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How does agoraphobia develop?
Agoraphobia develops
through a process called “generalization.” Fear produced by
a single panic attack in a single place and situation
eventually generalizes until the person fears nearly all
places and situations.
Here’s how it happens:
The onset of agoraphobia usually begins with an episode of
spontaneous panic. In most cases, the person gets
conditioned to associate panic with the place or situation
in which they experienced the panic attack and starts to
avoid it.
Also, most people don’t know what is wrong when they
experience their first panic attack. Not understanding what
is happening during an unexpected episode of panic can lead
to catastrophic thinking about what might be wrong.
Following the initial panic attack, the person becomes
afraid of having another one. This fear leads to obsessive
worry about when and where the next panic attack might
occur. The person literally “fears the fear.”
This obsessive worry triggers more frequent panic attacks
and the person gets conditioned to associate panic with each
new situation or place where he or she has a panic attack.
Because unexplained panic attacks are horrifying
experiences, most people start avoiding all the places they
have panic attacks.
At some point, panic attacks are experienced in so many
places that the fear of having a panic attack generalizes.
The person associates panic with nearly everywhere and
avoids most public places. In the most severe cases, people
with agoraphobia become confined to their homes. In extreme
cases, people with agoraphobia are even confined to their
beds.
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