Lately, agoraphobia has become an issue which has become more and more common in medical practises. For some it takes shape in not daring to drive a car on highways. For others, walking into open spaces or public places is the problem, and yet another group of people find it difficult to reach the doctor because they hardly dare to leave their own house. Other people again visit to their doctor with complaints of hyperventilation or even anxiety attacks.

What is Agoraphobia?

Agoraphobia is, first of all, an anxiety linked to being in a certain place or situation from which escape is difficult, or which can be experienced as embarrassing. Linked to this anxiety there is a type of avoiding behavior related to such situations, such as avoiding elevators or busy places, staying at the outer corners of the masses or in a place from which one can escape, or using public transport to avoid having to drive a car.

What therapy or treatment heals agoraphobia?

Different types of psychotherapy are useful, on the condition that the patient does not stop therapy before results are reached, and presuming that the fear of the fear, mentioned in another article, is treated as well.

Short solution focused therapy for agoraphobia

The advantage of short solution focused therapy for agoraphobia and similar disorders, is that it is very quick and elegant, and that there is less confrontation for the already exhausted and anxious patient. The most important advantage is that this type of therapy quickly recovers the confidence of the anxious person, so that they can solve their own problems again. The patient becomes, through the help of the solution focused questions asked by the therapist, aware of solutions which they can use in difficult moments. This way, the confidence in their own solutions and methods increases step by step.

Cognitive behavioral therapy (CBT) for Agoraphobia.

Cognitive behavioral therapy has proven to be very efficient for treatment of agoraphobia. The therapist helps the client to discover which negative thoughts go through their mind just before the anxiety occurs. Together they will then analyse these negative thoughts, this way teaching the anxious person to recognize their own negative thoughts and to disprove them. As this type of therapy is the oldest one which works well, there are many studies which show its effects. The only disadvantage can be that looking for the negative thoughts might be confrontational for the patient, leading to people stopping therapy or even avoiding the consultations. For people who are anxious about this confrontation, solution focused therapy could be one of the more suitable methods to use instead.

Rational emotive therapy (RET of REBT) by Albert Ellis for agoraphobia

RET was developed by the impressive New York therapist Albert Ellis, and it is based on the same principles as CBT. It is likely to be just as efficient, but the earlier mentioned therapy type has had more investment in research to prove this. Albert Ellis himself performed his therapy in a very dramatic and confrontational way, but with love for his patients and a lot of humor, causing the patient to feel understood and to recover quickly. I have had the pleasure to meet Albert several times before his death several years ago, and each time I was impressed by his authentic and special style of worked!

EMDR therapy for agoraphobia

EMDR offers a completely different approach in the treatment of agoraphobia, but is very efficient. The therapist will make you think of places and situations in which you are affected, and then will ask you to move your eyes back and forth during the visualization. Because of reasons which are too complex to explain in this article, the fear will slowly be reduced until it becomes nearly impossible to recall it.

Hypnotherapy for agoraphobia

Medical hypnosis is another alternative for treating agoraphobia. It is very efficient in acute situations, for example if you have a presentation the next morning for thousands of people. In such cases, hypnosis can be a quick fix. The immediate effect of a hypnosis session lasts about 48 hours. If you want to get rid of your anxiety in the long-term, you will need several sessions in order to more thoroughly reprogram the links and associations in your brain. Of course you can also learn self-hypnotic exercises as an addition to the therapy.

Self-hypnosis for agoraphobia

The advantage of learning self-hypnosis exercises, is that the self-hypnotic techniques put you in control over your agoraphobia. This means that you can deal with difficult situations by yourself.

Online Internet therapy for agoraphobia

Europe is somewhat behind compared to the United States when it comes to online internet therapy. You can sign up for an online therapy program which consists of a combination of daily self-help with weekly guidance by a therapist. A good program integrates the best elements from the different types of therapy mentioned above.

Self-help for agoraphobia

And if you are motivated enough to help yourself, but still want some guidance, it is best to start with a good online self-help program. You can ask for additional therapy in case this is needed later on. It can be good to try solving your problems on your own to begin with. What is needed for this, is a good system which contains knowledge of the most useful therapeutic concepts.

Self-test for agoraphobia

Would you like to know to what extent stress, tension, anxiety, or even depressed feelings might play a part in your agoraphobia? Then simply test this by filling out a simple test with 21 questions.

Paul Koeck, MD