Freedom from Agoraphobia

More About This Textbook

Overview
Product Details
Read an Excerpt

Overview

This is a premier program for overcoming Agoraphobia and Panic Disorder. It is written in every day, conversational language for ease of reading. "Freedom From Agoraphobia" teaches highly successful and research-proven techniques from Cognitive, Behavioral and Psychodynamic therapies. Meditation is also explained and full instructions are provided.

This program can be used with or without simultaneous medication treatment. It is designed for individuals, groups and treating professionals.

Also included is a coupon entitling the reader to receive the accompanying CD without additional charge.

Author's Comments

I have written this book in response to the continued (and highly-gratifying) insistence by my patients that I make this program widely available for people who suffer from Agoraphobia and Panic Disorder. The program has been very successful for many years and for hundreds of patients. It is becoming increasingly unusual because it does not rely upon medications or even need them to work (although they are explained). Instead, the program uses proven methods from three of the most studied non-medication therapies as well as meditation. It differs from other approaches in that it is based upon an understanding of Agoraphobia and Panic Disorder which became apparent to me more than 20 years ago and which continues to be experienced as uniquely helpful. This understanding is explained in the excerpt provided - "The Key To Agoraphobia."

This book takes one through the process of becoming free from Agoraphobia - through the frustration and successes, the tears and the joy. It is my pleasure to at last make this available to all. It ends with the statement: "Congratulations! You have grown wings. Enjoy flying." My hope is that you will start at the beginning and work this program through to the point that these words are addressed to you.

About the Author:

Mark Eisenstadt, M.D., has been practicing Psychiatry and successfully treating people who suffer from Agoraphobia for more than 25 years. He received his Bachelor of Science from M.I.T. in 1967, his Doctor of Medicine Degree from the State University of New York, Downstate Medical Center in 1971 and then completed a 3-year Residency in Psychiatry at Tufts-New England Medical Center in 1974. He is a Diplomate of The American Board Of Psychiatry and Neurology and has received The Physician's Recognition Award. He continues his work as a clinical Psychiatrist and Medical Director in Community Mental Health.

Product Details

ISBN-13: 9780974151205
Publisher: Mark Eisenstadt, M.D.
Publication date: 12/28/2003
Pages: 236
Sales rank: 992,995
Product dimensions: 0.54 (w) x 6.00 (h) x 9.00 (d)

Read an Excerpt

Chapter Four

The Key to Agoraphobia

The Secret of What's Behind It All

Here is the key that unlocks the door to life without Agoraphobia:

It is the word "traps."

We develop panic attacks when we're trapped in our lives. We stop having panic attacks when we escape from those traps. We go in and out of periods of having panic attacks as we go in and out of periods of being trapped in the our lives. It's that simple!

This is why people will have panic attacks for a number of years and then, apparently, get over them. To their great disappointment, the panic attacks come back after more years have elapsed, seemingly for no reason. But there is a reason. If we look at what has been going on in the individual's life we find that she was in a trap when the panic attacks began, had gotten out of the trap causing them to get better and somehow slid back into another trap resulting in their return.

But what is a trap? A trap is any situation we do not want to be in but from which we can see no acceptable escape. Straightforward enough, right? Read on. You will see that this simple definition - again: any situation we do not want to be in but from which we can see no acceptable escape -- contains all sorts of clues to the solution to Agoraphobia.

Traps can be big or little. They can last for minutes or years. They can have obvious exits or they can be nigh on impossible to find a way out of. They can be completely internal to the agoraphobic or they can involve all sorts of external circumstances and people.

Let's look at some:

Here's a common one that can last for decades if not a person's entire life:

Sylvia is growing up with a father who sexually molests her and a mother who drinks and refuses to admit what is going on. Sylvia has a friend who had the same problem with her own father and who told her teacher about it. Her father was sent to jail. Now, her whole family blames Sylvia's friend for the fact that they have to be on welfare. They do not have many of the things they could afford when Dad was there to bring home a paycheck. Sylvia certainly does not want to have everyone in her family angry with her. But on the other hand, the weekend is coming. And that's when Mom goes out drinking and Dad will be coming to Sylvia's bedroom. The result? Sylvia has a panic attack. (Not surprising, huh?)

