Tag Archives: agoraphobia

74. You can’t face your fears with clogs on.

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Its not fast but it can be furious.

 

Wise decision-making usually involves finding the Sweet Spot. On a golf club, the sweet spot is the area on the face that needs to come into contact with the ball. In life, the sweet spot refers to the best compromise between competing considerations. It might be a Ford Fiesta, it might be Bishops Stortford or it might be Jude Law. It depends on your parameters and your budget.

For travelling upward in buildings, the sweet spot is the escalator. Stairs are too tiring and elevators are claustrophobic, if you have a tendency that way.

How do you measure a fear of elevators? In metres of height, perhaps. Or storeys. How many flights of stairs will it take for you to opt for the little box – I nearly said coffin – instead of the stairs? For me, its about 8. To some extent that depends on the lift itself, how crowded it is, how likely is it to break down, and in the event of a breakdown, how long would it be before rescue? There’d be other factors too, such as whether you had your angina spray handy, your catheter in, what shoes you had on etc.

It pains me to set this down in writing, but I once had a pair of clogs; don’t ask why, it was the eighties. Entirely the wrong choice of footwear, it turned out, for a lift-phobic working in a multi (but less than eight) storey  hospital with slippery stone stairways. There’s almost no way of appearing nonchalant tumbling down a flight of stairs flinging X Rays and blood samples in all directions. Even House couldn’t have done it.

Will clogs ever return? I doubt it – the sweet spot for footwear is Airmax. Not WoodMax.

Or just possibly JesusMax, i.e sandals, if you’re in a hot country.

I just came back from India, which has put quite a few things in perspective. My problem with closed spaces for instance has been entirely sorted out after a few trips on the Delhi metro system.

There’s a theory going about, tested in Scandinavia, that if you removed all the road signs and traffic lights, the traffic would sort itself out quite safely, everyone edging forwards, slowly and gingerly, taking care to avoid other vehicles and pedestrians. The same unfettered system seems to work in Delhi, even though the Scandinavian model is played out on 32X fast forward, as though Benny Hill had become transport commissioner.

In Delhi, the auto-rickshaw hits the sweet spot for personal transportation. It’s cheap, it’s fast enough and if you stop for a moment there’ll be one next to you. There’s a nice breeze. It’s a thrill a minute, too. If I’d had cigarette papers I wouldn’t have been able to insert them into the gaps between the traffic (and I might have fallen foul of the new litter laws, too).

It was worth the trip though, to meet so many fascinating and lovely people, such as writer Murad Ali Baig.

Murad writes about motoring, Indian history, religion and many other subjects*. He’s putting the final touches to a book called ‘The Hijacking of God’, which is a brave enterprise now that there is such turmoil in the religious stock markets.

I found that Murad had been down a similar road to myself in assessing the cost effectiveness of whiskey. The good stuff is better than the ordinary, but not ten times better. I think its a version of the law of diminishing returns. The sweet spot for whiskey is towards the budget end of the market, though not quite Tesco blue stripe. Murad tells me that after 6 weeks of aging, the whiskey has matured. Sure, after 12 years it’s better. But not a hundred times better.

One of Murad’s themes is that religions started reasonably enough with excellent principles like peace and love, but soon fell victim to endless tiers of middle men like priests and mystics.

Soon it becomes clear to an outside observer that the religion is operating largely for the benefit of its own employees, who become relatively rich and powerful. The middle men create a false expertise, creating and interpreting myths and symbols, eventually leading to the Spanish Inquisition, TV evangelists and Robert Langdon.

Though one cannot entirely blame a religious ideology for the antics of its practitioners there are lots of parallels between the hi-jacking of religion and the misdirection of other worthy enterprises, such as charities and health services. Typically the primary goals of these organisations are to sustain themselves rather than achieve their stated aims.

Professions create a closed shop, hogging certain activities to themselves that were previously open to anyone.

I’m not sure where we would find the sweet spot for religion. We visited Jain and Baha’i temples, mosques and cathedrals and they all have plus and minus points. It doesn’t do to get too fussy about religion, but I can’t help thinking there’s a gap in the market. Something that does good weddings and funerals without too many food and clothing restrictions. Something that lasts about 40 minutes per week. Something non-violent, yet which permits hedge-cutting. Perhaps the Religion of Nike, where the only rule is ‘just do it’.

