Practice Patience

It would seem that the warm weather of summer is an inducement to slow down and live life at a more leisurely pace. Summer time and the livin’ is easy-and it’s a good thing because if things didn’t slow down for at least a few months out of the year, many of us would just fall over dead from the incessant demands of life in the 21st century.

While walking through O’Hare airport several weeks ago I looked around and saw that practically everyone was talking on a cell phone. I remembered some 10-12 years ago, all those people would have had to find a pay phone if they wanted to call someone, or wait until they got home-and that was okay then, but now expectations have changed.

It’s ironic. Faster and more efficient technological devices promise to save us time—but everyone I know feels like they have less time.

Did ancient people also feel that time was a thief? No doubt.

But this perception is undeniably compounded by an increasingly frantic pace of life in modern times. When I was a teenager my mother put up a refrigerator magnet that said, “the hurrieder I go, the behinder I get”. It seems that this modern age nudges us to hurry up. But as many of us experience, the more we hurry up, the less time we seem to have.

The less time we seem to have, the more impatient we become. When we are impatient, the world around us becomes a source of frustration. If we are feeling impatient, we are feeling self absorbed.

Last Labor Day weekend, I found myself in the airport in Atlanta. We had just celebrated my grandson Henry’s first birthday. The plane was supposed to leave at 4:00 pm. Thunderstorms put O’Hare on a ground stop. But by 6:00 pm the status had passed. A voice came over the speaker saying we would leave by 7:00, 3 hours late but we all knew it could be worse. We boarded the plane, taxied to the tarmac and sat there 30 minutes, 60 minutes, 90 minutes. The man sitting next to me struck up a conversation saying he was worried that he wouldn’t get into Chicago until after midnight and he had to be on the job by 6:00 am. Finally, by 9:00 pm, (5 hours late) we took off. An hour into the flight the pilot announced there were more storms in Chicago and rather than burn fuel in a holding pattern we’d land in Indianapolis. There was no way we were going to get into Chicago until 2 or 3 in the morning. My seatmate exploded – he hit his seat and cursed.

Fidgeting impatiently, he broke into a sweat and loosened his tie. His mantra was-I can’t deal with this-I can’t deal with this…. He kept mumbling about how tired he was going to be. It was now midnight, and we were sitting in the Indianapolis airport awaiting permission to take off. Suddenly my seatmate burst out laughing. He said, “I might as well just accept it, I’m not going to get any sleep.” “I might as well accept it,” this became his new mantra. Earlier he had told me that he was staying in a Lakefront Hotel in the loop and he had a view of the lake, so I tried to cheer him up. I said, “It’ll be great. You are going to walk into your room and the sun will be coming up over Lake Michigan. It will be a beautiful sight.” By then he was laughing about how all of that angst was a waste of energy.

We have all been in situations when our expectations about what was supposed to happen didn’t pan out. We all know what it’s like to erupt in frustration when events turn against us. We all know what it’s like for our minds to scream at us that it shouldn’t be this way. When things go haywire or we are falling behind impatience invades the mind.

When my seatmate first realized how late we were going to be, his mind began to speed up with negative thoughts. He quickly thought of at least 10 horrible things that could happen.

In the book Take Your Time Ecknath Easwaran says that when our minds are in a hurry, our thoughts are usually negative. A mind in a hurry is not a healthy mind.

Many years ago I had a full blown manic episode. It landed me in the psychiatric intensive care unit. One thing about that experience I remember was how my mind speeded up. Fast thinking is characteristic of a manic episode.

I was thinking fast and thought I was so smart because of my fast thinking mind. But now I see that when my mind was thinking so fast I wasn’t being smart, or clever — my mind was in overdrive which meant that I was so taken with my thoughts that my speedy thoughts were all that mattered to me. To have a crazy mind like that is a weird sensation. The faster the mind the more you create your own version of reality.

But when the mind slows down, there is space and spaciousness—and space and spaciousness in us is what makes room for others and other thoughts. When the mind slows down we become patient—when the mind is quiet, panic dissolves. And when we are less in a panic, less in a hurry, we see that life is not all about me. Learning patience is the process of quieting the mind.

The Sufi mystic Meher Baba put it like this: “A mind that is fast is sick. A mind that is slow is sound. A mind that is still is divine.”

Slow down the mind.

There are two ways to learn patience by slowing down the mind. The first is to become aware of what our minds are doing.

Whether driving a car, biking or walking, if we are running late, we probably started late. If there is not enough time in the day then we are probably trying to fit too much into the available time. If we are feeling irritated with our kids, frustrated with a partner or spouse or annoyed with a relative or aging parent what we need is patience. And the way to get patience is to slow down the mind. The first thing I do to practice patience is to have a little chat with my own mind. It helps me to remember that I have a mind but I am not the mind.

The second thing I do is practice patience every day. I know of no better way to practice patience every day then to practice meditation.

The purpose of meditation is to train the mind to be quiet. By the silent mental repetition of a mantra, the mind becomes absorbed in one thing rather than everything. As long as the fluttering mind is in motion, it is creating a commotion for us. As long as the fluttering mind is in motion it is pushing us to think thoughts, chatter internally, make judgments, keep things moving. Meditation teaches the mind to be patient. The more we are patient, the less we suffer.

Just think about times when you have felt impatient. Think about those times you have felt restless, irritated, anxious and intolerant. To be impatient is to suffer.

The purpose of spirituality is to give us tools that will reduce our suffering. A basic spiritual truth is that the more self absorbed I am, the more I will suffer, and the more I suffer, the more suffering I cause others.

His Holiness, the Dalai Lama once said, “The moment you think only of yourself, the focus of your whole reality narrows, and because of this narrow focus, uncomfortable things can appear huge and bring you fear and discomfort and a sense of feeling overwhelmed by misery. But the moment you think of others with a sense of caring, however, your view widens. Within that wider perspective, your own problems appear to be of little significance, and this makes a big difference.”

We practice patience because it not only reduces our suffering but it also reduces the suffering of those around us.

As I practice slowing down my mind, I learn to settle down, and when I learn to settle down I develop the capacity for compassion and love. Compassion and love are two sides of the same coin. Compassion is the wish for other beings to be free from suffering. Love wants other beings to have happiness.

Compassion and love grow naturally out of the mind that is spacious and slow. This is why practicing patience is the ground out of which compassion and love take root in our lives. And this is why lately, I’ve been repeating the mantra: practice patience – don’t hurry, be happy.

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Support groups

In my earlier rather depressing job description of parenthood I pointed out the lack of any form of trade union representation to argue for parental rights and needs. Of course, by its very nature, parents do their job out of love, and voluntarily sacrifice many material things to be able to care for their children. However, there is also little doubt that governments have frequently taken advantage of this absence of cohesion of parents as a group, in order to be able to dictate to them about the financial aspects of child-rearing. The health professional can begin to fight for parents and can offer a great deal of support as well as representing parental views. However, the emergence of self-help groups has to be one of the most encouraging and stimulating developments in recent years.

