The House Arrest Syndrome

A man’s home is his castle. This is an old adage we have heard since we were young. There is a lot of truth in this saying; we all need a place of refuge in life, a port in the storm, a place that is familiar to us that gives sanctuary, a place that evokes a feeling of comfort and security. But there is a dark side to this peaceful scene.

Agoraphobia Statistics In The U.S.
Agoraphobia is a mental disorder associated with a fear of crowds and open spaces as well as enclosed spaces, such as elevators and transportation vehicles, outside one’s home. People with this disorder have difficulty leaving the safety and comfort of their homes. The prevalence of Agoraphobia disorder in the United States ranges from 1 to 5% of adults and women are two to four times more susceptible. It can be precipitated by significant losses in one’s life, such as the death of a spouse, and other kinds of traumatic experiences. There is evidence showing heredity as a predisposing factor and separation anxiety in childhood as a precursor to its development.

In my practice and work with patients who suffer from a fear of leaving their homes, what I call “The house arrest syndrome,” initially the home is experienced by my patient as a refuge, a safe and pleasant place to dwell. Over time, however, this sanctuary becomes their prison as the world outside it becomes less and less familiar and scarier. Further compounding the problem, greater time spent watching television when it substitutes for direct experience with the real world distorts our perceptions of the world as seeming more dangerous than it is. The house arrest syndrome acts like a medicine that over time takes on addictive qualities, one’s place of refuge becomes a trap one cannot escape without exposing oneself to anxiety and, worse, even panic attacks.

Cognitive Behavior - Exposure Therapy Treatment
The treatment of house arrest syndrome requires a combination of cognitive and a form of behavior therapy called exposure therapy in which a patient is encouraged to gradually venture outside the safety of their home. The patient is thus slowly exposed to places and experiences avoidance of which had prevented them from living a normal life, such as shopping, visiting friends and family, attending appointments, and living a more enriching life. Exposure therapy is used in conjunction with cognitive therapy which helps a patient to examine the fears they might have about what might happen if they leave their homes and how these fears distort their expectations that cause them to avoid leaving their home. A combination of exposure therapy and cognitive therapy has shown significant success in both the professional research literature and in my experience with patients to treat this fairly common problem in clinical practice.

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Posted by Robert Hamm, Ph.D.