A practical treatment of agoraphobia.

Abstract

Agoraphobia?the condition in which a patient suffers in capacitating anxiety in public places or anywhere outside his own home?is a common syndrome affecting thousands of people in Britain. Optimism in treating it is contrary to much current opinion. However, after many years of practice with a special interest in the anxiety state of which agoraphobia has often been a major symptom, and especially after the results of my last 10 years' experience concerned almost exclusively with treating agoraphobic people, an opti mistic approach is in my opinion justified. A brief outline is offered here of my method of treating agoraphobia. The special difficulty of treating the disorder is that inability to travel to the doctor's surgery is often so much part of the agoraphobic's illness that he may rarely, perhaps never, succeed in making the journey. In these cir cumstances, offering a satisfactory programme of treatment and in addition giving the frequent encouragement and re assurance the agoraphobic patient needs present special diffi culties; while to treat a patient adequately at home is surely asking too much from a busy practitioner. The treatment described here overcomes these difficulties. It does not require the personal presence of the doctor. It is available when needed (which may be many times during one day) either at home, or away from home when the patient's agoraphobic fears are at their worst. In addition, the cost is negligible. Treatment is in the form of two books,12 two long playing (L.P.) recordings,3 quarterly magazines sent to 1,800 agorapho bic men and women in Great Britain and Ireland during the four years 1969-72, and a cassette4 for a small portable tape recorder. This remote control (perhaps direction would be a more accurate word) has made it possible to treat people living not only in distant parts of Great Britain but also in other countries. The books are available in most libraries, the L.P. record ings and cassette are in the library of the British Medical As sociation, and the quarterly magazines (1969-72) have recently been published in book form.2 In psychiatric clinics in Great Britain where the recordings are used patients are encouraged to bring their tape recorders and make copies, and no objec tions are raised. The condition is explained to the patients in the following way.