Agoraphobia Has People Fearful of Going Outdoors

Most people experience sweaty palms and a sense of trepidation on occasion, but some fears may become so severe that people stop doing such things as driving on the freeway, riding elevators or leaving their homes for months at a time.

When uneasiness, a sense of doom or a rapid heart beat begin to impinge on your life style or profession, you may need to do much more than think it’s time for a vacation or a visit to the family physician, according to local agencies that offer group sessions and individual counseling to help people combat their phobias.

“What happens is people start getting panic attacks,” said Claudette DeCourley, administrator for the San Diego branch of TERRAP, which stands for territorial apprehensiveness, a condition generally referred to as agoraphobia. “So they start seeing doctors, many doctors. Then maybe they are so nervous they start having heart palpitations, so they see a cardiologist, and so on.

“Then maybe they finally realize it is stress--they hear about someone else or see something on TV and they think, ‘My God, that’s me!’ ”

DeCourley said the condition, in which people are bombarded by “waves of panic” and the feeling they are going crazy or even might die in the threatening situation, can manifest in anyone 14 to about 75 years old, although the problem is more severe the longer a person neglects it.

“The majority of people I get are doing a lot of things, but just not enough,” she said. “I get a lot of working people, but some parts of the rest of their lives are not adequate. The most severe would be someone who can’t get out of the house or can’t even move off one piece of furniture.

“I’ve had two women who couldn’t leave their couch. They had people bring them water, food and just had all these things piled around them like water, books, a bedpan, remote control for the television, a radio. The least extreme is a person who is having some panicky feelings so they are curtailing socializing or shopping. It is not 100%, but they will avoid certain stores or places.”

Like other local anti-phobic programs, TERRAP identifies the person’s fear, and then, along with therapy, a trained counselor accompanies the patient into the threatening situation. For this reason, DeCourley spends most of her time out of the office, riding elevators, going shopping, climbing heights and walking around the city with the patients.

The 20-week program consists of 90-minute group sessions each week. The therapy group, about 10 people, works extremely well because regardless of what each person is anxious about, “their fear is the same; everyone in the group knows what the panic attack feels like,” DeCourley said.

The program, which is nationwide, costs about $1,200, and the San Diego branch has about 50 customers a year, she said. The program, however, is not guaranteed to cure the phobia or “panic disorder,” DeCourley said.

“The people are not cured when it is over,” she said. “The people who come here did not get this problem in 20 weeks. We are talking about a way of life, and you don’t change your way of life real fast. It takes a lot of change, but the important thing is that they have to keep making those changes.”

‘Virtually Housebound’

San Diegan Joanne Lakin, who saw a TV special on the program, was “virtually housebound” when she went to her first TERRAP meeting in 1981.

“I had left my family, and I just couldn’t cope anymore,” Lakin said of that time. “I was unable to go to the grocery store anymore, and what interested me on the program was they were talking about being able to stand in a grocery line, and I couldn’t do that. I had episodes off and on in a lot of situations, probably about 30 panic attacks.

Lakin, 50, said she also had panic attacks in her 20s and that as she got older she began to have them inside her home as well as outside. She participated in the program for two years. Today, Lakin said, she can go anywhere and do anything. She now runs the program’s Monday evening goal-setting class.

“When the program was over, I was not cured by any stretch of the imagination,” she said, “but I had a handle on my panic attacks. It took time and determination.”

Agoraphobics also often call the San Diego County crisis hot line, although this condition is usually not the problem they are calling about, said crisis team coordinator Pam Blackwell.

Problem Is ‘Rather Common’

“We usually find out about the agoraphobia when someone calls with a problem and we ask them if they have tried therapy or if they can go to a certain place for help,” she said. “Then they explain that they are afraid to leave the house, afraid to drive, or maybe can’t go out at night. So we educate them a little bit about what they might be experiencing, especially for somebody who doesn’t even know what it’s called, although it is rather common.”

Blackwell said it is unfortunate that most who use the hot line have little income, because agoraphobia is best treated by organizations and private practitioners who will make house calls, an expensive treatment. The crisis hot line refers agoraphobics to TERRAP and Recovery Inc., an international self-help organization.

Recovery Inc., which has eight branches in greater San Diego and two in North County, offers weekly meetings for people who have phobias as well as a variety of other problems. The organization is based on the belief that it is “life’s trivialities” that make a person retreat and have nervous tendencies, said Peter Babiak, 30, assistant area leader for greater San Diego.

“There are many agoraphobics who come to our meetings,” Babiak said. “Of course, they cannot be too severely phobic or they would not be able to leave their homes to attend the meetings or they would not feel comfortable sitting in one. If people have a severe problem, we encourage them to seek therapy or a doctor. We offer the support and additional feedback.

“We cannot offer treatment or diagnosis because we are not mental health professionals, but the leaders (people who run the meetings) have all had one problem or another and have been trained in the recovery method.”

Babiak, who was a leader for 10 years and has been in his current position for 2 1/2 years, said he got involved with the organization right after high school because of anxiety and depression.

“I have stayed with Recovery because I think of it as insurance, a way of maintaining my mental health and also a way to help other people.”