This paper aims to illustrate Henri Rey's notion of the claustro-agoraphobic ‘syndrome’. Two case studies focus on beginning (entering into) and leaving (coming out from) treatment since claustro-agoraphobic anxieties tend to erupt with particular violence and clarity around these events, emerging in the transference and countertransference as struggles to settle and contain the patient in treatment. This process re-evokes the patient's lifelong struggle with a merged maternal object as they are alternately overwhelmed by fears of being entrapped or entombed, their individuality threatened, or by fears of abandonment and disintegration. Caught between alternating terrors, survival becomes the overriding preoccupation around which they evolve the characteristic defences of a liminal existence, disabling the therapist and resorting to flight as a last-ditch solution. In the final section, post-Kleinian theories of destructive narcissism are used to throw light on the interlinked psychic processes underlying Rey's claustro-agoraphobic syndrome.