Expert: Stephen Price - 10/26/2006

Question
hi
the doctor has diagnosed that my mum has agoraphobia. can i ask how does this kind of phobia arises, whether it is hereditary and what can i do to help my mum?

Answer
How does agoraphobia develop?    

Agoraphobia develops through a process called “generalization.” Fear produced by a single panic attack in a single place and situation eventually generalizes until the person fears nearly all places and situations.

Here’s how it happens:

The onset of agoraphobia usually begins with an episode of spontaneous panic. In many cases, the person does not know what is wrong when he or she experiences the first panic attack. Not knowing what is wrong can lead to catastrophic thinking about what might be wrong.

After the initial panic attack, the person becomes afraid of having another one. This fear leads to obsessive worry about when and where the next panic attack might occur. The person literally “fears the fear.”

The obsessive worry leads to more panic attacks and the person learns to associate panic with each situation or place that panic is experiences. This causes the person to start avoiding places associated with panic.

At some point, panic attacks are experienced in so many places that the fear generalizes. The person associates panic with nearly everywhere and completely avoids public places. In severe cases, people with agoraphobia won’t even leave their homes for fear of experiencing a panic attack.

Is agoraphobia hereditary?    

There are twin studies that suggest that there may be a genetic component to agoraphobia. However, these research findings do not indicate that people inherit agoraphobia. Instead they suggest that people inherit a predisposition for anxiety or an excitable personality type.

The most common forms of therapy for agoraphobia are:     

Behavior therapy: focuses entirely on changing behavior. It teaches a person with agoraphobia to face feared situations instead of avoid them. This can be done in small steps (as in systematic desensitization) or all at once (as in flooding). Behavior therapy does not attempt to discover or treat causes of fear, it only focuses on steps to take to reduce feelings of anxiety and to keep it from coming back.

Cognitive therapy: focuses on identifying and correcting habitual, irrational thought patterns. In cases of agoraphobia, these faulty thought patterns feed feelings of anxiety and fear, as well as cause physical symptoms. m

Medication: is often prescribed by doctors and psychiatrists to be combined with behavior and cognitive therapy. Since medication can be addictive, it is usually prescribed for temporary symptom relief while the person with agoraphobia works towards complete recovery.

Insight therapy: focuses on figuring out what deeper feelings or fears are causing agoraphobia. In this type of therapy, the patient talks at length about his or her thoughts and feelings, and the therapist analyzes them.

If you have more questions, please feel free to email me directly at stephen@agoraphobia.ws or visit my website at http://www.agoraphobia.ws

Sincerely,
Stephen Price
Recovered Agoraphobic