A Terrorist Negotiator with Agoraphobia
Bill, a sixty year-old man, came to see me upon his doctor’s referral. He was a respected and admired politician in Spain. His career included negotiating on several occasions with the terrorist members of ETA (the Basque separatist organization) to cease sending extortion letters to Spanish businesspeople. He said that in his negotiation meetings, he only carried a pen and a paper meanwhile those sitting across the table brandished their guns. Even in such tense situations, face to face with violent terrorists, Bill was a fearless negotiator. However, he was afraid of something most of us don’t give any thought to: walking alone or leaving town.
“My agoraphobia started around 20 years ago”, he explained to me. “One day as I was walking down the street in my town, I suddenly felt cold and had a tingling sensation on my face. I couldn’t breathe, my heart was racing and I had a lump in the back of my throat. I got very scared. Later I realized that it was my first panic attack.”
Bill went on to tell me that gradually he had more panic attacks in places and at times he couldn’t predict. Soon he avoided going places on his own and had drastically reduced the distance he could drive away from the comfort of his hometown. He always asked his wife to keep him company. He never walked in the streets on his own. People, who knew about his fear, were accustomed to seeing him driving. The local priest knew that Bill’s fear was so strong that he couldn’t walk into the church. Unfortunately, when his mother had passed away many years ago, Bill was unable to attend her funeral.
After his fist panic attacks he had gone to the hospital thinking that he was having a heart attack. When they told him that he had only had an anxiety attack, he went to see a psychiatrist who diagnosed him with agoraphobia and prescribed him some tranquilizers to calms his fear and reduce his anxiety attacks.
Bill told me that he felt safe and calm if the driving distance was less than 20 kilometers. But he always asked his wife to accompany him. On rare occasions when his wife couldn’t, Bill would spot someone on the street he knew well and followed him from a distance and in this way feel safe.
I talked to him about the negative consequences of avoidance and asking for help. I also asked him to bring me a map showing the spots where he felt the worst. I taught him a technique that allowed him to walk on his own and asked him to bring back to me a detailed measurement of his phobia. I also gave him to task that would make him feel his fear in a new way.
“You want me to get more scared?”, Bill asked incredulously, “wouldn’t this make my fear worse?”
“You have lived with your fear for 20 years. I want you to undertake an experiment and feel what you already felt, but in a slightly different way.”
Bill came back after couple of weeks and reported that he felt better and more confident. He had done the tasks exactly as I had instructed him to and to his great surprise, Bill found that he was able to stretch the boundaries of his freedom. He was very excited because he had attended a funeral after so many years. He remarked that the priest had looked at him as if he had seen a ghost! All the townspeople were surprised to see him walking down the street on his own carrying a map and taking notes.
I cautioned him that he shouldn’t feel so optimistic about his success. I explained to him that it’s better to go very slow at the beginning; explaining the virtues of slow growth and gradual change.
“An olive tree is an ancient and venerable tree long valued for its fruit and the oil pressed from it. Some experts have documented that some olive trees on the Mount of Olives near Jerusalem, may be as old as 1000 years. The main reason is that olive tree grows quite slowly. On the other hand, pumpkins grow very fast. They become big and empty and are soon gone.”
But Bill was very eager to get well. Twenty years of agoraphobia were too long a time of limitation. He had rejected so many opportunities in his political life because he wasn’t able to leave his small region. He had many projects put on the back burner because of his debilitating agoraphobia. He wanted to get well soon and to be able to do the many things that he hadn’t been able to do throughout those 20 years.
After few more weeks and sessions with me, Bill drove alone!
Everyone was surprised to see him around his hometown. One of Bill’s brothers that lived in another county called him up because he had heard that “a miracle had happened” from Bill’s hometown friends.
In our last session Bill told me that he had gone fishing on his own for the first time in 20 years. He loved the experience. The freedom of being on his own and the vast beautiful ocean all around him He also had visited his elderly aunt who was very ill. He had been avoiding this visit because of family conflicts, but now that he felt free from fear, Bill felt that he could take on new personal challenges. During the first few minutes he had felt “a slight touch of anxiety” but soon he felt at ease.
This experience had a major impact on him because only five days after the visit his aunt passed away. Bill was relieved that he managed to reconnect with her before her death. Needles to say, Bill was now able to go to the church to attend her funeral.