Healthy people may not understand that some individuals are afraid of leaving their homes, going to shops, being in certain places or crowds. They also experience fear when they have to travel by train, bus or plane. Fear of confinement also occurs in places that are difficult or uncomfortable to get out of or escape from, such as theatres, cinemas, lifts, restaurants, as well as bridges, tunnels and basements.
In the mind of these people, places are associated with danger. They recognize that their fears are misplaced, but they have the impression that they are exposed to something terrible that they cannot control.
Agoraphobia often develops after difficult life events
The condition is often thought to be claustrophobia, but in fact it is called agoraphobia, and it is a quite common condition. The patient is actually afraid of the panic attack itself, dreading that fear will overwhelm them in a threatening situation. They do not want to take this risk, and therefore they try to avoid potentially frightening situations at all costs. Their fear is expressed in thought, feelings, physical reactions and behavior.
People with agoraphobia constantly seek safety and control. This phobia often occurs after a personal crisis, after an existentially threatening event such as the break-up of a marriage, the loss of a close relative or friend, a serious illness, one’s own or someone else’s illness, loss of work, financial difficulties, serious injury.
Phobic disorders are usually not caused by organ failures, have no genetic roots and are not associated with any mental disorder or psychological distortion. They are mostly faulty habits, fixed behavioral disorders that can be corrected, overridden and even completely eliminated with appropriate therapeutic education and cooperation.
Agoraphobic patients usually respond favorably to cognitive behavioral therapy. Two approaches can be used:
Desensitization
neutralization of frightening thoughts associated with phobic situations. A list of situations that the patient should avoid is drawn up together with the therapist. The situations are then ranked in order of difficulty. The person relaxes through progressive muscle relaxation and then gradually vividly imagines each situation, starting with the one that he or she fears the least.
Confrontation therapy
patients can gradually become accustomed to situations that they have carefully avoided. They are confronted with the situations they fear, starting with what they see as the most dangerous. This could be going to the theatre, a train ride, riding an elevator, a car trip to a foreign city, climbing to the top of a tower, etc.
Through confrontation training, the patient learns about their physical reaction and remains in the situation without anything happening to them. This can be complemented by learning relaxation exercises and doing them regularly.
In more severe cases, the treatment of agoraphobia requires clinical intervention, with the patient being prescribed antidepressants and anti-anxiety medication. Direct help may also be needed from a psychiatrist, psychologist or mental health professional.