Sunday, 15 November 2009

Agoraphobia Works! (for some)

If you suffer from a panic/anxiety disorder, you might find this post makes you angry.  You may find it insulting/controversial/ignorant/thought provoking/just plain wrong.  If so, please let me know!  I want to be wrong!  But I need evidence to make me change my mind.

Over the past years, I've met quite a few panic/anxiety sufferers.  The majority have got over or are getting over their problems, but some, like Marie, haven't.

Now, we all know that agoraphobia is not an incurable problem.  For example, how many housebound agoraphobics have chosen to stay in a burning house to experience voluntary incineration?  How many agoraphobics have refused life-saving surgery?  I haven't heard of any.  It would seem that if you give an agoraphobia sufferer, no matter how severe their condition, sufficient incentive, they can - at least temporarily - overcome their agoraphobia.  And if it's possible to set agoraphobia aside temporarily, then it's possible to remove it permanently.  Well, that's my theory, anyway.  Can you prove me wrong?

I was interested to learn why some people don't seem to be able to fight their agoraphobia.  Here are four of their stories.  Their names and any details which could identify them have been changed/omitted.  The fact that none of them is male is simply because I haven't met an unrecovered agoraphobic man (although I know of one online - but don't know enough about his story to include below).

Anne was a happily married twenty-something with no children when she was raped.  Her husband considered her "soiled" and left.  Scared of another rape and having lost her trust in men, Anne became afraid to leave her house.  She has been almost totally housebound ever since, and she's in her sixties now.  She doesn't work but instead devotes her life to her pets and spends most of her time on the internet.  She considers that her agoraphobia is not adversely affecting her life any more.  Anne has spent most of her life avoiding dealing with her mistrust in men.  Was agoraphobia a convenient excuse for choosing to be reclusive?

Betty got married and relocated far away from her friends and family due to her husband's job.  They had a good life together for a few years, although his possessive nature meant that Betty was unable to form friendships outside of their marriage.  Then she found out that he had been having an affair with her best friend.  Despite assuring her that the affair was over, he continued to see this woman.  Betty became insecure but had no one to turn to.  She became unwell.  This got her extra attention from her husband at first, but he began to tire of her attention-seeking "unwell" bouts.  Betty began to have panic attacks, and her husband got fed up with her and deserted her for her (former) best friend.  Totally humiliated, Betty moved back to her parents' house.  She tried to keep her relationship with her husband going by communicating with him by text and online, but he responded by taunting her with glowing reports of his new relationship and telling her how useless he considered her to be while she was with him.  Fifteen years and much therapy later, Betty is severely agoraphobic and despite being desperately lonely still believes that she's in love with her errant husband.  She lives on State benefits and with the assistance of her parents.  Is her agoraphobia conveniently hiding her inability to deal with the breakup of her marriage?

Carrie was psychologically abused by her father throughout her childhood.  She is married and has a lovely 10 year old daughter.  Her marriage has never been "ideal" because her husband pays her and their daughter almost no attention.  She works part-time in a convenience store a block away from her home and spends the rest of her time washing, cleaning, ironing, cooking, gardening and decorating.  Her husband has a full-time job and spends the rest of his time playing computer games.  He holidays with his mates.  He constantly puts Carrie down.  Nothing she does is good enough.  Her regularly tells her that she's ugly, although in reality she is an attractive woman.  This constant pressure has led Carrie through anorexia, depression and irritable bowel syndrome to panic/anxiety disorder.  Now agoraphobic, she cannot leave her area.  She also has some social phobia.  She believes that she still loves her husband but, despite recognising that he is abusing her, cannot imagine life without him.  All medications and therapies - and there have been many - have proved ineffective.  Is agoraphobia preferable to facing the reality of a sham marriage?

