Claustrophobia is usually the result of an experience in an individual’s childhood. Examples include being shut into a pitch-black room and not being able to find the door/the light-switch, falling into a deep pool without knowing how to swim, getting separated from parents in a large crowd, being left alone in a vehicle, and crawling into a hole and not being able to find a way out. These types of situations can cause trauma at the time of the experience which can affect the child’s ability to deal with any subsequent situation rationally. If a child observes a parent or peer’s behavior to restricted areas they may develop the same fear. Additionally, there is also a theory that claustrophobia is a prepared phobia resulting from genetic predisposal to be afraid of things that are truly dangerous.
Treatment of Claustrophobia
- In Vivo Exposure: This is the most common and effective way to treat claustrophobia. This method slowly and progressively exposes the sufferer to small spaces while helping him/her deal with the associated fear and anxiety. For example, a claustrophobic individual would start by entering an elevator and work up to a MRI.
- Cognitive Behavioral Therapy (CBT): The goal of cognitive therapy is to modify distorted thoughts/misconceptions associated with irrational fear to decrease anxiety and avoidance of restrictive situations. For example, CBT would try to convince a claustrophobic that elevators are not dangerous but are useful in getting to a destination more efficiently.
- Medications: This type of therapy can help manage the anxiety symptoms; however it does not deal with the disorder itself. Medications are prescribed to control panic and reduce anticipatory anxiety associated with claustrophobia. Antidepressants can be helpful when the feelings of fear are severe and debilitating. Three specific antidepressants; Paxil, Effexor, and Zoloft have been approved by the FDA to treat phobias. Benzodiazepines; Valium, Xanax, Ativan, and Tranzene may be prescribed for severe anxiety. There is a strong potential for dependence on these medications, and should not be taken for longer than four months. Additionally, beta-blockers (cardiovascular drugs) may be prescribed to reduce the physical symptoms of anxiety such as palpitations, elevated blood pressure, and increased heart rate. They work by blocking the flow of adrenaline that occurs during anxiety. While beta blockers don’t affect the emotional symptoms of anxiety, they can control physical symptoms such as shaking hands or voice, sweating, and rapid heartbeat.
- Relaxation Exercises: Deep breathing, meditating and doing muscle relaxing exercises are effective at dealing with negative thoughts and anxiety.
- Alternative/Natural Medicine: There are a few natural products and homeopathic medicines that some patients say help them manage panic and anxiety.
- Hypnosis: Post hypnotic suggestions may also help claustrophobia.
Law Enforcement Tips
Congress enacted the ADA Amendments Act of 2008 to clarify its intent as to who is protected by the Americans with Disabilities Act of 1990. In enacting these amendments claustrophobia was listed as an ADA disability. There have been several lawsuits related to this issue with varying results. The bottom line for a LEO is to avoid heartache if possible. If an officer can safely modify your confinement procedures when told that a suspect has claustrophobia and/or is having a panic attack he/she should do so. Check on a claustrophobic detainee often; especially in your patrol car or a holding or jail cell.
How to Help Someone Having a Panic Attack
- Remember, a panic disorder may be caused by very real conditions, such as hypoglycemia, inner-ear infections, and even congenital heart defects. If uncertain about a person’s medical stability call for paramedic back-up. Ask the person to describe what they believe is causing them to have a panic attack. Individuals who experience panic attacks often feel as if they are having a heart attack or dying. It is important to determine as quickly as possible whether there is a real physical danger or medical emergency.
- Ascertain the individual if he/she is currently being treated by a medical professional for an anxiety disorder. He/she may be using prescription medications, combined with behavioral modification techniques to deal with panic attacks that may be helpful in the current situation.
- Avoid discrediting the reasons why someone is having a panic attack. Do not use phrases like "there's nothing to worry about" or "it's all in your head", this will make the person feel more isolated, exacerbating the situation. Try to remain empathetic.
- Stay with someone who is having a panic attack by staying with him for the duration of the episode (usually about ten minutes). Have the individual sit down and talk to him/her in a relaxed and calm manner.
- If the individual is transported to a corrections facility notify the staff of their condition. A trip to an emergency room is normally not necessary and may in fact make the situation worse.