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Hello once more - Here is one of my favorite chapters from “Freedom From Agoraphobia.” Writing it was an opportunity for me to share some of the really valuable discoveries I have made in the course of years of doing therapy and trying to grow myself. It is a pleasure for me to be able to give them to whoever has ears to hear them. And since I am writing about Agoraphobia, it is you to whom they will go. As always, this: Since I am an M.D., I cannot express my point of view without being concerned about liability. So please note this disclaimer before reading further: Any medical information in this article is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. I hope you will discover a great acceptance of yourself and others in what follows: Article Twelve Insight-oriented Therapy: Part II Or How To Get Out Of Traps (Answer: Just do it.)
I know – you say that if you could have gotten out, you would have done so already and you wouldn’t be trapped. Right? Well, remember our definition of a trap? It was: “Any situation we do not want to be in but from which we can see no acceptable way of escape.” In other words, we can see no way out without paying a price we do not want to pay. So there’s always a way out – in fact, there are usually a number of ways out. But we are trapped because we have decided that the drawbacks of each way out are too great to be worth it. For example: Remember our little league mom? She was trapped because if she did not enslave herself to supporting the little league team, then she would be judged and looked down upon by the other little league parents. (And her own conscience, of course.) So there was a way out of her trap. She just regarded the price of getting out as unacceptably high. Another example: Remember Sylvia? The price of getting out of her trap of being married to an abusive husband certainly was quite high. She had to face the fear of his threats if she were to leave him. She had to find a way to support herself and her baby and maybe find that she wasn’t able to. If she left, she had no place to go and might be homeless. And so on. She is stuck - because the price of leaving is too high. But is it? In fact, Sylvia’s situation is all too familiar to therapists. They call it The Battered Wife Syndrome. They know the fears that keep the wife in the abusive relationship. And they know what has to happen (and usually does) for it to end. What has to happen? The battered wife has to reach the end of her tolerance for the relationship. She has to “bottom out” in alcoholism parlance. This means that she has to reach the point that she is so fed up with the abuse that she would rather face up to all her fears of leaving than go through one more day of it. So, fears or not, she goes. Although you could never convince her of it beforehand, the price of leaving the trap usually turns out to be far less than she had imagined. There are “Safe Houses” which solve the problem of where to go, how to feed the baby and herself for the short-term and how to be safe from retaliation by Darrell if he really even wants to carry out his threat. There are social services that provide money for longer-term food and low-income housing. There are agencies to help her get a job and daycare for the baby while she is working or going to school. And so on. She just had to be ready to take the plunge. Until she is ready, however, there is really nothing anyone can do. Time and again, therapists tell their battered wife clients about the ways out. And time and again, the clients tell the therapists all the reasons why they are trapped and can’t leave. So the therapists just shake their heads and say to themselves: “Some day she’ll have had enough.” So the answer to the trap
is another of those simple-but-not-easy things. In this case, it is
– just leave the trap. Often, it is quite hard. No one is pretending
that it’s not. But when you have bottomed out with life in the
trap, you will do it – come hell or high water. When I was in residency training, I was assigned for six months to be the doctor for an alcohol detox ward at Boston State Hospital. The ward covered South Boston, which was pretty famous for the amount of alcoholism going on there at the time. While working on this ward, some of the patients explained to me the concept of “bottoming out.” I have found it to be applicable to all sorts of human problems: The guys told me that an alcoholic would not quit drinking until he had “bottomed out.” Bottoming out was simply reaching the point that the cost of drinking was just too much to go on doing it. Something went off inside – some decision made itself – and the alcoholic “just knew” he’d had it with drinking. It was no longer an option. They also told me that alcoholics had high, middle or low bottoms. A “high bottom” drinker reached the point of quitting when he had lost his wife, kids, his job and his home – and found himself sitting in freezing doorways drinking cheap alcohol out of a bottle in a paper bag. (You see these guys in doorways in every city. They haven’t bottomed out.) A “middle bottom” drinker bottomed out only