What Causes Agoraphobia?

A Crippling Terror

When you hear the word phobia, think terror, because that is the emotional response phobias cause in people. That terror often results in severe physical stress responses, like trembling, nausea, dizziness, hyperventilation, or an inability to move. Your mind can develop a phobia of anything: a person, a place, a sound, a texture, a word, or even a concept. Once your mind forms a phobia, how much that phobia hampers your life will depend on how frequently you’re exposed to whatever it is you’re afraid of. If you live in the city and you have a phobia of zebras, then you will probably do alright most of the time. But if you have a severe phobia of water, simple tasks like washing your hands or taking a bath can seem life-threatening.

Symbols of Danger

Your mind forms phobias when it associates a specific target or concept with extreme danger. Your mind’s top priority is to safeguard your entire being: mind, body, and soul. The terror response that is triggered by phobias is actually your mind trying to protect you from harm by sounding an emergency alarm and flooding your physical body with commands to put distance between you and the source of danger by either fleeing the scene or freezing on the spot. When it isn’t possibly for you to quickly distance yourself from the perceived threat, your mind becomes severely upset, which results in you behaving in ways that often look strange and bizarre to other people.

Suppose you walk into a room and see a ticking bomb lying on the floor. It takes you a few seconds to understand what you’re looking at. Then you suddenly realize that those large red numbers counting down on that timer show how many seconds you have before a violent explosion occurs. What happens to your mind at that point? It panics. Adrenaline surges through your veins as your mind goes into emergency mode and tries to get your body to sprint out of the room. But suppose when you try to escape, you discover that someone closed and locked the door that you came through? What will happen to your fear level then? It will shoot up even higher.

To people with phobias, the thing that triggers their fear always feels like that ticking bomb. The intensity of fear they experience quickly escalates into the same kind of fear you’d feel if you felt like you were about to get injured in some horrible, life destroying way. Phobias seem very irrational to other people because they are based on perceived danger, not actual danger. A running faucet doesn’t pose any actual threat to your well-being. But to a person with a phobia of running water, that running faucet feels as life-threatening as that ticking bomb.

Making Associations

Phobias are more complicated than they first appear. The fear trigger–a spider, the dark, a high ledge–functions like a loaded key ring. Just as a single ring can hold many keys, the focus of a phobia is often linked to several terrifying beliefs and distressing memories. In some cases, triggering a phobia will cause a person to start having a flashback of one of the memories associated with that phobia. For example, when a woman sees a pool, her mind suddenly pulls up the memory of her nearly drowning in a pool when she was a young girl. Flashbacks like this can sometimes be so sensually intense that the person temporarily loses touch with reality and feels that they are actually existing in the memory world. A common example is the soldier who hears a loud bang and suddenly feels as if he’s been transported back to a battlefield. In reality, he is standing on a public street, but when he looks around, he sees military tanks and exploding bombs.

In cases where specific memories resurface in the mind, those memories feel terrifying because of the beliefs associated with them. In its ongoing effort to make sense out of your life and protect you from future harm, your mind is constantly analyzing your experiences and theorizing about what those experiences mean. How should you interpret the fact that you got deathly ill after drinking the wine your husband gave you? Should you interpret that to mean he intentionally poisoned you? Is he trying to murder you? When you find out he is also cheating on you, your mind might decide its murder theory has been proven correct. That theory will then become an accepted belief, and that belief will greatly impact your future behavior. You’ll want to move out of the house as soon as possible. You’ll want a divorce. You’ll never trust the man again.

The fuel for phobias is gathered when your mind forms some very upsetting beliefs based on negative experiences you go through. Instant phobias form when your mind fixates on a single element of a terrifying experience and turns that element into a symbol of great danger. This is what happened to the girl who nearly drowned. Her mind locked onto the pool she was in at the time and decided to link the concept of a pool with the threat of physical death. Another classic example of an instant phobia is when you get bit by a poisonous spider and end up in terrible pain. After your life is saved by doctors, your mind is frantic to protect you from that kind of danger in the future. It locks onto the memory of the spider as a symbol of physical agony and the threat of death. From that point forward, you panic at the sight of any spider that looks like the one you were bitten by.

Unlearning Negative Associations

To recover from a phobia, your mind needs help to adjust the terrifying beliefs that it is linking to your fear trigger. Not all spiders are poisonous. Even the ones that are can usually be avoided. With help, your mind can learn to see that it is perceiving danger where no danger exists. Where there is no danger, there is no need for panic.

Your mind has limited resources, and it takes a lot of resources to maintain a state of emergency alert. Your mind would love to be freed up from resource draining phobias, and once it feels convinced that it no longer needs to perceive the fear trigger as a terrible threat, it will gladly erase the associations it has formed. When it does this, it’s like you slipping all of the keys off of a crowded key ring. Once the ring has no more keys on it, you can pick it up without dragging a lot of keys along with it. In the same way, once your mind unlearns a phobia, it can interact with the fear trigger without panicking.

Agoraphobia

The longer your mind goes without getting help with its terrifying beliefs, the greater its fear can become. Remember that phobias are a result of your mind trying to protect you from severe harm by keeping you away from perceived danger. The more stressed your mind becomes for any reason, the more desperate it feels to keep you away from danger.

Suppose you are extremely tired and yet you are also the only lifeguard available to watch some children who are swimming in a pool. If anything goes wrong in the pool, it will be on you to save the day, and to do that, you’ll need a lot of physical resources. If you know you don’t have those resources because you are feeling drained from other stresses in your life, then you’ll look for ways to keep the kids out of the pool. If no one goes into the water, no one can start drowning, and that means you won’t have to worry about rescuing anyone.

In cases of agoraphobia, your mind is acting like that tired lifeguard. It feels extremely low on resources–so much so that it doesn’t feel confident about its ability to protect you well if you fall under attack. To protect you and itself, your mind pressures your body not to leave a certain geographical area that your mind considers to be a safe zone: a place where there is minimal risk of you being harmed. That safe zone is often a house or a single room in a house. The more stressed your mind feels, the more it will shrink the size of the safe zone. Again, the goal here is to protect you from harm by minimizing your exposure to danger.

So what causes your mind to decide that going outside or being in public places is a serious threat to your well-being? There are two main ways agoraphobia can start. The first is for you to experience some kind of trauma in a public place, such as getting hit by a car or seeing someone you love get stabbed. In these cases, your mind can instantly leap to a state of agoraphobia by deciding the outside world is a terribly dangerous and frightening place in which deadly threats spring up without warning.

In other situations, agoraphobia develops gradually and is not triggered by any kind of assault in a public place. In cases of gradual onset, psychological fatigue is often the cause. That fatigue could be worsening for several years or even several decades before your mind finally decides it must take drastic measures to start conserving its resources.

Responding to Agoraphobia

A mind with agoraphobia is like a long distance runner who has just collapsed on the ground from utter fatigue. If you want the runner to get up again, yelling at him won’t work. He needs rest, water, and food. He needs encouragement to go on. In the same way, your stressed out mind needs you to respond to its distress with respect and compassion. It needs to be able to talk about its fears without being mocked or criticized, and it needs help gaining new resources before it can be expected to start expanding its safe zone. Stressed out minds gain new resources by changing their beliefs. Your mind won’t change its beliefs unless it feels it has logical reasons to do so. When treating phobias through counseling, the goal should be to show the mind the logical error in some of its current beliefs, and then present it with a new set of logical beliefs that it will find much easier to live with. As the mind revises its beliefs, its stress levels will lower, and it will feel less threatened by allowing the body to venture outside.

This post was written in response to Amira.

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