[Juliana]

Hi there. I just thought I would share something that really helped me. I had severe agoraphobia for 3 years. Eventually, I got some treatment and started taking Celexa and Clonazepam and going to a Cognitive Behaviour Therapist. They were very helpful. I started getting out of my house occasionally, but my panic attacks were severe. I was getting frustrated by feeling that everything was one step forward and 3 steps back.

After about 5 months of this, I decided to do something that my psychiatrist thought was drastic. I hadn't worked in 4 years, but I decided I wanted to go back to full-time work. I saw a job I wanted and I applied for it. My psychiatrist didn't think I was ready, but my CBT told me to go for it.

He called it "flooding." It's something that some therapists walk their patients though, but I decided to do it by myself. I had reached a point where I just wanted to get on with my life. I was tired of THINKING about doing things and WORRYING about doing things. I just wanted to DO them! I went to the job interview and got the job. (For some reason, job interviews have always been very easy for me and I didn't find the interview process panic-inducing.)

I was terrified about going back to work, though. I was at a point in my recovery where I was only leaving my home for short periods of time each day and still having panic attacks. I was still too phobic to get on a bus, but I decided to challenge myself in a big way. I played the "What's the worst thing that can happen?" game with myself. I figured that the worst thing that could happen would be that I would get to the new job, have panic attacks constantly, freak out, not be able to handle it and have to leave and never go back. It would suck, but it wouldn't be the end of the world. It was a risk I was willing to take. I wanted my life back. I felt like I had wasted too much time already.

I ended up succeeding. Anticipation of the first day was so nerve-wracking, but I found that once I was at my new workplace, I was so distracted, so focused on learning new things, doing my work, meeting new people, etc. there was very little time for the panic to sneak in. Distraction has always been my best defence against panic attacks. I wasn't having to force distractions, though. There was so much going on, I was just naturally distracted from the panic. I still had panic attacks occasionally, of course, but I learned to deal with them. I reminded myself they were going to pass and I reminded myself that I didn't want to go back to sitting in my flat alone every day. Over time, it got much, much easier. I'm almost panic-free now. I have an even better job now that's much more demanding and I feel like I'm almost back to being the person I was before I got sick. I don't think I would have gotten to this point this quickly if I hadn't just jumped in and taken a "sink or swim" approach. I did it out of desperation, but it worked for me.

To help me along with the stress of going back to work, I did lots of walking and did yoga a few times a week. I find that exercise clears my head, calms me down and alleviates a lot of my anxiety. Yoga is amazing for relaxing me and yogic deep breathing is incredibly useful in everyday situations when you want to calm anxiety or get through a panic attack.

Just thought I would share what worked for me in case it's something that could work for someone else in a similar situation.

[(JD)]

Good for you! Glad it worked and that your T was supportive. Of course, you were really ready, weren't you!?

I wouldn't advise anyone to do this on their own, as they can end up worse than before, and quite traumatized. Exposure therapy needs to be that, imo, therapy. Mere exposure doesn't heal us. However I suspect you had a good handle on what to expect and how to manage, along with two doctors who were there just in case.

[Juliana]

Exactly, Sky. I would NOT have been ready for flooding without treatment with meds and two therapists working with me for months beforehand. I would NOT recommend that someone throw themselves into it without a whole lot of support and guidance from a professional. There's no way I could have done it 6 months earlier. I was having meltdowns just stepping on my back deck and panicking when I had to go down my front stairs to get the mail inside the front door. There's NO way I could have gone to work. It would have been extremely traumatizing.

I think it's a viable option for people who are feeling like they've come along quite far in their recovery and feel up for a challenge, though. It's important to have a supportive therapist. I had the cellphone number of my therapist memorized and he told me that I could call him at any time during my work day. That gave me some comfort. I'm glad I did things the way I did. Easing my way back into things was getting frustrating and I was finding that I was over-thinking things (I have a tendency to do that). I think flooding can be helpful for some people. I wasn't even aware that there was such a thing. When I told my therapist what I was thinking about doing, he said to me, "That's flooding." So, I just wanted to mention it in case it turns out to be a reasonable option for someone else.

[drclay]

Very interesting discussion.

Juliana's description of her dealing with panic and agrophobia in order to go back to work is beautiful, especially when paired with _Sky's comment about the dangers faced when confronting fears by yourself. Having an experienced therapist or a supportive, cautious friend with you is crucial, I think.

I'd be really interested in people's opinions about my description of confronting fears at http://www.psychologicalselfhelp.org...chap5_115.html

You are dealing some pretty heavy stuff here. But the consequences doing nothing are very serious.

