A HOME
TREATMENT PROGRAMME FOR AGORAPHOBIA SUFFERERS
(by Professor A Mathews-Oxford University) Published by S.W.A.G.(AUST.)
INC.
ISBN 0 9591710 0 2
ANSWERS
1 a) Open spaces in the country
Agoraphobia is often called a fear of open spaces but this is misleading.
It is sometimes present, but so is a fear of small, enclosed spaces.
b) Losing control in a crowded public place- Correct. This common
fear develops in most people with agoraphobia.
c) Staying at home with someone Staying at home instead of going
out is a common problem, but agoraphobics are not usually afraid of it
unless they are alone.
d) Being with other people On the contrary, other people can prevent
fear (especially familiar people), although crowds may be frightening.
BACK TO QUESTIONS
2 a) It can't be controlled very
easily No fear, agoraphobic or otherwise can be controlled easily.
b) It causes bodily changes All kinds of fear, agoraphobic or otherwise
can cause bodily changes, like your heart beating fast.
c) It is an automatic bodily reaction All kinds of fear, agoraphobic
or otherwise involve an automatic bodily reaction.
d) It is the same as fear, but without any real danger.-Correct.
There are no obvious differences between the experience of extreme fear
and agoraphobic panic, only between the situations which trigger them.
BACK
TO QUESTIONS
3 a) Association of a reaction
with a situation-Correct. 'Conditioning' described the way in which
everyone learns to react automatically to particular things or places.
b) Learning to be afraid Learning to be afraid of some situations
would be an example of conditioning, but the question asked for the meaning
of conditioning in general.
c) An oversensitive state following an illness No, this state may
cause panic feelings, but the word 'conditioning' refers to the way the
feelings are later attached to particular places.
d) Learning that two things always go together This is not quite
accurate, since it does not say anything about how reactions become automatically
associated with particular things.
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TO QUESTIONS
4 a) Keep him away from dogs
for a while If you do this, you will leave the conditioned fear untouched,
and perhaps to get worse.
b) Tell him to be braver next time. Talking does not usually do
anything to reduce conditioned fear, a different kind of experience with
a dog is necessary.
c) Give him a sweet to sheer him up This may cheer him up but it
will not do anything to reduce the fear - unless perhaps you give him a
sweet when he is getting nearer to a dog.
d) Introduce him to a more gentle dog-Correct. This will reduce
the conditioned fear and stop it spreading to all dogs, without preventing
him from being cautious with the fierce one.
BACK
TO QUESTIONS
SUMMARY SO FAR
a) A mental disease like schizophrenia No, the two things
are quite different, go back and read all again.
b) Due to physical illness The first panic attack may have followed
a physical illness, but there is no reason to think that agoraphobics continue
to be physically ill in any way. Go back and read all again.
c) A learned emotional reaction-Correct. Although other kinds of
behavioural learning occur later (like learning to avoid places) emotional
reaction is usually learned first.
d) Caused by lack of will-power It makes no more sense to call it
a lack of will-power than it does to say that about someone who jumps when
there is a loud noise. Go back and read all again.
BACK
TO QUESTIONS
5 a) You will find it more and
more difficult to go back.-Correct. Avoidance tends to strengthen conditioned
fear.
b) In time you will be able to go back without trouble. No, time
is likely to have the opposite effect.
c) You should wait until you are well before going back. You are
probably as well now as you ever will be, and waiting too long might make
it more difficult.
d) You should get someone else to go to the shop for you. If you
do this, you will be helping to establish a habit of avoidance and the
fear will grow stronger. You would not be helping yourself.
BACK
TO QUESTIONS
6 a) Acting insanely Agoraphobics
often fear that they will act insanely, but never really do.
b) Feeling faint or strange-Correct. These feelings and other of
the same sort are very common, and although alarming are quite harmless.
c) Collapse through physical overstrain. Agoraphobics often fear
that they may collapse, but they are no more likely to do so than anyone
else. Often they get little exercise, so they feel exhausted when they
practice, but this does no harm.
d) No special feelings With the exception of those who have given
up and never go out, agoraphobics do experience feelings which are unusual
for most people in ordinary circumstances.
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TO QUESTIONS
7 a) It won't give you any more
trouble Fears that have got worse over a period of years won't go away
as quickly as that.
b) It will be even more difficult next time No, it is usually only
the experience of panic attacks or the avoidance of a place that makes
going the more difficult. Go back and read it again.
c) It won't have made any difference It may not make any obvious
difference right away in all cases, but on average it is likely to reduce
the fear.
d) It will probably be slightly easier next time-Correct. It will
not always be obvious right away, since there are bound to be ups and downs
but on the average it will tend to get easier each time.
BACK
TO QUESTIONS
8 a) They will get rid of all
the feelings of fear No tranquilliser can get rid of fear, although
they do reduce it for a while. However, the question aimed at long term
usefulness.
b) People become dependant on them for going out Getting dependent
is usually only a problem if they are taken regularly for a long while.
In any case, the question asked why they were useful.
c) They build confidence for practise without tranquillisers-Correct.
The most important use of tranquillisers is to reduce fear for a while,
until enough confidence is gained to do the same practice without them.
d) They give something for people to rely on in an emergency. Some
people do rely on tranquillisers for 'emergencies' but that is not a good
idea as a rule. In this treatment, they are used only as part of practice.
BACK
TO QUESTIONS
SUMMARY OF TREATMENT PLAN SO FAR
a) Doing things one step at a time.This is a good thing to recommend for
someone with agoraphobia, as it builds up confidence for more difficult
items. The question asked which was the wrong thing.
b) Taking tranquillisers before some practice sessions.This does help when
new and difficult items are practised for the first time, so it could not
be the wrong thing to recommend.
c) Practice in going out every day.It is only by practice in facing the
feared situations that the fear will be overcome and it is important to
get into the habit of doing this daily, so this cannot be wrong.
d) Having help from others with things like shopping-Correct. It is not
helpful in the long run to get someone else to do the shopping. It simply
makes it easy for you to stay at home, and makes the habit avoidance stronger.
BACK
TO QUESTIONS
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