JUNGLE RULES OF SURVIVAL IN AGORAPHOBIA
By Joe Bolza, Clinical Psychologist. (see below for contact details)
Agoraphobia is both debilitating and upsettingly mysterious to most sufferers. Previously independent people suddenly become restricted. They notice that they may have trouble in supermarkets, crowds, traveling distances, going through tunnels and over bridges, driving on freeways, being alone, using public transport, sitting in cinemas.
What's going on?
When we have had a heightened sense of danger (as in panic attacks), it seems natural that we may instinctively try to access higher levels of security as insurance against danger. What we access is part of basic "jungle" survival systems, common to animals, infants, humans in war situations. As suburban adults, we normally don’t use them much, until we feel very threatened.
So agoraphobia is simply instinctively accessing these "high security rules". Safety is in numbers, therefore don’t be alone. The safest place is your "burrow", so stay close to home. The best way to avoid danger is to run, therefore have access to escape routes.The complication that happens is that when these rules can't be followed, this then causes anxiety or panic. For example, because of these "new" rules that you can't be "far from home", and "must have immediate escape routes", this then makes plane travel suddenly a major issue. You anxiously anticipate that you will be anxious or "have a panic attack" on the flight, so you are likely to avoid it.
Cognitive-behavioural therapy (CBT) can turn this situation around. For a start, explanations like this help show that we are not mad or weird but operating on “primitive / basic" survival instincts that are easily programmed. As well, CBT challenges and rewrites these rules.
I NEED TO BE WITH SOMEONE
The sense that you need some else around is because of the primitive safety in numbers herd instinct. You can help yourself best. Others are not familiar with coping strategies.
I NEED TO BE AT HOME TO BE SAFE
As we are not animals, we don’t need to be close to the burrow. Our “homes” are portable. We can be safe outside of home.
I NEED TO BE ABLE TO ESCAPE IF I WANT TO
Not if there’s no danger. There's no danger in panic attacks. I’m safe right here! No need to “escape” immediately. I can wait till the lift opens, the train pulls into the station, the plane lands.
As well, CBT sets up helpful "graded exposure" programmes that prove that the agoraphobic rules are irrelevant, Through CBT ( and a good therapist), plus your own determination, you can regain a full life.
Joe Bolza is a Clinical Psychologist specializing in treating panic, excessive anxiety and depression using cognitive-bebavioural therapy (CBT). His main private practice is with PADA (Panic Anxiety Depression Assistance) in Glen Iris. Ph: (03) 9886-9400.
He also works in Clifton Hill Ph: (03) 9489-5247.
He has a website www.lexicon.net/panicanxiety
