As we emerge from the pandemic there are some emerging differences in its impact on people’s lives. For many the end of the pandemic brings a return to normality, for others it’s about catching up on missed activities but for others there is a struggle around certain aspects of living. I wrote last time about an increase in people seeking our services and there appears to be a number of common concerns so today’s article is about one of these, the struggle many people are having in doing things that were easy for them pre-pandemic.
When I say reluctance this might be experienced as anything from a little apprehension and hesitation through to complete debilitating panic. Agoraphobia is the term most used to label the latter and its wikipedia definition is given as ‘extreme or irrational fear of entering open or crowded places, of leaving one’s own home, or of being in places from which escape is difficult’. The word given in that definition that I find most unhelpful is ‘irrational’ because and as the wikipedia dictionary states, irrational is understood as ‘not logical or reasonable’ when in reality and as neuroscience confirms our feelings are grounded in logic and their existence is entirely reasonable.
A part of our brain, the amygdala constantly takes information from the body’s senses and searches for risk, determining the degree of danger based upon existing information and experience. If the potential for danger is assessed as high then the body’s physiological response is one appropriate for the danger, otherwise known as our fight, flight and freeze reaction. The experience of the flight, fright, freeze response is in itself a possible source of distress and it becomes attached as information to the previously held bank of experience and information. Simply put, the unpleasant experience of a panic attack can in itself be the source of further panic attacks and this means that escalation is a natural outcome without some kind of intervention.
So if you have noticed a new reluctance then it is worth spending some time to reflect on your experience, questions you might ask yourself include are you reluctant to do things that you used to enjoy doing or found easy to do? Have you felt unsafe in a public space even though everyone else seems to be acting calmly? Do you feel more lonely in certain situations? Do you feel as though you need someone with you, feeling nervous or frightened at just the thought of being outside alone or any other situation? Or maybe it is particular types of confined spaces that trigger difficult feelings? Or maybe it’s different types of travel – cars, buses, planes, trains etc? Experiences of hyperventilating, dizziness, feeling unwell, panic, palpitations, being sick, exhaustion if you do try to push ahead? Feeling of missing out on everyday life, not wanting or being able to meet friends and family, go shopping, attend job interviews or travel? Finding yourself having negative sensations and feelings even though your thoughts are not able to determine any particular specific threat? Worrying about your worries?
Often when people come to see me I find out that they also feel ashamed and isolated by their experiences, this might be because of self judgement or because of bad experiences in trying to talk to someone else and I think this can be traced back to the lack of understanding that I wrote about at the start of this article.
The causes of agoraphobia and its milder experiences are not entirely clear, underlying health conditions, traumas as well as periods of change where someone has gotten used to a different routine are often relevant. Over the last few years the pandemic has created a particular context in which other people and being outside has had real risks so it is natural for us to take some time to readjust. We also have terrible events unfolding with a war in Europe and concerns about our climate, the cost of living crisis and so it can be natural to feel safer staying at home? But if at the moment you are finding that your quality of life is suffering because you cannot do things that you or others think of as everyday then maybe it’s time to try and take action?
As psychotherapists we take over where medical science ends so we always ask whether you have consulted your GP about your experiences. Assuming all potential physical causes and treatments have been considered we then seek to get a full understanding of the context within which your experiences occur, to try and locate a trigger point and develop solutions for change. Ultimately what we are seeking to do is give the amygdala new experiences and information that will alter its assessment of risk and change its response.
So if either yourself or someone you know has changed behaviour and appears risk averse the best starting point is acceptance that something very real is being experienced and that time and attention is needed to understand what that is – our experiences contain messages for us and sometimes we need to work to understand them.
Psychotherapist, Counsellor, Couples Counsellor and Coach
UKCP registrant, MBACP (accred), UKRCP
PGDip, MA, Adv Dip Ex Psych
Nicholas Rose & Associates
Counselling, psychotherapy and coaching for children, adults, couples and families.
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