Thursday, 5 July 2007

On safety

As a background to this post, I shall first attempt to dispel a common myth - the definition of agoraphobia as a 'fear of open spaces'. Complete twaddle, I'm afraid, although it's easy to understand how this misconception came about considering that, when taken literally, the word translates from its Greek origins as 'a fear of the market place'.

What it actually means is the fear of being anywhere that escape to a 'safe place' may be difficult, or that help, medical or otherwise, may not be available in the event of a panic attack.

So, with that out of the way: What is the definition of a 'safe place'?

Home? Car? Work? Bed? The arms of the rare friend who 'gets it'?


At the time of writing, I've had vicious attacks of the "please help me, I'm dying" variety in all of them, and yet still, somewhere in the back of my mind, they reside in a little box marked 'safe'. I still haven't quite worked out why this should be the case when other quite ordinary places - the Co-op, the short walk to the office at my last job, the train, the living room - so often fall victim to avoidance.

Hospital as a safe place is an interesting concept because any nurse in the land will tell you that in these days of rampant MRSA and other assorted nasties, it's probably one of the least safe places you can put yourself in. It does seem like a contradiction in terms when you look at it objectively, but I'm betting that isn't the reason that not many agoraphobics would comfortably admit to an A&E department being their safe place of choice.

'Choice' is a bit of a misnomer, because it's actually a last resort, generally used only when all else fails, when your usual safe places, for some reason, become temporarily otherwise. Really, it is, although you can see the disbelief on the faces of those who attend to you when, between hyperventilating breaths, you manage to splutter out the words "I didn't know what else to do."

Ladies and gentlemen, welcome to the curse of the dysfunctional flight-or-fight response - biological, inbuilt, and faster than the speed of rational thought. When we were sharing our living space with sabre-toothed tigers it no doubt served a purpose - to drive us away from danger without the inconvenience of needing to think about what we were doing; by design, therefore, it temporarily robs us of our ability to think clearly - and therein lies the problem.

Most of the time, after years of practice, you manage to snatch back a little rational thought in the middle of the mayhem. You know the routine, you know the pattern it takes, you know that if you can just wait it out, it's not going to kill you. But there are also occasions where for no apparent reason other than a sudden misfiring of neurons, you just can't.

So you do what anyone does when faced with a perceived threat to survival. You pick up the phone, and you call for help.

There's always that sense of burdening, of knowing, somewhere in the back of your mind, that you don't belong there. That the 999 operator talking you down from the blind panic and the chest pains and the incapacitating dizziness while waiting for the first response vehicle to arrive could well have - should have - been deployed on a more 'deserving' case, even as they reassure otherwise while reading from a script that you've 'done the right thing by calling us'. That just because you think you're dying it doesn't necessarily mean you are, while the person down the road with the cardiac problem or the pensioner slipping into shock after falling on the street may well be.

The guilt is overwhelming, the shame dropping over you like a bucket of ice as they hook you up to a machine which reads out yet another normal ECG and ascertain that yes, your blood pressure is ridiculously high, but that's not surprising under the circumstances. They pack you off home again with a shake of the head and a not-quite-out-of-earshot murmur about psychiactric liaison teams and still you can't quite get up the nerve to say yes, it's frustrating for me too.


Depending on the phase of the condition at any particular point in time, then, 'safe places' can vary wildy: out, with someone else; anywhere behind your front door; in your office; in your bed with your phone and your keys to hand 'just in case'. Anywhere with your phone and keys to hand - or sometimes in your hand - 'just in case'... although phones do tend to object to being taken into the shower.

I hope that when the day comes where the safe place is inside my own mind, I'll know I'm finally there.


An Unreliable Witness said...

Wonderfully written and very thought-provoking. And to prove that I'm "not just saying that", I do think you're wrong on bed not being a safe place, since I happen to know that buried under my duvet is, indeed, the safest place in the world.

So there.

Anonymous said...

'tis strange to read that (but enjoyable - but this perhaps isn't the place to fangirl your writing) because of the similarities and differences with my own experiences. Thankfully, my claustrophobia is pretty rare (I mean, panic attacks caused by it are rare, and fairly obviously triggered - small, dark places, or crowds of people) but there's that same flight or fight response. I'm not scared I'll die, as such, but scared I'm going to be crushed and suffocated. There's a very strange dual fear (this happens when I'm surrounded by a crushing crowd) both that someone will notice you and, at the same time, that no-one will and you'll be trampled under foot.

The very few times it's been bad, the bed or my room/house are the last places I can be. When it's at it's worse, I can't even be inside - I need to be able to see the sky and feel fresh air, so I can be sure I can breathe.

What fucked-up things your brain can do you, eh?

Sorry about waffling on, do keep writing, I'm finding this blog so interesting.

sheenagh x

Anonymous said...

The shower thing made me giggle - it's what I sometimes do on occasion.

Channon said...

Good post.