Sunday, April 30, 2006

Press Release for Agoraphobia Resource Center

I am submitting the following press release to PR Web to be sent out on May 2. I had never written a press release before, but here is what I wrote:

Recovered Agoraphobic Launches New Informational Website to Help People with Agoraphobia

Clovis, CA (PRWEB) May 2, 2006 -- A recovered agoraphobic has launched a new informational website featuring a free newsletter to help people learn about and recover from agoraphobia. Agoraphobia is the fear of having a panic attack in open spaces or public situations.

Stephen Price, who since recovering from agoraphobia has earned a masters degree in psychology and published original research on anxiety, created the Agoraphobia Resource Center (found on the web at www.agoraphobia.ws) to help others who suffer from agoraphobia.

The Agoraphobia Resource Center offers its visitors a variety of information on the causes, symptoms, and treatments for agoraphobia along with summaries of the latest research on the disorder. The site also includes informative articles, written from Stephen’s study of and personal experience with agoraphobia.

Visitors to the site may sign up for the free Agoraphobia Newsletter, a bi-monthly, online newsletter written specifically to help people learn what they need to know to recover from agoraphobia. Agoraphobics may also share their personal experiences on the site’s discussion board.

“I created the site I wish I had when I was suffering,” says Stephen. “The way I see it, the Internet is the best way to communicate with people who are afraid to leave their homes. There are 3.2 million Americans with agoraphobia at any given point in time, and my goal is to offer them a sense of community and hope through the Internet.”

Stephen is currently writing two e-books which should be available on the site by summer. One will be called “The Agoraphobia Handbook” and provide a comprehensive information source on the disorder. The other will be called “Goodbye Anxiety” and contain principles for recovery illustrated by the author’s personal success story.

Understanding agoraphobia is a major obstacle for most people in recovery. Many people have agoraphobia for a year or more before they even know what is wrong with them. Sufferers commonly visit a succession of medical doctors, many of whom are not trained to diagnose psychological disorders. The purpose of the Agoraphobia Resource Center is to remedy this situation.

“People have heard of most phobias, like claustrophobia and social phobia,” Stephen says, “but if you mention agoraphobia, people just shake their heads. My goal is create awareness so people will know how and where to get help if they or someone they love shows signs of having agoraphobia.”

Friday, April 28, 2006

No Hopeless Cases of Agoraphobia

I believe hopelessness is a myth when it comes to agoraphobia.

If anyone was a hopeless case then I was. For two years I could hardly leave my home without being totally overwhelmed by debilitating panic. During the daytime, I fought a constant battle to keep from hyperventilating and scanning my body to make sure all my vital organs were working. At night I paced around the house, worrying that I might stop breathing and die at any moment.

Each morning, I awoke to the sounds of acid churning in my stomach. Just taking a shower exhausted me and I could hardly swallow food at breakfast. I couldn't go to school, work, or church. I couldn't even go visit a friend and I was terrified when the telephone would ring and I though it was for me. I had panic attacks even when I was at home and at times I was confined to one "safe" room by my fear.

I tried therapy, a support group, and medications - but nothing seemed to help me. I thought about giving up and seriously questioned the value of my life. But I did recover. Many people with agoraphobia believe that if therapy, support groups, and medication don't help them then nothing can help them. There are many agoraphobics like I was who go through times of thinking they are a hopeless case.

There were two major turning points in my recovery: 1) Doing reading on my own to get educated about my disorder. 2) Meeting someone who had made a personal recovery from agoraphobia with panic attacks.

When I met someone who had experience with recovering from panic disorder and agoraphobia, not only could she understand what I was going through from her own experience – she knew what to do to get better. I could have confidence in her suggestions because she had made a complete recovery from agoraphobia and panic attacks herself.

Meeting someone who had recovered from the same thing I was going through was like being lost in a forest and meeting someone with a map who could show me the way out.

Thursday, April 27, 2006

You are Not Alone with Agoraphobia

Most people who get agoraphobia feel like they are the only one. Unless you have looked into the statistics, it is easy to feel like you are the only person going through what you are going through. You may feel like no one else experiences the kind of panic or anxiety that you do or that no one could ever understand you.This belief can be isolating and work against your recovery. It can lead to hiding your problem, not sharing it with anyone, and not getting the support or help you need to get better.

