Dear Dr. Norquist:
I think I am becoming more and more claustrophobic as time goes by. I am conscious of having been very afraid of small and confined spaces since I was young, but I was always able to stay away from places that caused me fear and so it was not a big deal until recently. For the past three years I have always avoided elevators. Now I don’t like going into subways either. I am afraid it is getting worse. I feel this shortness of breath and rising anxiety whenever I have to ride on the train. I’m afraid that one of these times I’ll pull the emergency brake, just so I can get out of the car and be able to catch my breath.
I know this is not good. I don’t know if it will keep getting worse. What should I do, like what kind of exercises could I practice, to make these symptoms become less and less in my life. Thank you.
Dr. Norquist responds:
Fear begets more fear. When you allow fear to take root in your life, it tends to sprout up in an increasing variety of locations, kind of like weeds in a garden, or crabgrass in a lawn. Over time it can start to take over your life – dominating your decisions about where to go, what to do, and how to do it. Staying away from places that caused you fear has allowed your claustrophobia to grow and to spread. The way to reclaim your life is to face your fears directly. You need to spend some time pulling those fears out by the roots (so to speak).
Claustrophobia can be dealt with very effectively in a straightforward manner. It requires unlearning the association your brain has made between anxiety and a particular situation (i.e., elevators and subways). Since relaxation and anxiety are physically incompatible responses, the goal is to associate relaxation with those situations that cause you anxiety. I know this may sound impossible to you currently, but it has been proven to be very effective and many with symptoms much worse than yours have successfully combated their phobias using this approach. It requires learning and practicing relaxation (using abdominal breathing, imagery, meditation or progressive muscle relaxation), and then being in this relaxed state while imagining yourself in situations that produces a mild level of anxiety. When this is mastered, you slowly and progressively move up your predetermined hierarchy of anxiety creating situations. It is important that you move up a notch only when you can maintain a relaxed state while visualizing the anxiety-producing scene. Eventually you can move on to pairing the relaxation state with a real-life hierarchy of situations.
Accomplishing this requires determination, practice, and support and ideally, professional help. There are several good books on anxiety and phobias that can walk you through this process (see E. J. Bourne, The Anxiety and Phobia Workbook). You can do this! Just take it step by step.
Check out Dr. Norquist’s new blog GrowingThroughParenting.com
(Dr. Sallie Norquist is a licensed psychologist (NJ #2371) in private practice and is director of Chaitanya Counseling Services, a center for upliftment and enlivenment, in Hoboken.) Dr. Norquist and the staff of Chaitanya invite you to write them at Chaitanya Counseling Services, 51 Newark St., Suite 202, Hoboken, NJ 07030 or www.chaitanyacounseling.com or by e-mail at firstname.lastname@example.org. Questions can address various topics, including relationships, life’s stresses, difficulties, mysteries and dilemmas, as well as questions related to managing stress or alternative ways of understanding health-related concerns. Ó 2019 Chaitanya Counseling Services