Hi Esther, yes its interesting bec ause of course if you are having a normal reaction to an abnormal situation then CBT will not help to treat that situation. Infact for me it is a little bit more complicated than that. I developed Agoraphobia a year and a half ago, after a severe reaction to an SSRI antidepressant.
I have infact had M.E for 16 years with a long remission in the middle of this time period, but was only diagnosed a year ago. So the doc thinks im depressed - i know im not, but fearing the bedridden illness i had had years before and never quite recovered from i decide that as i dont have any other diagnosis he must be right.
I take the antidepressants. Within 24 hours i go from being physically unwell with some mild anxiety to svere suicidal ideation, depersonalisation etc. This carries on for about 8 months even though i only ever took 2 doses of the SSRI. I also develop agoraphobia as i feel so weird whenever i try to go out or drive or go to work etc. I have panic attacks when i push myself to do these things.
Before getting the M.E diagnosis i have 6 sessions of CBT. The problem is that when we look at my irrational thoughts about going out alone, we discover that i am actually physically very unwell and therefore my agoraphobia is a reaction to not being able to cope.
I finally get a diagnosis (of M.E) after some Mito testing etc with Dr.Myhill which my GP then agrees with. Now i am left with M.E AND agoraphobia. I am improving slowly after much resting, pacing, supplements etc bt the problem is that the treatment available for Agoraphobia in the UK is CBT and every time i look at why i cant do things alone it is because of a REAL fear not an imagined one. Yes i know that most PWME dont develop agoraphobia so i know i still have some work to do on getting over it, but as it is MAINLY a rational response to my illness its hard to see how even CBT can help.
Sorry to rant on, but it seemed a pertinent point.
Also Eric mentionms that with proper treatment thier may not be so much anxiety and depression with this illness and i believe that to be true. After all if i hadnt been treated innapropriately and left with no diagnosis for 15 years then i dont think i would have ended up either as physically or as mentally unwell as i have been or am now.
Justy, I think a lot of use do develop agoraphobia and it is a reasonable reaction to how sick we get when we try to go out and do things. So the CBT for that could work against the defensive mechanisms we develop for dealing with the illness. I agree with you that it is grounded on rational fears in our cases. And we would not end up having to go through such "mind games" if our illness was treated properly to begin with.