Tackle the anxiety that comes with this fear of open spaces and being trapped in situations that are difficult to escape
It’s a panic disorder that centres on an intense fear about the possibility of experiencing anxiety or panic attacks in a situation where it’s difficult to escape, or of being in open spaces – and as we prepare to re-enter the world after more than a year of lockdown, agoraphobia is something many may be facing.
“This anticipatory anxiety is based on assumptions by the sufferer that they may have a panic attack where help is not available, or even humiliate themselves in front of others,” explains Paul Dodd, an integrative psychotherapeutic counsellor. “Fear and anxiety lead them to engage in safety behaviours, choosing to stay away from certain places or situations that they perceive could trigger panic attacks.”
Paul notes that the causes of agoraphobia are the subject of debate, but they may be linked to unconscious defence mechanisms that reinforce anxiety based on underlying assumptions about places or activities. If you are experiencing agoraphobia to the point where it is disrupting your life, it’s important to speak to a mental health professional or your GP. But here we outline some self-help strategies, to softly soothe these fears as we take the next steps back to normality.
1. Take action, now
It can be easy to brush things under the rug, or to avoid reaching out for help for fear of judgement or misunderstanding. But the sooner you address feelings of agoraphobia, the sooner you can start engaging in strategies to take back control.
“Don’t hide from your fears or engage in safety behaviours to keep you safe from anxiety, as this only serves as a temporary cure – the avoidance of an anxiety trigger may only prolong the panic disorder,” Paul explains. While these actions may feel soothing in the moment, long-term they could trap you in an unforgiving cycle.
2. Refocus your thoughts
“Move from the ‘what if’, catastrophic, negative scenarios, to something based in fact – rather than making assumptions or holding automatic negative thoughts about a situation,” suggests Paul.
Letting go of those automatic negative thoughts isn’t easy, but if you notice you’re having one, call yourself out. Stop what you’re doing, acknowledge that anxious thought, label it, and try to move on with the rest of your day.
“Move from the ‘what if’, catastrophic, negative scenarios, to something based in facts”
3. Actively explore and engage in exposure therapy
Exposure therapy is a technique for treating anxiety and phobias where the individual is exposed to their fear in a safe, controlled way. It may feel daunting, but Paul explains that this method could be useful for dealing with agoraphobia.
“Find a friend or family member who is reliable and supportive, who can accompany you when engaging with this. Take one small step at a time, and gradually build up your tolerance to each triggering scenario,” he explains. “For example, you may be afraid of taking train journeys. I suggest having a friend accompany you on a train journey lasting just one-stop, then revisiting the same journey, but going for two stops with your friend. Finally, repeating the same route alone, going just one stop, and so on – slowly building your confidence in this way, one step at a time.”
4. Practise mindfulness
“This means being able to be fully present in the moment rather than ‘time travelling’ – thinking of the past or future – for example when engaging in ‘what if’ scenarios which are often based solely on the future, instead of the here and now,” Paul says. “Concentrate on your surroundings, feel your feet on the floor – what can you hear, see or smell? This helps to reduce symptoms.”
5. Learn and practise breathing exercises
The power of our own breath should never be underestimated, and having a few breathing exercises in the back of your mind, to bring out when you begin to feel panic rising is an effective way to stay in control. Try the ‘4,7,8’ exercise: inhale through your nose to a count of four, hold your breath for a count of seven, and exhale through your mouth to a count of eight.
“Current advice is also to engage in ‘tapping’,” Paul adds. Emotional Freedom Technique (EFT), also known as tapping, teaches you to rhythmically tap specific parts of your body to help deal with stress. “The advantage of EFT is that it can be done alone, it can be very effective, and it can be done anywhere.”