At 17, Sylvia grabs the opportunity to get out of the trap at home by leaving high school to marry her steady boyfriend, Darrell. Sylvia's panic attacks go away and it looks like her problems are over. She becomes pregnant and has a beautiful daughter whose smile is the light of her life.

But Darrell's company goes broke and he loses his job. As months go by and Darrell is unable to find another job, he becomes increasingly short-tempered. He begins to stay out evenings and comes home smelling of alcohol. When Sylvia comments that their limited money might be better spent paying the bills, Darrell flies into a rage and hits her. Soon, the drinking, arguments and physical abuse have become commonplace in Sylvia's life. And she can see no way out.

Darrell has told her that if she leaves he will find her and kill her. (He demonstrated what he meant by a slap in the face.) In any case, Sylvia can see no way to support herself and her baby. She does not even have a high school diploma with which to find a job.

One evening, she sits in her bedroom waiting for Darrell to come home from the bar and knowing that an argument and a beating are coming with him. In her mind, she struggles to find a solution but keeps running into the same barriers as always. Darrell can't find a job. The economy is bad. He has no training for skilled work. He won't stop drinking. There is no way to avoid a fight when he comes home. Even if she does not say anything to him, he'll just get mad at that. If only she could run away. But where would she go? And she has no money. And Darrell said he'd kill her. And the baby needs things... and...and...

She sits there in despair, waiting for the sound of the car in the driveway.

The next day, Sylvia and her black eye are in the supermarket. She is stuck in a long line at the checkout counter. The baby is getting tired and irritable. It's hot and the fluorescent lights are bothering her. But she can't leave. She needs the diapers, formula and other items in the shopping cart. She desperately thinks: "Why don't they call for another cashier?" There is only the one checkout line and the cashier in that one is obviously a friend of the old lady she is waiting on. The two of them are chatting away, oblivious to the long line in which Sylvia is stuck. The cashier keeps talking and interrupting the old lady from writing a check for her purchases. The line isn't moving. There is no way out. The heat and light make Sylvia dizzy. She is sweating. Her heart begins to pound. Suddenly, Sylvia finds that she is having a full-blown panic attack. It's the first since she left home almost two years ago.

Naturally, Sylvia can now easily develop an avoidance pattern that includes going to the supermarket. The next time she thinks of going there, she will remember this panic attack and begin to feel anxious at the thought of going back. If she goes anyway, she may well have another panic attack. Especially if she gets caught in another long checkout line. She may believe that the panic attacks are the result of being stuck in the supermarket situation. In a small way, she would be right. But in a larger way, Sylvia will have panic attacks one place or another. She'll even have them at home until she gets out of the trap she is in with Darrell. If that trap goes on for years or even decades, her panic attacks will go on for years or even decades.

Often, the panic attacks themselves serve to indirectly improve the trapped situation. For example, Sylvia might go to a doctor or counselor who might help her to find ways out of her abusive marriage. Or Darrell might actually feel a bit better about himself now that his wife needs him to help her go to such places as the supermarket. So the return of Sylvia's Agoraphobia might make the marriage somewhat less unpleasant for both of them. But even if this happens, as long as Sylvia is in the trap, she will have panic attacks. And when she gets free of the trap, she will be free of them. (We will see how Sylvia does this and her panic attacks stop in Chapter 12.)

Let's look at some other traps:

The Little League Mom typifies another kind of situation I have often seen. She lived in a beautiful home in a beautiful town, had a caring husband and an athletic 14 year old son. Her son was a star on the local Little League team and the team had been the national champions more than once. (This probably looks pretty good until you learn that for her, it meant not having a life.)

The entire family was centered on the celebrated son's Little League activities. And Mom was the one who had to make it all happen. The family traveled to all the Little League games - which were often held in other states or in Canada. Mom had to do all the packing for everyone including Dad because he couldn't be counted on to even bring matching socks. (Would it surprise you to hear that she often described Dad as: "just like having another kid?")

She would lay out everyone's clothes for the trip, pack all the food, get the maps, arrange for the mail, call the police to keep an eye on the house while they were away and so on. The Little League moms cooked for the team and for the dads. She also had to drive her son to and from practice every day, attend meetings of Little League parents and do fund-raising for team uniforms and supplies. The bottom line? Almost all of her time was devoted to Little League activities. She was ready to scream.

