Recommended SELF HELP RECOVERY STEPS are
1) RECOGNISE, ACCEPT AND UNDERSTAND AGORAPHOBIA
2) ISOMETRIC RELAXATION AND CONTROLLED BREATHING
3) PRODUCTIVE AND CORRECT ATTITUDES TOWARDS PANIC AND SITUATIONS
4) GRADED EXPOSURE
5) KNOWLEDGE OF CLASSICAL CONDITIONING
Recognise, accept and understand its physical symptoms so that much fear and stress is reduced.
IT IS NOT A PHYSICAL DISEASE
OR A MENTAL ILLNESS
And do not believe, when told, “It’s only nerves”, but accept the truth that it is a
Temporary CLASSICAL CONDITIONED EMOTIONAL REACTION.
The nervous system regulates the activities of all the other systems. One of the three divisions of this system is THE AUTONOMIC SYSTEM that regulates the activity of many organs that are not controlled by the mind. These nerves are regulated through the central nervous system but at a sub-conscious level, thus eliminating the false diagnosis of ‘being mentally ill’. These organs include the stomach, bladder, heart, blood vessels, adrenal glands, and sweat glands. The main culprit with agoraphobics is the ADRENAL (flight/fight) GLAND that sends a message to run or fight – this is the normal protective message for survival but one sufferers experience in panic.
The nervous system can be ‘sensitized’ for hours or days afterwards giving the quality of life as ‘one long emergency’.
Agoraphobics should NOT FIGHT OR RUN – some choice!
We all have them; love, fear, hope, disappointment, joy, sorrow etc. both positive and negative and we would not like to be without the positive ones.
Agoraphobics have been conditioned to the emotion, fear (NOT BY CHOICE). Some of the positive emotions have taken second place. The fear emotion causes parts of the nervous system to send signals to glands and organs. These get prepared to defend the body. In fear, the adrenal (fight/flight) gland empties a hormone called adrenalin another called nor adrenalin into the blood stream. These cause a series of changes in the body.
THESE NATURAL EMERGENCY MEASURES GIVE THE BODY ENERGY TO FACE CRISIS, ESCAPE FROM THREAT AND TO PROTECT
And are vital to our SURVIVAL.
This explains why a face becomes hot then pale, mouth dry when any one has a fright. Everyone has these same feelings but agoraphobics always put them into the phobic situation, transferring them over:
Making it and keeping it a highly sensitized second stage fear
Sufferers, both those heading forward and those recovered, have to realize that the first fear is normal, and are not to be confused with the second state of fear
Frightening heart thumping comes with panic attacks but the heart is a totally strong muscle and can do the work (in strength) all the time of lifting one and a half short tones one foot off the ground every hour, even while you are sleeping. Your heart will not let you down. One does not die from a racing, thumping heart; strong palpitations have never caused a heart attack to anyone. The heart changes its rate of beating to meet particular needs. The hard beating of the heart is made aware by “General Adrenal”, the fight/flight gland.
AIR HUNGER (HYPERVENTILATION)
This is a common problem and causes many unpleasant feelings. This is again the body reacting to the Adrenal gland. Any person hyperventilates or gasps for air as if to need more oxygen because of breathing out too much carbon-dioxide from the body in an anxiety situation. The symptoms are lightheadedness, giddiness, blurred vision, dry mouth, cramps, trembling and shaking in legs, lump in the throat etc. This is because your blood has become slightly alkaline because of reduced carbon dioxide. If you do faint, the breathing pattern automatically returns to a regular rhythm. One need not be afraid that this will do harm.
If you are hyperventilating, stand still and hold your breath for a count of 10, then do it again and the balance of oxygen and carbon dioxide will resort back to being balanced again.
Slow you’re breathing down to 10-12 breaths per minute and keep your shoulders and chest quite still while moving your stomach in and out as you breath. (See further notes)
ü YOU CAN CONTROL AND STOP PANIC ATTACKS BY THIS CORRECT BREATHING TECHNIQUE
BOWEL AND BLADDER FUNCTION
A person’s nervous systems and emotions control these parts. It is the anxiety that causes a person to feel the urgency, and this brings on the fear of loosing control of the bladder and bowel.
Who hasn’t experienced the need to ‘go to the toilet’ ten times before an interview, for an example or going out to some important event? A person’s nervous systems and emotions control the bowel and bladder functions. It is the anxiety that causes a person to feel this urgency and this brings on the fear of loosing control of the bladder and bowel. Learning self-desensitization will relieve this.
This is very high with sufferers because of a long time of fighting instead of letting go, impatience with time, depression, fatigue. These all add up to increased stress and therefore prolongs recovery. The more you panic the more adrenalin is released and you will have a panic.
