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Many people, the vast majority of whom are women, suffer from agoraphobia. Literally the label means, fear of the marketplace, being in open and unfamiliar places. This is a terrifying and debilitating phobia in which victims are seized by “panic attacks”…
 
Standing in line at the supermarket, you suddenly feel queasy. Your heart races, hands begin to tremble, breathing becomes labored. Beads of perspiration appear on your brow, neck, and the palms of your hands. You feel increasingly dizzy. Wanting to cry out–to scream–you barely utter a sound through your constricted throat and parched lips. Gasping for breath, you run out of the store, blood draining from your face, and stagger to your car, enter, lower your head to the steering wheel and wait…the panic finally passes.
 
At this point, many agoraphobics begin running the gamut of doctors in order to find out why. When this fails to produce the desired answer, they seize on any coping strategy (i.e., something that at least temporarily reduces the panic) they can find. “Maybe if I stop going to the places where the panic attacks happen, they will stop.” What becomes learned from these panic attacks is to avoid the places and situations where they occurred. That which relieves the unbearable siege becomes safe, reinforcing. Leaving or “avoiding” the scene of the attack accomplishes this. Moreover, the fear of further panic attacks is so horrifying that the avoidance behavior generalizes to surroundings similar to that of the original attack. Hence, driving over bridges, riding elevators, sitting in restaurants, waiting in line, consulting with the children’s teachers at school, running household errands, even taking in the mail may become prohibitive!
 
As a result, an agoraphobic will restrict his range of motion to the extent that leaving the house or even thinking of doing so becomes unbearable. Living with so few degrees of freedom can be cumbersome to the victim, his family or even his friends. As if being trapped within the confines of “safety”, at home, is not enough, for many, even the mere thought (anticipation) of having to confront a panic-producing situation induces further stress. In other words, these individuals ultimately develop a fear of fear; agonize about the possibility they might panic and lose control! Thus, they experience chronic unremitting anxiety; feel helpless to change, and depressed about feeling helpless!
 
Typical comments of sufferers at this point include: “Life is always miserable.” “I feel anxious all the time!” “How can we go out tonight? I’m trapped. It’s hopeless!” So why does this happen? There is considerable evidence that most agoraphobics are individuals who, in childhood, failed to develop the resources necessary to cope with situations and conflicts that arise in one’s lifetime. Some were “overprotected”, and had difficulty behaving independent of family members. Suddenly, as adults, they found themselves in situations where they have to function autonomously lacking the necessary skills. Occasionally, new divorcees and college freshmen illustrate this point. Others had adult care-taking responsibilities bestowed upon them at a young age; and many lived with alcoholic or psychotic parents in an environment where change was the only constant! In these instances, a child can learn to become “housebound”, as her presence is needed by one or more parent for protection against another, or simply as a source of nurturance.
 
Agoraphobics, believing their situations are hopeless are frequently convinced they will never get better. However, those of you who are prisoners of fear, do not despair. There is help out there. In order to have the necessary “coping skills”, you first need to learn something truly fascinating about phobias, which I will share with you next week.