Defining the precise nature of your problem is the first necessary step on your road to recovery. But it is essential to do this in clear and unambiguous terms.
For example, saying ‘simply’ that you are agoraphobic or that you have panic attacks does not really describe the problem. It is rather like saying, ‘My car is not running properly.’ If you took your car to a garage you would provide the mechanic with more information than that – as much as possible, in fact – so that the problem could be diagnosed and sorted out.
You must specify or state what the problem is and how it affects your life. Find the answers to some basic questions, such as:
•What is the nature of your anxiety?
•What physical symptoms do you experience?
•Does your anxiety include certain thoughts, such as ‘I’m going to pass out’, ‘I’m going to collapse’ or ‘I must escape’?
•Do you use props that make the anxiety better? For example, using a walking stick, carrying a mobile phone or bottle of water may make you feel more secure. (These modifying factors are important because they can be used later in treatment.)
•Do you find some factors make situations worse, such as bright lights in supermarkets, being stuck in traffic, your menstrual cycle, or times of day such as night or early morning?
For example, someone might define their agoraphobic fear as follows:
•Fear of situations where there is no obvious escape, such as crowded buses, trains, theatres and supermarkets. This fear leads to an avoidance of such situations, which in turn restricts my ability to work, shop and socialize.
•The fear comprises thoughts connected with a loss of control (passing out, fainting, vomiting, collapsing, becoming incontinent). Although I know that these thoughts are irrational, they can be overwhelming.
It may be helpful to break the problem down in slightly different ways – by making a list of things that are causing you difficulty, for example.
•Try to identify exactly what it is that you are afraid of happening (for example, collapsing, dying, fainting).
•Define the situations that cause the anxiety. When and where does it occur?
•Define how the avoidance of those situations leads to handicap. What effects does it have on you?
Conclusion
Defining your problem is the first step on your road to recovery. Make sure that you do the following:
•Think about all the components that make up your problem.
•Identify those situations that cause you difficulty or that you tend to avoid.
•Define the thoughts that trouble you.
•Identify all those factors that make the problem worse or better.
•Define how the problem upsets and/or interferes with your normal activities.
Once you have done this, use your list as your problem statement, and go on to the next stage, which is to select your treatment targets or goals.