suggestion for agoraphobia w/panic d/o

• Agoraphobia with Panic Disorder by E. J. White, 9/22/98
  
  

I have been working with a pt suffering from agoraphobia w/panic d/o several months ago. This pt is elderly and homebound due solely to this condition. Knowing that she used to dance, I started a weekly routine of having her exercise with handweights in order to change her level of activity. She complained of physical (somatic) symptoms at first, which we explored, and now asks to do the weights regularly. After she's accomplished her "workout," I offer to take her out for some small reason, i.e. mail a letter on the corner. After waiting out her resistance (responding to her many concerns)she agrees about half the time. It helps that now, having had some success, I can remind her of how good she feels once she's out. My goal is to provide her with a structure around which she can organize her day (for years she managed her situation and held a full-time job) while continuing to explore what keeps her in place. I have found that agoraphobics tend to be profoundly sensitive to stimuli (hence the relative comfort of the cocoon), so adjustments to the environment need to be introduced with great care.

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