"Changing how you think"
"Changing how you behave"
"Changing how you feel"
"PROVIDING HIGH STANDARDS OF COGNITIVE BEHAVIOURAL THERAPY, CBT COUNSELLING IN BELFAST, N.IRELAND"
The word derives from the Greek, the agora being the market place, or place of assembly, and a phobia being an irrational fear. Sufferers typically experience intense fear in a range of situations where they perceive escape is not easily possible or help is not readily available. Examples of such situations are crowded shops, trains and tubes, lifts, motorways and being away from the security of home or a trusted companion. In turn, there may be abnormal worry about possible loss of control, socially inappropriate behaviour, physical illness such as heart attack, incontinence, fainting, going mad or dying. Sufferers may therefore often avoid a whole range of situations and day to day activity and may become housebound.Panic attacks may be limited to specific phobic situations, but sometimes occur more generally. Many people often experience depressive symptoms, but generally these improve when the agoraphobic problem has been treated.
There are various estimates, but probably 1% of the population suffer agoraphobia of such severity as to cause considerable distress and significant impairment of day to day function. However, up to one in ten of the population may have difficulty dealing with one or two of the situations mentioned above.
No single cause of agoraphobia has been identified. It tends to appear in early adulthood and is triggered in the first instance by an unexpected panic attack. The first panic is reported to occur "out of the blue". The person then begins to fear the occurence of another such attack and begins to avoid those situations which they believe may cause or worsen these attacks. The cause of the initial panic is only just beginning to be investigated systematically. Some relevant factors may be: life stressors, early experience with loss of control, a tendency to breathe too quickly, fluctuations in various brain chemicals and the misinterpretation of normal anxiety symptoms.
Treatment for agoraphobia has traditionally involved the use of medications such as tranquillizers e.g. Lorazepam (Ativan). In the last 25 years psychological treatments (involving behavioural and cognitive behavioural methods) achieve 70% or greater reduction in the problem.
There is no doubt that the central component of effective treatment is helping the sufferer to face their fears in graduated doses of difficulty. This treatment is commonly called exposure therapy and may sometimes require a therapist to help the sufferer enter the situation they fear. However, exposure therapy can often be carried out with a small amount of guidance from a professional or with a self help method. The principle underpinning this therapy is very simple, i.e. that if you stay in the situation and this exposure is repeated systematically, the anxiety fades away. In some cases the therapist may use methods which help the client re-evaluate their anxious thoughts by the use of cognitive techniques, i.e. to learn, for example that "everyone is not watching me". In addition some attempt can be made to deal with unexpected panic attacks using breathing exercises and cognitive methods.
Therapy may be carried out by suitably trained mental health professionals, i.e. clinical psychologists, psychiatrists, nurses and social workers, but increasingly these methods can also be used within self help programmes. Books containing such methods may be helpful and may assist the sufferer. BABCP
Ruby Wax visits Sarah to see what's happened since they last spoke, learns of her experiences of cognitive behavioural therapy, and sees how she copes outdoors.
Overcoming Panic and Agoraphobia provides a step-by-step
management program that provides the necessary skills for overcoming and preventing panic attacks and associated agoraphobia. This is an indispensable guide for those affected by panic disorders, but is also an important resource for friends and families, psychologists, and those working in the medical profession. Explains the many forms and causes of panic. Contains a complete self-help program and monitoring sheets. Is based on clinically proven techniques of cognitive therapy.
Panic disorder (agoraphobia in its most extreme form) can blight people's lives, causing extreme distress and severely interfering with day-to-day life. Panic attacks can occur in a wide range of supposedly 'normal' situations - driving, crowds, travelling on planes, waiting in line - and if not treated, can become more severe over time. Cognitive behavioral therapy has been found to be extremely effective in treating the disorder. In this series of talks, Vijaya Manicavasagar and Derrick Silove explain what panic disorder and agoraphobia are, what causes and keeps them going, and describe different strategies based on CBT to deal with and overcome panic attacks. The talks are focused on the following themes: the nature, causes and effects of panic disorder; recognising panic 'triggers'; changing lifestyle factors; controlling panic attacks; and, changing unhelpful thinking styles.
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