02/18/2026
This morning I did an exposure session focused on fear of open space on the ocean 🌊
It was also a good reminder of something that often gets confused: the difference between specific phobia (environmental type) and agoraphobia.
Both can involve fear of open spaces — but the why behind the fear matters.
In agoraphobia, the fear is usually about not being able to escape or get help if panic-like symptoms show up.
In specific phobia (environmental subtype), the fear is about the environment itself — for example, “I could drown,” “I could fall,” “I could be swept away,” or “Something bad could happen because of this situation.”
Same setting. Different mechanism.
And that difference changes how we conceptualize the case and plan exposure work.
Diagnosis isn’t just a label — it guides the intervention.
