Agoraphobia is a little more complex than that – it is the fear of being in any situation where things could go wrong without the chance to escape or get help. A lady contacted me who had been suffering worsening conditions for more than seven years. Initially it started as a little unease when people visited the house and developed into a situation where she could not go into a shop a bank or any public place without full-blown panic attack symptoms. Her heart would pound and she would feel sick and sweat all over, almost fainting at the thought of having to go and buy a loaf of bread. She also became more and more distressed at people visiting her home. Whether her symptoms were those of social phobia and or agoraphobia was never medically diagnosed. What was worse for her, was the youngest of her children was beginning to copy her behaviour in social situations and this was the final prompt for her to take action. Her doctor had given her medication but she didn’t find it helped change anything in these difficult situations, just dulling the panic attack symptoms. No one really knows the causes of agoraphobia, although their may be some parental influences that affect whether a person is likely to develop either of these conditions such as being over protective or over emphasising the danger of strangers.
Social phobia is much more than being shy, it is an absolute dread in certain situations that include meeting strangers, shopping, answering the telephone or starting conversations. We can make the mistake of perceiving someone as a shy person when in fact they are struggling hard to contain their panic attack symptoms. Unfortunately, as with my client, over time these symptoms become worse and often there is an increasing number of situations in which they develop. Guilt exacerbates the situation, guilt that loved ones have to go through it too, certainly in this case – the lady was upset that her children had to go to the shops for her, that she nor her children could have family and friends around, nor could she go to help them out or even attend family events. It was a vicious cycle of torment, in more ways than one. It is no doubt difficult for anyone not having been in this situation to even come close to understanding how badly it affects people’s lives and relationships.
Traditional treatment for both agoraphobia and social phobia is usually provided in two ways – drugs and CBT. Anti-depressants are often prescribed since there can be correlation between depression and phobias, or mild tranquilizers to dull the panic attack symptoms. CBT is usually offered and is very effective, it is typically anything up to fourteen sessions and helps you identify unrealistic or unhelpful beliefs and teaches the skills to react more positively in those situations that are causing difficulty. My client had two sessions – the first one taking a full history and then a hypnotic therapy session. After the session I put her in the car and went to our local supermarket, her husband who had been in the car waiting outside, followed. We went straight in to the supermarket and danced, yes, danced in the aisles, knocking a few displays and trolleys I might add as neither of us were particularly skilled at a tango. The second session, two months later, to make sure that all was well and ensure that the therapy was embedded really deeply in her subconscious mind. Four years on and whilst I don’t think she has danced in the aisles lately, she has attended her cousin’s wedding, goes to church every week and no longer sends her kids for a loaf.