You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
It follows from the nature of the facts … that we are obliged to pay as much attention in our case histories to the purely human and social circumstances of our patients as to the somatic data and the symptoms of the disorder. Above all, our interests will be directed towards their family circumstances…
When a psychiatrist used to dealing with children and families examines the problem of ‘agoraphobia’1 he is at once struck by its resemblance to school phobia. In both types of case the patient is alleged to be afraid of going into a place filled with other people; in both the patient is apt to be afraid of various other situations as well; in both the patient is prone to anxiety attacks, depression, and psychosomatic symptoms; in both the condition is precipitated often by an illness or death; in both the patient is found to be ‘overdependent’, to be the child of parents one or both of whom suffer from long-standing neurosis, and frequently also to be under the domination of an ‘over-protective’ mother. Finally, a significant number of agoraphobic patients were school refusers as children.
Although minor degrees of agoraphobia are probably common and, when of recent origin, probably have a high remission rate (Marks 1971), patients who come to the attention of psychiatrists are usually those who are suffering either from a chronic condition of some severity or else from an acute attack. Often a patient is intensely anxious, apt to panic when unable