Adam Elramsisy
Adam Elramsisy and Ariel Alter
3/24/05
Abnormal Psychology
Agoraphobia: A Myth Uncovered
Agoraphobia is commonly misunderstood as simply a fear of open places.
Agoraphobia is in fact, the fear of being in places or situations where it may be difficult
to escape in the event of having a panic attack. The DSM-IV names two different forms
of agoraphobia: “panic disorder with agoraphobia” and “agoraphobia without history of
panic disorder.” Agoraphobia does not apply if phobias are specific because that is
considered specific phobia. It also does not apply if the phobias are limited to social
situations because that is considered social phobia. Characteristic fears of
agoraphobics are fear of being outside of home alone, being in a crowd, or traveling
on a bus, train, or automobile. These situations must also be avoided or endured with
noticeable distress or anxiety of having a panic attack, or require a companion to be
present.
In order to be classified as agoraphobia, no other mental disorder must account for the
behavior. Other disorders that may cause similar behavior are, social phobia, specific
phobia, obsessive-compulsive disorder, posttraumatic stress disorder, or separation
anxiety disorder. Agoraphobia cannot be induced by the “direct physiological effects
of any substance (i.e. drug abuse, medication) or any medical condition."
Agoraphobia is usually concurrent with a panic disorder because these are the people
who believe that they are susceptible to have a panic attack in a situation where it may
be difficult or embarrassing to escape. It is possible, however rare, to have
agoraphobia without a past of panic disorder.
Agoraphobia is not a fairy tale. Real life people’s lives can become deeply affected by
the cold common fear of having a panic attack. Tammy White’s story best illustrates
the isolating effects of living with agoraphobia. Tammy White describes how her life
became the “fear of the fear.” Tammy had had two panic attacks in his town.
Associating the attack with bad feelings that cannot be controlled with the town, she
simply avoided it. “The further I got from my home, the more my fears increased.” To
her, it was easier and safer to emit the town from his daily schedule. Eliminating the
town from his life, she soon solely resided in his house. “My world had literally shrunk
until it became my house only. I made my home my sanctuary, but my home became
my prison, and fear was my jailer.” Every time she exited her house, she experienced a
myriad of horrifying thoughts. Her heart race would increase in fear, her forehead would
inflame, and she would feel “numb” throughout, monomaniacal thinking to get home.
Her family life became effected- not being able to participate in normal family outings
about town; Tammy’s family grew increasingly distraught and distant from her. She did
not have a job, only making her more prone to isolate herself in her housewife haven.
Only through therapy, was Tammy’s normal life restored.
Like all abnormal disorders, agoraphobia impairs a person from functioning effectively
in daily life. That is why the primary goal of treatment is to help a person get back on
their feet and initiate them back into the world of normal reactions toward stressful
stimuli, which are inevitable in life. Treatment of agoraphobia takes many forms, some
more successful than others. Since agoraphobia stems from an anxiety disorder, it is
only effective to treat the anxiety, or excessive fear of a situation that has the potential
to cause a panic attack.
Biological clinicians treat agoraphobia with medication. Researchers have found that
anti-depressant medications, such as Xanax and Lithium, are often more effective than
anti-anxiety drugs, such as benzodiazepine. However, powerful doses of
benzodiazepine are almost just as effective. Doctors and psychologists have proven
that the most effective form of treatment of agoraphobia is a combination of biological
and cognitive therapy.
Cognitive therapists of agoraphobics advocate a step-by-step treatment that changes
the way people think about their condition. First, the agoraphobic’s misinterpretations
about the “harmful effects” of the panicky bodily sensations they apprehend are
corrected through education. Second, the cognitive therapist teaches the agoraphobic
to interpret a stressful situation rationally, to prevent the panic sequence of thought.
Lastly, the agoraphobic is taught to deal with anxiety with techniques of relaxation and
breathing.
Systematic Desensitization is a behavioral method in treating agoraphobia. In “covert
systematic desensitization,” the person is asked to relax, and gradually imagine the
things that cause the anxiety, from least fearful to most fearful, on a “fear hierarchy.” In
“in vivo systematic desensitization,” an agoraphobic person is gradually or
immediately exposed to the situations, such as an open-marketplace, a mall, or an
airport, where anxiety usually may occur. This form of treatment is also called exposure
treatment, and is the most effective, accompanied with medication.
