Low Anxiety

Fear of the Subway Derails Thousands

Regina Stafford is slightly ill at ease as the B train lurches out of the 55th Street station in Boro Park. There are a few moments in the short ride to Coney Island when the thin mother of two seems threatened. When the lights in the car flicker and then go out. When the train suddenly plunges into a tunnel. And when the conductor announces that the train is being rerouted. The news elicits quiet grumblings from the other passengers. But for Stafford, who, at 39, has spent more than half her life desperately afraid of the subway, the unforeseen switch to the N train poses a significant challenge.

"Anything unexpected can set it off," she explains, pausing to listen intently for directions from the conductor. "It" is the sense of panic Stafford has experienced periodically since she was 13, a sudden clutch of terror that leaves her sweaty, dizzy, and lightheaded. When it hits in the subway, "You want out. You get the feeling that you're going to go crazy and you want to throw yourself out the window." You also never want to return to the hole in the ground, lest the trauma recur.

With the help of several therapists, her church, and a supportive husband— who happens to work as a supervisor for the MTA— Stafford has largely conquered the fear that, for years, has kept her off the trains and other public transportation, and confined her to a small "comfort zone" near her Brooklyn home. She even periodically takes short trips with the sole purpose of facing down her panic.

But thousands of New Yorkers are so terrified of the underground trains they refuse to ride them. As much as 10 percent of the population may avoid the subway because of phobias, estimates Dr. Michael Liebowitz, director of the anxiety-disorders clinic at the New York State Psychiatric Institute. The root causes can be claustrophobia, posttraumatic stress disorder, or— as in Stafford's case— fear of public places. One man, eventually diagnosed as a social phobic, refused to ride the train because of his fear of other riders. "He thought everyone else was evaluating him," says Liebowitz. "A subway ride left him feeling too exposed."

There are plenty of good, rational reasons to dislike the subways, of course. The underground system can feel like a torture chamber. A disturbingly smelly, hot wind blows in the summer— a disturbingly smelly, cold one in the winter. Rats scurry around. And as the trial over Kendra Webdale's death reminds, some people have been known to push others to their deaths on the tracks.

In fact, many subway phobias are rooted in real experience. Take the photographer who has taken to holding on to the nearest secured object for dear life whenever a subway approaches the station. Or the lawyer who became unable to ride the trains after he got mugged on the F platform.

Perhaps the most common— though not entirely rational— train-related fear centers around not being able to get off. "A subway is a prison for those who have anxieties," says Mary Guardino, director of the nonprofit Freedom From Fear, in Staten Island. Guardino herself avoided the subways for 12 years because she associated the trains with panic attacks. "You're trapped," she says. "On an Amtrak, you can go wash your face. On the subway there's nowhere to go."

If the train happens to stop in a tunnel or on a bridge, the sense of inescapability may become unbearable."I just wanted to get off and I couldn't," says Suzanne Gaines, 29. Gaines lives and works in Park Slope— a D train ride across the Manhattan Bridge from Manhattan. But her phobia, which began as a mild discomfort with the trains, gradually increased to the point where she found herself not doing the things she wanted to do just to avoid going underground.

Eventually Gaines sought help from therapist Nelson Howe, whose martial arts­style concentration and breathing techniques helped her back on the train. Taking the subway still isn't pleasant for Gaines— her boyfriend has to hold her hand when they go over the bridge— but she feels triumphant for confronting her fears, which, in six years, had expanded to include planes and elevators.

Indeed, experts agree that most fears of the subway can be overcome— and that without intervention, phobias can escalate. "The fear can spread into other areas," says Mark Sisti, a psychologist with the Long Island Center for Cognitive Therapy. "And the more general it is, the more difficult to treat." Sisti accompanies many of his patients on the subways. He might sit across the aisle from his patient, or ride in the next car. He insists such "exposure therapy" is essential to getting over fear of the trains.

Others believe subway phobias relate to childhood experiences that should be addressed in talk therapy. And some therapists and patients swear by medication. Reynaldo Garcia Pantaleon, a 32-year-old artist, used to take the local from his Washington Heights home to work in the East Village "in case I had to get off and look for help." But antianxiety medication he's taken over the last year has made his terror disappear as if into an underground tunnel.

"It's great," says Pantaleon. "I take the train everywhere now. I even like the express ones. They're faster."

 
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