"If the situation causing the ongoing of stress that perpetuates agoraphobia cannot change nor do I wish it changed, what would you suggest in the circumstances, to help the agoraphobia?" FIONA- Tasmania

Agoraphobia establishes tension, which may have been caused by a traumatic event, feeling physically unwell or by ongoing stresses. Can an agoraphobic recover even if the ongoing stress continues? The commonest ongoing stresses are marital and work problems. The theme of the problem is that the sufferer is unable to stand up for him/herself and feels he/she is letting him/herself down. Agoraphobia is a very limiting disorder and therefore many sufferers become depressed. The treatment of agoraphobia involves learning to relax, controlled breathing, thinking more helpfully and graded exposure. Carrying out these procedures will help the agoraphobic to feel better and the body will become more trustworthy so this will speed up recovery. When the agoraphobic feels better he/she is in a better position to solve marital or work problems.SWAG

"Is Agoraphobia hereditary?" TONY -N.T

International researchers have been trying for some years to establish "Is agoraphobia hereditary?" the closest genetic basis which may be involved (if proven) is in the field of 'Behavioural Genetic Patterns'. We know the 'initial factor or factors' causing a person to develop agoraphobia are circumstances which have happened in or around our environmental lifestyle, which were caused by something or someone other than ourselves. We, the sufferers of agoraphobia have been forced to accept those circumstances with no possibilities within human reach, to change them. Therefore, the conclusion of heredity of agoraphobia is still not established and only is a guess of family behavioural patterns which has opened a new field called 'Behavioural Genetics'. Nevertheless, if one brother had agoraphobia and his sister did not (two people rarely have identical lifestyles) the brother still would have to have a desensitisation program to follow and recover, because behavioural patterns can be changed. If the same outside events affected both brother and sister it may be that both could develop some similar symptoms of agoraphobia. SWAG

"How can I relax quickly?" Rosalie W.A.

Firstly, relaxing is a skill - it improves with frequent and regular practise. The 'art' of relaxing has been lost due to the condition but to learn an art like a musical instrument etc., it needs constant practise, almost on a daily basis to be good at it, so do be diligent in practising your muscle relaxation; you will succeed. Do the tense - relax exercises immediately you notice yourself becoming tense. e.g. tight jaw or shoulders, clenched fists. Drop your jaw and drop your shoulders, relax your hands. Develop the habit of reacting to tension by relaxing. With practise the tensing of your hand and leg muscles can be done without any movement that would attract attention. It helps to slowly tense and relax the muscles. When circumstances prevent you holding the tension for seven seconds, shorter periods will still help; but you may have to repeat it a few more times. Each of these exercises can be adapted to help in problem settings such as working at a desk or driving a car. Use them whenever you need to relax. By using these exercises, you should in a few weeks be able reduce your tension, prevent yourself from becoming overly tense and increase your self-control and confidence. SWAG

"How can I get over being down, after I have had a set-back?" Carol N.S.W.

"Never be discouraged about yourself ". That statement is an antidote for every defeat feeling. Look forward - look ahead - if now and then your thoughts bring unrest, keep your mind on a positive attitude and what you have already learnt - Assemble all the facts impartially. List these facts on paper, this clarifies your thinking; bringing various elements into an orderly system - you see as well as think. Thus, the problem and steps of recovery become OBJECTIVE & NOT SUBJECTIVE Think and plan your target - Your own plan - A goal to achieve - THEN PRACTISE DAILY Face the situation slowly - this may be difficult at first, BUT the MORE YOU DO IT THE EASIER IT BECOMES. Everyone has set-backs in many different situations, apart from agoraphobia, but this is not necessarily failure for it can open up new prospects of successful ways of mastering goals. SWAG

"I was driving the car, with my husband, I got in amongst the traffic. I started to panic, I wanted to stop the car and let my husband drive but I had read if I let him drive I wouldn't be getting anywhere, so I kept driving, did deep breathing. I settled down but the panic came on and off for a few times. By the time I arrived home I felt a wreck. Why? Did I do the right thing ?" Paula Qld.

