Claustrophobia Induced Anxiety and Panic Attacks

Source: Monica Antonelli

Mary walked into my office with a bright smile and quickly sat in a chair. But as soon as she started talking about her fear of enclosed spaces, her facial expression became tense and pained. She told me that she had been suffering from claustrophobia for many years.

Mary was afraid of any small and closed space. This included a fear of riding in elevators, buses and subway trains. She had been struggling with her fear for several years. However, recently a terrible experience in a health clinic had really scared her.

“I have chronic back pain”, Mary explained, “My doctor sent me to get a full body MRI scan. I avoided it for a long time, but last month I forced myself and went to get it done. One hour before the MRI scan I took some pills to calm myself. At the clinic the nurses were very nice and explained the procedure to me in detail. I told them I had claustrophobia and they gave me a sleep mask to cover my eyes so that I wouldn’t see the inside of the MRI machine.”

“I was really nervous but I put the sleep mask on and lay down. When the machine started sliding to place me inside that awful hole, my heart started pounding like crazy.”

“This, even though you couldn’t see anything!”, I added.

“I couldn’t see but I could imagine it! I knew where I was heading to. Then suddenly I had a panic attack. I screamed and pleaded with the nurses to get me out of it. It was horrible; feeling trapped there with my eyes closed. The nurses told me to take a break and to try again. They were very nice and reassuring but I just couldn’t go through with it. I was so embarrassed.”

How did she coped with her fear of closed spaces?, I asked. Apparently Mary took medication to calm herself. Another coping strategy she used to deal with her claustrophobia was to avoid enclosed spaces completely or have her husband accompany her when she thought that she would get scared and have an anxiety attack.

I asked her to book an appointment for an MRI scan in three weeks’ time. In the meanwhile, I told her that she would be working towards being comfortable with all the other enclosed spaces in order to completely get rid of her claustrophobia.

I helped Mary to realize that her two coping strategies – avoidance and asking for help – were actually making things worse. I gave her a task and an exercise to practice at home to feel differently about her fear of small spaces. Once she felt different about her claustrophobia, I warned her not to expose herself to it or in any way to face the fear. I told her that if she felt that she really wanted to do something (like getting into an elevator), then she could do it. However, she had to avoid forcing herself to change.

After two weeks, Mary started to do several things that she hadn’t been able to do for the longest time. For example, one day she rode a city bus. After a few minutes, as more and more people got on the bus, it had gotten very crowded. With many people on the bus Mary had felt uncomfortable, but she hadn’t gotten scared. Before our sessions together, the mere sight of a full bus caused her to feel afraid and anxious. However, this time she managed to actually ride a busy bus. After that she had gotten into and ridden an elevator alone.

I gave her a new task and taught her a new technique, in case she needed it, to apply on the day of the MRI scan. I learned from her later that Mary had showed up for the scan, a bit nervous. As soon as the nurses wanted to reassure her, she had asked them not to say anything about her possible reaction and had changed the subject. She had lain down without a sleep mask, free from fear. She told me that she had actually gotten bored because she had to lie there for 1 hour with nothing to do.

I was happy when Mary reported that, finally, she was free from her fear of enclosed spaces. She was free from claustrophobia! No panic attacks! No anxiety!