STOP DOING WHAT YOU CAN’T DO FIRST – THIS WILL LESSON TENSION SO YOU CAN REASON WITH YOURSELF.
TRY TO UNDERSTAND THAT YOUR BODY IS NOT A MACHINE, THAT IT HAS A LIMITED CAPACITY TO PRODUCE ADRENALIN; THERFORE THAT FIRST FEAR CAN COME ONLY IN A WAVE, AND MUST ALWAYS DIE DOWN IF YOU BUT WAIT, AND CALM DOWN. Sensitized nerves heal as naturally as a broken bone.
BREATHING CHANGES or ‘AIR HUNGER’
Just prior to the actual blast of panic, sufferers fall into a pattern of erratic and rapid breathing, which affects the blood carbon dioxide levels bringing on dizziness, anxiety and faintness. This is called HYPERVENTILATION. ‘For those who were seen at a study course on Agoraphobia in New South Wales, in Australia, the figure was near to 80% and higher still for those housebound who could not get to the University Clinic’.
Tension is the main cause here with adrenalin output, along with too much output of carbon dioxide by irregular breathing. You are very conscious of where you are; there is a small circle around you and you can see that far, but everything else is blurry.
LUMP IN THE THROAT
Or a tight restricted throat. This brings in the difficulty of swallowing and of a distressing feeling of breathing brought on by over breathing. It is made worse by tension of throat and neck muscles.
Of muscles follows emotional shock, when adrenalin is released and the blood drains from the rest of your body into muscles and therefore does not circulate properly.
This is behind giddiness, blurred vision etc. Tension brought on by adrenal output interferes with the balance mechanism. The swaying type of giddiness may also accompany low blood pressure or felt when high blood pressure drops quickly, e.g. hot weather. It is reassuring to know that giddiness follows a fall rather than an increased blood pressure.
It is important to know about the energy and vitamins foods give the body, so take an interest in the right and varied balance of food your body needs.
The more you panic the more adrenalin is released adding to the situation.
‘No tranquilizer can get rid of fear’ (Mathews,) but can be useful in starting off on a desensitization program, only if you wish this. It helps the brain’s perspective awareness of bodily functions that disturb you. When the time is right, reduce them slowly until they are not needed.
(isometric means exercises intended to strengthen muscles by pressing one part of the body against another), AND
Lack of knowledge on these two subjects has kept tension going so with this new information offered and proven by thousands of sufferers, you too will know how to act to stressful situations, with a state of relaxation, instead of utter confusion.
RELAXATIOIN TECHNIQUES & CONTROLLED BREATHING ARE PART OF THE NEW BEHAVIOURAL PATTERNS TO USE FOR UNCONDITIONING or DESENSITIZATION
Firstly, with the relaxation technique, sit in a comfortable chair, quietly and be still. To make your body obey you and to reduce the tension that persists in your body, you force the muscles against other parts of the body and hold them tightly, (that’s the meaning of ISOMETRIC) for a count of ten. When you let them go, they retract like an elastic band or a
Ø You are starting to take control of your body instead of your body always dictating to you
You may feel frightened at first as being relaxed is foreign to you and you feel vulnerable, but don’t give up as this will all help in the long run. Being persistent and never giving up is one of your strong traits, as you very well know. Use your strength in this area to press through to a more relaxed state.
There are 16 muscle groups so try this exercise out, each muscle individually, eventually using every part of your body from your head, face, tongue, arms, hands, stomach, buttocks, legs, to the toes, holding each for a count of 10 tightly. You will be surprised at how much better you will feel. Repeat this exercise twice.
(You can take parts of this exercise as well as the controlled breathing technique where ever you go without being obvious to others, so taking your cure with you.)
A LEARNED CONDITIONED REFLEX CAN BE REVERSED
A white rat was placed in a box and every time a bell sounded it was followed by an electric shock to the rat. After a time the rat became highly sensitized and afraid of the sound of the bell, because of the shock that followed. (Conditioning was formed).
Next a leaver was put into the box, so when it touched it, would stop the shock given. The rat inadvertently touched the lever and came to learn that if the lever was touched, the shock would not follow. It did this at the sound of the bell and its sensitized state lowered. After the test was over the rat was no longer sensitized. (Unconditioned response completed)
Be patient with yourself for it is not surprising that many sufferers have forgotten the natural art of relaxation because of all the confusion and bewilderment associated with this condition.
a) Do not expect too much too quickly, but do expect improvement.
b) Be prepared for ‘ups and downs’
c) Attitude has been a downfall; let yourself enjoy your relaxation periods.
d) Restlessness and discomfort. It always occurs in the early stages of relaxation; don’t fight against it.
e) Unable to relax muscles; keep reading on for an answer
f) Strange or unfamiliar feelings; this is common. Open your eyes and reassure yourself all is well.
g) Practice stomach breathing at night as well. (More to come).
