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The cognitive behavioral therapists made a momentous discovery in the 1980s when they found that many people with agoraphobia and many specific phobias have a fear of the physical and psychological effects of fear which is stronger than their dread of the context in which they experience them. It meant that the task of cure can in some cases be simplified into demystifying fear and learning not to aggravate its symptoms. After many years of being told so, I have finally begun to understand that the tangled thoughts accompanying my irrational fears are merely the sparks thrown off by the grinding machinery of panic when it has no external cause. Beneath all the philosophizing on my notepad, beneath the “ideational content” (as the psychologists put it) of my anxious searching and catastrophizing, is actually the anxiety of being far from help when the panic itself hits. When one can remove the sting of the panic – through therapy, practice, medication, or simple understanding – one can actually face the phobic trigger without that sense of doom, even when the dread has become so ingrained as to have begun to seem virtually rational. One discovers that being “near help” is not necessary after all, that one isn’t so far from “home” after all, that one’s surroundings are not after all “un-homey,” since one carries safety in oneself. But then one also has to be prepared to dismantle all that has grown up around these fears and to face their personal significance and usefulness.
-- Allen Shawn, Wish I Could Be There
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