Anxieties Underlying Phobia of Sexual Intercourse in a Woman

My patient, a married woman now aged 37, was transferred to me five years ago after one-and-a-half years of analysis. Her complaints could be divided into four categories:

1. Claustrophobic fears of being trapped in underground trains, theatres, etc., on heights and on water, of being hemmed in by crowds, of being alone in the house and leaving it. Panicky fear of suffocation when she pulled a garment over her head and when she washed her hair.

2. Hypochondriacal fears and psychosomatic symptoms. Fear of losing her voice, her sight, her mind, of losing the power of her legs, of throwing herself out of the window. Frequent sore throats, choking and not being able to swallow, breathlessness, colicky cutting pains, heaving.

3. Difficulties in object relationships particularly with women, feeling exploited, mocked and accused.

4. Inhibitions in work, eating, and intellectual inhibitions.

In appearance the patient is small, fair, neatly though plainly dressed, looks younger than her age. She comes from a small town, from a middle-class family. Her father was described as quiet, reserved and reliable. Her mother, according to the patient, suffered from fears and complaints similar to her own, yet was the centre in company. The patient has a sister three years older who was described as bossy and bad-tempered in childhood, but now they are on friendly terms. My patient was born in 1916. Her mother told her that she was breast-fed for eight or nine months, that she was a healthy baby, and stressed particularly that she was quiet and did not cry. She talked early but was slow in starting to walk. When she was one year old her father was called up and posted abroad. He returned when my patient was about four-and-a-half. During her father's absence my patient slept with her mother and went with her everywhere. She was her mother's favourite whilst her sister was spoilt by her grandfather. After her father's return she