Agoraphobia and its Relation to Hysterical Attacks and to Traumas1

The analyses of a traumatic neurosis and of some twenty cases of agoraphobia and similar phobias have led me to conclude that there is an intimate connection between three separate problems: the significance of hysterical attacks, of psychic traumas and of the anxiety experienced in agoraphobia, which I take as a typical example of the mechanism of phobias in general.

Freud2 originally defined the hysterical attack as 'nothing but phantasies projected and translated into motor activity and represented in pantomime'. These phantasies are, as he tells us, unconscious and, like the latent dream-thoughts, subject to distortion, a process which comprises condensation, multiple identification, antagonistic inversion of the innervations and reversal of the sequence of events. Freud holds that the hysterical attack is a substitute for an autoerotic gratification, previously practised and since given up, and that the loss of consciousness, the 'absence' characteristic of such attacks, 'is derived from the fleeting but unmistakable loss of consciousness which can be observed at the climax of every intensive … sexual gratification'. We know, further, the view taken by Freud of the phenomenon of the arc de cercle, characteristic of major hysterical attacks: he holds that it represents 'an energetic disavowal by antagonistic innervation of the position suitable for sexual intercourse'. Ten years ago I published an interpretation of the arc de cercle3 which was suggested to me by a quite unequivocal dream related by a female patient. Freud himself tells us that dreams often contain the explanation of hysterical attacks. My patient, a hysteric, dreamt that she assumed the arc de cercle posture with the feeling that, in so doing, she