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For the better understanding of what will follow, I believe it would be useful to have in mind a case to which I can refer back as an example.
A woman in her early thirties came to be treated for severe agoraphobia and claustrophobia. Her symptoms had started five years before, shortly after her marriage. She had gradually limited her activities to an ever decreasing minimum. Finally she had reached a state in which she could not go alone in the street, and had always to be accompanied by another woman. Even then, she could not go on a bus or any other vehicle from which she was not able to get out instantly when she wanted to do so. At home, she could not stand being left alone, and when she was with people, the door of the room had to remain open, lest she might be locked in. Her movements were greatly restricted. She felt forced to walk very slowly, and in a rather stiff manner. She could not lie down in a horizontal position, and had to sleep half-seated in bed, as she believed that if she lay down her stomach would touch her heart; when this 'happened', she would develop an anxiety attack, with palpitations and tachycardia. Walking briskly would produce similar effects. The first time I saw her in one of these attacks the pulse was in the neighbourhood of 150 a minute.
She was afraid of being alone with her husband, and always needed the presence of another woman near her. It will be easily understood when I say that her symptoms had reduced her to a state of almost complete invalidity.
My purpose in presenting this case here is not to enter into details regarding the interesting and sometimes very complicated phantasies