Avoidance behavior

In general, people with agoraphobia avoid places and situations that are hard to escape from or that might be embarrassing to have to suddenly leave. Most commonly, this is because they fear having a panic attack or unexpected catastrophe and not being able to get help or get away. In other words, people with agoraphobia avoid situations in which they are likely to feel trapped or stuck.

Examples of situations avoided by most people with agoraphobia are being outside or away from home by themselves, being in crowds, sitting in a middle row in a theater, standing in lines, being on a bridge, driving a car (especially in heavy traffic), or taking public transportation like buses and planes. In sum, people with agoraphobia are likely to avoid getting caught in a situation that escape would not be easy, immediate and unnoticed.

In many cases, people with agoraphobia avoid any place that is outside of a certain radius around their own home, unless it is a “safe” place or they are with a “safe” person (see below). Because of the dire need to avoid unsafe places and the possibility of a dreaded panic attack, people with agoraphobia are masters at making up excuses to explain their behavior.

3) Developing “Safe” People

People with agoraphobia tend to develop “safe” people. “Safe” people are people with whom the agoraphobic is highly familiar with and feels emotionally close to. “Safe” people are usually parents, spouses, children, or close friends and relatives. With a “safe” person, the agoraphobic can travel further away from home or enter feared places and situations. In other words, the presence of a “safe” person makes otherwise unsafe places and situations feel safe for someone with agoraphobia.

People with agoraphobia will typically explain feeling safer with a “safe” person by saying that they feel like someone would be there if they had a panic attack or emergency. The agoraphobic, however, is usually aware that the “safe” person does not possess any abnormal powers to stop a panic attack or save them from other perceived dangers. “Safe” people offer the agoraphobic a source of psychological comfort rather than any real safety.

4) Developing "Safe" Places

Just as people with agoraphobia develop “safe” people, they also develop safe places. "Safe" places are places in which the agoraphobic feels psychologically comfortable. The most common "safe" place for someone with agoraphobia is his or her own home. Other common “safe” places are the homes of “safe” people, therapists’ offices, and other established retreats where the agoraphobic normally feels comfortable going.

There is no set amount of safe territory common to agoraphobia. Some people with agoraphobia are able to establish more safe places than others. While some may feel safe in a number of locations away from their home, others are confined solely to their homes, even others to certain rooms in their homes, and in extreme cases confined to their beds.

If these symptoms describe you - then keep reading. I will be back to post more on how I recovered.

Agoraphobia: Fear of the Unknown

2006-02-15T08:20:00.000-08:00

When I first started having symptoms of agoraphobia I was totally in the dark and didn't know what was wrong with me. Like many people who first start experiencing panic attacks, I thought there was something wrong with my physical body. I thought something might be wrong with my heart or lungs because of the rapid hearbeat and smothering sensations that go along with hyperventilation during a panic attack.

The physical symptoms of panic and anxiety that are part of agoraphobia really scared me. I had one of my first major panic attacks during a class in high school and just thought I was getting really sick or something. When I went to a doctor and couldn't figure out what was wrong, I went back to school. That was because I had been feeling better while at home. When I went back to school, however, all the panic symptoms came back and I thought I was sick again. Since the doctor couldn't tell me what was wrong, I started to fear the unknown which only heightened the panic and anxiety.

Long story short, it took me about a year to figure out that I had a known psychological disorder called agoraphobia for which I could get help. During that year, I was terrified about what might be wrong with me and kept seeing doctors who couldn't help. Meanwhile, the agoraphobia fed off my fear of the unknown, took root in my life and built a strong foundation.

Needless to say, identifying your disorder is key if you have agoraphobia. It is much harder to overcome if you go a year in the dark like I did and let the fear build. In my next life I will be sure to know about agoraphobia before I get it so I can nip it in the bud. In this life, I guess I will just work at helping others gain an awareness, to try and save them the time and fear I went through during my dreadful first year with agoraphobia.

What is Agoraphobia?

2006-02-13T13:01:00.000-08:00

I think one of the reasons agoraphobia was so hard to recover from was because it snuk up on me before I even knew what agoraphobia was. I already had full-blown agoraphobia before I became aware of the term.

I mean who has heard of agoraphobia that hasn't either suffered from it themselves or known someone who did. I think most people are familiar with terms like "panic disorder" or "anxiety disorder" but whenever I mention that I had agoraphobia, most people just shake their heads and look at me funny.

I am sure that if I had suffered from claustrophobia I would get a lot more understanding and sympathy. Why is it that most everyone has heard of claustrophobia and not agoraphobia when the two are related - in fact, they are nearly exact opposites. People with claustrophobia fear closed spaces and seek more open environments. People like me with agoraphobia fear open spaces and look for places where you can feel closed in and surrounded by something. Feeling closed in can actually help someone with agoraphobia feel safe.

Anyway, I have been thinking of putting up a website dedicated to people with agoraphobia since our disorder doesn't seem to be recognized by the mainstream. When I was doing some background reading for the site, I looked up different definitions of agopraphobia on the web. Here's what I came up with:

Definitions of Agoraphobia on the Web:

1) Irrational fear of being in a situation where escape is difficult or impossible.

2) Marked fear of being in places or situations from which escape might be difficult or embarrassing; fear of being out of control or fear of losing control when in a public place, eg, a restaurant, shopping mall, or classroom. Fear of being in a place or situation in which help might not be available in the event of a panic attack.

3) a Greek word that literally means "fear of the marketplace." This anxiety disorder involves the fear of experiencing a panic attack in a place or situation from which escape may be difficult or embarrassing.

4) a condition which leads to extreme anxiety and fear about leaving the safe environment of home, being in open spaces or being alone or in a public place.

5) the abnormal fear of being helpless in a situation from which escape is difficult or embarrassing, often characterized at first by panic or anxiety and finally by avoidance of open or public places.

6) Irrational or abnormal fear of open spaces or large crouds of people.

6) the fear of public places or open spaces. People with agoraphobia try to avoid being in situations that make them feel trapped.

7) fear from open places and the presence of many people aroundlibrary.

8) an abnormal fear of open or public places.

9) Agoraphobia is the fear of going out into public places. Agoraphbia can occur with or without panic attacks.

10) Fear of leaving a safe place.

11) a morbid fear of open spaces (as fear of being caught alone in some public place).

12) Agoraphobia is a form of anxiety disorder. The word is an English adoption of the Greek words agora (αγορά) and phobia (φόβος). Literally translated as "a fear of the marketplace", agoraphobia is a fear of open or public spaces where help in an emergency might not be readily available.

But this, by far, was my favorite definition:

Agoraphobia: What the Heck Is It???

I guess it will be a while before agoraphobia gets the full respect it deserves as one of the most common anxiety disorders.

I'll be back to write more about my experience with agoraphobia later.

Agoraphobia Help

2006-01-21T17:45:00.000-08:00

Get insightful information about agoraphobia at the Agoraphobia Resource Center website at:

www.agoraphobia.ws