3/24/05
Abnormal Psychology
Agoraphobia: A Myth Uncovered
Agoraphobia is commonly misunderstood as simply a fear of open places.
Agoraphobia is in fact, the fear of being in places or situations where it may be difficult
to escape in the event of having a panic attack. The DSM-IV names two different forms
of agoraphobia: “panic disorder with agoraphobia” and “agoraphobia without history of
panic disorder.” Agoraphobia does not apply if phobias are specific because that is
considered specific phobia. It also does not apply if the phobias are limited to social
situations because that is considered social phobia. Characteristic fears of
agoraphobics are fear of being outside of home alone, being in a crowd, or traveling
on a bus, train, or automobile. These situations must also be avoided or endured with
noticeable distress or anxiety of having a panic attack, or require a companion to be
present.
In order to be classified as agoraphobia, no other mental disorder must account for the
behavior. Other disorders that may cause similar behavior are, social phobia, specific
phobia, obsessive-compulsive disorder, posttraumatic stress disorder, or separation
anxiety disorder. Agoraphobia cannot be induced by the “direct physiological effects
of any substance (i.e. drug abuse, medication) or any medical condition."
Agoraphobia is usually concurrent with a panic disorder because these are the people
who believe that they are susceptible to have a panic attack in a situation where it may
be difficult or embarrassing to escape. It is possible, however rare, to have
agoraphobia without a past of panic disorder.
Agoraphobia is not a fairy tale. Real life people’s lives can become deeply affected by
the cold common fear of having a panic attack. Tammy White’s story best illustrates
the isolating effects of living with agoraphobia. Tammy White describes how her life
became the “fear of the fear.” Tammy had had two panic attacks in his town.
Associating the attack with bad feelings that cannot be controlled with the town, she
simply avoided it. “The further I got from my home, the more my fears increased.” To
her, it was easier and safer to emit the town from his daily schedule. Eliminating the
town from his life, she soon solely resided in his house. “My world had literally shrunk
until it became my house only. I made my home my sanctuary, but my home became
my prison, and fear was my jailer.” Every time she exited her house, she experienced a
myriad of horrifying thoughts. Her heart race would increase in fear, her forehead would
inflame, and she would feel “numb” throughout, monomaniacal thinking to get home.
Her family life became effected- not being able to participate in normal family outings
about town; Tammy’s family grew increasingly distraught and distant from her. She did
not have a job, only making her more prone to isolate herself in her housewife haven.
Only through therapy, was Tammy’s normal life restored.
Like all abnormal disorders, agoraphobia impairs a person from functioning effectively
in daily life. That is why the primary goal of treatment is to help a person get back on
their feet and initiate them back into the world of normal reactions toward stressful
stimuli, which are inevitable in life. Treatment of agoraphobia takes many forms, some
more successful than others. Since agoraphobia stems from an anxiety disorder, it is
only effective to treat the anxiety, or excessive fear of a situation that has the potential
to cause a panic attack.
Biological clinicians treat agoraphobia with medication. Researchers have found that
anti-depressant medications, such as Xanax and Lithium, are often more effective than
anti-anxiety drugs, such as benzodiazepine. However, powerful doses of
benzodiazepine are almost just as effective. Doctors and psychologists have proven
that the most effective form of treatment of agoraphobia is a combination of biological
and cognitive therapy.
Cognitive therapists of agoraphobics advocate a step-by-step treatment that changes
the way people think about their condition. First, the agoraphobic’s misinterpretations
about the “harmful effects” of the panicky bodily sensations they apprehend are
corrected through education. Second, the cognitive therapist teaches the agoraphobic
to interpret a stressful situation rationally, to prevent the panic sequence of thought.
Lastly, the agoraphobic is taught to deal with anxiety with techniques of relaxation and
breathing.
Systematic Desensitization is a behavioral method in treating agoraphobia. In “covert
systematic desensitization,” the person is asked to relax, and gradually imagine the
things that cause the anxiety, from least fearful to most fearful, on a “fear hierarchy.” In
“in vivo systematic desensitization,” an agoraphobic person is gradually or
immediately exposed to the situations, such as an open-marketplace, a mall, or an
airport, where anxiety usually may occur. This form of treatment is also called exposure
treatment, and is the most effective, accompanied with medication.