after he’d lost all these things but also had been brought to emergency rooms more than once, vomiting blood. He was bleeding into his esophagus so severely that if they hadn’t been able to give him transfusions in time, he would have bled to death. The ER doctor usually had told him that the next time would be his last. They just wouldn’t be able to sew up the burst veins in his esophagus one more time. That experience would bring the middle bottom guy to the end of drinking. And the “low bottom” drinker did not reach his bottom this side of the grave. I also learned from these guys that until someone reached his bottom, nothing was going to get him to stop drinking. It did not matter how convincing you were or how good his intentions. If he hadn’t bottomed out – if that switch inside him hadn’t been flipped, he was going to keep drinking. I think this is why Alcoholics Anonymous has a central concept of “a Higher Power however you understand it.” We do not have the power to flip that switch. It seems to be built in. If losing wife, kids, etc. is enough for us, that’s just the way we’re built. If it isn’t – again, that’s how we’re built. So on the detox ward we learned to be honest and unblaming with each other about the bottoms. If a guy hadn’t reached his bottom yet, there was no blame. It was how he was built: He was going to go back to drinking and that’s just the way things were. Nobody ragged on him about it. And nobody tried to get him to rag on himself. He was going to drink and we’d see him and help him dry out the next time he came through the detox ward. And hopefully, there would be that next time. I learned from the guys that the best help I could be for someone was to give him the straight facts of his case with no sugar coating and accept him wherever he was in the process. We didn’t need to pretend with each other. We understood what it would take to quit drinking and if that hadn’t happened yet, then so be it. Moral: We help each other and we help ourselves the best if we accept ourselves as we are - honestly and without judgment. Without whipping ourselves into changing. Instead, simply learning the facts about our situations and having compassion for ourselves if we can’t yet get unstuck. So I’m going to give
you the straight facts about remaining in traps. If you can’t
get out yet, that’s O.K. But it may help Back to Agoraphobia In the end, most traps are ways that you are not being true to yourself. It is not being true to yourself to keep subjecting yourself to physical or emotional abuse like Sylvia was. It is not being true to yourself to sacrifice your life to the wants of your baseball-playing son as our little league mom did. It is not being true to yourself to live a life of many “shoulds” and very few “wants.” It is not being true to yourself to rarely have fun. It is not being true to yourself to live in fear – of regret or loss or guilt or shame or physical harm. Joel S. Goldsmith, a 20th century mystic, wrote a book entitled: “Man Was Not Born To Cry” (see References). So true. On many levels. Panic attacks can quite literally be considered as representing messages from an inner part of you. The messages you are being sent are something like: “Look out! Danger! If you do this thing, you will lose part of your life!!” Because to spend time not being true to yourself is to not be really living that time in your life. And those hours are gone forever from the hours you are given to be here on Earth. Is it any wonder that the physical and emotional response to life-robbing situations is the same as the “fight or flight” response that animals have to life-threatening danger? What happens if you ignore the message? Well, what happens each time an animal is in danger? Sure. It gets the same “fight or flight” response. So ignoring the message just causes it to keep being sent. In fact, as people spend more time being untrue to themselves, the intensity of the message increases. It’s as though an inner self is yelling louder and louder to get your attention. This is why you will have panic attacks as long as you stay in your trap. And they may even increase in frequency or intensity. The tension of not being true to yourself can build and build until something must give – you get a panic attack. Here, we arrive at a strange point that is always reached in the overcoming of Agoraphobia: the realization that the panic attacks are actually your friend!! They are warning you that your life is going away without being lived. And they are pushing you to learn this and get your life back. Sometimes, it looks to others that the agoraphobic is just being selfish by using the fear of a panic attack as an excuse for not doing something she does not want to do. You may have thought this yourself. If so, you did not understand that you would not be feeling a panic attack was in the offing if your life weren’t already overly weighted in the direction of doing “shoulds” rather than “wants.” In other words, your insides knew that another trip to the grocery store was going to be that extra straw that would be just too much. It would be just that extra bit that was too much of not being true