First of all - STOP DOING WHAT YOU CAN'T DO. This is a basic principle. You should have let your husband take over while you tried to concentrate on correct breathing and iso-metric relaxation. (If you are at the wheel, grip it tightly and tense muscles for the count of seven then relax). Keep repeating this till tension dies down. If your husband was not with you, the best thing would have been to stop the car at the side of the road and do some of the iso-metric relaxation and correct breathing.
Use your stomach and not your chest when breathing to overcome a panic. Feel your stomach go in and out to a six second breath. This will stop panting, or overbreathing or too deep breathing. SWAG

"I often wonder if it is possible for one to beat this thing alone without any help. I do have props (they don't know it though) and it often causes me to worry as to whether I'll get over it this way. I drive to town and know that when I get there I have friends to call on if I need to be near someone and I wonder, should I think this way? Maybe if I knew there wasn't anyone, I wonder if I would be able to drive to town myself!!" Sandy N.S.W.

We all have friends - agoraphobic or not. We all need a helping hand and want to give a helping hand. Your friends would be happy to support you if they knew your need. There are many definitions of a friend - some are "supportive", "understanding", "patient". Share your need of support and the friendships will grow stronger. Would you support them if they needed you? You need not feel ashamed to admit you do (at this stage) have agoraphobia. Today therre are many arers and voluntry helpers. Famous people from all walks of life, all through history have been hit by this problem, but now there is awareness and answers. It is not a mental illness or a nervous disease and is not a result of our mistakes in life but came from unfortunate and sometimes unavoidable circumstances beyond your control. SWAG

"What should I do while practising graded exposure? " Julian TAS.

Suppose you are out practising, when suddenly you feel that "strange feeling". If at all possible, try not to rush home. TRY TO FIND SOMEWHERE TO REST. Sit down somewhere, walk back a little way, try to stay near the place where the feeling started. Remind yourself that these feelings can not harm me; talk to yourself, "I will breath evenly and steadily; I will do some relaxation techniques, I will calm down and I will know that this is a time for me to progress; I will think of all the things I have done and congratulate myself." Plan the next step now that you are feeling much calmer, look around and start to plan what you will do next; make sure that when you are ready to go that you start off in an easy relaxed way - there is no need for effort and speed. The longer you stay out the better you will be, the anxiety always will die down naturally or better still with controlled breathing, will always prevent a panic from occurring. The golden rule is here, never rush to try and leave the situation, when you have calmly made a decision what to do next, start off relaxed. Don't even care what other people think, remove that thought from your head. SWAG

"Why are specifici descriptions of behavioiur patterns so important?" HELEN N.S.W.

Agoraphobia can't be treated as a physical or mental disease, pills can help, but the people involved must also change the way they behave. The right way to start off in the right direction, is changing the behaviour of the way we have been previously conditioned towards circumstances and places (crowds and schools etc.). Once we do this, thoughts and feelings automatically change later on. The action to take is, if you feel terrified of crowds, you should start mixing with smaller groups of people. They will help your feelings change towards large ones. This will build up your confidence and give back to yourself, trust in your body once more, because you will realise that it will not let you down, but you have to prove this to yourself first before you will believe it. If you have come to a halt, it may be that the time you chose was too difficult for you, a smaller target on your list maybe, or just head toward the target of your choice and note where you got up to each day. Soon you will notice that you will start passing your half-way targets. "Don't do anything you can't do but do something and do it every day". Try to practise a little every day - you are now unconditioning youself the right way and you are not the only one doing it, we all are ! FEAR COMES FROM THE UNKNOWN - KNOWLEDGE OF WHAT TO DO CONQUERS FEAR! SWAG

"I am continually worried about being a sufferer of agoraphobia, can you help me stop this?" LEN Victoria