The majority of these groups are focused on some particular aspect of parenthood. This may be crying, hyper-activity, asthma, eczema, the disabled, and so on - but they are a very real and valuable step towards parents understanding their problems more, feeling less isolated and being much more involved with professional decisions that may affect their children.

As well as self-help groups there are many other groups and organisations that give parents a voice and can offer support, reassurance, help and guidance. It is no secret that one of the chief advantages of mother and toddler groups, and pre-school playgroups, is the support that these groups offer the parents - not just the children.

A fascinating piece of research done in the 1970s looked at some of the characteristics of American parents.1 These characteristics applied to almost every parent, irrespective of social class, ethnicity, education, or religion. Even though over 20 years have passed, the chances are that they apply to you as well. They certainly apply to me. These were a selection:

• We have no real idea as to what a 'good parent' is
• We get virtually no parenting training
• Our view of parenthood is somewhat romantic
• We expect to be able to solve problems that the professionals can't
• We have complete responsibility for our children, but only partial authority
• We expect extremely high standards of ourselves as parents
• We often have to work with incomplete or conflicting information when trying to resolve situations with our children
• The standards we set for our children are even higher than those we set ourselves. We want them to be happier, and more successful, than we ever were.

We certainly mean well. Nevertheless, we simply have to accept that many of these beliefs are incompatible. We are bound to get stressed. The function of this book is to look at some of the stresses that inevitably arise from parenthood,, to give practical guidance as to how you can lessen their impact, to show you who can help, and how you can help yourself. But -1 might as well admit it straight away - this book's title is more than a little optimistic. There is no way that parenting will ever be completely stress free. But I do believe that stresses really can be diminished to a remarkable extent, so that the pleasures of being a parent totally overwhelm them. And you will believe it too. Read on.



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The attitude of society

That isn't to say that society doesn't appreciate and understand the intense importance of parenthood. After all, how often have you heard the phrase 'Of course, I blame the parents' when some bad news story about a young person becomes public? During the trial of the British au pair, Louise Woodward, in Boston in 1997, countless articles in the nation's newspapers were devoted to analysis and criticism of the parents of the child that died. Their child had died, and they were criticised Everyone in their heart of hearts knows that the skills involved in being a parent are absolutely vital.

And just how does society show its appreciation of all this vital work on behalf of the next generation? You've guessed. When social scientists in the United Kingdom are grading various professionals because they need to collect statistics on patterns of disease, or educational or social needs, the job of 'housewife/mother' is placed in the same category as 'unskilled'.

There is much more to this than pure symbolism. It genuinely does reveal society's true attitude. When women are asked 'do you work?', how many reply 'no, I am just a mother1? Even today, many professionals such as doctors, and other interviewers often say such things as 'do you have a job, or are you a housewife?' Maybe no insult is intended, but the inevitable implication from such thoughtless remarks comes shining through. Society's prejudice is all too obvious.

Parents, and mothers in particular, are frequently made to feel inferior - an attitude exemplified by the development of the 'super wife and woman' ideal, whereby a really successful woman is expected not only to have a demanding job and be a perfect mother, but also to look glamorous and have all manner of fulfilling hobbies - possibly writing the odd book or two about them in her spare time. Is it any wonder that other women can feel distinctly inadequate?

There is no doubt that the sociological changes in the past two or three generations have given most women an entirely new set of options for their lives. Whereas in the past it was expected that every woman would simply settle for life as a mother and supporter of her husband, society has changed its view of a woman's potential place in the world and this means that the opportunities are very much broader. It is wonderful that the entrants to many professions are now at the very least as likely to be women as men. It is entirely healthy for society that cabinet ministers, doctors, engineers, secretaries, and chief constables should be appointed purely on the basis of merit and ability, rather than on which set of chromosomes they have. However, it is extremely unhealthy when society expects women in these jobs to do them in addition to being parents. The job description of parenthood is quite simply big enough, and it is entirely unreasonable simply to add this to someone's paid employment. There is a limit to what any one person should be expected to do.

I have little doubt that attitudes are changing but we are still an enormously long way from a genuine equality of opportunity. In my experience, when children wake at night it is still far more likely that the mother will get up than that the father will. Over and over again I have heard mothers say things like 'of course I always get up to the baby at night. It isn't fair on my husband to expect him to do it. He's got a job to go to/ If both a father and mother go out to work, it is still unusual for it to be the father who stays off work when the child is ill. There is far more Up service paid to equality than any genuine change of attitudes.

One of the most potent causes of stress in any of us is the failure of reality to live up to one's expectations. There can be no doubt at all that almost all parents have entirely unrealistic expectations of what parenthood is actually like. Even those who manage to achieve all the activities of a 'superwoman' often put themselves under intolerable stresses.



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My Panic Attack (4)

But there was one problem I felt unable to face. I had happily sailed through my music exams and the day came when I was told that I had to play the piano at assembly. To play in front of the whole school, knowing that many girls would be only too eager to criticise my performance, was unbearable.

Again the nights of frantic anticipation. I could imagine all the things that could go wrong. I could see all the gleeful faces as the whole school enjoyed hearing me make a fool of myself.

Why did I not just refuse to play? I could not bring myself to do it. I couldn't run away this time, so I cracked my thumb joint with a hammer. A difficult 'accident' to explain at the hospital, but I ended up with my arm in a sling and an overwhelming feeling of relief at the honourable way of escaping from my ordeal. I now suffer from chronic arthritis in my hand as a reminder.

II scrambled through my exams. There were too many gaps in my education for me to do really well, but at last I reached my final day at school... and I didn't want to leave.

Even travelling was no longer a bugbear. I attended a secretarial college, travelling into the centre of London every day. The fears were all behind me and I could look ahead to a future as a normal person. A relative in the Foreign Office got me a job in MI6. Sounds exciting, but it was basically just another secretarial post where I was very happy and made many good friends.

I was engaged to be married, although we had a five-year wait ahead of us as Michael had to get his law degree and qualify as a solicitor.

One winter's day I was just recovering from a bout of flu and waiting at a bus stop on my way to work. Disaster. Back swept the terrifying feelings that I thought had gone for good. I didn't know how to handle them and staggered into a shop, where I asked for a glass of water and telephoned for a cab to take me the ten miles home from the centre of London. Of course, as soon as I arrived home I felt perfectly all right apart from being a bit shaky. After-effects of the flu, I decided, and opted to take another week's sick leave to make sure I had completely recovered. I never dreamed that the old demon had raised its ugly head again.