I will admit that my case of agoraphobia made me feel like some kind of a freak for a while. I felt like I must be the only person in the world that couldn't leave my house without hyperventilating and getting weak and dizzy. I felt alone and isolated in my suffering, as though no one else has experienced the type of things I was experiencing.

Going to a support group didn't help these feelings of isolationat all. Though the people at my support group all said they had anxiety disorders and some even said they had agoraphobia, they could all sit through the whole group session without leaving. I, on the other hand, could only stay about five or ten minutes without being overwhelmed with panic and walking hurriedly to the door – and I was on lots of valium.

So I felt like the freak, even among a support group of other people with anxiety disorders. The truth is, you are not alone if you suffer from agoraphobia. In fact, you are in good company. About 3.2 million Americans suffer from agoraphobia at any given time (Anxiety Disorders Association of America, 2005). That's a lot of people who share your experience!

They are not necessarily losers or societal outcasts either.

There are some pretty big names among these 3.2 million agoraphobia sufferers, too. Former NFL football star and Heisman Trophy winner, Earl Campbell, has suffered from debilitating agoraphobia at times, as has Oscar Award winning actress, Kim Basinger.

I said all of this to say that if you have agoraphobia, it might be helpful to find someone else who has been through agoraphobia and recovered. The best support and help may come from someone who understands your disorder from their own experience - and can share what they did to get their life back.

Wednesday, April 26, 2006

Setbacks Don't Have to be Setbacks in Your Recovery from Agoraphobia

Setbacks can be one of the most discouraging things during your recovery from agoraphobia. They can make you feel like you have lost weeks, months, or years of hard-won progress and that you are back at square one. Fortunately, this is not the case.

Don't give up when you experience a setback. My recovery from panic disorder with agoraphobia didn't happen overnight. It was a hard fought battle with many setbacks. But it did happen, and today I am totally free from panic attacks and agoraphobia.

Your recovery may not happen overnight either, and your progress toward recovery may not all be forward. You may experience some tough setbacks along the way. I am writing you today to tell you not to make too much out of these setbacks.

I can remember working really hard with my desensitization program and getting to where I could go to four high school classes in a row before going home. It had taken me the better part of the past year to achieve this and I had started by going to only one class per day and slowly added classes over time. Then one morning early in my junior year of high school, I had a major panic attack during first period and had to go home. I was devastated. I thought all of my hard work had gone down the drain and I would have to start my recovery over from scratch. I was so consumed by these thoughts that I didn't go to school at all for the next couple of days.

Looking back, I am glad to be able to tell you that my thinking was totally wrong. This happened in September. By mid-November of that year I was playing on my school basketball team and attending almost a full day of school on a regular basis.

My encouragement to you is that all progress toward your recovery from agoraphobia may not be forward progress. There may be days when you experience so much panic or anxiety that it feels like you are right back where you started. But take heart, days like this do not mean you are starting your recovery over.

Each time you reach a new level in your recovery, you can get back to that level fairly quickly no matter what setbacks you face. It's best not to gauge the progress of your recovery from agoraphobia on a day to day basis. In most cases, recovery from panic disorder and agoraphobia is more like a marathon than a sprint. You can best measure progress toward your recovery over longer intervals of time.

Because of this, don't take setbacks too seriously no matter how bad they may feel. In fact, it might be better just to expect to have some setbacks along the way. In the end, if you persist in doing the things you need to be doing to recover, you will recover from agoraphobia and get your life back, no matter what happens on any given day.

Take it from someone who went through lots of setbacks but ended up overcoming a case of severe agoraphobia with panic attacks. Persistence wins in the end. I know this because I did it – and if I did it, so can you.

Tuesday, April 25, 2006

Agoraphobia Online Newsletter

While there are a number of newsletters on anxiety and panic disorders on the internet, I have decided to start a newsletter that is specific to agoraphobia. I am happy to say that people have already been signing up since I began advertising it Saturday night.

Articles that will be featured in the first issue issue (May 1) include:

- Top 10 Ways to Panic-Proof Your Life (A recovered agoraphobic's perspective).

- Can You Assume That Your Psychologist Will Use the Most Effective Treatments for Agoraphobia? What Does Research Say?

- Some Simple Guidelines For Choosing a Good Therapist.

Sign up for the newsletter on the Agoraphobia Resource Center website. The link is found on the sidebar of this blog.

