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DISCUSSION: Dr. Frank Berchenko spoke of the clinical aspects of claustrophobic indecision, and expressed reservations about the extent of both the claustrophobic base of states of indecision and the omnipresence of womb fantasies in claustrophobia itself. He stressed the defensive level of anxious indecisiveness. The 'teasing out' of fantasies in such a complex syndrome is important in order to isolate those fantasies that help us to identify more specific genetic factors.
Dr. Jerome Levine mentioned the complexity and variability of the clinical phenomena subsumed under states of indecisiveness. He agreed with Dr. Gehl that indecision is common in many clinical states. He felt the author was emphasizing the phobic displacement and projection of libidinal and aggressive id wishes onto the ego function of decision making, though the latter itself can be divided into a series of complex functions.
Dr. Alan Eisnitz cited examples from everyday language which seemed to illustrate the use of underlying fantasies of the type described; he felt that claustrophobic fantasies do not necessarily involve womb fantasies. Dr. Merl Jackel noted that Lewin described two types of claustrophobics: patients who fear entering the claustrum and those who fear being evicted once inside. He questioned whether the second is truly claustrophobic; the fear might be related to anxiety concerning the outer world. Dr. George Wiedeman questioned whether all claustrophobic symptoms are necessarily related to womb fantasies.