I put the episode out of my mind and happily travelled back to London the following week. Back at the same bus stop, and my knees started to wobble and my breathing speeded up. It was all coming back. Luckily a bus came along and, jumping on to it, I broke the sequence of panic.
I couldn't believe I was back to square one, but I became increasingly worried abut my journey to work and organised my day around a variety of coping strategies. There was no way I could avoid the bus journey to the centre of hondon and, desperate for human contact, I would talk to anyone else standing at the bus stop. I always carried a newspaper to look at while I waited, and when the panicky feelings started to build up I would dart into the nearest telephone box. (How I would have welcomed a mobile phone.) I would telephone my mother, the only person who knew about my struggle. Having once suffered from agoraphobia in her youth she would talk me through the feelings and encourage me to keep going.

Every day was a continual fight against rising panic and feelings of unreality. Every morning I felt sick with appre¬hension but I was determined to hide my distress. I could not bear anyone to know about it and dreaded making a fool of myself in front of other people; I was determined not to draw attention to myself though I may have looked somewhat twitchy and uncomfortable to anyone who studied me care-fiilly as I stood at the bus stop. I carried a card on which I had written my name, address, date and destination.

When the real world started to slide and my memory played tricks I would read this over and over again to reassure myself that I really existed.

I would deliberately arrive at my office half an hour before anyone else so that I had time to have a cup of tea, sit down and recover my equilibrium. I loved my job and dreaded the fact that I might have to give it up, despite the misery of getting to the office each day. Sometimes when I felt really bad I would think of looking for work nearer home, but I knew instinctively that once I gave in the phobia would follow me; then I would give up the local job and retreat into my home. I had to conquer the problem before it conquered me.

I was not tackling the phobia correctly, any expert would tell you today. Face the panic, experience it and go through it, they would say - but I was trying to avoid it at all costs. Every time I experienced a severe panic attack I would become more sensitized and likely to have another one. Avoiding the panics enabled me to operate on an even level and live a normal life, but I am sure I would probably have overcome it more quickly had I known the modern way of going about it.

I combed libraries and bookshops looking for information about agoraphobia (panic disorder wasn't known to the lay person in those days). There was very little written for the sufferer, and what I could find frightened me even more.

I consulted a psychiatrist (I picked his name out of a newspaper, hoping to find an expert in his field). 'You are probably quite a nice young woman/ he told me. 'But you are obsessed with your symptoms which are caused by an anxiety state, and you will just have to learn to overcome them.' I had hoped some sort of treatment might be available but was warned off by the great man, who felt that as I did not appear to have any underlying problems and was managing to cope, any treatment might result in aggravating the condition rather than curing it. This was in 1953.

No treatment, just keep going! At least I had acquired one comforting piece of information: agoraphobia would not kill me and it would not ruin my life unless I let it.

Recovery would take me five years. It was very gradual but I tried to adopt an optimistic approach to life. Every day I would find something to enjoy. It may have been a compli¬ment - oh how vain I was! — it may just have been enjoying the music of the buskers on the way to work; I have always responded to any kind of music. One spring, Piccadilly Circus was filled with multi-coloured bubbles inviting the public to the Ideal Home Exhibition.

I talked to people - anyone who looked as though they might be responsive - so I was never alone. These tactics would do nothing for my panic attacks but they made me feel more cheerful. I learned to smile at everyone and was gratified to find that about 80 per cent of the public would smile back. Life was definitely looking up.

II still had trouble travelling around London. My office had moved to the bottom of Whitehall and I had to cross Parlia¬ment Square every morning. Sometimes I couldn't do it and would have to take a taxi, making some feeble excuse such as that I was late for an important meeting.

It was at this time that my future in-laws invited me to join them and Michael on a summer holiday to Wales. I gritted my teeth on the long journey but would not have dreamed of admitting that I felt nervous. My father-in-law to be had been my family doctor all my life — but I never consulted him about my agoraphobia!

I felt relaxed and at ease with my second family, but then Michael announced that he and I were going to walk up Snowdon. Remember I couldn't walk across Parliament Square without feeling ill. I was really stuck. No way was I going to let on that I couldn't face that mountain.
It could have been worse. I kept my head down all the way as I found the open sky too vast and overpowering. I had blisters on my feet and took off my shoes as I felt happier concentrating on my sore feet than on any panicky feelings.

I have photographs to prove we reached the summit, but I couldn't wait to get to the bottom again, pleased to find I felt a sense of achievement. Two weeks later I was back in a taxi circling Parliament Square to get to my office in Whitehall.
Gradually it all faded. I hardly realised how much I was progressing until it became obvious that my nerves were no longer dominating my life. It takes some time to appreciate that one is really free. The biggest bonus was discovering that all the other anxieties disappeared, and instead of being a permanently anxious person with many devastating fears I discovered that I had become less fearful than most of the people I knew, that having trained myself not to worry, I didn't worry. It is possible to change one's life around.

I have described how my life changed when I had overcome my fears, but my crowning success was my wedding day. Four hundred guests in a London church in the middle of Piccadilly - one of my 'panic spots' some years earlier. The service was long and I thoroughly enjoyed every moment without even a frisson of fear. My self-confidence was so high I felt like floating off the ground. I will never forget that day.



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My Panic Attack III

It took a term for the novelty to wear off. The feelings of anxiety which had been pushed below the surface began to trouble me once more and I felt increasingly trapped. Sleeping in a dormitory with rigid rules about not talking after lights out and no reading in bed left me with too much time alone with my thoughts and my out-of-control imagina¬tion. Mealtimes meant more rules and there were no accept¬able excuses to leave the table. Eating became a problem with so many people watching and noticing my jittery behaviour.

At first I was able to cope with services in the school chapel (two each day and three on Sundays) but, inevitably, as the panicky feelings began to recur I found it more and more difficult to sit still until the end of a service.

Lessons were becoming an ordeal too. I would watch the clock: twenty minutes until the bell goes ... ten minutes ... five minutes. Little wonder that I started to slip behind with my school work again when sitting through a forty-minute lesson was purgatory. The feeling of being trapped built up even when I was sitting near a door. There was, of course, no chance of asking to be excused; you might get away with it on one occasion if you could plead an emergency - but not a second time.

i The last straw came when I was told that I had to propose a vote of thanks to a visiting lecturer. It meant standing up in front of the whole school to speak and I knew I couldn't do it. For days - and worse, for nights — beforehand, I lived with this terror, visualising how I was going to make a fool of myself, forgetting what I had to say, breaking down in front of the whole school. My imagination was as usual running out of control and I knew I would not be able to walk on to the stage, smile sweetly and say my piece.

On the day itself I was sick several times and the terror built up and up. There was no way I could tell anyone that I couldn't go through with it, and as the time approached I felt even worse. I ran away from school.

