Psychology Online

Therapy of agoraphobia

This is the continuation of the topic agoraphobia, general information on the topic can be found at: Agoraphobia

introduction

People who have an anxiety disorder (see also: fear) are ill should deal with their illness, i.e. address the causes, symptoms and consequences. As with all other anxiety disorders, the first step in successful therapy is to admit the fear to yourself. The Agoraphobia As a result, it has great adverse effects on the life of the person concerned. In order to be freed from obsessive thoughts and fears, it is necessary to seek therapy at an early stage. Psychotherapeutic treatment (behavioral therapy) should be accepted regularly and in the long term as a supportive measure by the people, so that good treatment results can be achieved. If there are also panic-like conditions, it can be very useful to give additional medication (psychotropic drugs).

Treatment of agoraphobia

Treatment can include several measures. Since the person has significant anxiety, it makes sense to provide general information about the anxiety first.

General information about anxiety

It makes sense to explain to the patient that fears can be not only negative but also positive. This would explain to patients that fears of certain situations or objects are natural and can save our lives. We humans protect ourselves from dangers through fear because we avoid them. When people were still hunting, they survived only because of their fearful reaction. They responded quickly to attacks and went to safety. Even today, the fear reaction saves our lives, for example in traffic. On a busy street, the fear of the approaching cars keeps us from crossing the lane. If you as a pedestrian overlooked a car and can jump back at the last second, physical fear reactions suddenly appear (racing heart, sweating, tremors, etc.). This experience will encourage pedestrians to behave more carefully in traffic in the future.
Such an example should be brought closer to the patient as it also depicts the positive aspects of anxiety.
In the affected people, however, the fear is much more pronounced than in healthy people. Through the exaggerated fears, the person isolates himself from the outside world and feels at the mercy of his fears.

The real goal of therapy is that Panic attacks and thus to help people to deal with fearful situations normally again. People who participate in a Agoraphobia are ill, lose confidence in themselves. The affected people have lost the belief that they can cope with a certain situation by themselves. Building trust in yourself is therefore another important goal of therapy.

Exposure therapy

Within the Behavior therapy Confrontation with fearful situations has proven to be a successful method to lose fear of situations or objects. The person concerned consciously seeks out situations (often accompanied by the therapist) that they have avoided in the past or only approached with great fear. As with other anxiety disorders (social phobia, specific phobia) that the person learns to stay in these situations. Thus, despite her fear reactions, she realizes that nothing bad is going to happen. This step is also known as "decastrophizing", since the feared catastrophe will not occur. So that the person concerned is not helpless in the fearful situations, they learn to reduce the fear reactions in the respective situations with the help of relaxation procedures. The person realizes that if they actively counter the fear in the situation that they can act independently and do not have to flee from the situation. Possible relaxation methods are Progressive Muscle Relaxation or autogenic training. There are two types of procedures within exposure therapy that are used depending on the type and severity of the anxiety present.

Systematic desensitization
Flooding

1. Systematic desensitization

Before the person is “confronted” with the actual situation, the therapist discusses each individual step with the person concerned. A fear hierarchy is created, i.e. the person should name the fearful situations, broken down hierarchically. Starting with situations that are hardly feared by her, to those situations that are very much associated with fear. With the help of this hierarchy, the aforementioned situations are then gradually sought out by the person concerned. As soon as the first signs of fear reactions appear in the situation, the person should use the relaxation technique he has learned (e.g. Progressive Muscle Relaxation) independently reduce their fears in the situation.

2. Flooding

Another method is flooding (overstimulation). Here, after the preliminary discussion with the therapist, the person is confronted with the strongest fear stimulus (situation). The person must not flee from the situation, but should wait in the situation and learn that the fear will eventually reduce independently. The person learns after the first session that no bad event has occurred and the fears of the situation are unfounded. This procedure is most effective, but also very stressful for the person concerned.
Since this procedure is very successful, it is very often used for anxiety disorders, for example also for specific phobias. An average of 10-20 sessions are required so that the person can go back to the previously fearful situations almost without fear.