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January 29, 1963. DEPRESSION AND CLAUSTROPHOBIA. Raymond H. Gehl, M.D.
Dr. Gehl emphasizes the frequency with which claustrophobia and depression alternately occur in the same patient. He investigates this phenomenon in terms of structure and genetics, comparing the two clinical entities to show their similarity. Then he outlines a schematic pattern called the claustrophobic-depressive cycle. Studies by Freud, Helene Deutsch, and Bertram D. Lewin are cited, suggesting the close relationship of anxiety, phobias, and depression. The author presents three case histories.
The first patient came to analysis because of severe claustrophobia. Her life history revealed that the illness began with claustrophobic symptoms but included periods of depression and insomnia. The claustrophobia consisted of a fear of being stuck inside trains, elevators, buses, etc. As a child she was ignored by her mother who favored her brother. At the age of ten she was moved into her parents' bedroom and exposed to their nudity and sexual activity. Two attempts at finding outside interests, love for a dog and interest in movie actors, ended painfully for the patient. Analysis of the claustrophobia showed it to represent a desired haven symbolizing the wish to be nursed and loved by the mother. It was also a potentially frightening place in which the patient feared she would lose all control.
A second patient entered analysis for impulse-ridden behavior, insomnia, and depression. Beneath her frantic overactivity lay a fear of solitude or inaction. Visiting her sick father produced panic with a feeling of being trapped in the hospital room.
A third patient was depressed and felt trapped in any close relationship. During analysis she developed the claustrophobic symptom of being unable to enter airplanes.
Under the heading, The Closed System—A Configuration, Dr. Gehl compares the symptoms of claustrophobia and depression, both of which involve a closed system, creating a disturbed, trap