I went back, of course, and I won't go into details of my punishment and disgrace. This was fifty years ago, and no one then would have considered that I might actually have needed help for a psychological problem.

I asked my parents to take me away and let me return to the local high school. Panic attacks and daily assembly would be preferable to a twenty-four-hour school environment. I said I was unhappy at boarding school and told some lurid stories about life in that eminently respectable establishment. Being unhappy was reason enough where my sensible parents were concerned, but I was grilled by the headmistress, house mistress and other members of the staff who insisted on being told why I wanted to leave their precious school.
Was I leaving because I was unpopular? I was indignant about that as I had many friends. Anything wrong at home? Death in the family? Bankruptcy? Divorce? I looked at them blankly and then explained that I was suffering from delayed shellshock after my - mostly imaginary - experiences during the Blitz. Did they believe me? I never found out.

It was such a relief to make yet another fresh start that I felt practically normal again. It didn't last, of course, but as the old feelings crept back, the time had come to do something about the problem. Hauled up before the head, I found out that at the age of sixteen I could at last explain why I was invariably late for school.

At last the adults were sympathetic. During assembly I was allowed to slip into one of the side rooms if I felt unwell. Better still, I was not forced to attend assembly at all but could wait in die classroom until the other girls returned. My form teacher let me sit near the door and I had permission to slip outside the class for a few moments if the tension became unbearable. Would you believe it, as soon as I ceased to feel under pressure I found many of the hitherto impossible situations I had avoided before became tolerable; now I could talk about the things that bothered me and tackle problems such as standing on my head in PE or hanging upside down on the wall bars in the gym, both of which activities invariably made me feel sick and dizzy.

I would take a packed lunch instead of eating with the crowd; but that didn't last long, as I found I was missing out on most of the news and gossip, so I was soon back lunching with my friends. The best thing was that nobody thought there was anything peculiar about me.



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My Panic Attack II

War was looming and we moved to the country. Sometimes at school I would experience fluttery feelings of anxiety, but being fairly stoical I put up with them. After all, my mother had assured me that they couldn't hurt me.
Unfortunately my all too vivid imagination was getting out of control, and as more and more phobias became part of my life I would go out of my way to avoid anything that might upset me. Apart from medical and dental phobias I had a horror of skeletons, people with any deformity, being blind¬folded, hanging upside down (how I hated PE lessons), tunnels, travelling any distance, sleeping away from home, nose-bleeds, abstract thoughts, infinity, cemeteries, clouds, darkness, silence, thunderstorms - and tidal waves! I knew I would never see a tidal wave but the thought was disturbing.

The list was almost endless. There seemed to be so many upsetting things to cope with that I was only really happy in the fantasy world into which I slipped at every available opportunity.

\ School was becoming a problem. Morning assembly became an ordeal which had to be faced every day, but the dread of it was with me every waking moment. Most nights were disturbed by troubled dreams, and at breakfast I would feel sick and tearful, filled with worry about the coming day. The journey to school involved a long walk, a bus ride and another walk. This itself was becoming more and more difficult as panic was always just below the surface, waiting to strike if I allowed myself to stop and think. I became addicted to daydreaming to get away from the situation, pretending to be another more glamorous person triumphing over difficult and heroic situations. In my fantasy world, I was in control.

When filing into the school hall for assembly, my first thought was always what the hymn was for that day and how many verses it ran to. Up to three was bearable but any more and the panic would well up, making me feel sick, dizzy and unsteady. My great dread was that I might faint, though I never did. As things got worse I frequently had to slip out of the hall with the excuse that I felt unwell. There was no point in trying to explain further, I'd tried that and nobody understood.

Then sitting through lessons became difficult, and I was trying to avoid assembly by arriving late to school almost every day. The atmosphere that I had once enjoyed was becoming unbearable: too many people, too much noise — my mind felt overloaded and I could not concentrate on my lessons. I withdrew from my friends, who found me odd'. I still managed to hang on, though too many days off meant my school work was affected.

Strangely enough, the adults around me never suggested I saw a doctor. In those days one was just considered to be a 'difficult* adolescent. In any case, the suggestion of a consultation with a doctor would have filled me with horror. I had to cover up my real problem.

Boarding school, my parents decided, and I went along with this idea. A new start, a different atmosphere. I had read so many books about girls' boarding schools and I knew it was all going to be jolly good fun ... new friends, midnight feasts and lots of practical jokes. Above all there would be no travelling to and from school. The daily journey to my present school was becoming a nightmare in itself. Being privately coached soon helped me to regain my educational level and my confidence was returning when I passed the entrance exam to the new school.



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My Panic Attack

Panic attacks and agoraphobia were part of my life from childhood until my mid-twenties. My mother was agora­phobic and at one time was housebound for two years. I didn't even notice this, mainly because my brother and I, and later our sister, were brought up by a nanny. We had a very happy childhood and a good social life, but I was a nervous child with an over-active imagination. I was happiest when retreating into a fantasy world and weaving stories to entertain my siblings and my friends.

One day I was enjoying my weekly ballet lesson. My mother sat with her friends and smiled encouragingly every time I caught her eye. As the winter afternoon was bleak and dark, someone switched on the lights, and suddenly from being a carefree child I became a nervous wreck for no apparent reason. The noise of the music was overwhelming, the lights were too bright and everything around me seemed unreal. I ran to my mother for reassurance, and after I had calmed down we went home and the family doctor was summoned. It was decided that I was suffering from a reaction to a tonsil operation I had had a few weeks earlier.

These days, I suppose this would have been diagnosed as a panic attack caused by post-traumatic stress, and certainly the experience had been particularly stressful. In the 1930s there was no such thing as a pre-operative sedative; I was wheeled straight into the operating theatre and, amid the frightening sight of surgical instruments and gowned adults, was held down while the rubber mask was placed over my face. I fought against the horrible smell of the gas, screaming with fright as the anaesthetic took effect. I can still remember vividly the sensation of falling and the blackness overcoming me while disembodied voices alternately soothed and scolded me.

Two weeks in hospital did not unduly disturb me and I didn't appear to have any after-effects. In fact, I soon forgot the ordeal and didn't worry abut it until the panic attack when I was dancing.

I never did go back to ballet lessons. I had a few mild panic attacks and felt generally jumpy but my mother reassured me and said the nerves were just something one had to put up with.

Some time later I had to visit the dentist. This was a regular occurrence and did not bother me until I saw the family doctor in the surgery and knew what that meant.. . gas. I fled from the surgery, out of the front door and along the road, pursued by several adults.



