Andrea Perry is an author and integrative psychotherapist based in the UK. She taught in Japan before returning to the UK to work in mental health. She ran a private practice for 12 years and is a former Chair of the British Association of Dramatherapists. She provides training, public presentations and consultancy to student counseling service staff, collaborative family lawyers, coaches, career and debt counselors, and HR staff from the public and private sector. Her newest book "Claustrophobia - Finding Your Way Out: Hope and help for People Who Fear and Avoid Confined Spaces" was published in late 2007 by Worth Publishing of London, UK. I recently had a chance to interview Ms. Perry about her book and her experiences with claustrophobia.
NoFearMRI: Can you tell us about your book?
Andrea Perry: I wrote my book to find out if there was any hope for people who experience claustrophobia, and I'm delighted to say there is - lots of hope. I've described my own experience, and I've included quotes from my research with many other people who experience claustrophobia as well, authentic accounts which I believe convey the experience very powerfully. I've looked at the historical background and the current environmental factors that may be increasing the likelihood of more people suffering from claustrophobia - the current rate is around 10% of the population, at some time during a lifetime - and I suspect this figure may rise. And I've included a huge range of self-help techniques, as well as a review of the therapies that have worked for some. I very much hope that reading the book, people who experience claustrophobia will feel less alone, and encouraged to believe they really can overcome their fears.
NoFearMRI: Can you tell us a bit about your own experience with claustrophobia?
Andrea Perry: I've always been a bit claustrophobic, and as a child and young person I often used to wake up if I was in a strange bed scrabbling at the wall, trying to find a door or a way out. I think this may have arisen from two experiences when I was very small, one where I was locked in a cupboard by an elderlly uncle as a 'joke', and another incident in which I nearly drowned. But as an adult, the most impactful experience was travelling through the Channel Tunnel between England and France, when we were going on holiday - having gone to sleep on the journey towards the terminus, I woke up as our car entered the train. A steel door comes down in front of your car and the one behind, effectively trapping you in a box inside a train inside a tunnel under the sea - kind of the worst nightmare you can imagine for someone who is already 'a bit' claustrophobic - and very sleepy! - that is what triggered the phobia for me. I'm aware that the impact was very powerful not only because I was asleep, and therefore quite vulnerable, but also because our family had been going through quite a lot of stress at that time. After that experience, I found going through tunnels, using the subway or trains or buses or taxis with electronic doors, using elevators, even going through revolving or security doors truly terrifying, and for a while my world became very limited by these fears.
NoFearMRI: How long did it take for you to find a workable solution?
Andrea Perry: Once I really set my mind to the challenge of overcoming claustrophobia, I would say it took me about eighteen months to really feel I could do everything I could before. Back in the '80s I lived in Tokyo, so a fair test of my 'recovery' was whether I could use the London 'tube' (ie subway) especially at rush-hour - and I'm delighted to say I can. I still feel very proud about this - I'm sure my fellow passengers could have no idea why I'm grinning! And I've been back through the Eurotunnel, on the train, and it was a great trip.
NoFearMRI: What helped you to overcome your fears?
Andrea Perry: There are several key factors that helped. Because I had previously found writing a book about a problem an incredibly helpful way of dealing with it (Isn't It About Time? How to stop procrastinating and get on with your life Worth Publishing 2002) I decided to do the same on overcoming claustrophobia. So everthing I tried, every tactic and tip I learnt about and had a go with, became part of my research and part of my recovery. Finding out what issues other people had, what they had tried that had and hadn't worked for them was truly inspiring. I read books about fear, about anxiety, and personal first-hand accounts by people who had been trapped in different ways. Writing was also hugely helpful, in that it offered both a focus for my thinking and a way to reflect on what was happening for me.
I came to recognise that claustrophobia is a fear like any other - and that part of the fear is entirely rational. Small confined spaces can indeed be dangerous, and I realised I needn't, in fact shouldn't aim to eradicate my fear entirely: I might need it to motivate me if something actually happened! I genuinely believe that people who experience claustrophobia can alert designers, architects and engineers to the potential for trauma or danger in spaces that hold humans, especially those that are electronically controlled, with new possiblitiies of entrapment.
So it was simply the irrational aspect that I needed to overcome - and for me that was a process of learning more about self-soothing, loving myself more if you like: as well as learning to take account of every tiny scrap of evidence that I was making progress, and to build memories of that, to build a bridge between the voice of reason and my terror. People also played a huge part - my claustrophobia 'buddy' who I could phone and share news of progress - my family, who patiently listened to tales of my adventures, and were very supportive, and all the amazing people who shared their experiences of claustrophobia with me.
NoFearMRI: Can you discuss some other ways from your research that people can cope with, or overcome their claustrophobia?
Andrea Perry: There are numerous self-help techniques that help, and also several forms of therapy (principally EMDR, hypnotherapy, CBT, solution-focused EFT and possibly psychodynamic therapy where there is no history of trauma and a strong emotional content to the phobia). The self-help techniques involve psycho-education, ie learning about the dynamics of panic, and becoming mindful of what is going on inside us: taking things step by step with an attitude of curiosity and experiment, ie enroling ourselves as researchers in our own process of recovery: self-soothing: building an internal relationship of trust within ourselves, so that when 'we' endeavour to calm ourselves down in the absence of real danger, we believe what we are telling ourselves; relaxation and breathing techniques: visualisation: the use of calm packs and memory prompts - I have a range of cards with supportive messages that friends wrote for me to take with me, and whilst I no longer need to look at them, I have their memory to draw on as an anchor.
And so much besides - and no one technique is the winner, we're all different and what works for one person may not for someone else, so it's a question of having a go and finding out, small step by small step. Even having the willingness to have a go is a tangible step in the right direction, so it's impossible to 'fail', it's a learning process and you'll get there.
NoFearMRI: Do you have any advice for claustrophobia sufferers who are scheduled for an MRI exam?
Andrea Perry: I did quite a lot of research about MRI facilities, since I was aware that this was a 'pet hate' for many people who told me about their claustrophobia. I think the NoFearMRI site is a terrific idea, because it addresses these concerns and aims to demystify the process, which is of enormous benefit and helps counter the horror stories out there. So I'll be suggesting people visit this site.
I've been impressed with the designs of the new generation of scanners, which have taken claustrophobia into account. However, even if you have to go through an older scanner, my advice would be to remember that you have the right to be treated with absolute respect by the staff working with you, which includes being given the time to talk through your concerns, talk through the procedure and ask any questions you might have. Well-trained staff are aware of the issues for people who experience claustrophobia, and they know that it is in everybody's best interests to prioritise enabling the patient to feel relaxed. Ask them to check in with you as often as you need them to. There's nothing wrong with taking a friend or family member with you, for support, and good units will make this possible. Visualising a successful process and outcome is a technique used to good effect by hypnotherapists, and it is very applicable here. Visualise the scanner as an incredibly supportive friend, trying to learn about you in order to provide the best possible help. Give it a name - sing it a song in your mind, make a poem about it.
Learning what works for you in other small, confined spaces before you get to the MRI will be helpful, whether it's something to think about like a list of presents, the loving faces of everyone you know, a visualisation of a beautiful place or favourite journey, mindful breathing, whatever works best. And finally, remember that it will be over soon, and think about what you will do next and how great you'll feel that you've managed to go through the process.
NoFearMRI: Thank you very much for your time.
Andrea Perry: Thank you so much for giving me the opportunity to contribute to your site.