It is impossible to just ‘tell your body to relax’, for it will take no notice so you are left with tension. To trick the body and make it obey you, this ISOMETRIC type is designed for agoraphobics and is successful.
Now on to the second part of the physical actions needed to be taken -CONTROLLED BREATHING
Is probably the most important KEY to recovery as when the balance is upset in the lungs and then the blood stream, this affects so many other parts of the body.
Getting this right is paramount to success.
Don’t be frightened about some new things to practice for this one is so simple and can be done any time and any place.
Some specialists say, “Take a few deep breaths” and that is the wrong advice as it will only keep the breathing out of balance.
Sit comfortably in a chair quietly and notice that with each breath, your chest expands and so do your shoulders, watch and be aware.
When breathing this normal way, as soon as some external thing happens or you get a fright, it can cause the breathing to suddenly alter, making it too big, too quick or too shallow.
This is when everything goes ‘haywire’ and the effects of this ‘out of control’ breathing will change the balance of oxygen and carbon dioxide in your lungs then into the blood stream, bringing on panic sensations and the fear of loosing control.
Put both hands on your stomach with fingers touching and while keeping your chest and shoulders completely still, move your stomach in and out as you breathe, slowly and regularly. Practice it every day for a few minutes until it comes as ‘second nature’. Doing it at bed time, lying on your stomach is a good way. Don’t be impatient with yourself; the highly sensitized body didn’t occur quickly! It may take a couple of weeks before you can use it as a ‘weapon’ to deal with agoraphobia and be able to call on it quickly.
That’s all it is! For this method keeps the balance of carbon dioxide and oxygen in your lungs correct, so stopping a panic.
THREE reasons why YOU need to learn BREATHING CONTROL
Ø FOR SUCCESSFUL RELAXATION
Ø FOR THE CONTROL OF PANIC ATTACKS
Ø FOR EMERGENCY SITUATIONS
PRODUCTIVE AND CORRECT ATTITUDES TOWARDS PANIC AND SITUATIONS
With the knowledge of Recovery Steps, the MIND DOES HELP IN THE BEHAVIOUAL PATTERN IN A LARGE WAY.
Once the Second fear has set in, your mind has become programmed to tell yourself, “What If” because of the constant attacks coming ‘out of the blue’ --------------This is a natural way to think, as one day seems free of sensations and another day full of them-------------
WITH CORRECT KNOWLEDGE, SELF-TALK CAN BE AN ASSET
WITHOUT KNOWLEDGE TO GO WITH SELF-TALK
Excuses would still be made; trying to cope would still be a problem.
“WHAT IF”, AND “BUT” AND “I CAN’T GO BECAUSE…….” Become words that are NO LONGER USED by the sufferer. CONFIDENT, SELF PRAISE, ‘SELF-TALK’ PROVES TO YOURSELF HOW CAPABLE YOU REALLY ARE AND MANY SECURITIES IN YOURSELF ARE ONCE AGAIN REINFORCED.
You remember very clearly the person you were before this ‘parasite’ attached itself to your life so you are still that same person with all the fine attributes and abilities still there ready to re-surface. You know the strong determination to get to the bottom of this debilitating condition, you know you will not leave a ‘stone unturned’ to find an answer, so commend yourself on this admirable trait. ‘The best is yet to come’.
Have you told a trusted friend? You may be surprised at how quickly they respond by sharing something about this problem they have come across or be eager to learn more.
One thing she/he must do is to tell a trusted friend and not be ashamed.
All thinking refers to how people organize and use their past experiences to cope with present situations. In the past this has been difficult, because not enough was known about agoraphobia although experiences taught the agoraphobe to avoid – a high price to pay, but not in the future.
Agoraphobia has forced the thinking to be shaped primarily by sensitive inner feelings, negative attitude, critical judgment or thought and past memories.
Some ways to of preventing negative thoughts and control this form of thinking are:-
ü TO VERBALISE POSITIVE STATEMENTS TO REDUCE AND PUSH OUT THE NEGATIVE
ü REMOVE PRE-JUDGEMENTAL THOUGHTS IN WHICH CONCLUSIONS OF CONFLICTING FACTS ARE REPLACED WITH NEW TRUTHS. E.g. “I will panic today because I panicked yesterday” BREEDS THE NEGATIVE PATTERN OF THOUGHT.
Before starting out on the new recovery steps, think about the goals and sub-goals – visualize yourself achieving them – combine this with practicing the quick isometric relaxation and the new controlled breathing.
