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Dr. Weiss regards agoraphobia from the psychodynamic point of view as an anxiety reaction, originating from a feeling of ill-being, which corresponds to impulses pertaining to a repressed and dissociated portion of the ego which has become a part of the organized adult ego.
This statement conveys a defense mechanism of the agoraphobic patient, which Freud, as Dr. Weiss comments, had pointed out, and which has stimulated several thoughts which in my opinion may contribute to emphasize certain aspects of the concepts of the author.
First, it should be pointed out that while agoraphobia defends the patient from a repressed and dissociated portion of the adult ego which is the cause of the ego disturbance, a manifestation in which there is no genetic difference with other neurotic symptoms, agoraphobia implies the fear of disintegration in a specific situation, i.e., the feeling of loneliness and abandonment in an open space, felt in fantasy as frightfully dangerous.
That repressed and dissociated portion, in my opinion, contains strong aggressive impulses which stimulate paranoic and depressive anxiety. The sadomasochist characteristics of the agoraphobic, as well as his inhibitions, sexual deviations, persecution and depressive guilt feelings, should not be disregarded—all of which points to the paranoic and depressive background common to all agoraphobic patients. The symptom practically reaches the limit of a delirious rapture of the schizoid type even though a sense of reality subsists.
When protected, the agoraphobic adult may display executive, aggressive, domineering and even abusive behavior; unaided, he experiences the fear of the disintegration menace.
The sexual life of the agoraphobic is always confused. Occasional orgastic satisfaction, as in the patients described by Dr. Weiss, is followed by temporary relief of the phobic reaction. In such cases the analysis of the selected object and the emotional evaluation of the erotic relationship are the clues which per