Saturday, April 22, 2006

New Agoraphobia Website

I had agoraphobia before the internet became so widely used. Looking back, I wish there had been a helpful website or two with information about agoraphobia. Since I couldn't leave my house very easily, the internet would have been the perfect place to learn about agoraphobia.

Recently, I have started the website I wish I had when I suffered from agoraphobia. The information I am putting on the site would have saved me about a year or so of my life. I spent over a year just trying to figure out what was wrong.

Anyway, the link to my website is posted on the sidebar of this blog.

Check it out today and sign up for my free, bi-monthly newsletter. Oh, and I am calling the site the Agoraphobia Resource Center.

Thursday, April 20, 2006

Causes of Agoraphobia

There is no single cause of agoraphobia, nor is there any one factor that has been proven to be present in all cases. However, here are a list of factors that commonly contribute to the development of agoraphobia:

Family Factors
Growing up in a family with rigid rules or belief systems
Having an anxious parent as a role model
Having an overly critical parent that demands perfection or has unrealistic expectations
Having an overprotective parent
Receiving performance related approval as a child
Being abused as a child either physically or emotionally
Growing up with alcoholism in the family

Personality Factors
Oversensitivity to emotional stimuli
High levels of creativity and imagination
Black-and-white thinking
Perfectionism
High need for approval
High need for control
Suppressing or denying feelings
Tendency to disregard physical needs or acknowledge connection between the body and emotions.

Biological Factors
Oversensitivity to adrenalin
Oversensitivity to hormone changes
Oversensitivity to medication
Oversensitivity to physical stimulus (lights, sounds, temperatures, bodily sensations, etc.)
Large amounts of sodium lactate in the bloodstream

Usually a number of these factors contribute together to the onset of agoraphobia.

Monday, April 17, 2006

How to Provide Support for Someone with Agoraphobia During a Panic Attack

If you are with someone with agoraphobia and they start to have a panic attack, you can be a major help or a major hindrance. Here are some tips on how to be a major help.

First, ask ahead of time what the person would prefer you to do during a panic attack. Some people like to be left alone to concentrate on using their own strategies to get through it. Some people like to be talked to or touched. Knowing your friend or loved one's preferences is the first step toward being able to help during panic.

If the person with agoraphobia would like you to talk them through a panic attack, ask them specifically what types of things he or she would like you to say. If they cannot tell you, here are some good ideas:

1) Validate their emotions. Tell them that you are sorry they are experiencing the anxiety or panic. Let them know that you are acknowledging how they feel without judging them. Whatever you do, don't try to use logic or reason to tell them why they shouldn't be anxious. This is the opposite of validating someone's feelings and can make the other person feel stupid for feeling anxious and lets them know you don't get it.

2) Let them know you will stay with them. The presence of a "safe" person with whom the person is familiar and trusts is very comforting to most people during a panic attack. Sometimes its not what you say to the person having the panic attack, but just that you are there with them that makes the difference.

3) Remind them that panic, hyperventilation, and the other physical sensations felt during panic are not dangerous and that they are sure to live through the panic attack. Its good if you read up on the different sensations people feel during panic so you can address them. For example, a person may say they are feeling tingling in their hands and feet during a panic attack and ask if you should take them to a doctor. Knowing ahead of time that tingling sensations are a common physiological response to hyperventilation might give you the confidence to let them know what they are feeling is normal during panic - and keep you from wondering if your friend or loved one might be having a heart attack, stroke, or something dangerous.

If your friend or loved one with agoraphobia says they like to be touched during panic attacks then putting a hand on their shoulder or back, or even holding their hand until the panic subsides can be of great comfort.

Another idea is to lead the person away from the situation or place that triggered the panic and help them get somewhere safe. This may mean guding them out of a crowded restaraunt and helping them get to the car to calm down. It might mean leaving an event in the middle and driving them home.

People with agoraphobia really appreciate it when someone understands enough to help them out of the feared situation and get to a safe place without criticizing, judging, trying to talk them out of the panic, or asking lots of questions.

When you are helping someone with agoraphobia out of a situation that has induced a panic attack it is best to hold your comments and questions until later. Most people cannot think during a panic attack and having to listen to someone else's opinions or being faced with questions will only annoy the person having the panic attack, or cause them to start arguing with you.