THESE NEW CHOICES YOU MAKE AND PRACTISE ARE IMPORTANT, FOR NEW ACHIEVEMENTS WILL BRING GOOD MEMORIES AND REPROGRAMME THE MIND.
Even on ‘off’ days do something – the work of practicing is hardest when it’s a bad day but it’s more valuable then to do it. EVEN IF THERE IS A TIME WHEN PRACTICE CANNOT BE DONE, THE GROUND COVERED WILL NOT BE LOST.
‘Your mind and body work together and influence each other.’ (World Book Encyclopedia) Think about relaxing your mind – hobbies help do this. When you concentrate on a hobby (like tapestry, a picture puzzle, wood carving etc,) you do not think about your troubles; you can forget everything else for that. Everyone tries to develop correct ways of doing things………you also must learn to think correctly about this conditioning now you have the tried and successful method of recovery.
GRADED EPXOSURE & DISTRACTION METHODS
This is practicing in a special and successful way, small goals you wish to achieve in the future. Some professionals have said to sufferers to just ‘attack the goal with force and determination and I’ll support you’; which is called ‘flooding’ but that will not bring about a good outcome as often this will cause ‘set-backs’ and added fears.
‘Firstly, make a list of all the things that you would like to do if you were completely recovered.
Don’t forget difficult things (like a long journey), which have been avoided for many years. Anything you think might be a good idea in principle can be put on the list as a long term target.
Put all the items on the list in order, from the least difficult to the most difficult. Make a careful note of this order – you will be using it later’. (Professor A. Mathews)
A SLOGAN to be REMEMBERED IN ALL YOUR GRADED EXPOSURE IS
“DON’T DO ANYTHING YOU CAN’T DO BUT DO SOMETHING AND DO IT EVERY DAY”
(Dr. Graham Quinton, Psychologist)
Choose the smallest goal and visualize how much of the goal you could achieve at THIS very moment, not tomorrow or next week but NOW. Never choose something you think is beyond you but achievable now.
Get a note book to mark the time, date and level of anxiety from 0 to 10. Take some drink, glasses etc and set off slowly, and stop at the point you decided before you left home, to reach. Don’t go any further. Why, you say? I feel good! This will defeat the purpose for the fact of SUCCESS must be recorded both in your memory and in your diary. Try and reward yourself when goals are achieved, make it a pleasant thought and memory.
REMEMBER – GRADUALLY ONE STEP- ONE STEP AT A TIME.
The following example of planning a step at a time, including sub-goals:-The goals should be set by the agoraphobe and no undue pressure added. The target is to drive alone to the nearest shopping centre. The day that the task is to be completed should not be decided upon till sub-goals have been achieved. The example shown is simple and not finely detailed but enough to use as an example.
1. I sit in the passenger seat of my car while it is parked in the driveway for a few minutes. The engine is not running.
2. I sit in the driver’s seat of the car while it is parked in the driveway. This time the engine is running.
3. I go for a short drive in my neighborhood with my friend driving, to become familiar with the surroundings.
4. I drive my car down the driveway to the gate and back to the garage. My friend is sitting in the passenger’s seat.
5. I drive my car down the street and return home. My friend is watching me from my gate
6. With my friend in the passenger seat of my car I drive around the neighborhood for
7. With my friend following me in her car, I drive around the neighborhood for 5-10minutes. (prior to that my friend has been sitting in the back seat while I have driven previously on the same route.)
8. I drive alone around the same route and my friend is waiting for me at my gate.
9. With my friend driving I go to the nearest shopping centre and back.
10. I drive to the shopping centre with my friend in the back seat of my car and home again
11. I drive to the shopping centre alone; my friend is following me in her car and also follows me home.
12. I drive alone to the shopping centre, where my friend is parked waiting for me; she follow me home.
13. I drive alone to the shopping centre, where my friend is parked waiting for me, she follows me home---SUB-GOAL---
14. I drive alone to the shopping centre and back home alone, my friend is waiting for me at home ---SUB-GOAL---
15. I phone my friend at her home and tell her I am driving to the shopping centre alone, she waits on the phone for my return.
16. I drive to the shopping centre and back alone.
* RECORDING IS ESSENTIAL IN ALL BEHAVIOUR CHANGE PROGRAMS BUT NOWHERE MORE THAN IN THE THREATMENT OF AGORAPHOBIA WHERE THE DISORDER FOLLOWS A FLUCTUATING COURSE AND THE RATE OF IMPROVEMENT IS UNEVEN. It will stop despondency about any ‘set back’.