If Murad took a look at Psychology and Psychiatry he’d soon spot the mythology. True, there is no setting fire to lambs. True, there are no dietary restrictions, beyond the heavy use of Ristretto. The only vestments are tweed jackets.

But when it comes to Jargon, Gobbledegook or what UKIP would probably call ‘Mumbo Jumbo’, I feel we have now gone one ahead of the god-squad. There are sweet spots in psychotherapy, but such gems- such as REBT – are often shrouded in mystery.

For our ‘Agoraphobia’ we have ‘Graded Exposure in Vivo’, which means taking the elevator up one floor, or ‘Flooding’, which means getting on the Delhi Metro at Central Secretariat station at 9am on a Monday morning. Immersion in the train is a kind of baptism. Once you’re on there’s no turning back.

Though those trains are the most crowded spaces I have ever experienced, after a short while I felt surprisingly calm. I think it might have been the sudden announcement that the train had facilities for charging your laptop. I’d have given the Nokia a bit of free juice, that’s if I’d been able to move more than half an inch in any direction.

Sometimes your worst fear happens and you just laugh. Thank you Mr Nike for keeping it simple. I just did it.

 

 

*Murad Ali Baig: ’80 questions to understand India’, Tara Press.

 

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12. Grappling with the wrong trousers.

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What the well dressed tree is wearing this year.

A procession of girls moves jauntily down Oxford Street. Each girl carries an identical Gap carrier bag and wears brightly coloured skinny trousers. The legwear ranges through many colours and materials – there are 23 different types in the shop.

It took me a while to realise it was an advertising event. Initially I just assumed that ‘Jeggings’ had really taken London by storm, either that or Mayor Boris had passed a new bye-law banning big trousers.

How tempting was it to join that line? So called ‘modelling’ is one of the strongest determinants of human behaviour. But by the time I had got into those trousers the line would have reached Tottenham Court Road and disappeared.

Some animals are hard-wired to behave exactly the same as their neighbour, making possible formations like shoals of fish and flocks of starlings. Someone explained to me that starlings and fish do not need to be particularly clever to pull off this trick. All they need is the instruction ‘do the same as the one next to you’.

Humans like to create this effect too, in Busby Berkely movies for instance or the Red Arrows air display team.

We are used to seeing similarly clad people in other contexts, such as children in school uniform and North Koreans in boiler suits. We like to be wearing the right things.

A demonstration of modelling behaviour is one of many attractions to be found in the local shopping centre. Since social services closed all the day care facilities, shopping malls and libraries are the best places to hang out to keep warm.

Compared with the library, the shopping centre is quieter and more studious in atmosphere. Also there are more books to read.

This part is vital – before you visit the shopping centre – establish the goal. On this occasion the target is: 1.To experience the sensation of being out of place; 2. Not to respond to this sensation by buying something.

For your day out, start by re-framing the shopping centre as a kind of art gallery.

All the familiar shops / exhibits are there (not you Woolworths). There are lots of things you can do free: try out the mattresses in John Lewis, try on lots of jeggings, use the computers in PC world to look up reviews on the same model you are trying, so you can spurn the attentions of the salesperson, use the cameras to take pictures of other people testing cameras on you, try on tester perfumes and marvel at their interesting names.

Or go into Superdrug, and ask for a super drug, such as beta interferon. Ask why they call themselves Superdrug when the best drug they have is ibuprofen.

My hypothesis is that shopping behaviour is a sublimated form of hunting, or at least gathering. The important thing to remember is that all the fun is in the hunt, and once the quarry is cornered then the fun is over. It is all about the expectation of reward – pulling the trigger on a purchase is entirely unnecessary.

Buying something is like coming home from a day’s fishing with a small trout you could have bought in Morrison’s for £3. The trout’s dead eyes communicate to you: So what?

You should have thrown it back in.

Things are not always what they seem, and shopping malls allegedly have a purpose beyond amusement or art.

Shopping malls are meant to part people with their money, rather than act as a recreational facility for escaped psychiatrists. The architects and designers have put in some subtle influences to work on your mind.

One of these is the so-called ‘Gruen Transfer’. This is a place, within the centre, that is designed to disorientate people, by using a combination of unusual shapes and textures and lighting, often accompanied by Muzak.

Apparently the effect is similar to a unit of alcohol or other anxiolytic. People slow down through the Transfer, and co-incidentally this is where the higher priced items are located.

