About Agoraphobia (Dr. Claire Weekes) – EP 48

About Agoraphobia

Dr. Claire Weekes wrote about agoraphobia in her groundbreaking book, “Hope and Help For Your Nerves”.  On this episode of the podcast, Holly and I go through what Dr. Weekes had to say about this fairly common anxiety disorder.  Dr. Weekes explains agoraphobia and offers her advice on how to approach it for best results.

The Highlights

• Chapter 8 of Hope and Help For Your Nerves focuses covers agoraphobia.  Dr. Weekes entitled it “Fear Of Leaving The Safety of Home (Agoraphobia)”.
• When Dr. Weekes was writing, agoraphobia was primarily conceptualized as a fear of leaving one’s house. Dr. Weekes also talked about how women primarily develop agoraphobia, which we now know is not really the case although it is possible that women are more likely to discuss agoraphobia if they are struggling with it. The chapter also continually uses the “she” pronoun, which is a reflection of the times in which the book was written.
• Both Holly and I were agoraphobic at one point. Both of us did not talk about it and did our best to conceal our struggles. Dr. Weekes starts this chapter by talking about how while claustrophobic people talk openly about that issue, agoraphobics often rarely admit to the problem.
• Avoidance is the thing!  The first subheading in the chapter is “She Avoids and Avoids and Avoids”.  Dr. Weekes is targeting the maladaptive coping response – avoidance – that fuels agoraphobia. An agoraphobic starts avoiding situations they feel that they will not be able to handle due to anxiety and discomfort.  When anxiety and panic pop up in more and more places, avoidance grows and grows.
• When Dr. Weekes talks about “your first mistake” in this chapter, she’s talking about how the fear of being afraid will cause you to tense up and start resisting before you even walk out the door.  Now we talk about exposure and response prevention as being so effective when treating agoraphobia.  What Dr. Weekes calls that “first mistake” is essentially the maladaptive avoidance response in the form of tensing, resisting, and trying so hard to fight the anxious, uncomfortable, afraid feelings.
• Holly and I agree that when approaching agoraphobia, committing to doing scary things rather than waiting until you feel OK to do them, and not giving yourself an “out”, can be really helpful in the recovery process.  Plan your exposures and challenges, schedule them if you can, then do them without question.
• “The worst thing that can happen is that you allow yourself to be afraid.” This quote is a bit misleading.  I think Dr. Weekes was talking about your REACTION to being afraid. Trying to face recovery challenges and exposure by not being afraid is not going to work. You will be afraid.  That isn’t failing. Work on changing your reaction to that fear first. That’s where recovery happens.

Learn More

 

• In a stroke of genius, Dr. Weekes walks you through what a typical exposure for agoraphobia might look like.  She doesn’t call it an exposure exercise, but it really is. Using the example of leaving the house, taking a walk, and being stuck in a conversation with a neighbor Dr. Weekes asks you to imagine what she might say to you to coach you through the experience.
• “If I can just get back home ….”.  Holly and I both relate to the idea that getting back home will make things better.  We challenge the assertion that home is safer than anywhere else. In the context of being afraid to be afraid, home is no different than anywhere else, which is a key concept in agoraphobia recovery.
• Being able to relax into fear and panic while in those “unsafe” places is something that takes time and practice, but it does change those challenging experiences that drive the avoidance that then drive agoraphobia. Dr. Weekes talks about changing your reaction to that fear, then being “not so impressed by the tricks your body is playing on you”.
• “Take yourself by the hand.”  This is a VERY empowering concept from Dr. Weekes.  Agoraphobia recovery is not about being saved or fixed by safe people, doctors, therapists or other helpers.  Recovery is about learning that YOU can get through the fear and discomfort you experience when you leave your “safe spaces”. You are capable, you have always been, and recovering from agoraphobia is really the process of learning that you were never in any real danger and that you simply do not have to be afraid of being afraid any longer.