Why not quit? Well, was she going to stand up in front of her friends and be the only mom who did not care enough about her son to support his great effort and success in athletics? Certainly not!

The result was practically a foregone conclusion -- panic attacks. (We'll also see how she solved her problem later on.)

Another person with an obvious trap was Audrey who had recently put her mother in a long-term rehab hospital because of a broken hip. She had done so with the greatest reluctance and only after exhausting all other possibilities. The reluctance was because Audrey had heard all sorts of horror stories about rehab hospitals: People were neglected there. They were given the wrong medications. No one came when they called. Sometimes patients were abused or left to lie in their own waste for hours or even days before anyone took notice. Audrey knew that sometimes older people die after breaking a hip. And so forth.

Nonetheless, her mother's physical needs were way beyond what Audrey could manage at home. And there was no one else to provide the care. Finally bowing to the inevitable, Audrey had her mother admitted. Her fear was so great, however, that Audrey spent all day every day at her mother's side -- making sure that none of the disasters occurred. Audrey's husband and children were left to fend for themselves. They did not accept this easily. The staff of the hospital also complained that Audrey was driving them crazy (which she was). They constantly pressed for her to go home. But Audrey could hardly compound the sin of having put her mother in such a place by leaving her to the harm that would surely befall if she was not there to prevent it.

Result? You got it - panic attacks. (More about Audrey later.)

Lastly, let's look at a very temporary trap - the so-called "bad drug trip." Here's how it goes:

Cody and his friends decide to "drop some acid" (take LSD). Half an hour after taking it, Cody is happily enjoying the various bizarre colors, shapes and other hallucinations he is having. At one point, the thought comes: "Wouldn't it be great if this went on forever?" This is followed by the worry: "How do you know it won't?" Cody has heard stories of people whose LSD use resulted in permanent hallucinations. To reassure himself, Cody concentrates on a picture across the room, trying to get it to appear normal. But it still seems to be glowing and pulsing - alternately getting larger and smaller. Then, it assumes some strange shapes - no longer being a rectangle.

This increases Cody's worries that his hallucinations will never go away. He tries harder to get rid of them but they remain despite all his effort. He feels he must stop being on his "acid trip" but there is no way to stop. He becomes frightened. His fear then appears as dancing lights and animal shapes coming towards him. Cody panics. His heart is racing and feels as though it will burst out of his chest. He seems to not be able to get enough air - the room is too small and all the air is almost used up. He must run outside before he suffocates. But his knees feel weak and unable to support him. He must get out but he can't...

Indeed, most "bad trips" due to hallucinogens are actually panic attacks. These panic attacks are all the result of the same trap - each time, people become convinced that they need to stop experiencing the effects of the drug when they have no choice but to go on experiencing those effects for the next several hours until the drug wears off. Usually, this is triggered by some unwanted experience such as unpleasant hallucinations, feeling out of control or fearing "going crazy." As a result, the drug-intoxicated state that had originally seemed desirable becomes intensely undesirable.

And this brings us back around to our original definition of a trap: an unwanted situation from which we can see no acceptable way out. If the situation had not become unwanted, Cody would have happily experienced the drug effects and no panic attack would have occurred. Indeed, "talking people down" from bad drug trips (so common in the 70's and 80's) consisted of persuading them to not resist the drug effects. They were instead encouraged to simply allow the experience to run its course. Thus, the trap would cease to be one because they had changed the first half of the equation -- the desire to get out.

One of my early patients went through several steps in learning about traps in therapy. At first, she learned what her major trap was. (Let's call it her "Life Trap" since it is the trap her life was in overall.) With much difficulty, she worked her way out of it. After that she would come in having sometimes had a good week and sometimes a bad one. Since we knew that there was no longer a major Life Trap going on, the recurrence of panic attacks had to mean that she had gotten into some small "Day-to-Day Trap."

"How have you gotten trapped this week?" I would ask. "I haven't," she used to say at first. "The panic attacks just came out of the blue."

This would leave no choice but the tedious process of going over the whole week day by day. What had she done Monday? Had she wanted to do what she did? Had she made plans that she was really not comfortable with? Had she allowed herself to be pushed into a commitment to do something or go somewhere that she really wished she could get out of? Had she had strong feelings about something? Feelings that she felt she could not or should not feel and express? What about Tuesday? No? No traps? What about Wednesday?...