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Social Phobic Case Study - Allison

Allison is in her late twenties:

I am a social phobic. My panic attacks started when I was at secondary school. I was always blushing from an early age but hadn't actually experienced panic attacks until I I was directly asked questions in a classroom or had to give presentations. Simply walking into someone I knew would leave me a mess. After leaving school I chose a university course that avoided presentations and tutorials, for I knew that if I had to talk to a group of people my panic attacks would be unbearable.

However, after I arrived at university I found the course had changed and tutorials and presentations were compulsory. I managed to get away with attending the minimum of tutorials or being signed off sick, but every -presentation I had to do would end in a severe panic attack, even after four years. Sometimes the panic attacks would last up to an hour or more, and the embarrassment and shame lasted for a year afterwards. Sometimes I would get -so drunk the night before that I would still knowingly be drunk while doing the presentation the next morning ... the alcohol helped me to avoid a panic attack.

After leaving university I worked in various jobs where I could avoid any position of responsibility and confrontation with others, although tasks such as typing, writing or answering the phone in front of anybody would leave me shaking, flushed, faint, having palpitations and with a numb left arm for anything up to an hour afterwards. If anyone came to talk to me and looked me in the eye, the same things would happen. I could not even carry a cup of tea without having to sit down if I knew someone was watching.

Socially I could not eat in public without severe tremors - or even lift a glass to my mouth in front of anyone. I could not sit at a table with people looking or talking to me without blushing, which would lead to panic attacks. I could not take hold of salt or pepper pots without shaking, or even sign my cheques or Switch receipts in shops. All these things became impossible and I avoided them at all costs - unless, of course, I was drunk first, knowing that the next day the symptoms would then be much worse! If ever I walked into someone I knew, I would have a panic attack when they saw me and so I avoided going out. If anyone stared at me on the tube I would have an attack, and if I was standing up I would feel I was going to pass out, blinded with dizziness and acute panic.

This has been my life for the last five years, and each new counsellor I got I prayed would help - but to no avail. I have had cognitive behaviour therapy, hypnotherapy and done a lot of work myself to try and solve the problem. Nothing worked, much to the dismay of all my counsellors, who knew that I knew what they were going to say next!

So I ended up severely depressed whereas I had not been depressed before. I was ashamed to go to work where everyone felt sorry for me and I left my job. I was scared to go out in public places where I knew I'd meet someone I knew, and as my depression worsened I couldn't face any public place. Sometimes when I was on my own I also, suffered - if I got a piece of food stuck in my throat, if I thought I had left the gas cooker on, if I thought I might be late for something - so it was not just social situations that instigated the panic. Carrying around an enormous and unbearable weight from my throat to my stomach became my life, until I finally accepted the fact that I would have to take medication as I couldn't continue like this.

I was loath to take drugs but took my doctor's advice and am now on an antidepressant which took some weeks to work, but I persisted. This drug has had some side-effects but I am no longer suicidal. The weight has lifted; I can get out of bed, can work and not panic and I can go out in public. Although nobody believes me I would definitely not be here today if it was not for this drug.

Many social phobic young people find school life very difficult. They may be brilliant scholars but they are struggling with their fears of people and find it difficult to settle in school and make the most of their academic talents.

An adolescent social phobic is in a sorry plight, particularly if he also develops agoraphobia, which often happens, causing him to become housebound. Lack of contact with his peers exacerbates the condition and may result in a retreat into daydreams and fantasies, avoiding contact with the real world outside his home and inevitably losing touch with other people. A girl may hope for a romantic hero to arrive at her front door and sweep her off her feet, though she certainly would not be able to cope if he wanted to take her away from the safety of home.

It is especially difficult to persuade adolescents to take part in a treatment programme, as recovery would mean having to face up to the realities of normal everyday life.

Some older women who have become housebound may focus all their emotions on to a well-known celebrity - often an actor or a pop singer, and often dead (safer). Recently there was a television documentary about a woman who was in love with Elvis Presley, and her restricted life revolved around the singer, his recordings and a mountain of other memorabilia.

It is not only in the Western world that social phobia is a problem. In Japan, 1.2 million young people, 75 per cent of them boys and young men, suffer from severe social phobia known as bikikomori. They become completely isolated in their bedrooms, refusing to see or speak to anyone, including their own parents. Their families are so devastatingly embarrassed and ashamed that they keep it a secret and virtually isolate themselves. Because of their embarrassment the condition is only just becoming recognised, and at last counsellors are being trained to help the sufferers and the rest of their family.

It is suggested that the problem arises because of the huge pressures young people are under to succeed at school. They often start by developing school phobia and agoraphobia as they begin to avoid school Severe social phobia develops from there, and the sufferer retreats from the outside world altogether.
This state of affairs wouldn't arise in Great Britain as therapy is available, although the waiting lists may be long. In the meantime, the phobia organisations can offer advice and practical help.



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Scial Phobic - Eating In Public

Another problem the social phobic has is eating in public, particularly in a restaurant or at an important social function, though some people may find the experience of eating with just a couple of friends or even members of the family equally distressing.

Rose, aged twenty-two, had an unfortunate experience: when lunching with a group of old school friends, she had to eave the table, feeling unwell and nauseous.

I could not rejoin them because the feelings just over¬whelmed me again, and although my friends were sympath¬etic I felt ashamed and embarrassed. Since that time I have felt unable to eat in front of other people. As I am to be married in six months' time the thought of the wedding reception is with me the whole time and I live in dread of the occasion.
I make no excuses for including all these examples of social phobia. I feel it is important that people understand just how life-disrupting this problem can be for the sufferer.

Blushing is a major problem for those who feel the need to hide their fears from other people. A scarlet face is impossible to conceal and inevitably draws attention to the blusher and comments from their companions.

Martin: I have been a social phobic since I was a child of ten years old. Even before this age I had other phobias and terrible anxiety. This phobia has ruined my whole life. The main symptom is a terrible fear of blushing, which happens instantly in nearly every social situation. The way I deal with these situations may sound pitiful to others who can't possibly imagine how it feels.

At the age of eleven in school I used to sit always against a wall so that one side of my face would be covered. Nobody could see that side because of the wall. Then I would rest my elbow on the desk and cover my other cheek by resting it in my hand. 1 would literally be trying to hide my face from everyone. I would avoid any group situation and I used to spend hours walking the playing fields on my own, avoiding contact with anyone.

Other ways I would try to deal with this phobia were to pretend I had a cold or flu and whenever someone spoke to me I would take my handkerchief and blow my nose (another way of hiding my face). At other times I have burned my face on purpose with a sun lamp so that no one could see when I was blushing. I was teased and ridiculed in school, even by my so-called friends.

I can still recall the terrible anxiety that I felt from 9.00 till 3.45 every day of the week. However, it didn't end there because the phobia applied to absolutely everybody, so when I got home I couldn't eat with my parents. I would take my food on a tray to the darkest room in the house to eat it, as I was ashamed of blushing in front of my family, and unfortunately today at the age of thirty-five I still am.

