I was asked a great question recently,

“If certain situations trigger panic, then why do we sometimes panic in a situation, and then are sometimes able to stay calm in that same situation?”

The reason why we react differently in the same situation s because panic attacks are not a purely automatic response. If I have written somewhere that situations trigger panic, this should not be taken as an absolute rule.

We may react differently in the same  situation because there are two sides of the brain at work when it comes to panic attacks.

Sure - panic attacks are partially triggered by emotional memories or associations formed in the right brain through experience. But your thoughts, which come from the left side of the brain, also play a role in determining whether or not you panic. Your thoughts can override a panic attack.

That’s why I recommend self-help techniques for agoraphobia that work on both sides of the brain:

1) Relaxation, visualization, and reconditioning to replace associations on the right side.

2) Learning to detect and replace panic-producing thoughts on the left side.

Of course, many other factors influence a panic attack, such as being tired. But these are the two major influences, associations and thoughts.

For most people with agoraphobia, the safe zone is either their home or a certain distance from their home. Much literature on agoraphobia recovery is written with this assumption.

Recently, I was emailed a very good question that challenges this assumption:

“Why did I have a panic attack when I went shopping just two streets away, but on another day I traveled 1400 kilometers without having a panic attack?”

The answer to this question lies in understanding how the safe zone develops. The safe zone is not always defined as a certain distance from one’s home in all  directions.

Phobias like agoraphobia develop through associations formed in the brain through experiences that are recorded as emotional memories. In other words, safe places are places in which someone with agoraphobia learns to associate safety through pleasant emotional experiences. Unsafe places are places in which a person learns to associate fear or danger through experiencing panic attacks.

In most cases, a person with agoraphobia experiences panic attacks in so many places away from home that the fear generalizes - and most places outside the home become regarded as unsafe. In other cases, the fear does not generalize and certain places are recorded in the brain as unsafe due to panic experiences, while other places remain perfectly safe.

In summary, panic attacks are most likely to occur in places where the brain has recorded a memory of panic, regardless of the distance from home. If the fear does not generalize, places in which a person has not experienced a panic attack are less likely to trigger one.

This is a common question for parents with agoraphobia, especially if they have young children. If have agoraphobia, it’s natural to feel concerned about your children developing anxious or phobic behaviors from watching you.

The best information and advice for people in this situation is written in a book called “How to Help Your Loved One Recover From Agoraphobia” by Karen Williams (in Chapter 5 “How Agoraphobia Affects the Family”)

Here is a summary of what the chapter says:

There is some evidence that phobias, including agoraphobia, are passed on both genetically and by modeling (though experts disagree on the strength of each influence). So trying to hide agoraphobia from your children, or not talking about it won’t really protect them.

According to Dr. Arthur Hardy, who spent his life treating agoraphobics including Karen Williams (the author), “it helps children to be allowed to take part in the recovery process.” Dr. Hardy believes that this helps keep children from becoming phobic themselves. If you have agoraphobia, he suggests that you allow your children, if they are old enough, to help you in positive ways such as goal setting and practicing facing your fears.

But even if your children are not old enough to help in the recovery process, the best thing is to model recovery from agoraphobia and not avoidance behavior.

Also:

- Make sure your children know they are not to blame for your anxiety and panic attacks, that you are not mad at them, and they had nothing to do with the cause of your problem. Children have a tendency to blame themselves or feel guilty when a parent has a problem like agoraphobia that they don’t fully understand.

- Make sure your children have permission to be angry at the way agoraphobia makes you act sometimes, and give them a chance to talk about it.

- If agoraphobia is keeping you from paying the amount of attention to your children that you feel they need, communicate the reasons why the best you can and arrange for your child(ren) to receive attention from another source, such as a close relative or trusted friend. This will help keep your chidren’s self-esteem healthy, and keep them from feeling rejected.

Of course, the level of communication you can have with your children about agoraphobia will increase with their age, but “with a little attention and sensitivity on the part of the parent, children will come through this crisis better than most parents think they will” (quote from the author).