DrClay

i read your chapter nine. i've never used therapy or drugs to overcome my serious fears.

i was born in 1943 to very poor parents and learned early that not doing what you needed to do was probably going to affect you in a not so pleasant way. i.e. you the bulld that you were afraid of..... you rode the horse that bucked you off occasionally or ran off with you...you looked for strays where you knew there were bears..then being too fearful to ride the schoolbus with the lecherous driver meant you didn't get to school and you couldn't have a perfect attendance. (you didn't tell that sort of thing then to an adult)

as an adult, i just continued trudging down that path and faced off whatever i had to. the first time i went on a major, major photography assignment i was so scared that i couldn't talk....but the creative side of me was the stronger side. so i stayed and got the job done. the first time i camped in 20,000 acres (with only my dogs) i was so scared i couldn't sleep. but i wanted those photographs more than i wanted the sleep.

i've been in charge of patients that i was fearful of, but never let it show.

but......i do have "anxiety attacks" over meaningless, to me, small things. i occasionally take a med for it and meditate and play ALOT of music. (did i pay that bill or take that book back or something minor and i build it into a "bigger" issue for awhile.)

but as far as letting a big fear get the best of my work, i wasn't given that choice as a child and i've never taken it was an adult.

i don't know if this interests you, but it's how i've dealt with fear all of my life. i've turned in portfolios, interviewed subjects and fell flat on my face. but there's a part of me that gets back on the horse.

[drclay]

fayerody:

I was impressed with your history. Us poor kids have changes to learn things that protected kids don't learn. I like your attitude of "getting back on the horse" especially if you don't fall off after that.

You said you read my Chapter nine, maybe you meant Chapter five.

I like to hear of stories like yours. They give the rest of us home and courage.

drclay

[Juliana]

I can totally relate to your post, fayerody. Before I got agoraphobia, I was very good at facing fears. I started performing on stage (competing in music festivals) at the age of 6. I learned to calm my nerves. Having to deal with some nervousness was well worth the pay off -- getting to do something I loved -- singing or playing piano for an audience.

I was always calm and focused and confident in job interviews and client presentations. I just focused on how much I wanted the job or the account. I refused to let nervousness or fear interfere with my goals. My family was poor when I was growing up. I knew that I was on my own when it came to financial stuff. If I didn't work my butt off to get into the university of my choice, keep my grades up to get scholarships, apply for (and get) good part-time jobs to help pay my school fees and buy some food, no one was going to do it for me. The same determination was with me throughout my career.

I have always had a fear of heights. About 10 years ago, one of my biggest clients was a hockey team. I was working on their promotional materials and wanted some clear shots of the logo at centre ice. They lowered the score clock down to a few feet above the ice and I had to climb in (it was a small-room-sized box with a 2' x 2' square cut out of the floor). They hoisted this thing up on pulleys (swinging one side first, then the other, etc.) all the way up to the top of the arena. I was shaking and scared, but I wanted those photos. I had to lie down on the floor of the score clock, and lean the top of my body out of the hole in the floor to take the shots. Despite my fear, I managed to focus and get some great shots.

So, I always felt like I could face my fears very well. I wasn't fearless, but I didn't let fear stop me from doing anything. That all changed when I got agoraphobia and panic attacks, though. It was like I was blindsided. It happened suddenly. I was 31 years old and had been struggling through a severe case of Benign Paroxysmal Vertigo. It was physically debilitating. Suddenly, all my coping techniques seemed to disappear and even when the BPPV got better, my former self didn't return. I felt like I didn't have my rational side with me anymore. I couldn't talk myself through the fears. That ability was just gone and I was left with overwhelming physical symptoms (nausea, shaking, inability to swallow) and just sheer panic when faced with the simplest of tasks.

So, I don't fully understand WHY it happened. It never occurred to me that I could get agoraphobia. I was a confident, outgoing person before it happened. I'm much better now and have relearned the coping techniques that used to come naturally to me. I'm starting to feel like my former self again.