Because of PAX I have been able to face up to the problem and seek help at last. Though I have a long way to go I am determined to overcome this, having tackled the first obstacle - learning that it doesn't matter.



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Social Phobias and Panic Attacks

Dr Alan Wade, a GP from Clydebank, became aware of the condition through his interest in phobias and panic attacks.

'Sufferers grossly underachieve/ he says. They often don't earn as much as the average person and favour solitary jobs where they can avoid scrutiny. They may even choose t& be unemployed because they can't face going out. They are prone to depression and other disorders such as agoraphobia, which has similar symptoms.

These phobias do not evoke much sympathy in those who have never experienced them. On the whole they seem trivial and sufferers do their best to hide them, feeling that they might be laughed at. Walking past a line of people standing at a bank counter, writing a cheque, speaking in front of a class - such simple actions for most of us, but agonising for many social phobia sufferers.

How can a visit to the bank be as traumatic as a visit to the dentist? It is the way that a phobic person's mind works ¬always jumping ahead, expecting the worst. One member of PAX explains his fear of his bank and the thoughts that run through his mind.

There are a lot of people waiting, I feel trapped already. I should have checked how much there is in my account. Supposing there isn't enough to cover this cheque? Why is the bank clerk looking at me in that funny way? What is the computer telling her? Why has she walked away? Everyone is looking at me.
By this time he can hardly take his money because his hand is shaking so much.

Another PAX member, this time a woman, wrote;

I cannot bear to be looked at. I am afraid I might do something silly, make a fool of myself, make a mistake or lose control in some way. More than anything I am afraid of anyone KNOWING I'm afraid.

Again, the problem is the need to escape before she commits the dreadful crime of drawing attention to herself. As we see, this is closely linked to the agoraphobic state. Avoiding social situations means that she may become housebound, but unlike the agoraphobic who can find sanctuary from her fears in her home, the social phobic finds that her problems follow her indoors.
To this person, the arrival of an unexpected caller can be a disaster. The sound of the doorbell, a knock on the door, sets off warning signals. Who is it? Why are they here? What do they want? These thoughts flash through her mind as she ducks into a corner where she cannot be seen. Her heart races, her mouth dries up as she feels the situation is getting out of hand and she won’t be able to cope. The only thing to do is to stay hidden until they go away. Unfortunately there are times when visitors must be faced,



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Social Agoraphobia Sufferer - Escape to Safety

The agoraphobia sufferer has a need to escape to safety. She may be in a crowd of people, she may be alone in her phobic situation, but she feels trapped by her inability to detach herself quickly from the place where she is un¬comfortable and escape to her home or somewhere where she feels safe.

The person who suffers from social phobia does not have the same need to escape from a situation; it is other people he finds threatening, He cannot bear to be looked at, to have his body space invaded, to be touched, even inadvertently. Some sufferers find it physically impossible to touch or be touched by anyone other than members of their own immediate family.

Social phobics feel they are under scrutiny all the time; they imagine that all eyes are upon them and experience symptoms of acute anxiety, displaying outward signs of distress such as blushing, sweating and hyperventilating which they are sure everyone notices and despises them for. They are afraid of drawing attention to themselves, of being embarrassed by making a mistake or making fools of themselves. At the root of their shame is a fear of losing control in some way or not being able to continue what they are doing while they are being watched.

Social phobics often find themselves unable to relate to other people on any sort of personal level. They may have difficulty in expressing their emotions and feel that they cannot get close to others physically or emotionally; often, they are children who have had an over-protected upbringing, have not developed a sense of independence and are therefore unable to function adequately in an adult social world.



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Social Phobia - Other people are quite dreadful The only possible society is oneself

A cure for shyness!' Newspaper headlines in the late 1990s were quickly taken up by the programme This Morning when Richard Madeley and Judy Finnegan told the nation that this new drug would transform the lives of people who suffered from devastating shyness. In fact, this drug - Seroxat (Paroxetine), an antidepressant - was not new. ?or several years it had been prescribed for depression, panic attacks and agoraphobia, and a large number of PAX members were finding it very helpful towards over¬coming their problems. Recently, though, Seroxat had been hailed as the new treatment for social phobias and acute shyness.

This Mornings presenters announced that they would hand out supplies of the drug to volunteers, who would be asked to try it out Tor a few days' and then report back to the programme, hopefully to tell viewers that their shyness had disappeared and that they were able to enjoy a full social life once more.
Fortunately, some concerned doctors and some of us involved in the phobia organisations managed to stop this irresponsible experiment before it got under way. Can you imagine the hopes raised and then dashed to the ground? Of course, the drug has been of great help to thousands with anxiety problems, but it takes a good three weeks to act and it needs to be prescribed by a doctor or psychiatrist, preferably in conjunction with further therapy.

What a fuss to make about being shy, you might think. After all, thousands and thousands of people suffer from shyness and a lack of self-confidence. Surely it is a matter of facing up to life and tackling problems, something that would automatically improve with maturity.

Social phobia is a growing problem which affects equal numbers of men and women, unlike agoraphobia, which is a condition more often attributed to women, though there is a considerable overlap between social phobia and agoraphobia.



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PAX newsletters

PAX newsletters are full of enthusiastic reports from recovering members.
Penny (thirty): I was never completely housebound but was heading that way. My GP prescribed Seroxat, and although it took several weeks before I noticed any effect it has been extremely helpful. I was told by my GP that I also needed to see a cognitive behavioural therapist as I could not rely on drugs for ever and must learn how to manage panic attacks if they returned. I found this a rather depressing outlook. Eventually I did see a behaviourist, by which time my GP had weaned me off Seroxat, encouraging me to try and do without it.

Unfortunately the panic attacks returned. It had been so easy to live a normal, panic-free life and I rather resented finding myself back to square one. I had to learn to tolerate the panics - though it took several attempts to get through the first occasions when I had to stand outside the super¬market. I didn't know it at the time, but my husband was hovering about, out of my sight. He wasn't convinced that wasn't going to react badly, collapse or burst into tears. The therapist wasn't too pleased when he found out and Richard was told quite firmly that he was to keep right way and let me work towards recovery on my own, without im fussing around me.

I realised how much I had depended on Richard's support in the past, but it was pointed out to both of us that his attitude was holding me back.

After four months I can now shop in the supermarket on my own. I still dread the panic attacks but am learning to tolerate them. My next step is a train journey - alone. I would feel happier if the trains were more reliable, as they are inclined to stop sometimes for fifteen minutes between stations. If this happens I shall look on this as an oppor¬tunity to put into practice all I have been taught about going through panic.

