The term agoraphobia literally means fear of the market place (from the Greek) but is used to mean fear of busy, crowded places, which markets, of course, usually are. It tends to blend with claustrophobia (fear of enclosed places), although one can be claustrophobic without being agoraphobic.
Agoraphobia is a self-protective response to the fear of panic attacks. Most people with agoraphobia have experienced many terrifying, seemingly inexplicable panic attacks and, as a consequence, want to stay at home as much as possible, to try to prevent them happening or to feel less unsafe if they do, and to have someone with them if they go out. This is perfectly natural. Once the amygdala gets in on the act and is in hyper-alert survival mode, it patterns matches to events and experiences that have only remote connections with the source of a panic.
As we saw with Jenny, understandably panicky feelings in the supermarket queue that were misinterpreted led to another panic attack in the post office. Quite possibly, she would have gone on to have another attack in a place where there were a lot of people, but not necessarily queueing, such as while she was standing on a crowded train or a bus. Maybe the person in front of her there, whom she was terrified of collapsing or vomiting upon, was wearing a pink coat with a fur collar. Then perhaps another day, when she was in the familiar little local park with her children at a nice quiet time, she had yet another, seemingly incomprehensible, attack - one of the other mums was wearing a pink coat with a fur collar. Jenny may not consciously have remembered the pink coat, but her amygdala has ...
In such circumstances, when it suddenly seems that any-time and anywhere, these terrifying attacks can happen out of the blue, what can be more normal than wanting to stay at home, where you feel safer? What can be more normal than wanting to have someone with you to help you, if circumstances force you to go out? It is a response that dates back to our evolutionary past, when we were vulnerable to dangerous animal predators. After all, we had very few natural defence mechanisms available to us. We didn't have sharp talons or huge jaws to use to defend ourselves, if we felt under threat. So our instincts were to retreat to our caves when scared and to gang up on whatever was attacking us (i.e. have someone else alongside). These are absolutely natural responses to environmental threats. The only problem is that, nowadays, mostly, the environment isn't really threatening. Our amygdala is responding to the wrong signals.
But this doesn't mean a life sentence. It can be straightforward to correct, once you know how.
Conitinued in this article: Some other common phobias