Overcoming Escalator Phobia: A Journey Through Anxiety and Treatment

Fear cannot be cured?

Dr.
Tang: I remember that on January 19 of this year, I wrote to you expressing my fear of escalators, and you replied suggesting that my attending physician arrange for psychological and behavioral therapy.
However, my fear has become increasingly severe, and now I am also afraid to be around crowds.
For instance, there is a fan meeting at the end of this month, and in the past, I would have contacted them to arrange a place to see our idol together.
But now, I don’t dare to reach out; I just want to go and come back quietly so they won’t notice anything unusual about me.

During the SARS outbreak, many department stores closed their escalators.
I tried to step onto an escalator to force myself to shop, but I just couldn’t do it.
The moment I stepped on, my legs would tense up, and the more I forced myself, the more anxious I became, making it even harder to step on.
People around me probably thought I had a physical disability! My attending physician referred me to a psychologist for treatment, but it hasn’t worked.
The techniques like "biofeedback," "relaxation exercises," and "flooding" have all failed for me, making me feel increasingly difficult to treat and hopeless.

Additionally, the psychologist pointed out that I have no future and no goals, and he wants to "treat" my future (which shouldn’t be a reprimand, considering I am paying for this).
His words make me uncomfortable, and just thinking about what he said gives me headaches, keeps me awake at night, and makes me want to cry.
I ended up taking the Xanax (an anti-anxiety medication) that my doctor previously prescribed (I only took one), and it helped me sleep.
Once I sleep, all my worries disappear.

Right now, I feel so miserable, my head hurts, and I am so scared.
I just want to cling to the virtual world of the internet, but when it starts to merge with the real world (like online gatherings), my suffering returns...

Wei Wei, 20~29 year old female. Ask Date: 2003/07/14

Dr. Tang Xinbei reply Psychiatry

Dear Weiwei,
It seems that your "fear" has intensified.
I am still unsure if it is related to the symptoms of your schizophrenia.
Have you considered how your "fear" originated? I mentioned that the clinical treatment for "phobias" includes not only medication but also cognitive and behavioral therapy, or a combination of biofeedback and systematic desensitization.
However, if your issues stem from schizophrenia, it may be necessary to reassess whether these methods are appropriate for you.
Your therapist is making efforts to use various approaches to help you overcome your fears, but it seems you find it too harsh, leading you to want to escape? I suggest discussing this with your primary physician for further evaluation and necessary adjustments.
Wishing you peace and joy!

Reply Date: 2003/07/14

More Info

Overcoming escalator phobia, or any specific phobia, can be a challenging journey, especially when anxiety symptoms escalate to the point of affecting daily life and social interactions. From your description, it seems that your fear of escalators has not only intensified but has also led to avoidance behaviors that isolate you from social activities, such as gatherings with friends or fans. This is a common pattern in anxiety disorders, where the fear of a specific situation leads to broader avoidance of social interactions and activities that may trigger anxiety.

Firstly, it’s important to acknowledge that phobias, including escalator phobia, are often rooted in anxiety and can manifest in various ways, including physical symptoms such as increased heart rate, sweating, and a sense of impending doom when faced with the feared object or situation. The fact that your fear has escalated to the point where you feel unable to engage with others or even approach an escalator is a significant concern that warrants further attention.

You mentioned that previous therapeutic approaches, such as biofeedback, relaxation techniques, and flooding therapy, have not been effective for you. It's not uncommon for individuals to respond differently to various therapeutic modalities. Cognitive Behavioral Therapy (CBT) is often recommended for phobias and anxiety disorders, as it focuses on changing negative thought patterns and behaviors associated with the fear. If you haven't already, it might be beneficial to discuss with your therapist the possibility of incorporating CBT techniques into your treatment plan.

Additionally, exposure therapy, a component of CBT, involves gradual exposure to the feared object or situation in a controlled and supportive environment. This method can help desensitize you to the escalator over time. It’s crucial that this exposure is done at a pace that feels manageable for you, as pushing too hard can lead to increased anxiety and avoidance.

You also mentioned the use of Xanax (alprazolam), which can provide short-term relief from anxiety symptoms. However, relying on medication alone may not address the underlying phobia. It’s essential to have a comprehensive treatment plan that includes both medication and therapy. If you find that Xanax helps you cope temporarily, it might be worth discussing with your doctor about the potential for adjusting your medication regimen to better support your overall treatment goals.

Furthermore, the feelings of hopelessness and lack of direction that you described in your interactions with your therapist are concerning. It’s vital to have a supportive therapeutic relationship where you feel understood and validated. If you feel that your therapist is not meeting your needs, it may be worthwhile to seek a second opinion or find a therapist who specializes in anxiety disorders and phobias. A good therapeutic alliance can significantly impact the effectiveness of treatment.

Lastly, consider engaging in self-help strategies that can complement your therapy. Mindfulness practices, such as meditation and deep-breathing exercises, can help manage anxiety symptoms in the moment. Journaling about your fears and experiences may also provide insight and help you process your emotions.

In summary, overcoming escalator phobia is a journey that may require a multifaceted approach, including therapy, medication, and self-help strategies. It’s essential to communicate openly with your healthcare providers about your experiences and feelings, as this will help them tailor a treatment plan that works best for you. Remember, recovery is a process, and seeking support from friends, family, or support groups can also be beneficial as you navigate this challenging time.

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