Sooner or later, we would discover what it was. Then, we would find a way out of the trap and the panic attacks would stop. And the next time she came in having had a bad week, we would go through the process all over again. But each time, she learned more about what traps were and how she got stuck in them. And she learned what being true to herself really was.

It did not take very long before she would come in having had a bad week and I could simply ask: "So how did you get trapped?" She now knew enough to be able to look over her week by herself and figure out what the trap had been and how to better handle the situation. This was close to the endpoint of our treatment. After that, when she had panic attacks, she asked it herself: "How have I gotten myself trapped?" And she could figure it out for herself. She took the final step when she developed the ability to "see a trap coming" - she would not allow herself to be put in a situation that she knew would be a trap for her.

Then what? Success!! No more panic attacks!

More to come about how to get out of traps when we talk about therapy in Chapter 12.

Assignments for Chapter 4

1. Identify your traps. If you have trouble, there is a lot about how to do this in Chapter 11. However, it is a good idea to make a start on it now.

Write down all traps that came to your mind as you read this chapter. Do you already know what your current overall "Life Trap" is? If so, write it down together with all the reasons you want to get out but cannot.

Have you had some little Day-to-Day Traps during the past week or so? (Like feeling you must go somewhere but being unable to?) If you have, write down every one you can recall. Start a running diary called "Traps" in a notebook. Each time you find yourself in one, write down the date and what the trap is. You don't have to find a solution to it. For now, it is enough to simply identify and record it.

2. Look over your response to the Chapter 1 assignment of writing down the periods in your life when you had more (and less) panic attacks. See if you can identify the traps that caused each period of increased panic attacks. Write down your results.

3. Field Trips are an essential part of this program. If you skip doing them, you may as well put this book down now. It will not work for you. Simple as that. Field Trips are experiments in treating the world around you differently and checking out whether your assumptions about how the world will respond are really true. In this chapter, we have been getting down to the nitty gritty of why life has been the way it has. This is also a good time to begin giving yourself experiences in living differently in the world. Read the "Experiments" section of Chapter 14. From here on, devise and take field trips at least weekly. Make them fun as often as possible. Fun is fine. But do them!

4. Continue your Anxiety Diary - especially during Field Trips.

Customer Reviews

Be the first to write a review

( 0 )

5 Star

(0)

4 Star

(0)

3 Star

(0)

2 Star

(0)

1 Star

(0)

Your Rating:

Poor

Below Average

Good

Very Good

Exceptional

Review Guidelines

Tell the world what you think of this product.

Add Recommendations

Your Name: Create a Pen Name or Leave Anonymously

Barnes & Noble.com Review Rules

Our reader reviews allow you to share your comments on titles you liked, or didn't, with others. By submitting an online review, you are representing to Barnes & Noble.com that all information contained in your review is original and accurate in all respects, and that the submission of such content by you and the posting of such content by Barnes & Noble.com does not and will not violate the rights of any third party. Please follow the rules below to help ensure that your review can be posted.

Reviews by Our Customers Under the Age of 13

We highly value and respect everyone's opinion concerning the titles we offer. However, we cannot allow persons under the age of 13 to have accounts at BN.com or to post customer reviews. Please see our Terms of Use for more details.

What to exclude from your review:

Please do not write about reviews, commentary, or information posted on the product page. If you see any errors in the information on the product page, please send us an email.

Reviews should not contain any of the following:

- HTML tags, profanity, obscenities, vulgarities, or comments that defame anyone
- Time-sensitive information such as tour dates, signings, lectures, etc.
- Single-word reviews. Other people will read your review to discover why you liked or didn't like the title. Be descriptive.
- Comments focusing on the author or that may ruin the ending for others
- Phone numbers, addresses, URLs
- Pricing and availability information or alternative ordering information
- Advertisements or commercial solicitation

Reminder:

- By submitting a review, you grant to Barnes & Noble.com and its sublicensees the royalty-free, perpetual, irrevocable right and license to use the review in accordance with the Barnes & Noble.com Terms of Use.
- Barnes & Noble.com reserves the right not to post any review -- particularly those that do not follow the terms and conditions of these Rules. Barnes & Noble.com also reserves the right to remove any review at any time without notice.
- See Terms of Use for other conditions and disclaimers.

If you find inappropriate content, please report it to Barnes & Noble