Day by day you practise goals this way and change goals when you wish. Never think that you have to increase the goals, it’s not the size of the goal but the point of succeeding that is remembered. Goals can be smaller or larger according to how you feel as each day can present different feelings. Repetition will bring success and confidence. Keep the above motto in mind at all times.
If your progress has come to a halt, then it may be that the item you have chosen is too difficult at the moment; then you will have to invent some practice items in-between where you are now and the next target, to bridge the gap.
‘Use Distraction Methods when you have the ‘jim jams’. Your car is too far away, home is too far away, the shop is too crowded, the building too tall. Your anxiety says “get away from here and fast”.
Firstly, slow down, don’t fight it. Though very uncomfortable, the fear is not dangerous
Don’t run away to safety, however powerful that impulse may be. The ‘running away’ will be associated with a lowering of anxiety, and this ‘bailing out’ behavior will promote further avoidance of that situation, making recovery much more difficult. So, stay there. Don’t race to the car or back home. The act of running or hurrying can, itself, fuels anxiety. Avoid jerky movements. Watch your breathing and ‘change down gears’ into stomach breathing; this will stop hyperventilation which causes ‘pins and needles’ etc.
You can breathe your way into and out of anxiety’.
A sweet drink, such as orange juice can lower anxiety considerably. You may carry a small carton of drink with you when undertaking exposure tasks. Remember too, that panic to the agoraphobic is nothing new. You have been there before. Cure revolves around successful management of individual panic attacks. (Dr. Wayne Wardman)
There are numerous aids sufferers use to help support progress like wearing sunglasses, holding an umbrella, taking sweets, the dog, drinks and many more, each to their own pattern.
1.) PRACTISE DAILY (no matter how small)
2.) PLAN YOUR GOAL THEN BREAK IT DOWN INTO SUB-GOALS (choose pleasant goals not mundane ones).
3.) EXPECT ‘UPS AND DOWNS’
4.) ONLY PLAN WHAT YOU ARE 70-80% SURE OF SUCCEEDING
5.) THE AIM OF A NEW BEHAVIOURAL LIFESTYLE IS TO REDUCE FEAR AND REGAIN TRUST AND CONFIDENCE IN YOUR SELF BOTH MENTALLY AND PHYSICALLY.
6.) ASK A TRUSTED HELPER, IF NECESSARY TRANQUILIZERS MAY HELP.
7.) ONLY DO ONE STEP AT A TIME
8.) USE THE DIARY IMMEDIATELY (not two hours later).
9.) CHART AND UNDERLINE YOUR SUCCESSES, NO MATTER HOW SMALL.
10.) PLAN TO RATIONALIZE YOUR THINKING.
KNOWLEDGE OF CLASSICAL CONDITIONING
Examples of CONDITIONING:-
A child gets excited (reaction) when a favorite
relative of friend arrives: the aromatic smell of incense always reminds Mary
of her trip to
These all work by association.
THIS AUTOMATIC REACTION IS COMPLETELY NORMAL
Not strange, peculiar or odd.
These four examples are normal bodily reactions to various events.
A conditioned reaction occurs when a person’s body is monitored when attached to a lie detector, the heart, blood pressure, perspiration, breathing, trembling; are all tested when questions are asked.
THE WHOLE BODY REACTS.
Think of the reaction of the child meeting a fierce dog mentioned before. The result is that the child is now terrified – this reaction is now a completely learned one.
IT HAPPENED WHETHER THEY LIKED IT OR NOT
When anyone (agoraphobic sufferer, anxious person, anyone at all, friendly, casual, shy or confident) goes to the theatre or restaurant and while there dining or watching a performance, for some reason, feels nauseated or worried because of a sick relative or animal, not enough air and the room is stuffy, or maybe they come over with a feeling of physical weakness, they immediately leave.
MENTALLY AND PHYSICALLY FEAR IS ENFORCED.
A small fire breaks out in an airplane – the oxygen becomes restricted and there is no way of escape
WHEN SOMEONE IS TRAPPED AND CANNOT ESCAPE, FEAR IS ENFORCED MENTALLY AND PHYSICALLY.
First stimulus – unknown but terrifying and brings bewilderment and confusion.
Second stimulus – places and situations where panics have occurred or could occur.
THIS IS LEARNED
IN A COMPLETELY
AND CAN LEAD TO THE CRITICAL BEHAVIOR PATTERN OF AVOIDANCE
The body can stay in this action because there has been no answer fed into the brain to stop this fear cycle.
