Recommended SELF HELP RECOVERY STEPS are
1) RECOGNISE,
ACCEPT AND UNDERSTAND AGORAPHOBIA
STEP
1.
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 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!
EMOTIONS
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
Try
to understand that your body is not a machine, that it has a limited capacity
to produce adrenalin; therefore, 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 leg.
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
THE HEART
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.
TENSION
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’.
BLURRED VISION
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.
WEAKNESS
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.
TENSION
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.
DIET
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.
REACT TO ALL THESE SYMPTOMS
WITH RELAXATION & CONTROLLED
BREATHING.
The more you panic the more adrenalin is released adding to the situation.
TRANQUILIZERS
‘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.
STEP
2.
ISOMETRIC RELAXATION
(isometric means exercises intended to strengthen
muscles by pressing one part of the body against another), AND
CONTROLLED BREATHING
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.)
UNDERSTANDING
THE
PROCESS
OF SENSITIZATION
AND
DE-SENSITIZATION
BOTH
MENTALLY AND PHYSICALLY
WILL
RESTORE
TRUST & BELIEF
IN
YOURSELF
A LEARNED CONDITIONED REFLEX CAN BE REVERSED
ANIMAL EXPERIMENT
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)
REMEMBER the ability to RELAX is one of the MOST
NATURAL
HUMAN ABLILITIES
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
STEP
3.
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
BUT
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.
STEP
4.
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
---SUB-GOAL---
6. With my friend
in the passenger seat of my car I drive around the neighborhood for
5-10minute.
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.
---SUB-GOAL---
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
---SUB-GOAL---
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.
SUMMARY
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.
STEP
5.
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.
Example 1.
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.
Example 2.
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
Example 3.
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.
Example 4.
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.
One type of conditioning concerning
agoraphobia is
CLASSICAL
CONDITIONING
which occurs when two fears are co-joined, the
panic and the fear of the panic. This is a second stimulus that brings on
behavior similar to the first.
ASSOCIATION
First stimulus – unknown but terrifying and brings bewilderment and confusion.
ASSOCIATION
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.
*AGORAPHOBIA IS A STATE OF
SECONDARY FEAR AND TERROR*
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
INTO its
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.
RATIONALIZATION
BETWEEN
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.
STEP
6.
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”
Proverbs20:18
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
r
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.
BUILD
TRUST IN YOURSELF PHYSICALLY AND MENTALLY STEP BY STEP – YOUR BODY WILL RESPOND
NATURALLY AND IT WILL PROVE TO YOU IT WILL BE
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
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