Like I said before, trying to talk them out of the panic with reason or logic will just invalidate their feelings. Its unrealistic to expect a person having the panic to think rationally.

Whatever happens, stay calm and try to practice the things I just discussed. Speak in low, soothing tones and move using gentle, slow motions. The best thing a person can have during a panic atack is the presence of a calm role model who cares for them.

Friday, April 14, 2006

Agoraphobia Support: Ten Things Not To Do

Here are ten things not to do if you are trying to be a good support person for a friend or loved one with agoraphobia:

Don't:

1) Try to fix their problems with reason or logic

The anxiety and panic that come with agoraphobia come from irrational fear. Trying to use reason or logic to help will only make your friend or loved one with agoraphobia feel like you think he or she is stupid. If reason and logic worked, most people with agoraphobia would be better already. If a person with agoraphobia is sharing irrational thoughts with you, try active listening (hearing and making reflective statements about their feelngs) to let the person express emotions.

2) Try to force them to try any one recovery method

You may think you know best what they should be doing, but trying to force your way will only undermine the recovery process. Part of recovery has to do with the person gaining a sense of mastery or empowerment in his or her own life - and taking responsibility for oneself. You might suggest options, offer incentives, but don't try to force your way on someone with agoraphobia. Never use words like "should" or "shouldn't." Feeling trapped into having to so something with no other options is one of the psychological contributors to agoraphobia in the first place.

3) Try to solve all of the person's problems for them

If you try to do everything for someone with agoraphobia that he or she is afraid to do for himself or herself, you are just enabling the person and making the disorder too convenient for them. In extreme cases, the person will start enjoying the care and attention you are giving them and lose incentive to recover. The idea is to encourage, but let the person with agoraphobia take responsibility for his or her own life.

4) Question the person's desire to recover

Most people with agoraphobia want to recover. Most people would not choose to live through the nightmare that agoraphobia can be. Though the avoidance behavior and paralysis from anxiety might make someone look like they aren't trying or don't really care about recovering - believe me, they do. Questioning this is only hurtful and humiliating. Someone with agoraphobia doesn't need to be spending energy convincing others of their desire to recover. They will need all of their energy for the recovery effort.

5) Set time limits for their recovery

Let the person come up with his or her own goals. Setting recovery goals for a person with agoraphobia that are set in time only puts them under added pressure and stress. For instance, don't tell your spouse she has to get well by summer or she will ruin your vacation to the Bahamas. People need to be internally motivated to recover, not pressured by someone else.

6) Set goals for or evaluate the person's progress toward recovery

Remember, they are recovering for themselves, not you. Guide them to make their own evaluations but don't make it about pleasing you. People pleasing is already a problem and source of anxiety for most people with agoraphobia. Whatever you do, don't compare their progress with someone else's. Every case of agoraphobia is different and to a different degree. Feeling the need to compete with others in recovery just adds needless anxiety.

7) Try to get them to be spontaneous or do something unexpectedly

For someone with agoraphobia, this is highly likely to trigger panic or at least an escalation in anxiety. One of my worst memories as an agoraphobic was when my parents tried to get me to take a trip out of town on short notice. I felt suddenly overwhelmed and out of control.

8) Accuse them of wanting to have agoraphobia for selfish reasons

Having your motives questioned is the worst if you have agoraphobia. My parents used to accuse me of wanting to be sick to be able to stay home from school. I can tell you from experience that no one would decide to suffer from the horrors of agoraphobia to stay home from school, work, or anything else. Questioning motives humilates the sufferer and put the focus on having to convince others of something rather than the recovery process.

9) Psychoanalyze

No one likes to hear someone else's speculations about what's wrong with them. Keep your guesses to yourself, especially if you are not a psychologist or mental health professional. Its ok to help the person in the process of self-discovery or listen to a person analyze himself or herself, but under no circumstances act like you've figured them out. Sufferers of agoraphobia don't need more advice. They will get that from everyone who tries to fix them. The best thing you can offer them is understanding - that's what they really need from you as a support person.

10) Criticize

People with agoraphobia are already too hard on themselves and are usually perfectionistic. being critical only promotes this sort of thinking. Only criticize if you are doing it constructively and the person knows it is because you care.

Oh, and one more thing.......never, ever, ever give up on them. Your friend or loved one with agoraphobia needs you to keep believing in them, even during times when they lose confidence in themselves.

