Agoraphobia--Is it Really a Phobia?

Wikipedia defines Agoraphobia as "an anxiety disorder precipitated by the fear of having a symptom attack or panic attack in a setting from which there is no easy means of escape. As a result, sufferers of agoraphobia may avoid public and/or unfamiliar places. In severe cases, the sufferer may become confined to their home, experiencing difficulty traveling from this 'safe place.'"

It's true that phobia is another word for fear, however, agoraphobia doesn't respond to standard techniques for ridding oneself of phobias. Typically to over come phobias a desensitization technique is used where by the individual is taken into a relatively deep state of relaxation and instructed to remember a place or time in their life when they felt perfectly tranquil and at peace. They are then instructed to think of the fearful thing being some distance away in time or physical distance. For instance someone fearful of flying is instructed to think of booking a flight a month away as opposed to being on an airplane as it takes off.

Suggestions are then given that by having the person oscillate back and forth between images of being tranquil and booking the flight so that the tranquility spreads to the act of booking the flight. Next the individual is instructed to bring to mind an image of being closer to the time and day of the flight, i.e. making plans for getting out the luggage (still several weeks before flight time).

Again the same procedure is used to have the tranquility spread to the act of getting out the luggage. This same procedure continues in step by step fashion (called a hierarchy) until eventually the individual is imagining him/her self on the plane during take-off.

This desensitization technique is sometimes augmented with a biofeedback instrument called the galvanic skin response (GSR) instrument which actually measures activation/deactivation with the various images.

Agoraphobics, however, do not respond to this standard technique which is called Wolpe's desensitization (named for the doctor who discovered it). In fact they have one of two reactions:

1. Upon closing their eyes and beginning to relax, they experience a panic attack.

2. They desensitize one or two steps, as done in the procedure, and either regress or reach a plateau and find that they can't get relaxed again.

This is because agoraphobia--even though it's a fear of fear--is actually anxiety panic attack and must be dealt with as such--get rid of the panic attacks and the fear disappears all on its own.

Dealing with panic attack is not the easiest of tasks. Typically most professionals try to have the anxiety panic attack sufferer learn to control their body using basic relaxation stress management skills as are used by most hypnotists or biofeedback specialists. These are the same techniques they use for all other problems. The sufferer is given tasks of managing their breathing and letting their body relax. It works about 30% of the time which is the typical results for any placebo.

Most often the sufferer becomes upset with him/her self for not being able to learn basic body management skills and in some situations may actually have a panic attack while trying to learn the self regulation techniques.

What is clearly necessary is to shift from internal type of relaxation exercises (breathing and relaxing different parts of the body) to an external focus for the largest problem in the sufferer overcoming panic anxiety attack is that they jump to conclusions about their breathing as they try to control it which flips them into anxiety. What they resist persists.

External relaxation skills where by using wakened hypnosis (instead of the eye closure type), to have them focus on observing their surroundings instead of coming to conclusions about their internal changes is the solution.

The result is that eventually they learn to observe their breathing, muscle tension... instead of coming to conclusions. They learn to "go with it" as opposed to fighting it. As they learn to feel the tension without making it wrong, it disappears.

Ultimately they remember they used to have a problem but forget what the symptoms felt like.

end of article--

Richard Kuhns B.S.Ch.E. NGH certified, a prominent figure in the personal development field, has three websites:
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