While I was going through the worst of the agoraphobia and panic attacks, though, rational thinking and all my previous coping techniques just didn't work. There's a lot of interesting information in Dr. Clay's chapter about challenging and facing fears. I'm sure many people would find it helpful. A lot of those techniques were things that I put into practice in my daily life before I got agoraphobia and I use a lot of those techniques now that I have recovered (ALMOST fully recovered). When I was in the throes of agoraphobia, though, I couldn't even force myself to stand on my own back deck for 5 minutes. My rational coping skills were gone. There was so much panic and the physical symptoms were so overwhelming, I couldn't access the rational part of my self. All I could feel was nausea, shaking, the choking feeling of not being able to swallow. Rational thought didn't stand a chance. It couldn't compete with all of that stuff.

i'm sorry.........i'm under so much stress right now (neighbors were fighting dogs) that i read 9 and couldn't figure out how it related. but i "got back on the horse" and read it anyway...... i'll go read 5 now....... thank you for your kind words. growing up very poor is a very good way to learn a lot early.

juliana, i also went through a time of agoraphobia. very intense. and being rational about it did zilch. i tried all the suggestions, read the books, did it all........couldn't leave house to go to T........

i loved your hockey story. i wanted a photo of rodeo cowboys, bulldogging......but i wanted it from the back of the action. the stock producer let me climb up on the chute and straddle the chute right over the steer that was going to run out...i thought i was going to die.....when those quarter horses took off, the earth shook. but it's one of my best shots and it's in a museum in New Mexico. we can do those things and then blam!

i've recovered from the agoraphobia and still do the death defying stuff. i was in my 50s when i took the rodeo shot.

Dr. Clay, do you think any of this resilence is inherited or is it environmental? thanks, pat

[Juliana]

Your rodeo shot sounds awesome! That is so cool that it's in a museum. I would LOVE to see it. I find that the creative drive is SO strong... it can push us to do things that scare us. It can be much stronger than fear.

It really is confusing isn't it... We can do these amazing things, face our fears, seem fearless to other people... but then BAMMO! agoraphobia strikes. I flew to Chicago this summer to interview the lead singer of my favourite band. So many of my friends were saying they would be too nervous to do that, but me... a former agoraphobe, still struggling with panic attacks... I was just psyched! I wanted to meet him and I wanted that interview.

I'm so glad your agoraphobia is a thing of the past too.

That question you posed to Dr. Clay is a good one. I always thought I was just a naturally confident, outgoing person. It seemed like I was just born that way... and I feel that way again now most of the time. There was a 4 year blip of agoraphobia and panic attacks, though. That still doesn't make sense to me.

[Juliana]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
fayerody said:
Dr. Clay, do you think any of this resilence is inherited or is it environmental? thanks, pat

</div></font></blockquote><font class="post">

I just noticed your use of the word "resilience." That's interesting. Whenever I have faced tough challenges, my dad's "advice" to me is always the same. "Sweetie, you're resilient ." He's right and I always remind myself of that when I'm facing something I don't think I can handle. Of all the talents and gifts and abilities I have, resilience is the one that has been the most useful and the one I'm most thankful for.

juliana, i'll try to find a small copy of it and post it in the gallery.

i'm dying to know what Dr. Clay thinks about our question........i just always "bounce" back.......even when it seemed i might not.

[Wants2Fly]

Excellent discussion. I am reading with great interest. Do post your photo, Pat.

[Juliana]

Oh, please do post your photo. I would love to see it.

Can you do me a favour? When you post it, can you let me know and tell me where to find it? I'm still quite new here and having trouble navigating. I have a lousy sense of direction.

i am going to post another "bulldogging" photo and you can see how close i was to the action. i haven't found the smaller one that i want you to see. i'm afraid it is filed away in a stacked box somewhere. the one that i did find is too big for me to scan. but i'll keep looking.

click on photos....it's up on the top of our page. look under "member galleries" and click on "f".....my name will come up.......xoxox pat

[drclay]

Juliana:

I think your posts are very helpful because they make no bones about flooding being difficult, hard work. And if you just push yourself to do something scary for a little while and then give up, the fear and panic will be worse (you have reinforced and trained the fear response to respond). So, you need to keep pushing to do hard, scary things until they become less scary with practice. You illustrate those points well.

Good for your CB therapist!

drclay

[drclay]

fayerody:

All real life experiences interest me, even the self-help experiences that don't work or do harm. We are just learning here.

drclay

drclay

[drclay]

fayerody:

You asked: "Dr. Clay, do you think any of this resilence is inherited or is it environmental? thanks, pat "

I'm pretty convinced that both the positive (strength, e.g. resilence) and the negative side (weakness, e.g. panic withdrawal) are influenced by one's genes and by one's learning experiences. And the strength of the + and- varies by age and your learning history and other stuff we don't know about yet. I think we will take decades to learn about the sources of our emotions, although many people can clearly see where their emotions come from.