Denise is a stunningly beautiful 25 year old single girl living in a small rural town with her mother.  Despite her unpretentious beauty and popularity at school, Denise has always lacked self confidence.  After leaving school aged 17, Denise had a series of jobs in a nearby city in the beauty and fashion industries.  Mainly due to her lack of belief in her capabilities, she was spectacularly unsuccessful in all of them.  She began to have panic attacks at work, and this was an extra contributory factor in her losing jobs.  Soon she began to have panic attacks at job interviews or on the way to job interviews. In time, this escalated to the point where she became completely unable to leave her small town.  Due to her looks and her sexual expertise, she has had lots of boyfriends.  They all leave when they discover just how much her agoraphobia controls her life, but there are plenty more blokes ready to take their place in her bed.  Denise lives off State benefits and all the treatment for agoraphobia she has received so far has failed to help her.  Does agoraphobia mask her fear of getting a job?

These ladies have one thing in common.  They don't function as normal adults.  Agoraphobia is a convenient excuse to avoid changing their lives.  Sure, their freedom is limited: but is this limitation voluntary?  From the information I have been able to glean, I believe that it is.  While "suffering" from agoraphobia, these ladies can:
  • Avoid having to work for a living
  • Avoid relationships where the partners take equal responsibilities
  • Avoid going anywhere they don't want to go to
  • Avoid taking full responsibility for their lives
  • Get more than usual attention and/or care
  • Avoid making life-changing decisions
As far as I can see, agoraphobia works for these ladies.  By making agoraphobia the reason why they can't change their lives, they can avoid tackling their real issues.

And what about Marie?

Over the years, her level of agoraphobia has changed many times.  When the incentive is great enough, she can do almost anything.  For example, although today - just the same as when I met her - she cannot cross the street to go to a shop or visit the doctor, she has previously gone round supermarkets, furniture stores, busy markets, accompanied me to a hospital appointment, visited the x-ray department in the middle of a large hospital, taken a theory test - on her own - for her driving licence on the 2nd floor of an office block, given birth to two children in hospital (but won't visit the same hospital today)....I could go on, but you get the picture.

Here's what she has told me -
  • I'll get out of agoraphobia one day
  • I know how to get out of agoraphobia, but it's not easy
  • I don't feel strong enough to change things yet
  • I'll start getting out of agoraphobia when I'm ready
All of the above means just one thing - Marie doesn't have sufficient incentive to change her life.  She is comfortable with her current quality of life.  Agoraphobia works for her, too.  Her agoraphobia isn't her main problem - her main problem is whatever is preventing her from taking the necessary steps to conquer it.

Marie was agoraphobic when we met, and I accepted her as my life partner as she was (and is).  If she never changes, I'll still want to be with her. It's my belief that Marie could get much more out of life if she would shed her agoraphobia.  I know that she accepts this, at least in part, but she can also see that her responsibilities would increase.  Is this what is killing off her incentive to change?  Is she scared to assume the full responsibility of being a fully functioning adult?  The story continues...

Wednesday, 11 November 2009

Minimising Monophobia, Messing with Medication

Last time I went to Ireland, Marie, for the first time, remained at home.  Her mother came to stay to reduce her anxiety.  That was good.

This time, she did better.

This time, she invited her friend Becky to stay with her in the evenings, and decided to stay on her own in the daytime.  And Becky doesn't even drive...

It went fine.  Just the occasional anxiety attack.  A great success.

Then I came back, tired but happy, ready to celebrate her success.  Ripe for romance.  Keen to canoodle.

But Marie went to bed.

And, for the majority of the time, that's where she has stayed since.  She only gets up to eat or to use her laptop.

Apparently, during my absence, Marie had missed two days' medication.  Only two days, but it was enough to wreak havoc.  All the side effects of her medication began again.

We've been through this before.  The side effects fade after a while and then disappear.  It takes 1 - 4 weeks.

In the meantime, it's up to me to hold everything together.  I attend to the domestic duties, chauffeur the children (who are brilliant and as supportive as their tender years will allow) and look after my business.  The typical parent in a single parent family with two young children.  Somehow I also fit in looking after Colm's needs and acting as an agony aunt to sad separated Colleen, hormonal expectant Collette, worried Jenna and Carla who has new job insecurities.  I'm a busy, busy boy.