Wednesday, April 12, 2006

Top Ten Ways to Support Someone with Agoraphobia

Here are ten ways to be a healthy support person for someone with agoraphobia (written by a recovered agoraphobic):

1) Offer unconditional acceptance

This means being non-judgmental and non-critical. It means not thinking of agoraphobia and the behaviors that go with it in terms of good and bad or right and wrong. It means not putting the person down or voicing disapproval when they do things you don't understand. It means letting the person know that you love them, care about them, and will not abandon them whether or not they recover from agoraphobia.

2) Practice active listening

Hear and validate the person's feelings or emotions by making reflective statements to let them know that you heard and understood.

3) Increase your knowledge and understanding by reading about agoraphobia

Read all you can about agoraphobia and listen to the person who is suffering about their experience. Don't assume you know what they are going through.

4) Help the person find a motivation to recover

Help them find a purpose greater than their fear. This is one of the most important factors in anyone's recovery - discovering a reason for living that makes fear irrelevant. Discuss their dreams and fantasies with them. Draw out their desires. Engage them in discussions about their skills and interests and what would bring them the most satisfaction in life.

5) Reward their progress and accomplishments no matter how small

Recovery is usually made in a lot of little steps. Sometimes it takes a lot of work to gain just a little ground and its easy for someone with agoraphobia to get discouraged at the pace of recovery. Verbal praise and other rewards for taking even small steps forward can be very encouraging and keep a person motvated to keep pressing forward.

6) Show patience when the person makes mistakes or suffers a setback

Setbacks are a part of almost every recovery and are not intentional on the part of the sufferer. Setbacks, no matter how bad they seem are usually temporary. In most cases, setbacks only become major or prolonged when the person with agoraphobia blows them out of proportion in his or her mind (catastrophizing) and perceives them as worse than they are. By showing patience and not getting upset when your friend or loved one experiences a setback (and by not blaming them), you can help them perceive setbacks as minor and keep them from slowing down the person's recovery more than necessary.

7) Respect the person's autonomy.

If you are helping guide someone's recovery from agoraphobia, make suggestions and offer options, but always leave the decisions to the sufferer. Giving the person freedom to choose will help him or her gain a sense of control over his or her own life - which is so desperately needed to recover.

8) Keep your word always

Let the person with agoraphobia know what they can expect from you and follow through at all times. The sufferer really needs to trust you and feel safe in your presence. Agoraphobia is all about fear and people with agoraphobia and panic attacks are usually very insecure. Having a safe person they can trust helps build the security they need. So don't promise more than you can do and always keep your word.

9) Show confidence in their ability to handle their own life

Don't get into doing everything for a person with agoraphobia. Challenge them to try things they think they can't do. The more you show confidence in the person's ability to handle things, the more likely they are to gain confidence of their own.

10) Take care of yourself

To be a good support person, you need to stay rested and model good self-care habits. Don't make your whole life revolve around the person with agoraphobia. Keep up with interests, social activities, and relationships that don't have anything to with helping your friend or loved one recover from agoraphobia. Learn your limits and don't try to do more than you can do. Be able to say no when you aren't able to help anymore and don't be afraid to ask someone else to help you when you need to rest so your patience and energy need to be revitalized.

Friday, April 07, 2006

Helping Someone with Agoraphobia Want to Recover

You'd think that everyone with agoraphobia would want to recover, but as I discussed in my last post, some people have some deeply ingrained reasons to cling to their disorder.

One of the best things you can do to support a friend or loved one with agoraphobia is to help them find the desire, motivation, or will to recover if they cannot find it within themselves. What you do to accomplish this should probaby depend on their reasons to stay ill. But in general:

Assure them that they will not lose your attention if they get better, that you would still love and care for them and want to be close to them should they recover from agoraphobia.

Don't let them get away with putting the responsibility for their problem on other people - especially on you. Lovingly confront them when they start to do this and don't get involved in conversations about how someone else is to blame for their problems.

Also, do not be an enabler and cater to their every whim. If you start doing everything for them (shopping, communicating with people, doing the things they are afraid to do for themselves) you are taking responsibility for their disorder and making it convenient for them to stay in their agoraphobic state.

Treat them like the worthwhile person that they are and remind them they are worthy of a better life. Stay positive about who they are, be encouraging and don't get involved in conversations about why they are a bad person or deserve to have agoraphobia.

