Systematic Desensitization for Treatment of Agoraphobia
Sometime around 1984, I discovered what I "had" by means of a talk show here in sunny Florida. Up until that time, from the age of 13 to my mid 30's, I just thought I had some form of mental illness. After all, being afraid of going to my mailbox was a pretty strange thing to have happen to me!
Anyway, I saw a local talk show featuring a woman who was talking about a "challenge," just like the one I had. Immediately, I knew she was talking about me! She was offering a self-help group about 15 miles from my house that dealt with something called "Agoraphobia". At long last, I had a name for my "challenge" and I soon learned that I certainly was NOT crazy, that I wasn't alone in my challenge, and that there was help.
The program I attended taught the concept of systematic desensitization to deal with agoraphobia.
Systematic desensitization involves reducing your sensitivity to certain stimuli in a given anxiety-producing situation in very small, controlled steps. This is done by exposing yourself to the situation a little bit at a time, and never letting yourself get beyond a level of #3 on the anxiety scale (scale goes from 1-10). By doing this, your mind can never remember having a "bad" experience in any given place, and therefore you're more likely to return.
Listen to a relaxation tape or use another method of relaxing before going out and trying this method. Doing a trial-run in your mind can also be useful, so that when you actually face the situation, you'll feel that it's a familiar scene that you've already been through successfully.
Always keep the "5 R's" in mind. They are:
Here's a sample summary of a practice situation:
I walked into the supermarket and experienced a #2 anxiety level. I stood and used my tools (talk to self or to partner, count labels, look out the door. Anything to keep anxiety levels down).
I proceeded to the middle of the supermarket and checked my symptoms and decided I felt okay and was under a #3. I decided to walk to the back of the store and suddenly my anxiety rose to a #4.
Slowly I turned around, verbalized what I was feeling to my support person and walked outside. I went to a "safe place" in my imagination (imagined a quiet, relaxing scene) recovered and relaxed fully. I then decided to try again.
I walked back into the supermarket, felt comfortable. Walked to the back of the store and decided to buy ONE item. I got to the checkout line and only felt a #2 anxiety level. I paid for my purchase and left.
By going to the supermarket with a short list of have to's, it's easier to relax and do the practice in small steps. You can't do a practice when you have to do your weekly shopping.
If you never let yourself get above a #3 anxiety level while practicing, you'll eventually desensitize to the situation! This method can be applied to most life situations, driving, doctor's visits, having company in your home, social situations, etc.
If you're willing to go out the next day and practice again in the same situation, you know you've done your practicing correctly! :)
Click here for Barb's suggestions for desensitizing, using shopping as an example.
Psst..... If you're practicing desensitization and would like a little help explaining your challenge to a doctor, dentist, etc., the form letter here might be of help to you!
Last Updated: 02 July 2016
Reviewed by Harry Croft, MD