Today Marie looked a little better and got up before lunch time.  I hope the worst is over.

Tuesday, 10 November 2009

The 2nd Belfast trip

↑ Matthew - doesn't he look much better? ↑

Matthew isn't well and he might not be getting much better, but he's not getting any worse. A new heart defect has been identified and he has digestion problems...but these are not life-threatening problems and he's holding on.

In my opinion, the outlook is quite good; there is no (currently known) reason why he shouldn't come out of this and lead a normal life. Colm had a very difficult 1st year and nearly died but now he's as strong as an ox; Colleen had a near miss cot death, I was told that she probably had brain damage and now she's as healthy as any 25 year old; Collette, who had heart failure before she was born, was not expected to survive more than a few hours, spent her first few months of life on life support...she's expecting her first child in January!

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← Jenna with niece Shannon

I'm so glad I went back to see Jenna and Matthew! Matthew was a lot better and I was able to hold him lots. The feeling I get when a tiny, helpless baby lies in my arms looking up at me with wide, dark eyes... I can't describe that feeling, but it's unique and incredibly moving. Or am I just a soppy softie? - if so, I don't care!

Joseph, Orla and my eldest granddaughter Shannon (14) also had the opportunity to meet Matthew for the first time. Actually, I was really impressed that Shannon was taking such an interest in her newest cousin. Growing up fast, Shannon is turning into a responsible, caring young woman - a granddaughter to be proud of.

With husband Colin currently unemployed, Jenna's family don't have the funds for many days out. I made it my mission to get them out of their house as much as possible. Additionally, with her family's recent relocation, granddaughter Elisha is rather lonely. Joseph and Orla provided her with all-day company. Surprisingly, there were very few arguments.

If this was by an unknown artist, would you hang it in your living room?

We visited the Ulster Museum in Belfast - recently re-opened after a £17m ($28.36m) refurbishment. For a little city, it really is quite an impressive museum. You can see what it has to offer by clicking here. Less impressive for me was the Sean Scully exhibition which occupied all of the art galleries there. I honestly can't see why anyone would buy one of his paintings. - and I wouldn't hang one on my wall if it was given to me free. I know that the general public side with me since the museum was extremely busy and the art galleries almost deserted.

I have visited the Ulster Folk and Transport Museum several times over many years, but have never seen the transport exhibits. My last trip there was no exception: perhaps I'll check it out on my next visit? However, everyone - perhaps especially the children - thoroughly enjoyed exploring the well presented buildings and their period contents. The authentically costumed ladies and gentlemen plying extinct or ancient crafts were simultaneously entertaining and educating.

Every time I visit Ireland, I go to Dunnes Stores for clothes. The prices belie the quality; and the selection is both large and tasteful. Joseph and Orla found much to their liking during our shopping trip, as did I, so we purchased an amazing amount of clothes for an incredibly small amount of money. There was much which Marie would have liked, but surprisingly, Dunnes Stores has no presence online. I couldn't take the risk that any speculative purchases that I would make for Marie would fit and/or please her critical eye.

← Joseph took this portrait of Elisha. You can tell that it wasn't a planned event!

A visit to the excellent Lisburn Pool provided a very enjoyable aquatic diversion which nicely rounded off our trip.

The trip was an unqualified success. Joseph told Marie that he would like to live there; Orla liked playing with Elisha; Elisha cried sorely when we were leaving and keeps asking Jenna when we'll be back; Shannon told me that she had really enjoyed herself; Jenna had a well-deserved diversion and some helpful company (me - excuse the lack of modesty).

So where was the ugly, strife-torn, low-income, depressing Belfast? Still there, of course, but only providing an insignificant background to the good times being had by our little party. Beauty can co-exist with ugliness!

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Joseph wrote a rather good blog post about his trip to Ireland. Click here to see it, and if you would leave a comment, it would thrill him to bits - and perhaps encourage him to keep writing. The blog post was taken from his essay "Half Term Diary" which was his half term homework. During our trip, he took loads of photographs and several are included in his post. His photographic skills are improving all the time.