Most of all - help them find a purpose greater than their fear. This is one of the most important factors in anyone's recovery - discovering a reason for living that makes fear irrelevant.

Discuss their dreams and fantasies with them. Draw out their desires. Engage them in discussions about their skills and interests and what would bring them the most satisfaction in life.

People who are driven to action by a heartfelt cause seldom worry about what might happen if they fail. People who have a reason for living are seldom afraid of freedom, choices, or change. Their focus is usually on making a difference in the world rather than on being afraid of what dreadful thing might happen to them.

In the most extreme cases, people with a strong sense of purpose do not even show fear in the face of death.

Thursday, April 06, 2006

Why Some People Don't Want to Recover From Agoraphobia

You would think that someone with agoraphobia would want to get better. This may not necessarily be true.

Believe it or not, some people with agoraphobia (or other anxiety disorders) would rather not recover. Although they might not admit this consciously, some part of them just doesn't want to let go of agoraphobia so they cling to the disorder like a dear friend.

Some people with agoraphobia enjoy the attention and care they receive from others. They might not have experienced the same level of attention and care before they got agoraphobia or may fear losing it should they recover. This attention and care could come in the form of financial or emotional support among other things.

Other people with agoraphobia might fear getting well because it would mean making changes. They may not feel confident that they would be able to cope with or handle the responsibilities of a normal life and the idea of recovery leaves them feeling unsure and overwhelmed.

Still others with agoraphobia may inherently feel like they don't deserve a better life. They may feel guilty about something and feel like they deserve to suffer. Agoraphobia for these people could be like a prison they have put themselves in to serve out a sentence they feel like they have coming.

Some people with agoraphobia might not feel responsible for their disorder and get a psychological benefit in blaming it on other people. In other words, having a psychological problem like agoraphobia provides a way of getting back at someone (like their parents) whom they wish to make feel guilty.

Some people with agoraphobia might fear freedom. They may not trust their impulses or they may doubt their level of self-control . They might be afraid that they would go out of control in some way (emotionally, physically, financially) if they were to get well and be faced with new freedoms.

Some people with agoraphobia may simply be unmotivated. They know that recovering from agoraphobia would be a lot of work and they don't have any reason to put out the effort. They may not have a sense of purpose for their lives, and so they have no reason to work towards getting well.

Some people with agoraphobia may have other people who are reaping a psychological benefit from their illness. Their close friend or family member might derive a sense of self-worth having someone with agoraphobia being totally dependent on them. That person could be sabatoging their recovery, enabling them instead of challenging them to face their fears and get better.

Whatever the case - some people with agoraphobia might have more reasons to stay sick than get well. To recover, they really need to find a reason to get well.

As a support person for agoraphobia, you can help someone find a reson to get well. I'll share some ideas about that later.

Tuesday, April 04, 2006

What Makes Someone Vulnerable to Agoraphobia?

I just read an interesting article in the January 2006 issue of American Psychologist on the subject of how anxiety disorders including agoraphobia develop. Allow me to share the mian points.

First, the authors acknowledge that the going theory of how anxiety disorders like agoraphobia develop is through conditioning. They describe two types of conditioning:

Exteroceptive conditioning: learning to associate external cues like sights, sounds, smells, etc. with anxiety and panic.

Interoceptive conditioning: basically learning to fear the fear. Associating lower levels of anxiety sensations with full blown panic. This is when you are conditioned to notice minor sensations and feelings in your body and relate them to high levels of panic - so that these smaller anxiety-related sensations actually start to trigger panic attacks.

Second, the authors pose the question:

"If simple conditioning explains the cause of panic disorder and agoraphobia then why do some people who experience panic attacks go on to develop panic disorder and agoraphobia and some don't?"

In reviewing the literature, the authors answer this question by saying that what is known as "contemporary learning theory" explains why some people are prone to being conditioned into panic disorder and agoraphobia and others are not.

In other words, someone's genetics and prior learning history can make them vulnerable to developing full-on panic disorder or agoraphobia if they experience a single panic attack. Here are the factors that have to do with your genetics and learning history that put you at risk for developing panic disorder and agoraphobia:

1) Genetic personality traits like neuroticism and trait anxiety.

