On the last track, we discussed three aspects of panic disorder, namely typical manifestations; irritable bowel syndrome; and loss of significant person.
One great source of anxiety for many of my clients is the thought of travel. For some, it might be certain aspects of a trip such as the thought of an airplane or going through forests. For others, it might be just the simple idea of being away from a safe environment and placing themselves in a totally new one. Because of this anxiety, many clients stay at home and never experience the world around them, which causes embarrassment and regret.
On this track, we will examine three steps to help clients overcome their anxiety over travel. These three steps are Motivation; Pleasurable Tie-Ins; and lessening anticipatory anxiety.
Three Steps in Overcoming Anxiety
Step #1 - Motivation
One of the first steps in helping a client take a trip is Motivation. Many clients only wish to take a trip to test how well they could stand up against their fears, which only increases their anxiety over failing. I also find it important that a powerful outside force is pulling them to their destination, for instance a close family member or exotic locations. Phil was a client of mine who refused to leave his hometown.
A few years ago, Phil had experienced a panic attack while visiting a friend in another city a few miles over. Ever since, Phil has associated leaving his hometown with panic attacks. Although the frequency of the attacks has diminished significantly during his treatment, he still cannot bring himself to leave his home. During one session, Phil expressed a desire to see his family, who lived in Brooklyn, several miles away. However, Phil was extremely reluctant because visiting them would require him to leave his comfortable bubble.
As it turns out, Phil had made his desire known around the time of the Brooklyn Bridge Centennial celebration. I decided to give pamphlets to Phil about the festivities which described Brooklyn in shining terms. Gradually, Phil became more and more interested with the bridge, its history, and architecture. Finally, he wrote a letter to his family saying that he may plan a trip to see them. His family became so entranced with the idea, that they sent him letters every few days encouraging him to come up. Finally, Phil decided to make the trip just in time for the celebrations.
Think of your Phil. Could he or she use some motivation or outside force to help them make a trip?
Step #2 - Pleasurable Tie-Ins
A second step in helping a travel-anxious client is through Pleasurable Tie-Ins. If a client has a specific fear of traveling itself, I find that associating a pleasant action or hobby along with the negative aspects of the trip makes the travel less worrisome. Not only does this ease the anxiety, it also distracts the client from the fact that he or she is exposed to an object of fear.
Susan was a 36 year old client of mine who had developed an avoidance of long drives. This came as a result of a panic attack that Susan had had during a long drive to see a friend. Although driving itself had not caused the panic attack, Susan now associates long drives with the attack and so avoids them. Susan stated, "It may not be so bad when I’m in the car, but just thinking about what happened the last time I tried to take a long trip makes me anxious and scared."
I asked Susan if she enjoyed any particular types of music. She replied that she especially liked opera. I suggested that Susan keep a stack of opera CDs in her car and to play them whenever she drove. Soon, Susan began to look forward to taking short drives because she could listen to her favorite music. Eventually, the anxiety over a long car ride diminished and Susan could look forward to long trips as long as she had her opera tapes to keep her calm.
Step #3 - Lessening Anticipatory Anxiety
In addition to motivation and pleasurable tie-ins, the third step to reduce travel anxiety is to lessen anticipatory anxiety. Most often, an anxious client will extrapolate all the things that could go wrong or that are going to happen during a trip. This will likely lead to negative anticipation and a cancellation of the trip. To avoid such a dilemma, I ask clients to compile facts about their fears, so that instead of the object being linked to emotion, it instead is linked to cold hard facts.
Cecilia, a 43 year old client of mine, had made it her goal to go on a vacation to the beach with her family. Cecilia stated, "I was terribly afraid of bridges because I’d always get a panic attack whenever I crossed a bridge. I used to worry all the time: What if I get stuck there and can’t leave? My family wanted very much to go to the beach, but in order to get there, we had to cross a very long bridge."
To help Cecilia prepare to face her fears, I asked her to read up on the particular bridge she would be crossing: she looked up material on the bridge in the encyclopedia and she began to think of the bridge in a factual way rather than an emotional way. When the time came for her to cross over the bridge, Cecilia found herself delighted by the expanse of ocean underneath it and even wanted to drive over it again.
Technique: Eleven Tips for an Anxiety-Free Trip
In addition to motivation, pleasurable tie-ins, and lessening anticipatory anxiety, I give my travel-wary clients a list of "Eleven Tips for an Anxiety-Free Trip". The list includes the following:
- Have a definite, pleasant destination. Don’t just go for the sake of going or to test yourself.
- If at all possible, have a friend meet you at your destination or at a halfway point, to complete the trip together. If that’s not possible, call up a friend before you leave the house and when you get to your destination.
- Plan your overall trip before you start, but also make allowances for the unexpected. Look forward to small delights: colors, sounds, experiences. It’ll make your trip far more interesting than if you try to plan each little detail in advance.
- The chances of something bad happening on this very trip are very, very slim. So don’t spoil your trip with unnecessary worry.
- Bring along some food. Don’t rely on what’s out there.
- Greet people with cheerfulness and enthusiasm. Get into a positive social mood.
- If you seem to have a lot of nervous energy ready to pounce out of you, think of it as excitement rather than nervousness.
- Have something enjoyable to do during the trip.
- As you travel, let go of all muscles not in use. Make those muscles as slack as possible. Even when they seem quite relaxed, make them even more loose.
- Try not to jump too far ahead of yourself Try not to see every aspect of the journey all at once. Break it up into one baby step at a time.
- Try not to control every aspect of your surroundings. Whatever happens will happen.
Can you think of any clients who have travel anxiety? Would they benefit from "Eleven Tips for an Anxiety-Free Trip"?
On this track, we discussed three steps to help clients overcome their anxiety over travel. These three steps are Motivation; Pleasurable Tie-Ins; and lessening anticipatory anxiety.
On the next track, we will examine four aspects of exercise and diet to help reduce the severity of panic attacks. We will discuss the benefits of exercise; aerobic exercise; anaerobic exercise; and diet tips.
What are three steps to helping clients overcome their anxiety over travel?
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