Many people have written to me who are having professional help and making progress with their recovery, and remind me about the late Dr Claire Weekes. In the 1960s her books helped thousands, and her advice is as appropriate today as it was forty years ago when Self Help for Your Nerves was the most requested book in libraries all over the world.

William wrote to the PAX newsletter:
I am a man of thirty-one and a recovered agoraphobic (note 'recovered', not 'recovering'). I have had six months of treatment - behavioural therapy at my local hospital - and I am for ever grateful to those who have helped me tackle my fears and overcome them.
I also attribute much of my present happy state to Claire Weekes, the Australian doctor whose books helped me through the worst time in my life when suffering constant panic attacks. I had to be persuaded by my mother to look at these books - I thought they were just for neurotic women.

Dr Weekes teaches four concepts of fear:
Face fear - do not run away.
Accept fear - do not fight it.
Float through fear - do not run away.
Let time pass - do not be impatient.

I would urge fellow PAX members to read Self Help for Your Nerves.



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Only Way Tackle Agoraphobia

Those of us who have emerged from the shadow of agoraphobia know that there is only one way to tackle it, and that is by exposure to the situations which you feel you cannot face - exposure to the situation and exposure to the unpleasant symptoms. Agoraphobics are inclined to judge their progress on their ability not to feel panic. Two or three panic-free trips to the supermarket; they are doing really well. Then on the next occasion the old frightening feelings come flooding back and it's back to square one again.

Face the fear. Enter into the phobic situation. Sounds simple and easy to do, but it can seem an insurmountable task for the agoraphobic. The most traumatic approach is known as flooding, where the patient is exposed to her most dreaded situation and encouraged to remain within it, experiencing the worst sensations that her phobia can produce, facing the panic feelings and the distress that follows until the peak is past and the symptoms gradually evaporate. This might take a few minutes, or it might take an hour or two, but the important point is that the sufferer stands her ground until the anxiety starts to lessen, and has to be prepared to remain "until it does.

The patient's fear is that her system cannot tolerate the acute phase of a panic attack, that there must be some terrible climax which will prove fatal. This is not so; when the panic feelings reach a peak there is only one way they can go -down. They will gradually subside and the sufferer will find herself sick and shaky but still in one piece ... and a step nearer recovery.

There is no doubt that such an experience is more exhaust¬ing than exhilarating, but it cannot be denied that if she is well prepared by her therapist and has the motivation and the courage to co-operate, this can be the fastest way to overcome agoraphobia.

Systematic desensitisation was popular in the 1970s as this as a more acceptable form of therapy for the patients. It involved learning to relax completely before visualising the phobic situations that the agoraphobic most feared. Learning o curb her out-of-control imagination was difficult, but the therapist would then guide her to the next stage - actually going to these places and finding that she could tolerate them without experiencing a panic attack.

This approach was very time-consuming for the therapist and unrealistic for the patient who, happily acclimatising herself to the phobic situations, was unprepared when a panic attack did materialise, didn't know how to cope with it and became disillusioned with the treatment.

These days the patient is instructed to take a different view of her phobia, changing her negative attitude towards e problem ('I know I shall have a panic attach) and telling herself instead, 'I shall probably feel panicky but I am no longer frightened by the thought of this as I understand how to over¬come it!

Instead of the flooding approach, where the agoraphobic was plunged into her worst nightmare and forced to endure the panic until it peaked then subsided, she is now instructed by her therapist to take it a step at a time.

She is told to 'construct a hierarchy' - making a list of her phobic situations ranging from the very mild to the most alarming. Listing them from one to ten, she will then proceed up the scale, learning to tolerate each one before progressing to one she finds more difficult.

The object of the exercise is not to try and avoid a panic attack but to actively encourage it to do its worst. Knowing that it is not going to damage her in any way, the agoraphobic goes through the experience, emerging at the end unscathed. Unlike the flooding technique the process is gradual, and the patient does not have to tackle her worst fears until she is well prepared.



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Travelling is the agoraphobic's worst nightmare

Travelling is the agoraphobic's worst nightmare, particularly if he has to use public transport. Mingling with fellow travellers, waiting interminably for a bus or train while the anxiety grows, having to stand because there are no available seats - these are all situations which the sufferer dreads, believing that he is not going to survive without making an exhibition of himself.

Jo (sixteen): I have to take two buses and walk half a mile to school each day. Several of us travel together but I couldn't manage on my own. I live in dread that my friends might be ill or not coming to school that day for some reason. It is the walk that I feel I can't face. I dream about it most nights and see myself losing control, fainting or screaming. I never have fainted but the thought hangs over me like a dark cloud.

My doctor says I have agoraphobia and has put me on a waiting list for treatment at the hospital. He was a bit vague about what sort of therapy I will need and I am now very worried because I don't know what to expect. I've read about electro-convulsive therapy: I don't think I could face that. My imagination is working overtime filling me with fear and dread.

Although Jo's agoraphobia is fairly mild it could get worse if she doesn't have some help now. She could probably get help from one of the phobia organisations but as she is on a hospital waiting list it is important for her to know what to expect. Not ECT, for a start. One of the reasons so many agoraphobics refused to seek treatment in the past was that they knew the condition was often treated by electro-convul­sive therapy. Forty years ago, when it was assumed that agoraphobia was automatically linked with depression, many people underwent shock treatment for something they did not suffer from - it did nothing for their phobia. Depressed? Of course they were depressed: they were faced with the possibility of becoming permanently housebound and no one could explain to them exactly what was the matter. In the majority of cases the depression was caused by the agoraphobia, not vice versa.

There is a school of thought which feels that the cause of agoraphobia must be identified before the patient can be helped through analysis and psychotherapy, and it is obvious that if someone is seriously disturbed, psychotherapy will be a vital part of their treatment. However, most agoraphobics can pinpoint the onset of their condition to a time following a major upset in their lives.



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Common Contributing Factors that Cause Teen's Depression

Genes

Genes are materials in the cell that determine our physical and other charac­teristics such as eye color, height, and blood type and are passed on from one gen­eration to the next. Probably several genes are involved in depression, and families with histories of alcohol or anxiety problems also carry a higher risk of depression. This does not mean that if a parent has depression (or bipolar disorder), that the child will have depression (or bipolar). In fact, when a first-degree relative of a child (parent or sibling) has depression, there is a 1.5 percent chance of the child being depressed and 16 percent chance they will have bipolar disorder. Likewise, if a first-degree relative has bipolar disorder, the child has a 4.5 percent chance of becoming bipolar and a 14 percent chance of experiencing depression. The bottom line is, most children of depressed parents do not become depressed, but they are at higher risk than the average child.

