Agoraphobia
Agoraphobia is one of the most limiting anxiety disorders because it typically involves a complete inability to go to certain places and/or participate in certain activities due to a fear of getting trapped, having a panic attack, or being embarrassed. Generally, agoraphobia is caused by experiencing a panic attack either in the specific place or situation that is being avoided, or having experienced a panic attack or extreme embarrassment or adverse physical reaction at some point in one's life, and the fear of this experience happening again becomes a fear of going anywhere with no 'way out' in the case that this uncomfortable experience happens again.
What makes Agoraphobia so difficult to treat, is that very often it is manifested by the person being unable to even leave their home, or being unable to go a certain distance from home. As a result, sufferers of Agoraphobia have a very hard time getting the treatment that they need since getting to the therapy office is often way too much of a hurdle; if they were able to go out and attend treatment somewhere, then they wouldn't even need the therapy anymore!
Signs & Symptoms: Do I have Agoraphobia?
Some signs and symptoms of Agoraphobia include:
inability to leave the home, alone or with others
fear of crowds or waiting in line
fear of being in any situation that there is no clear exit
fear of enclosed spaces
fear of closed spaces
using any form of transportation, particularly public transportation
Online Therapy for Agoraphobia
With online therapy being a thing, those struggling at home with agoraphobia finally have some accessible options for treatment. Obviously, there is no need to travel or go anywhere for seeing an online therapist, so this takes care of the main obstacle preventing most with Agoraphobia from getting treatment. So long as the person with agoraphobia is getting his or her basic needs met and is not a danger to themselves or others, they are suitable for online treatment.
Acceptance and Commitment Therapy / ACT for Agoraphobia
ACT approaches Agoraphobia in a much different manner than traditional CBT (Cognitive Behavioral Therapy) does. In ACT, your therapist will work with you to better observe and understand the specifics of your anxiety and the physical panic symptoms that you experience in order to help you objectify your unique experience in a way that it is not as threatening as it is when you are in the moment of panic and actively working to avoid it. You might expect that the goal of therapy will be to eliminate your feelings of panic and learn how to not panic, but this will not be the case. The goal of ACT for Agoraphobia is centered around how you want to be living your life, based on your values, or the things that are most important to you. With ACT, your therapist will help you "play" with your anxiety experience in order to get more familiar with it and understand it better until it is well separated from your identity - this is called defusion. When anxiety becomes externalized in this way, it becomes much simpler to work with and the threatening nature of it can subside. It does not necessarily mean that the experience of the anxiety is diminished, it just means that you are regaining your power and are able to work alongside the anxiety from a new frame of reference. Said in other words, ACT works to get you off of the rollercoaster, and to a place where you are instead watching the rollercoaster.
ACT in essence is a form of exposure therapy that starts with exposure in the mind. Your therapist will not try to convince you of how unrealistic your fear is, will not try to help you argue or invalidate your anxiety, nor will your therapist try to help you to think positively through your anxiety. Your therapist will help you understand your anxiety for what it is, make space for it to be with you, and walk you through baby steps to help you get to where you want to go, using your values as your personal motivators and guides.
If you or someone you know are struggling with agoraphobia, please feel free to reach out to me for more information about my approach to treating Agoraphobia.