An example of CLASSICAL CONDITIONING
Suppose a person tastes some lemon juice that makes the person salivate. While tasting it a tone is sounded. If these two occur together many times, eventually the tone by itself will make the person salivate. PLACES CAN BRING ON A PANIC BECAUSE OF CONDITIONING
An example of normal apprehension:- if you have been commissioned to deliver a parcel to a remote farm house in the country and it’s late at night, when you find out there is no one home but your delivery must be placed inside the lounge room, your fear rises and the heart starts to race. This is normal, but when you put all the lights on, the fear subsides for the light reveals just a safe, comfortable country homestead. The knowledge you are learning now will start to reduce your fears.
KNOWLEDGE REDUCES FEAR AND AIDS RECOVERY.
THE BRAIN IS SATISFIED WHEN AN ANSWER IS GIVEN AND THE REACTION IS STOPPED
Everything is seen clearly in the homestead and there is no threat or dread. So too with this condition of agoraphobia, once you know and understand that it is a Classical Conditioning that can in time be Unconditioned, that you are highly sensitized and can be de-sensitized, some of the unknowns will be known and can bring some relief. A vital point to remember is, that
It has happened repeatedly ‘out of the blue’ and the automatic bodily reaction occurs, i.e.
normal protection response when facing situations or places that are likely to trigger off a panic. These attacks occur before the habit of avoidance begins which is the CONDITIONING of a CRITICAL BEHAVIOURAL PATTERN.
The first attack may have happened after a serious operation or physical experience – this does not mean that the agoraphobe is continually ill physically.
Mental fatigue does come into this cycle, usually at the beginning, when the sufferer is very confused, and when the body is at low ebb; awareness of symptoms are more highly sensitized.
In the case of agoraphobia the second stage of fear can become chronic because of lack of knowledge. Dr Claire Weekes had a patient, who, when knowledge and understanding was
given, it removed the second fear with only the normal intensity left.
Dr John Franklin (N.S.W.,
Some of the fears are listed in the introduction, but simply put, it is a fear of
loosing control of the body anywhere, home or away from home;
it’s so intense; there is the feeling of dying or going insane.
ANY FEAR, AGORAPHOBIC OR OTHERWISE IS NOT EASY TO CONTROL AND HAS NOTHING TO DO WITH WILL POWER.
ANY FEAR CAUSES CHANGES IN THE BODY.
THE AGORAPHOBE SUFFERS MORE EXTREME FEAR THAN THE AVERAGE PERSON IN ORDINARY CIRCUMSTANCES.
ANY FEAR OF ANY KIND IS AN AUTOMATIC REACTION TO PROTECT
e.g. a person leaning relaxed on a stationary car will jump when the horn is accidentally blown.
Often the sufferer feels they are going insane or will act insanely in public. This is the secondary fear that keeps the first fear cycle rolling. This does not happen as she/he goes through torture just to prevent this. The thought of making a fool of themselves is added pressure and adds the mental fatigue. Feeling faint and strange is quite common and harmless, though unpleasant.
A CYCLE BEGINS AND A PANIC IS ANTICIPATED CONSTANTLY; THE POSSIBILITY OF IT HAPPENING AGAIN IS ALWAYS THERE, YET, ON THE OTHER HAND, IT MAY NOT!
No. 30 again flag
BUT to PUT IT BACK
Fear is not all bad, some are healthy fears and very necessary for our protection and survival. The fear and panic that the agoraphobe experiences is a secondary fear and nothing to be ashamed of but just to be recognized that it has protected us from overworking the emotions that are already highly sensitized. It has protected us from not knowing how to handle what we did not understand through lack of knowledge.
THIS IS A
You can uncondition these responses which have become fear added on fear.
(SHATTERED SELF CONFIDENCE CAN BE REBUILT – IT’S A STEP BY STEP PROCESS.)
SIMPLE BEHAVIORAL PATTENS ARE LEARNT FOR RECOVERY.
It’s very useful to write down a list of your fears on paper, the healthy fears and the secondary state of fears and take a good look at them and see them for what they are. Repressing fears is similar to avoidance and can lead to the conditioning of avoidance. Owning up to them and airing them is like Graded Exposure. Looking at them and gradually rationalizing the difference.
Healthy –The mind is completely absorbed in the obvious encounter or subject causing the fear and is logically and automatically dealing with the answer e.g. fire, interview.
Intense – The mind is confused, with nothing to solve. All reasons remain unknown and the thoughts turn into themselves creating confusion, adding mental fatigue, thus creating a non-stop fear cycle.
A correct attitude plays an important part in the recovery. Learning to encourage oneself is vitally important. She/he constantly criticizes themselves. Feelings and emotions need to be changed with a positive and correct attitude; feed in positive ideas and gradually a new opinion of worthiness will begin; without this recovery is much slower.