Yes, there is a way of reducing the habit of worrying. Firstly note that it is a habit and can be broken like any other habit. Now that you have some knowledge about agoraphobia, it is good not to add anything more to this condition, like worry. Worry is your enemy for it takes away the pleasures of today - yesterday has gone and tomorrow hasn't arrived yet, so now is the most important time for you. Tell someone who is understanding, for keeping it to yourself eats away at your personality, and usually those around you know anyway. Don't concern yourself what others think ,as most have been in this situation. When you hear someone say, "I changed my mind" does that sound foolish? No of course not as we all can change our minds so say to yourself, "I choose to empty my mind of my worries about today and the future". " I reject these thoughts or worry". Have you heard the phrase "Don't take tomorrow to bed with you"? Today or now is what our thoughts and energy New energy, strength and freshness comes in the morning to face the new day. Make a list of the blessings that you have, a friend, a comfortable bed, shelter over your head, plenty of variety of food to enjoy, sight, hearing, a peaceful government, etc., etc. The body is renewing itself constantly with powers that are inbuilt, quietly working in spite of the way we may think so we can thank God for this unique creation. SWAG

"I thought I was ready to travel with my husband to our son's farm 100 km from home but we only got a few kilometres away when I had a severe panic and had to come home. What do I do to get my spirits up again and start again?" RHONDA VIC.

Set-backs, unfortunately, are inevitable for if this did not happen there would be no agoraphobia for it would just disappear like the 'flue' gradually stage by stage. The saying "Every cloud has a silver lining", is relevant to set-backs as even though it brings a 'cloud', after, there can be valuable changes in attitude and a profitable assessment of the problem. Look at the situation and check if it was too high or at the wrong time re your circumstances or health. Practise 'inviso' desensitisation to that problem when you are relaxed about it's image, then repeat 'inviso' desensitisation again. You must give yourself simple goals and pursuits for a while but see that you get out of doors each day even if only in the garden. "Aggies" always say that this is only temporary and anxiety will not cancel the many strides you have ahead or the goals you have planned in the future. Some constructive thoughts you can make are, "I'm feeling bad today and didn't make it, but I have felt this way before and still have made it and survived and often forgotten about it ". Make a 'love list' which includes 10 positive and true points about yourself. Repeat these when you feel down. A serious tip from a fellow 'aggie' in W.A when panic strikes. STOP - sit or lean against smoothing - close your eyes and picture a BIG STOP SIGN in large red letters. Keep visualising and repeating this until the panic wears out and subsides. During this time don't forget your correct breathing technique!! SWAG

"Does it help to know the cause of my Agoraphobia?" BRIAN S.A.

You don't need to know why you have agoraphobia, just take charge of the problem. Accept it and work from there. The next step is to understand that taking charge of changes entails certain responsibilities, especially to yourself!! Begin today to do those things necessary for your recovery. Practise for yourself! You know you can recover - you know you can have the help of a support person, whether by Inter-net, including this site, mail or friends, relative or community aid. You have not forgotten B.A. (before agoraphobia) that you were a capable, independent person achieving many things that you are proud of; that person is still you, and this temporary conditioin will pass and one day be behind you. Did you know that 'aggies' have on the whole a high I.Q.? You have the right to be you! It does take a lot of convincing to believe you can recover but when you make that breakthrough, you really know it! SWAG

"I have a fear of telling my family and friends about my agoraphobia, what should I do?" MELONIE S.A.

Do not be afraid to reveal your problems and yourself to others - risk it and experience acceptance, help and understanding in action. Maybe you have a guilt fear that comes from the early days when little was known about it and it was put into a category of an unknown mental illness, but thank God this condition is out in the open and has nothing at all to do with that, but is a CLASSICAL CONDITIONING. This could be your first fear, followed on by a fear of being exposed with thoughts of, "How can I explain it so they can understand it? "and "What will they think of me?" Then comes the fear of judgement with, "What will they think of me, perhaps they will laugh at me or think I am inferior?". At this point you feel that this situation is more than you can handle but we can reassure you that this will not happen, so continue on reading. You do not want to put yourself in this position for then may come rejection which then brings humiliation. NEVER PRE-JUDGE HOW OTHERS MIGHT OR MIGHT NOT REACT. By keeping this to yourself, you are adding burdens on top of yourself unnecessarily and missing out on life's unexpected happenings and events you could be enjoying. You will be very surprised when you decide to tell those around you what has been troubling you, that there will be far more empathy than criticism, especially if you are armed with the correct information to satisfy their curiosity. By hiding this condition others will diagnose your problem incorrectly, so make it easy for them too. After YOU ARE THE EXPERT on the subject. In the long run it is these people that are closest to you, that can help you through your de-sensitisation programme. Professional people are not able to help everyday. We are more influenced by those around us daily in many different ways - how we feel and behave, so it is very important that those around us do know about the problem and can help when help is needed. Another reason is - treatment not done in your own environment can also be a disadvantage - sometimes treatment in a hospital away from the home, shows improvement but the improvement goes when you are back home again, SO IT IS NECESSARY THAT YOU CAN PRACTISE IN YOUR OWN ENVIRONMENT. SWAG