Brain Chemicals

A number of brain chemicals, or neurotransmitters, help brain cells communi­cate with one another. Serotonin and norepinephrine are two such chemicals, and people who are depressed tend to have lower than average levels of these chemicals in certain parts of the brain. Because medications that increase levels of either of these chemicals tend to be helpful in about 80 percent of depressed people, we con­clude that many people have a biological basis for their depression. However, these brain chemicals are also influenced by environmental factors. Children who are abused, for example, can have altered brain chemistry associated with their abuse.


Kindling

Once the brain gets used to thinking in depressed ways, it becomes progressively easier to slip into these depressed thinking patterns in response to problems. This "kindling" (or tendency for commonly used thinking styles to become automatic) is one reason why early treatment of depression is so important!

Life stress

Most people respond to stress with a "fight or flight" response, to either deal with the stress or escape it. Depression occurs in reaction to stress only when the stress is either:

1)too great to deal with (for example, a major loss); or

2)repeated and perceived to be inescapable (termed "learned helplessness"). Stress often acts as a trigger for an episode of depression.

Learned Helplessness

Learned helplessness (the perception that stress is inescapable) is particularly prob­lematic, because it interferes with the desire to help oneself. After all, what's the point in trying to change things if you can't reduce the stress anyway? Eventually, this attitude leads to hopelessness and despair. Some theorists link most or all depression to this state of mind.

In most cases, depression is due to a combination of several of these factors and not just one alone.



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Agoraphobia And Driving Phobia

Unfortunately, agoraphobia/driving phobia seems to be on the increase, among both men and women. On motorways in particular, nervous feelings begin to build up when surrounded by heavy trucks belting along, spraying smaller cars with water, mud and dust. It might be ten miles to the next turn-off, time to let anxiety build up until the driver finds the tension unbearable. He cannot stop, and feels as though he is whirling into space and there is no escape.

Ken: Driving along the motorway at around sixty miles an hour, I thought I must have been in an accident and died, the sensation was so weird and 'out of this world'. After the first flash of fear I managed to drive on to the hard shoulder and pull up. By that time I was shaking violently, sweat was pouring from me and I felt as though a great weight was pressing on me, stopping me from breathing. It was no accident, I realised, but by then I was convinced I was having a heart attack. There was no way I could get out of the car to get help; I just sat there trying to make sense out of the totally unreal feelings. After some five minutes things began to get back to normal and I nervously started the car, creeping along cautiously, hoping I would reach the next exit safely. Once off the motorway I felt slightly better and eventually got home.

Unfortunately this has happened a couple of times since. I am a professional man in my forties and consider myself pretty well-balanced. These episodes have shaken me badly; I now wait for the next attack to hit me and am beginning to feel that somehow I am going to have to avoid motorways altogether.



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Women's Phobia

Women, of course, always accepted in earlier times to have a more delicate constitution, were not so reticent about admit¬ting to nervous problems. There are many examples during the last hundred years or so of women who were quite possibly suffering from what we would now recognise as agoraphobia. Shock, anxiety, frustration and physical ill health often lie behind the development of agoraphobic symptoms. How many swooning Victorian matrons languished on their day¬beds? How many wilting maidens suffered fits of Vapours' or slipped into a decline that might today be recognised as agoraphobia?

In later life, Florence Nightingale, with no physical outlet for her tremendous nervous energy, became housebound and was a semi-invalid for many years. After the shock of Prince Albert's death, Queen Victoria retreated from public life, unable to face her subjects en masse. Elizabeth Barrett was confined to her couch with physical symptoms which miracu¬lously improved after Robert Browning whisked her off to Italy and married her. Retrospectively we can only guess, but each of these ladies displayed classic agoraphobic tendencies. Even in fiction there is Charles Dickens' Miss Havisham in Great Expectations, housebound since being jilted on her wedding day.

Not all agoraphobia sufferers experience constant panic attacks. Some people, women in particular, may become housebound for a variety of reasons, resulting in a loss of confidence and unwillingness to leave the house. The longer this lasts, the more nervous the subject becomes as the outside world appears hostile and threatening. If she is persuaded to go further than her base she may well experience rising anxiety, leading to a full-blown panic attack.

Many agoraphobics are free from their fear when driving because the family car can feel like an extension of the home; like a snail or a tortoise, these sufferers would like to carry with them a permanent shell into which they can retreat at any time.



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Phobiaas History: fact and fiction

Phobias are not a phenomenon of contemporary life; through the ages people have suffered from a variety of phobias, but it is interesting to find that there are few historical references to omen being affected. This does not mean that women did suffer from them, but probably reflects the sexist bias that only events happening to men were worth recording!

Apparently there was no shame attached to a man admitting to a specific phobia, but when agoraphobia, with its background of sudden panic attacks, became recognised, it quickly came to be considered a woman's problem. Described the housebound housewife's complaint or the 'empty nest syndrome', it was linked with menopausal women whose children had left home. Even more alarming, until recent years agoraphobia was known as the 'Latent Prostitute Syndrome' and still is in some Scandinavian countries. This assumes that these women are afraid that unmanageable sexual urges might cause them to attack a man in the street. Therefore it is safer for them to stay indoors away from temptation!
It is hardly surprising that agoraphobic men disliked being identified as suffering from the condition as they battled on, determined to lead as normal a life as possible. Many men have a horror of anyone knowing they are agoraphobic, as there is often a definite possibility of jobs being at risk and careers ruined if their 'weakness' is exposed. At one time there were a number of well-known men in The Open Door -television and other media personalities, an eminent lawyer, several doctors and even a Member of Parliament. The late Roy Plomley, famous for his programme Desert Island Discs, admitted (privately) that he could imagine nothing more traumatic than being stranded on an island with no possibility of escape. Roy's agoraphobia was so bad that his wife had to drive him to and from the BBC; he couldn't travel on his own by public transport, nor could he drive his car alone.

There are, of course, a few recorded incidences of male agoraphobics, including - of all people - Sigmund Freud, who for several years had a fear of travelling and became so anxious that he would arrive at a station an hour before his train was due to leave.



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Men Suffer Agoraphobia Too

In the early days of The Open Door (TOD) it was thought that as many as 90 per cent of agoraphobics were women. Now it is recognised as being around 75 per cent.

In the 1960s when I started TOD all our publicity was through women's magazines, with articles such as 'A prisoner in her own home', accompanied by photographs of a middle-aged woman peering anxiously through her net curtains. Programmes such as Woman's Hour featured such women, and all the agony aunts in the women's magazines reassured sufferers from panic attacks and agoraphobia, referring them to TOD and the other phobia organisations then springing up. No one seemed concerned about any men who might be experiencing the same problems until the 1970s, when the media began to acknowledge this.

At last, newspapers, radio and TV featured male agoraphobics and how their lives were affected by the condition. At once the phobia organisations began to hear from more and more men, many of them in their early twenties, which was a surprise to some of us. Until then, agoraphobia been assumed to be a female disorder.



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