******PLAN the WORK THEN WORK the PLAN******
THE NEW BEHAVOURAL PATTERN OF LIFE SHOULD BE STARTED as SOON as possible STEP by STEP
Its not the size of the step that counts but only making it – THE STEP is important no matter how small. (Keep in mind the slogan ‘Don’t do anything you can’t do but do something and do it everyday’)
Look at these steps as spokes in wheel and call it your ‘Wheel of Progress’; each spoke needed to make the wheel strong.
RATIONALISATION - The Final Stage
********IT IS IMPORTANT TO REALISE
THAT YOU CANNOT CHANGE WHAT HAS HAPPENED –
*********IT IS IMPORTANT TO REALISE
THAT YOU CAN CHANGE HOW YOU REACT TO WHAT HAS HAPPENED.
Let not a day pass without renewing your attitude.
Practical advice from a Recovering Agoraphobic
WE HAVE HAD THESE STRESS SYGNALS SO LONG WE FEEL AS THOUGH THEY WILL NEVER LEAVE!
Our body is simple responding to what we think and remember!
Panic attacks although
alarming are nerves highly sensitized,
But also understand that nerves can be desensitized. The habit has
been a long time in your mind, giving it a collection of bad
memories, and a tired mind easily forgets the advice given.
NO TRUST IN ONESELF
An agoraphobic has tried so many different ways to recover,
before trying again. We think it won’t work. Trust the advice
given if you do not trust yourself – your body will act on the
advice we give it. This happens automatically once we have
understood what to do.
PANIC ATTACKS ARE SO STRONG WE THINK WE HAVE GIVEN UP
We believe it is impossible to think when a panic strikes,
But you DO THINK. The thoughts are “I must get out of the
shop”, even though it is the wrong thought. YOU DO HAVE
TIME TO THINK. Here is where to start changing your think-
ing to, “Rest in a quiet place” and start to react against tension
with relaxation and with the correct attitude.
WE FEEL EMOTIONALLY THE FIRST STEPS ARE TOO MUCH
This is based on lack of confidence in what our bodies CANNOT
DO. You will be very surprised that we CAN RELY on our body
to function correctly if we give it the chance. Understanding that
thinking inwardly is natural in the circumstance right now.
We should not be interested in our past, BUT interested in our future! And our FUTURE, remember, is where we are to spend the rest of our lives.
Naturally set-back comes to everyone, and sure, we have a rough time of it. WHO DOESN’T??? We now have ‘ammunition’ to use to change our future and recover.
Our lives have been shaped by ignorance BUT now WE can do something about it.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * *
“YOU ARE SOMEONE SPECIAL”
Accept this fact. You are not inferior to anyone, different YES, WONDERFULLY DIFFERENT. Wouldn’t it be dull if we were all alike?
One of the worst things you can do to yourself is play the “Comparison Game”
DON’T DO IT. Sometimes we do this but stop yourself and do not compare yourself with another person-there is really no need to. It is an unhealthy thing to do. Refuse to play this game.
A PERSON WITH THIS ATTITUDE MAY BE KNOCKED DOWN BUT NOT BROKEN
What is SELF-LOVE?
Self-love is a crowning sense of self-worth
It is an ennobling emotion of self-respect
It is awareness of personal dignity
It is what the Greeks called ‘reverence for the self’
p.5 (draw super shirt)
Every negative emotion has a natural positive one to counteract it.
Ø How do you eat an elephant? ONE BITE AT A TIME
Ø How do you climb a ladder? ONE STEP AT A TIME
Ø How do you chop a tree? ONE CUT AT A TIME
Ø How do you care for yourself? ONE CHOICE AT A TIME AND KEEP CHOOSING!
SELF-ESTEEM IS ONE OF THE DEEPEST
OF ALL HUMAN NEEDS
Self-confidence does come back and when the taste of reward is known to us once more, three things occur:
v Opportunities can be spotted with-out confusion
v Problem solving becomes clear
v Determination begins and we are motivated.
Never miss an opportunity to congratulate yourself on any achievement – mo matter how small. REMEMBER or list the things that you have done, so you will not forget your achievements. Then you can look back and it will surprise you just how much you have accomplished. – Try it and see- Prove this to yourself.
P.25 (draw faces)
WE ARE REWARDED SELF-WORTH AND SELF-RESPECT ONCE MORE; GLAD TO BE ALIVE AND OF COURSE KNOWING OURSELVES A WHOLE LOT MORE AND MUCH BETTER THAN WE DID BEFORE – IT’S A FACT!!!!
