Answer true or false:

• I get anxious in most situations where I have to stop and wait, for example, stoplights, standing in line at the grocery store.

• I avoid or am afraid of traveling on public transportation, trains, buses, commercial jets.

• It´s uncomfortable for me to be in a closed-in place or in a crowd of people.

• I often feel trapped by something in my life situation, such as my job, marriage, family responsibilities, health, or debt.

• It´s difficult for me to make a long-term commitment to someone or something.

The fear of confinement runs through a number of different phobias including: fear of flying, fear of elevators, fear of crowded public places, fear of small enclosed places (claustrophobia), and fear of being "stuck" anywhere in traffic, bridges, tunnels, or riding on public transportation. Of all of the types of fear, I believe that fear of confinement most frequently disguises an underlying fear of something else, what some psychologists would call a "displaced" fear.

Growing up in a dysfunctional family situation; for example, if your parents were physically or sexually abusive, or perhaps alcoholic, can instill a fear of being "unable to escape or get away." A child has no choice but to endure such mistreatment: it´s easy to understand how a fear of being trapped might develop under such circumstances.

If the fear of confinement has its origin in childhood trauma, including birth trauma, where you literally were confined or trapped, you may benefit from seeking the assistance of a therapist skilled in treating post-traumatic stress difficulties.

It may be necessary to recall the incident, fully express the feelings you had at the time, and then make a new decision, a reinterpretation, of the meaning of the incident so that you can let it go and be free to go on with your life. Techniques such as hypnotherapy and eye-movement desensitization and reprocessing, EMDR, may help in this process.

Fears of confinement are more frequently related to present circumstances than past. The fear may serve as a metaphor for some way in which you feel confined or trapped in your present life, whether in your job, your relationship with your partner, your economic constraints, your health limitations, or even your daily schedule.

By addressing and freeing up the problem in your life, you suddenly find you can drive at rush hour or stand in line at the grocery store more easily. This is not to deny the importance of exposure therapy in overcoming situational phobias. Yet it may be necessary both to do exposure and address issues of interpersonal or existential confinement in your current life to ensure long-term recovery.

If you happen to be dealing with a phobia where you have a problem with feeling trapped, you might ask yourself whether there is any broader sense in which you feel trapped by the circumstances of your current life.

Finally, the fear of confinement may arise simply from feeling trapped in your own body without the ability to easily move. When you are anxious, your muscles tighten up and your body naturally prepares for "fight or flight." However, if you´re in a situation where it really is difficult to move, for example; the window seat on an airplane or next in line at a checkout counter, you may suddenly feel very stuck.

There you are, in a sense "locked" within the tightening muscles of your abdomen, chest, shoulders, and neck with no way to actively channel the sympathetic nervous system arousal or adrenaline surging through your bloodstream. If the sensation grows strong enough, you may perceive it as entrapment, not just being stuck, especially if you tell yourself you´re "trapped."

At this point you may escalate to a full-blown panic reaction with a strong urgency to run. Had you been able to move more easily in the first place, perhaps the perception and fear of entrapment would have never occurred.

In my experience, the most effective way to handle this situation is to go with your body´s need to move, wherever possible. If you´re standing in line at the checkout counter, put your bag down and leave the store for a minute, walk around, and then return. If you´re stuck in traffic on the expressway, pull over to the shoulder if possible, get out and move about. If you´re seated on an airplane, get up and walk to the bathroom and come back, repeating this several times if necessary.

If you have to keep your seat belt fastened and can´t leave your seat, shake your leg, wring a towel, write in your journal, but do something to channel the excess activation in your body. Keep telling yourself, "This restriction will be over in a while and I can get up and move again," or "There's nothing dangerous I'll be able to move about soon," or "I may be restricted", but 'trapped' is a false perception." The better you become at perceiving the situation for what it is, restriction and not entrapment, the less anxiety you are likely to experience.

If fear of confinement is a problem, you need to address the underlying issue. Is your fear left over from a previous trauma? Is it a metaphor for some current restrictive situation in your life? Or is it simply your way of perceiving situations where your mobility is limited? Perhaps two or three of these possibilities are simultaneously true for you. When you understand the source of your fear, you can overcome it.