I know this isn't a very helpful answer. Maybe in time we will learn that we, as individuals are strongly influcened by our genes in certain specific ways. That would help understand ourselves but it is certain that many life experiences with scary situations influence our panic reactions and influence our confidence in our calming/coping mechanisms. Do you agree?

drclay

[Juliana]

Thanks Dr. Clay. My therapist was the best. He was a PhD psychology student and I was one of his first CBT patients. He was far more helpful than any of the psychiatrists I have seen. (No offense to psychiatrists; I'm sure there are great ones out there, but I haven't had much luck in that department.)

[drclay]

Addition to my comment about genes vs. learning experiences in the creation of fears. I should have said more:

Maybe it doesn't make much difference if genes or experiences play a major role in arousing a fear response because the treatment of a fear usually consists of learning to be calm in the previously fearful situation. Exposure and learning new ways of coping are possibilities. Don't forget there are ways to overcome fears without experiencing the usual experience of exposure. Read about desensitization in my Chapter 12.

drclay

</font><blockquote><div id="quote"><font class="small">Quote:</font>
drclay said:
fayerody:

You asked: "Dr. Clay, do you think any of this resilence is inherited or is it environmental? thanks, pat "

I'm pretty convinced that both the positive (strength, e.g. resilence) and the negative side (weakness, e.g. panic withdrawal) are influenced by one's genes and by one's learning experiences. And the strength of the + and- varies by age and your learning history and other stuff we don't know about yet. I think we will take decades to learn about the sources of our emotions, although many people can clearly see where their emotions come from.

I know this isn't a very helpful answer. Maybe in time we will learn that we, as individuals are strongly influcened by our genes in certain specific ways. That would help understand ourselves but it is certain that many life experiences with scary situations influence our panic reactions and influence our confidence in our calming/coping mechanisms. Do you agree?

drclay

</div></font></blockquote><font class="post">

i agree with you because when i try to think it through and separate it, i never can. i always come up with a reasoning that validates one and then the other. i was reared by very brave and hard-working people. so i saw a lot in them that i see in me now.

i also skipped some grade school and went to college at a very young age and that toughtened me up as i was far from home and pretty much left to my own devices and resources.

i had breast cancer at 31 and have had 11 surgeries on my left side and two on the right side. had reconstruction (they SAID it was safe in 1974) and i am now trying to prepare to have it "undone" as i want a few painfree years. none of this scares me. i have nothing left to fear physically.

i saw my dad break his leg in a hay baler, in the 40s and watched how he handled that and the farm work.....somewhere i picked up the idea that pain was just that....pain. and if you lean into it, it works for you.

so, see........i yoyo.....cause it could be genes and it could be environmental. i think it's both. however, i am prone to put a little more weight into genes for resilence.

no one in my family rodeoed. we ranched. and somehow i found myself doing a book on rodeo and climbing in the arena and standing in front of the chutes and doing whatever it takes to get "the" photograph. (hanging upside down into face of saddlebronc rider for close up of the grimace on his face just before he bucks out) i saw no "daredevil" stunts growing up but never hestitated to do them myself.

my family (siblings) view me as somewhat an oddity. they are all very conservative, isolating, fearful and just plain boring. they genuinely think i'm insane. and to the Indian cowboys and cowgirls i am some kind of an "magic" person. i have "powers" according to them. i am from two tribes and anglo and grew up mostly with Indians.

thank you so much for entering into this realm of life with me. i've wanted to discuss it with someone for years and years and years.

Dr. Clay, i answered your PM and the PM gremlin ate it......i'll get back to it after work today. thank you......pat

[Wants2Fly]

Wow, Pat, that is some story that you have. I am very impressed!

You're a true champion.

oh, i don't know about that.........but i've tried to follow my true dreams.....thanks, Wants........xoxoxo pat

[(JD)]

I'm using virtual reality to do this, for my "flying" phobia. Well, actually it isn't the flying that gets to me... it is the whine of the turbine engines of the jet, and the feeling of being trapped...both relate to when I was injured... so since I want to fly out to NM later this summer, it seemed a good way to flood me with the reality that the airplane's engines are not the turbine engines where I was injured, and I'm not really trapped in the plane, like I was under the shelter.

I am doing well with this THERAPY (not on my own by any stretch of the imagination.) But after the first session I was too numb to know how I felt, and after the second, I began only after reacting (a bit here on PC too) that I was reacting. But even after I had realized I had reacted in xx situation, I didn't realize that right at that time I was still reacting. T says once we have a 3rd session (Tuesday?) we will know where I'm going. (We'll have a 3rd wavepoint ) Panic attacks are horrible imo. I don't like the idea that I won't be comfortable on the plane, but that I won't be obvious to others is important