The term agoraphobia is generally misunderstood and mistreated. Its literal definition suggests a fear of ‘open spaces.’ This is not only incomplete, but a misleading view. Agoraphobics are not necessarily afraid of open spaces. Instead, they are afraid of having panicky feelings, wherever these fearful feelings may occurat home, in public buildings, or in crowded supermarkets, driving a car or driving over bridges or places that are certainly not ‘open,’ but are unfamiliar or triggers feelings of being ‘out of control.’
The majority of sufferers are women and the onset is usually early in adult life. Depressive and obsession symptoms and social phobias may also be present but do not dominate the emotional picture. In the absence of effective treatment, agoraphobia often becomes chronic, though usually fluctuating. In my experience working with agoraphobics three traumatic experiences were prevalentverbal (emotional) abuse, physical (hitting/spanking) and/or sexual abuse/incest.
In these three scenarios the person has been ‘overwhelmed’ and ‘out of control’ of their environment by the verbal, physical or sexual abuse perpetrator’s behavior. Because these traumas are usually perpetrated by the parent, or someone the child knows and trusts implicitly the child’s reaction is one of betrayal, fear of reprisal if they tell and fear for their very life.
Along with being hit/spanked the parent declares, “I hit you for your own good. This hurts me worse than it hurts you. If you were good I wouldn’t have to hit you,’ or many other variations of this theme, which serves to blame and shame the child and disavow any responsibility of the adult.
The confusing message a sexual abuse/incest survivor endures is even more insidious, because it is implied that the child is special. The perpetrator doesn’t say, “Come here and I will abuse you,” but, “Come here because you are special (my daughter), I love you and I want to show affection;” thus she is deceived, and the affection she expected was in fact abuse. Not only has she been duped and betrayed, she is ‘out of control’ with regard to what she experiences. Thus, she goes into shock and then struggles mightily to come to gripes with her experience and feelings. No sooner has she regained her equilibrium (which may take days or weeks) she experiences the abuse again, and thus she is ‘out of control’ again. This roller coaster existence becomes a way of life for her. At some point she will vow to: “Never allow herself to be vulnerable, out of control or duped.” Thus, anything which triggers the feelings of vulnerability, being out or control or duped catapults the survivor back into the shock and struggle to come to gripes with her experience and feelings.
Traditional talk therapy/psychotherapy treats symptoms because symptoms can be quantified and identified, or so it is claimed by traditional modern medical and psychiatric practices. Thus Emotional Pain is described in terms of symptoms Agoraphobia, Depression, Anger, Anxiety, Panic Attacks, Self-Esteem issues, Mood Swings, Compulsive Behavior, Chronic and Acute Fear, Self-Injury, Suicidal Thoughts, Shame, Guilt, Eating Disorders, or Addictions) does not heal itself. Time, marriages, children, success, wealth, buying a bigger house, or faster car, changing jobs or relocating will not CURE it. The damage is sometimes very deep, pervasive and profound. It is a soul injury. The person has been robbed of his or her integrity, core identity and trust.
The legacy of every unhealed verbal, physical or sexual abuse survivor includes diminished self-worth, limited ability to trust, and the burden of a shameful secret she or he cannot express. This legacy leaves the survivor’s ability to develop necessary life skills inhibited. She remains co-dependent on her caretakersher nuclear or extended family, foster parents or her surrogate family, babysitter, doctor or priestwho have frequently become another abuser. In her diminished self-worth, limited ability to trust and the burden of a shameful secret she becomes anxious as to how she will continue managing the rigors of life. Thus, she needs some way to cope with these burdens and anxiety arises. A person may fear having anxiety attacks, ‘losing control’, or embarrassing him/herself in such situations. Many people remain in a painful state of anxious anticipation because of these fears. Some become restricted or ‘housebound’ while others function ‘normally’ but with great difficulty, working gallantly to hide their discomfort.
Agoraphobia arises from an internal anxiety process that has become so intense that the suffering individual fears going anywhere or doing anything where these feelings of panic or feeling ‘out of control’ have repeatedly occurred before. Once the panic attacks have started, these episodes become the ongoing stress, even when other more obvious pressures have diminished. This sets up a “feedback condition” which generally leads to increased numbers of panic attacks and, for some people, an increase in the situations or events which can produce panicky feelings. Others experience fearful feelings continuously, more a feeling of overall discomfort, rather than panic. Agoraphobia is both a severe anxiety reaction and a phobia reaction, as well as a pattern of avoidant behavior.
The good news is: Emotional, physical and sexual abuse can be healed. Healing takes place when the core issue is addressed. Treating depression, anxiety, panic, or agoraphobia is treating symptoms. Treating symptoms does not heal the internal wounds which the trauma created or change the behaviors the survivor has chosen to cope with the pain, avoid the pain or numb the pain. Using a variety of healing techniques the core wound can be healed, thus the verbal (emotional), physical and sexual abuse becomes a distant memory and the painful aftereffects no longer existi.e. the agoraphobia (panic, anxiety, feeling out of control, etc) is no longer needed as a coping mechanism.
Dorothy M. Neddermeyer, PhD, author, If I’d Only Known… Sexual Abuse in or out of the Family: A Guide to Prevention. specializes in verbal, sexual abuse/incest and physical abuse prevention and recovery. http://www.gen-assist.com/book.asp