I am not convinced that there is a strong evidence base for the Gruen Transfer, or other devices perpetrated by the advertising industry. Certain low budget shops seem to generate the same emotional disruption.

The oddly named B and M store, sometimes sub-headed ‘Bargain Madness’ can induce such profound despair that it could probably be used as a testing lab for possible new antidepressant compounds. Here the store has been less discreet about its use of disorientation – the clue perhaps is in the word ‘madness’.

Agoraphobics, who tend to have panic attacks in shops, seem to dislike places where there is no clear sightline to the exit. The entrapment induces a sense of doom. Though Morrison’s have an excellent range of vegetables, the way they are laid out can set a person on edge.

Individually, fruit and veg items are not threatening, but when they gang up like this, piled high on all sides, it creates a kind of jungle effect reminiscent of Apocalypse Now.

Another piece of (probably bogus) psychology I have read, relating to supermarkets, is that people have an ‘innate tendency’ to gravitate anti – clockwise. This led to supermarkets placing their main entrances on the right hand side of the shop.

If it was on the left, people would just drift further leftwards into the vegetables section and beach themselves in the courgettes.

Staff would come out to spin customers into the next section, like fairground attendants on a waltzer.

I wonder if it is different in the southern hemisphere, or for the left handed?

It is perhaps a little frightening to think that someone has manipulated the environment in such a way that you have unwittingly bought yourself an expensive, weirdly named perfume.

I am not just referring to ‘Obsession’. What about ‘Hypnotic Poison’, ‘Crazy in Love’ and ‘Thallium’? The internet tells me there is a perfume called M-75, which is the name of the rocket Hamas fires into Israel.

Perfumes, like the Gruen transfer, and the clockwise supermarket, are designed to create an altered state, but what exactly is the state of mind called? In the case of perfume, if it isn’t the name, it is probably solvent intoxication.

Or perhaps it is the feeling of being out of one’s element, or out of step with others. A warning that you are on unfamiliar territory.

Behaviourally, it is supposed to trigger a purchase decision.

The purchase decision is a learned behaviour that creates comfort, possibly by stimulating the ‘anticipation of reward’ section of the mind. The unsettled feeling is briefly quelled, only to be replaced by regret that you have suddenly become poorer and the shop richer.

How comforting is it to be in a herd of people all dressed appropriately and behaving in the same way? Enough people must love formations of soldiers to make it worthwhile dressing thousands of people this way and arranging them in large city parks. Everyone seemed to love the Olympic opening ceremonies.

Lots of people like to be in queues, and will probably join the end of any queue if they find one. If other people are after something, instinct says there is probably something there to have.

There is often not much to be found at the end of a motorway queue, which is formed by the pulsatile dynamics of traffic flow rather than obstacles, but the queuing instinct has evolved over the lengthy period of human history before tarmac and has not yet abated.

The instinct to behave like the person to the left of you is deeply rooted and possibly imprinted at an early age. Experiencing the feeling of being in the wrong place or in the wrong outfit is deeply discomforting.

Many people hate the moment in a restaurant when they have to set out to find the toilets. The fear is not that they will never find the toilet, but rather they will make them-self look foolish to others by dithering round the restaurant.

That is why I think it is a very tall order for CBT to try and get people to fight the idea that it matters a lot what other people think of you.

In the golden era of CBT, pioneers tried to attack this set of cognitions using grand behavioural tasks.

Albert Ellis, pioneer of CBT and our hero, in his list of the top 12 Irrational Ideas, included this as number one:

‘the idea that it is a dire necessity for an adult human being to be loved or approved by virtually every significant other person in his community’

Loved? Maybe not. Approved? Maybe not? But thought to be wearing the wrong trousers? I’m afraid it’s a deal breaker.

Maybe it shouldn’t matter. Maybe not as much. Certainly try and test how much it matters. Certainly try and get it back into proportion.

But it just does.

That leaves us with a burning question. If it is so important to blend in with everyone, why do certain people do everything they can to attract attention to themselves? For instance by dying their hair a florescent colour?

This is perhaps the exception that proves the rule, since these people are relatively few in number, especially in professional groups like accountants or dentists.

Several answers to this – you choose the one you like best:

So that they are visible in traffic?

Reaction to feeling left out or insecure?

Mating ritual?

Group or gang identity?

Genuine lack of insight about how they look?

They are doing a CBT assignment to reduce the irrational cognition that it matters what people think about them?