2) History of learning experiences in which you learn to perceive yourself as helpless or lacking control.

3) Being rewarded for engaging in sick role behavior when experiencing anxiety or panic. (The article says that adults who experience panic attacks are more likely to have grown up in households where they witnessed chronic illness and learned to perceive any unusual bodily sensations as dangerous).

To summarize the author's points, initial panic attacks set the stage for internal and external conditioning that could lead to panic disorder and agoraphobia but.......

people with the above risk factors having to do with genetics and learning are more vulnerable to being conditioned into panic disorder or agoraphobia.

Part of the significance of this finding is that by using this "contemporary learning theory" model to understand how panic disorder and agoraphobia develop, it might be possible to identify people who are at risk for these disorders because of their personality and help them unlearn their helplessness and playing the sick role before they get conditioned for panic disorder and agoraphobia.

By the way, the title of the article is "A Contemporary Learning Theory Perspective on the Etiology of Anxiety Disorders." The authors are Susan Mineka and Richard Zinbarg from Northwestern University.

The article covers the development of specific phobias, social phobia, obsessive compulsive disorder, port-traumatic stress disorder, and generalized anxiety disorder in addition to panic disorder and agoraphobia.

Monday, April 03, 2006

Agoraphobia Support: To Be A Good Support Person You Have To Take Care of Yourself

A person with agoraphobia may be prone to having a lot of needs or placing a lot of demands on the people they are close to. If you are going to be a good support person for someone with agoraphobia - then you may need to know where and when to draw the line. In other words, if you are going to support a friend or loved one with agoraphobia, you'll need to also be good at remembering to take care of yourself.

Here are some things to do to take care of yourself:

1) Keep up with your friends. Don't let the person with agoraphhobia isolate you to the point where they are the only person in your life.

2) Keep up with your job if you have one. Also keep your outside hobbies and interests. Although you may make lots of sacrifices to spend time with your friend or loved one with agoraphobia, its good to remain functional with your normal responsibilities and participate in recreation.

3) Get the sleep, nutrition and exercise you need to stay healthy. If you get too stressed then pamper yourself with a hot bath, a massage, or a good glass of wine. Don't feel like you have to be suffering all the time just because your friend or loved one with agoraphobia is suffering all the time. It doesn't help them if you let yourself get unhealthy.

4) Don't blame yourself or take responsibility for their condition or lack of progress if recovery is slow. Remember that it is their job to recover and your job to be there for support. If a bad day for them always means a bad day for you, you may be taking too much responsibility for their disorder.

5) Know your limitations and don't put unrealistic expectations on yourself to fix everything. Its ok to rest when you need to or ask for someone else's help in taking care of your friend or loved one with agoraphobia if you need a break.

6) Do something to express your own emotions and receive support for yourself. This could be in the form of a counselor, support group for people who support agoraphobics, or just a good friend you talk to often. Sometimes it can be almost as hard to watch someone you care about suffering as it is to suffer yourslf.

To use an analogy from lifeguarding - you are not going to be able to save someone from drowning if you start to drown yourself. This holds true if you are supporting someone with agoraphobia. To be a good support person, you've got to remember to take care of yourself.

Sunday, April 02, 2006

Agoraphobia Support: Guidelines for Good Listening

Being a good listener is another important quality in being a good support person for someone with agoraphobia. Being a good listener makes you someone the person with agoraphobia can share their feelings with. This is important because much of the anxiety someone with agoraphobia experiences could be coming from holding feelings in and not expressing them.

As someone who has suffered from agoraphobia I can tell you that one of the reasons people with agoraphobia (or anyone else for that matter) don't share their feelings with others is because most people are not good listeners and will just hurt your feelings even worse by not really listening or not validating them.

Probably the most crucial element to being a good listener for someone with agoraphobia or an anxiety disorder is being able to hear and validate someone's feelings or emotions by making reflective statements to let the person know that you heard and understood.

For example, if a friend with agoraphobia tellls you they are afraid they might have a panic attack and embarrass themselves if they go out on a date the best response would be:

"It sounds like you are really scared."

This lets the person with agoraphobia know that you heard their feelings. It lets the person know that you have heard their initial feeling and invites them to share more about it.

Some bad responses that do not show that you heard their feelings (and responses the average person would give) are:

"If you weren't so worried about having a panic attack you probably wouldn't have one."

