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Phobias: Common causes of agoraphobia

by Sarah Graham
Wednesday 29 October 2014
710 6440

As Halloween approaches, we're looking at phobias - specific anxieties relating to particular objects or situations. Some of these, such as arachnophobia (phobia of spiders) or coulrophobia (phobia of clowns), can be fairly easily avoided in most everyday situations, while others are much harder to avoid and may have a far more debilitating impact on your life.

Agoraphobia is one such phobia, characterised by an extreme anxiety of places or situations from which escape might be embarrassing or difficult. For those affected by the condition, it may prevent them from visiting public places, travelling on public transport, or even leaving the house. 

Anxiety UK's Amber Smith says: "Agoraphobia is a debilitating condition that includes fears not only of open spaces but also of other situations such as crowded places, being alone and anywhere where a person might be afraid of having panicky feelings. Indeed, most people affected by agoraphobia are very rarely afraid of open spaces, and are more commonly afraid of experiencing panic, wherever these fearful feelings may occur.

She adds: "Many people have felt such feelings at home, while driving, in supermarkets, and even when sat in the hairdresser's chair. In fact, the worst scenario for any person experiencing agoraphobia is one in which they feel psychologically 'trapped' and unable to escape with immediate effect."

We asked some RSCPP therapists to explain some of the common causes of agoraphobia.

Past experiences of fear 

Agoraphobia is personal to each individual affected by it and causes can vary widely, relating to events in the distant past and buried in the subconscious mind. Perhaps you had a frightening experience as a child, which evoked strong and unpleasant emotions, and even a particular physical sensation. It could be that over time these become associated with a particular object, sight, sound or even smell. For example, fears originally evoked by an early experience of Halloween may be triggered in the present by something, such as a mask or costume, or even the ring of the door bell and the sound of 'trick or treat'. This can lead to behavioural changes, as well as emotional distress.


Past experiences of embarrassment 

Agoraphobia can often be triggered by experiencing an embarrassing event, such as a panic attack or vomiting in public, which then sets up a fear that this may happen again, and that you will be judged negatively for it. You then may begin to avoid being in public places such as shops, cinemas or public transport. This reinforces the belief that something awful would happen if you entered these spaces, denies you the opportunity to confront and test out your fears, and keeps the anxiety going. You may also engage in the use of what are known as 'safety behaviours', such as always needing to be near an exit (for ease of escape should you start to feel anxious, sick, etc.), or 'safety props', such as always carrying around a bottle of water.


A cycle of fear

Whatever the particular experience that first caused your agoraphobia, Registered Counsellor Tracey Nimmo says the condition may begin with slight panic attacks when faced with your specific trigger and build into something more debilitating. "These attacks can happen without warning and you may feel you have no control over your own body," she says. "This can be very frightening, and fear of the unknown may then lead to you withdrawing from situations or requiring somebody to be with you."

A psychological cycle begins, which can eventually lead to a you feeling unable to leave home for fear of what may happen.

She adds: "You may find that this grows into a belief that if you go anywhere you will have a panic attack, and a psychological cycle begins, which can eventually lead to a you feeling unable to leave home for fear of what may happen. If that happens, you effectively become your own prisoner, unable to leave your 'safe place', and this may lead to loss of confidence, low self esteem, depression."

Finding support

If you are concerned about the issues raised in this article then you may like to read about finding the right therapist for you. If this route is not appropriate for you, your GP can assess you and direct you towards support.

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Updated 29 October 2014