"I want to plan going to the dentist for I have heard of other 'aggies' who have achieved this so I know I can; please give me some tips" SUSAN. Canberra ACT

Once you have reached the dental surgery show the receptionist your I.D. card and chat with her; she may ask you how they can best help you. Sit in a place that feels comfortable and relax-loosen your muscles (the isometric way) to make sure you are as relaxed as possible. Do some stomach breathing as well. Listen to the conversation around or speak with others. Note what they are wearing for distraction and maybe count how many articles you see made up of a particular colour. Taking a portable radio/cassette with you with some appropriate music to play - the dentist will not mind as you are doing him/her a favour in helping your agoraphobia. They want to help but don't always know the best way so will ask you how they can help. This gives you confidence they are on your side. Never think that you are trapped, once they have been told, as they will stop their treatment at any time you wish with just a movement of the hand to indicate. While you are being treated you can count each breath and in-between each number starting with 1 you can fit another word in like 'peace' or 'calm'. (Maybe use another word or words as suits you.) Say 'one' then 'peace' (next breath) 'two' then 'peace'(next breath) 'three' then 'peace' and so on till you get to fifty. If you loose the sequence start again with 'one'. This method is also good if trying to sleep, it's far better than counting sheep! Try writing a letter while having your teeth fixed or making a shopping list. A very 'BIG NO' for all agoraphobics is DON'T APOLOGISE for being in need of special consideration from the general public or any professionals. Children hold up a dentist much more than you. Don't rush home, go slowly or have a 'cuppa' somewhere to celebrate. To take some trusted person with you is quite acceptable and there is always an extra chair there for them. Telling the public, opens a door of acceptance and support from them, making practising so much easier. Don't leave it too long before you go again. You may pick up more ideas from other 'aggies' who can share them with you, to make this goal achieveable and successful. SWAG

"I don't understand why there is so much importance put on the breathing side when it is a natural thing that occurs without effort, surely the body knows what it is doing?" BEN S.A.

You are right in saying that breathing is automatic but we don't always allow our breathing to happen smoothly as we continually do things which restrict it! Things like fear, grief, anger and even exhilaration are emotional states which produce physical changes in the body. These changes increase the overall body tension and restrict breathing. Holding in these emotions also restrict breathing. Maybe you have not been aware of this change. When panic happens, the mind issues a 'red alert' to the body. Fear will create tension, and tension will effect the ability to breathe correctly. Any great amount of excess tension will upset the balance and interfere with normal breathing so this inability to breathe correctly is one of the most common reactions of agoraphobia. This explains why we must be aware of our breathing pattern. Using Controlled Breathing technique for this is a very important KEY TO RECOVERY. This will help to stop a panic as it restores the correct balance in the body. SWAG

"I have heard that putting a paper bag over my head when I have a panic, will help me, but I don't want to draw attention to myself and look a freak. What does that do anyway and can I use some other method to help my breathing?" GORDANA N.S.W.

