Reluctant to leave the house post-lockdown? You may be suffering from cave syndrome

By | July 24, 2021

In the spring of 2021, as much of the United States was beginning to emerge from lockdown, psychiatrist Dr Arthur Bregman started to notice a common theme among the patients at his Florida practice. Though many were fully vaccinated and rates of infection in the state were stabilising, a deep anxiety had set in.

any were paralysed in their lockdown routine, unwilling to leave the house and mix with friends or even go to the supermarket. They were fearful of the virus but, more than that, they were afraid of breaking out of isolation and the small, manageable world they had become accustomed to. “I saw early on that people were cowering in their caves,” says Dr Bregman. “They were nervous to go to the grocery store, they still weren’t visiting people.”

Experts like Dr Bregman are calling it “cave syndrome”, and the phenomenon is playing out on both sides of the Atlantic. Though we’ve spent more than a year longing for things to go back to how they were, many are now feeling — sometimes to their own surprise — reluctant to emerge into the light.

Dr Bregman’s patients presented with a spectrum of symptoms, from mild anxiety to full-blown agoraphobia. “I have patients who are in their room with a mask on,” he says. “They’re afraid they’re going to get it, they don’t go out, they get their groceries delivered. These are the people who really need psychiatric help.”

In the UK, where restrictions eased radically on Monday, research by the London South Bank University showed that nearly 25pc of Britons are still avoiding being in public places.

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UK-based therapist Sheri Jacobson says she’s seen a huge increase in treatment requests recently, with anxiety the “top issue” people want help with. Clients are experiencing “fluctuations in feeling ready to re-enter the world and then worry and fear about doing so”.

While, for some, the reluctance to step outside is about a fear of Covid or a newfound social anxiety, others, says Jacobson, have come to enjoy living in their “cocoon” and embraced their inner hermit. They don’t want to give up the benefits they have found from living in lockdown and resume the commitments and choices we faced before, she says.

“For many — though not all —people, our home is our safe space, somewhere we feel very comfortable and free from threat. We think about the hectic pace of our old lifestyles, and the maintenance involved — revisiting our wardrobes, considering gifts, childcare, the financial costs of going out, for example — and can feel it’s preferable staying in,” she says.

“People have retreated inwards, they’ve had to. It’s normal habituation. We’re habit forming creatures. We get used to whatever is the current state of play.”

Dr Sarita Robinson, a survival psychologist at the University of Central Lancashire, agrees that the rise of cave syndrome comes down to human beings’ excellent ability to adapt to changes in their environment.

After the profound adjustments we all made back in March 2020, returning to “normal” is a fresh challenge. “A lot of people have anxiety about a change in routine. They’ve adapted to this new normal and suddenly we’re asking them to readapt back to their old lives and that takes quite a bit of a shift mentally,” says Dr Robinson.

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CBT techniques could be beneficial for people struggling with cave syndrome, Jacobson says, as could setting clear goals for how you would like to feel and where you would like to be able to go.

“Go slow if you need to,” says Dr Robinson. “Don’t feel like you need to be pressured into socialising if you’re not ready yet. It’s about baby steps.

“Maybe you’re not up to going and having a meal in the pub but you could go and have a drink in the beer garden.”

Dr Bregman has his patients follow his “MAV” approach. “M stands for mindfulness. Think about what you’re afraid of. Share it with others.” Once you have identified what is making you anxious, it’s time for A — positive attitude. Start with something manageable that you really want to do and which won’t throw you off course. Get a friend to meet you somewhere close by and have a gentle walk.

Finally, V is for vision. Dr Bregman recommends making a list of intentions. To get out of your cave, says Dr Bregman, “you have to have a vision and follow it”.

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