Teased to the idea of having an anxiety attack in a public space, the victims of agoraphobia think that they will faint, go crazy or die. They reshape their daily life to avoid their torment, until the day when leaving home becomes impossible. Much more than the crowd, agoraphobia fear fear.
By Elisa Vallon
How to explain agoraphobia?
Agoraphobia is often wrongly restricted to the fear of the crowd. In reality, it is defined by "the fear of finding oneself in a place where one could make a panic attack and from which one could not go out quickly or be rescued", explains Hervé Montès, psychiatrist and president of the French Association of Behavioral and Cognitive Therapies. This mental disorder, which often occurs at the time of adulthood, affects 2 to 4% of the population and is the world's leading reason for consulting in psychiatry.
From an anxiety attack to agoraphobia
Agoraphobia occurs in several stages. First episode: the panic attack. We must imagine that this equates to the worst state of anxiety, automatically associated with three types of thoughts: "I'm going to die", "I'm going crazy", "I'm going to commit a reckless act, to feel uncomfortable, to scream". Seen from the outside, it is difficult to realize the power of the panic attack. It is an extreme fear, where the agoraphobic lives the impression of an impending death.
This first episode passed, panic disorders appear: the recurring fear of being afraid. The agoraphobes are paralyzed at the thought of reliving this terrible feeling of panic. Anxiety increases, they enter into permanent self-monitoring. Agoraphobia takes root.
The more we avoid them, the more the fears multiply
The brain of the agoraphobic assimilated the panic attack to the place where it took place. The logical answer is to get around this place; the unconscious therefore sets up an avoidance strategy. If the first attack took place in the supermarket, it first requires to flee this place. "If I felt bad, it was because it was too hot, that there were too many people, too much light ... The brain makes associations of ideas, "explains Hervé Montès. Little by little, fears are nibbling on the ground and we should not just discard supermarkets but all places where we find the same atmosphere. Until the day when 100 meters in the street becomes impossible. "Our alarm is changed .It triggers much too early, it must be resolved," schematizes Muriel, with agoraphobia.
According to the numbers, women are more affected. But these statistics are biased by the fact that men consult less.Because being afraid is being weak. Shame is a real problem. Many agoraphobes keep everything for themselves and isolate themselves. The gear begins: fear, confinement, loneliness, depression.
CBT to combat avoidance strategies
To talk about it right away is to act. Most of the time, it is recommended that a person come for panic disorders, phobias and agoraphobia to follow a CBT. With 80% success in patients, behavioral and cognitive therapy is considered the most effective fight against agoraphobia. Coming from the United States, she acts on fear in a frontal way. "The goal is to give back to people their freedom," says Hervé Montès. The TCC is based on progressive and recurrent exposures of the patient to the object of his fears. "You have to go to the field, see his fears, say hello to them, and we'll get there little by little," says Alice, suffering from agoraphobia and creator of Agorafolk, a site dedicated to "agoraphobic optimists". With her therapist, she learns to frequent the subway: "Three steps and tomorrow, we'll get four, he looks at me, my hand is on my heart, I look back all the time for fear of losing myself". For the exhibition, two key words: recurrence and graduation. Ideally, it should be exposed two to three times a day. Each with a different sensitivity, other therapies exist, more or less amazing.
The contribution of psychoanalysis
Parents too strict, the fear of being bad in maths ... Psychoanalyst Michel Cresta thinks that agoraphobia comes from the world of childhood. The school, for example, is a "phobia nest". People with agoraphobia feel constantly judged as failing. "But this look that judges and condemns is often their own look," says the specialist. Fear is built to say something, psychoanalysis seeks to solve the underlying problem, to understand "the meaning of agoraphobia in the patient's life".
Meditation to Learn to Let Go
Given its genetic and family history, every person with agoraphobia makes choices among different therapeutic options. Beyond classical psychiatry, Mindfulness, mindfulness meditation, especially associated with CBT, can learn to accept ... letting go. People suffering from agoraphobia are in a state of hyper control: "What if I faint and if I have a crisis, and if no one comes to rescue me?" ... They forget that for the moment, everything is fine.
An "invisible fear" difficult to understand
"It's in your head, take it this subway!" ... Most of the relatives do not understand. But agoraphobia is an invisible fear, we must accept that everything is not understandable. There is no perfect attitude to adopt with an agoraphobe, but it is important to be there, encourage initiatives, without forcing.On the other hand, we can encourage the person to talk about it, by inviting him to register on sites or associations. Meeting other people, sharing their fears, tips and methods, can really help.