to yourself. When all is said and done, you simply must get out of your Life Trap if you want to overcome your Agoraphobia. Medications can cover it up temporarily, but that inner you will still be sending its message somehow. It is my belief that if you take away its ability to express the message through panic attacks, it will find some other way – like physical illness. Something is telling you that you are not living in a healthy way for you. If you are willing to heed that inner something’s message, your only choice is to get out of your trap. Remember Audrey who was trapped in the Rehab Hospital at her mother’s side? I suppose she could have taken medications and gone on living there. But this was not her way of dealing with problems. She had entered a costly treatment program for Agoraphobia. It was getting nowhere. No amount of persuasion, education about Agoraphobia or encouragement succeeded in moving her out of the rehab hospital. Finally, the therapists had to give her the choice: either get out of the hospital or take a full refund of her money and quit the therapy. Because, they explained, she would only be wasting everyone’s time and efforts if she hoped to stop having panic attacks while remaining in her trap. Audrey came close to accepting her money back. But, in the end, she made the choice to be true to herself rather than to subvert herself to her fear of guilt over her mother. She went home. The panic attacks stopped. There could have been a call one day that something awful had happened to her mother. Audrey had had to decide that even though this was possible, she had to live her own life and be part of her family. She knew that she had provided as well as she possibly could for her mother’s needs and that she had to let it go just as a parent cannot follow her child to school every day to make sure no bully picks on him. It wasn’t easy. But Audrey knew it was right. And, as so often happens, the consequences of breaking out of her trap were not the disaster she had imagined. She could have gotten that call from the nursing home. But she never did. Your Life Trap Inventory Here’s an exercise in self-honesty that really takes courage: Take a piece of paper and draw a line down the center of it. At the top, write out the name you give to your trap. For example, “Dating A Married Man.” Label one column “Pros” and the other “Cons.” Then, honestly and ignoring all your judgments about each item, write out everything you get from staying in the trap and everything you give up. It does not matter what each entry makes you look like. Be ruthless. If it’s true, put it down. Here’s an example for Sylvia’s trap:
The point here is not weighing pros and cons or seeing which list is longer. The point is being honest with yourself and getting it all down. Doing it in your head, you may bounce from one pro to one con and back to the same pro and then to another con and so on until you’ve just got a headache. This way, if you have any further thoughts, you can add them to the inventory and then just move on. Any decision you discover will not be a matter of weighing things in your mind. It will be the result of reaching your bottom about your trap. Getting all the issues down in black and white will free you up to do whatever is right for you at that time instead of just spinning your mental wheels. It may be right to give yourself permission to stay in your trap for the time being. Or it may be right to move on. My brother has an excellent method of resolving indecision: He flips a coin. Then, if he finds he’s really unhappy about how it came up, he knows that he wants to do the other thing. All we are after here is clarity about the issues involved and where you are about them. Remember: getting things out into the light of conscious awareness often results in their getting healed automatically – without you having to do anything else. I am extremely grateful that a long time ago, the realization came to me that decisions aren’t made, they’re discovered. Weighing pros and cons and then making a decision doesn’t work. We don’t have the ability to make a decision. And if we do something based upon a made-up decision, we will forever be looking over our shoulders because the issue really is still undecided. Decisions happen inside of us by themselves – such as the bottoming out decision. All we can do is to discover a decision that has already been made. Meditation is a great way to do this. And such discovered decisions are always the right ones – we never regret them. Because however they turned out, we were being true to who we were at that time. How could anyone do better? Overall, then, the way to get out of your Life Trap is simply to be honest with yourself about what staying there is costing you and let your heart do the rest. You will know when you’ve bottomed out and are ready to make the change. (It could even be now). Next month, we will go into meditation – the rapidly growing art of finding that quiet and accepting place inside. Until then, my very best wishes to you, Mark Eisenstadt, M.D. You can find Article Thirteen Here
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