"Maybe you won't have a panic attack and there's nothing to worry about."

These responses let people know that you think its silly for them to be worried about having a panic attack. They do not let the person know you have heard their feelings.

Hearing and making reflective statements about feelings is part of a skill called active listening. Active listening is a way of listening to someone that lets them know you care about them and are really hearing them. Since many people with agoraphobia say that what they need most in a support person is someone who will listen to them, here are some guidelines for active listening:

Be attentive. You have to make an effort to listen carefully. Don't daydream and don't talk.
Think about the main point the speaker is trying to make. Also, don't be thinking about what you are going to say the whole time the other person is talking.

Make reflective statments at first by paraphrasing or restating in your own words what the speaker is saying. Especially when they share a feeling (fear, anger, sadness, regret, guilt, etc.)

Good phrases to use when making reflective statements are:

"What I hear you saying is....."

"It sounds like......"

"So in other words....."

Try to leave your own emotion out when you're listening. Try not to argue back in your mind. These things detract from what the speaker is saying. In other words, be objective and try not to let your own judgments and biases cloud what you are hearing from them. Try to really see things from the other person's perspective and wait to hear their whole message before forming a response.

Ask for clarification if you don't understand a point the speaker is making. Ask questions to invite them to elaborate on points that seem important.

Avoid distractions. Sit close to the speaker, if possible.

Be aware of more than just the person's words. Look for body language, gestures, tone of voice, posture, etc. See if you think the persons non-verbal communication is congruent with what they are saying. (For example - some people smile when they are telling you they are upset). If the person's words and body language don't match, ask for clarification about what they are really feeling but be gentle about pointing out the descrepency.

When you do offer feedback, try to do so honestly but without passing judgment or expressing approval or disapproval of them as a person.

As you can see, good active listening is more than just not saying anything and nodding. Good listening is a skill that may take some work to develop if you don't come by it naturally. However, developing good active listening skills will make you a good support person for your friend or loved one with agoraphobia.

Plus - being a good listener will help you in your other relationships, too, even with people who don't have agoraphobia.

Saturday, April 01, 2006

Support for Agoraphobia: A Little Understanding Can Go A Long Way

Besides offering someone with agoraphobia your unconditional acceptance, a second vital key to offering good support is increasing your own knowledge and understanding.

In other words: Read all you can about agoraphobia and listen to the person who is suffering about their experience.

One of the problems people suffering from agoraphobia face when trying to find good support from others is that too many people overestimate their psychological knowledge. When I first decided to study psychology in college I had people say to me, "Isn't psychology all just common sense?" No one ever said that to my roommates who were studying bio-chemistry - yet psychological phenomena are just as complex.

If you had cancer or heart disease none of your friends or family members would presume to know what you should do for treatment. When you have an anxiety disorder like agoraphobia, everyone seems to think they know what you should do.

Psychology is not all common sense. Anxiety disorders like agoraphobia are just as complex as any medical problem. That is why it is important to read all you can to understand your friend or loved one with agoraphobia.

People with agoraphobia are likely to behave in ways that are hurtful or open to misinterpretation if you don't know what they are experiencing. For example, my family used to accuse me of not wanting to go to school, trying to mess up family vacations, or in general, thinking only myself and my own feelings. If you know someone with agoraphobia, chances are that you have probably thought of them as selfish or thoughtlesss at some point.

However, the more my family read up on agoraphobia - the more they realized that I wasnt trying to skip school or do anything intentionally to make the family miserable. They realized that I was suffering from a real disorder and wanted to recover, just as if I had been sick with cancer or a heart disease.

People with agoraphobia are famous for coming up with excuses to get out of things that scare them. They are also famous for becoming self-absorbed, in tune with their own emotions and out of tune with the feelings of others. The more you read up on agoraphobia, the more you will understand the reasons why and be able to support your friend or loved one with care and patience.

I can say from personal experience, your friend or loved one with agoraphobia probably doesn't want to be selfish or do anything to upset you, frustrate you, or hurt you. They are just sick and need you understanding and support to get better.

Remember, almost no one wakes up one day and decides they want to screw up their life. Most people with agoraphobia really do want to get better. They just need a little live and support from a few understanding people.

If you read up on agoraphobia - a little knowledge and understanding will go a long way in supporting your friend or loved one in their recovery from agoraphobia.