“PLANS SUCCEED THROUGH GOOD COUNSEL”
R A T I O N A L I S A T I O N
The FINAL key word in the efforts to cope with and overcome agoraphobia. Apart from the fact that agoraphobics now have steps to use in alleviation their panics, which is a great help to their recovery, as a program into recovery – something else is required! Thinking logically about various situations and rationalising these situations, helps mentally, to put things in perspective. This has always been a very important part of my recovery …
RATIONALISE your shakes/ dizziness/ aching muscle /pumping heart/ head and eyes etc. and ask the questions:- HAVE I HAD LITTLE SLEEP? HAVE I EATEN PROPERLY? AM I GETTING OVER A VIRUS? HAVE I OVER-EXERCISED? AM I RUSHING WITHOUT REALLY NOTICING? AM I PUSHING MYSELF? Other things could be:- have I had an argument, a crash, dieting, getting a cold, many late nights, etc.?
REALLY THINK ABOUT IT AND RATIONALISE THOSE FEELINGS!!!!
WHO IS THE REAL ‘ME’?
YOUR REAL SELF. Your real self, your basic personality has been eclipsed by confusion, conditioning and restrictions. Beneath these factors lies the REAL YOU.
COMMUNICATIVE. You can talk to anyone, anywhere about anything. You may think that you are quiet or have been told falsely to have a ‘social phobia’, but when you remove concern about what others think, your talkative nature will assert itself.
NATURALLY EMPATHETIC. You relate well to others, you feel for other people and their problems. Others respond to your natural understanding and concern.
EXCITING TO BE WITH. Your personality is exciting when you let your self be the real you – attention becomes focused on the conversation, or life around you.
OUTGOING. “Me?” You ask. Yes! When you relax concern for ‘What others might think’, your attention becomes focused on the conversation, or life around you.
INTELLIGENT. Did you know the average I.Q. among agoraphobics is 124? That’s 10 points about the average. We’d have to be bright to invent some of the excuses we cone up with - right?
CREATIVE and PRODUCTIVE. There is not a sufferer who is not artistic by nature, whether it is crafts, gardening, computer skill, writing, business skills etc., while housebound. Your creativity cannot remain repressed.
FUN. Yes, “Fun”. We’ve seen anxious people who hang tight to their support person’s hand and after a matter of days has dissolved into gales of laughter. We have a great sense of humor.
ETHICAL. Your innate sense of responsibility and citizenship make you a good candidate for anything you undertake. You have a highly developed sense of what’s fair.
ENERGETIC. We know anxiety makes you feel ‘dragged out’ most of the time, but you have an amazing amount of energy at your disposal when you need it. You are not lazy, only confused and afraid and that will pass.
CARING. Your sensitive nature equips you with the ability to care about others without stint. But you have to use the aspect of your personality to care about yourself with the same energy that is spent on others. Then you allow yourself to be the person you really are
THE REAL YOU. These facets of your personality peek out from beneath the facade built, because of agoraphobia. Start acknowledging these positive and true aspects of your nature. Allow yourself the freedom to express the best you can be!!!
YOU CAN GET ON TOP AND STAY THERE
Extracts taken from “Productive Thinking and Expression” manual by Jill McBeath Riley 2003
THE COSTS OF AGORAPHOBIA AND THE REWARDS OF CHANGE
Quotation from “AGORAPHOBIA a CLINICAL and PERSONAL ACCOUNT”
By Dr Wayne Wardman, a recovered agoraphobic who is also a medical doctor.
‘The losses incurred in the years of this condition are incalculable. How do you reckon the value of the loss of freedom? What is the price of one failure, one day of depression or anxiety, or one blast of panic?’
‘I would hardly call myself a hero….I am simply an ordinary person with a very difficult problem…..After such an experience can there be some pay-off? I would say that there is. Firstly, there is the understanding of what it is like to have ‘been there’. I now have a depth of feeling with others like me that transcends words. From beginning to the end, the taste of the successes was very sweet. There was ecstasy in being able to say “I did it. Little old terrified me did it”
There is the heightened awareness which recovery has given me. I can appreciate simple daily events as being special, simple because now I am free to do them: the evening walk, shopping with a friend, the drive through beautiful countryside.’
I cherish these ‘ordinary’ events in a way that I never could have, had I not experienced agoraphobia.
AGREE WITH THIS IMPORTANT AND CORRECT INFORMATION AND START TO LET IT CHANGE YOUR MIND AND CORRECT SOME OF YOUR THINKINIG ON THIS SUBJECT
(WE CAN ALL CHANGE OUR MINDS - WHENEVER WE CHOOSE!)
FOLLOW THE RECOVERY STEPS AND THESE SYMPTOMS WILL BE REDUCED AND EVEN DISAPPEAR.
SENSISTIZED NERVES HEAL NATURALLAY, THE SAME AS PHYSICAL DAMAGE TO THE BODY