This advice has benefit, but it is not really what you want to do in public. The purpose of the bag is to breathe in the carbon dioxide that you are breathing out as you have lost too much of it. This occurs because of erratic breathing - too short breaths, panting or too large breaths. You are of course aware that panic situations do cause a dramatic change in your breathing. When the balance is upset, energy is blocked - the state of distress is the result. It is necessary to stop this panting or overbreathing and change the pattern to Controlled Breathing and the body will naturally help itself. The best way to restore the balance of oxygen and carbon dioxide in your lungs and blood stream is to learn the Controlled Breathing (see topic on this site), which is only pushing the stomach out slowly when you take a breath, instead of moving your chest and shoulders. It is necessary to practise this simple exercise on a daily basis at home for at least two weeks, so that when you are out it is easy to change quickly. High altitude climbers must carry their own oxygen because of light- headedness. Being in an overcrowded room without proper ventilation will have a similar effect! and the emotion fear, when brought into the situation as well by the restriction of these muscles or tight clothing or by chronically poor posture - the result, a full 'flight or fight' situation. The conscious use of a breath is an invaluable tool. Used periodically, this following exercise utilises the lungs to capacity and extracts great amounts of oxygen from the air. Here is a way of experiencing a FULL BREATH. While it is not possible to fully expand the lungs with every breath, it is vital in awareness to experience how a complete breath feels. Try this sitting, standing and lying down. 1. Exhale.........., contracting the stomach. 2. Inhale slowly as you expand the abdomen. 3. Exhale. All relaxation techniques support the use of breath control. SWAG

"I am having a patch of difficulty in getting to sleep at the moment, could you give me some tips on how to change this?" CHERYL N.T.

Here are some pointers that you can try out as this can be a common problem with 'aggies' at times, as well as many others. Distract your mind from the problems of the day by reading a book, doing a hobby or having a conversation. If your day was an inactive one, do some exercises. Establish a 'getting ready for bed routine' to be carried out, unhurriedly and quietly to gradually slow down your metabolism. Once in bed, find a really 'comfy' position and breathe slowly and gently, as if already asleep. Feel the tension drain off every muscle, starting with your feet and legs then working up through your body. Don't dwell on sleep. Listen to a relaxing tape using an ear or pillow plug - it breaks the wrong sleeping pattern. To slow down the mind, give each breath a number, starting with 1 and progressing up to 20 and in-between each number put a word in. For example use a word like 'peace' or 'calm'. If you find this easy and don't get side-tracked you can increase the goal to 50 or add another word every alternate number. Make yourself return to the beginning if your mind runs away with other things. This is a very successful method of getting off to sleep. There are many variables to this if you find this easy; try counting backwards. If you wake up in the night and find your mind fixed on the coming day's events etc. have pen and paper on your side table and jot down those things and then leave them to deal with the next day, knowing that nothing can be done in the middle of the night. If sleep evades you completely just get up, make a hot drink, read a little until you are drowsy then settle down and try again. SWAG

Why are specific descriptions of behavioural patterns so important? JANICE -CAIRNS-QLD

Agoraphobia can’t be treated as a physical or mental disease, pills can help, but the people involved must also change the way they behave. The right way to start off in the right direction is changing the behaviour of the way we have been previously conditioned towards circumstances and places, crowds and schools etc., and once we do this thoughts and feelings automatically change later on. SWAG

I have a problem, I feel trapped when I am on the toilet and don’t like the door shut, I need a solution to so can you help me? J.P. N.S.W.

We know a therapist who had a client with the same problem so he was advised that it would be broken by de-sensitising. The therapist asked what were his interests and was told that motor cars were one of them. To help the client to stay a little longer and feel a bit more comfortable he was told read motor magazines and soon he was able to stretch the time and calm the tension slowly until he could stay without the fear of entrapment. He got so interested in the magazine he was distracted enough to be gradually desensitised. SWAG

As soon as I have to take a shower I feel tense and apprehensive of being trapped in the shower alone, I have to leave the door open, what can I do about this?

This is the same feeling of being trapped once you are in the bath but to overcome this you can phone an understanding friend or get a family member to help. This will not take long to change but be patient with yourself. If your ‘phone friend’ will stay on the line and read the paper while waiting so you know she/he is not watching the clock or feeling rushed themselves, you can then calmly carry out your ablutions. After a while doing this routine with no pressure from yourself or your friend it will become normal again. We know of an ‘aggie’ who couldn’t remove her clothes to get in the bath without the same feelings but she was told how to desensitise herself by filling the bath and without take off all her clothes just get in for a few seconds then stretch the time longer. She did this and soon was able to enjoy a bath the proper way; she had a good friend to support her in accomplishing this success. SWAG

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