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A woman of forty complained of agoraphobia of eight years duration. A few months before treatment she developed attacks, usually when she was expecting her husband home from work, in which she suddenly felt faint and had to sit or lie down quickly. Sometimes she would actually fall or slump to the floor. There was mental clouding or brief suspension of consciousness. She felt that she lived in a dream or a nightmare. Shortly after treatment began she had a dream of walking through a corridor looking for her husband. He came staggering out of a tavern. She could never quite catch up with him. She seemed to be short of breath and was fainting, but did not pass out completely. She then found herself on a landing at the top of steep steps. She fell down one step and while this was happening her husband disappeared.
The author concludes that the patient had unconscious destructive fantasies. The state of semiconsciousness was admirably suited for maintaining the visual image of the destruction of the loved and hated object, her husband. Precisely this type and quality of syncope was described as a waking symptom.