Psychoanalysis of A Case of Agoraphobia

Agoraphobia is a neurosis of relatively frequent occurrence, which may be recognized by the following complex of symptoms: the patient suffers from an invincible dread of going out into the street alone. To step out into the street becomes a nightmare, the very thought of which arouses fear of the expected fear. This fear increases with every unsuccessful attempt to go out, and continues, accompanied not only by successive fits of depression but by palpitations, trembling, and sometimes even breaking out into perspiration. The intensity of the fear is very great, and (as all authors confirm) bears all the characteristic marks of a real fear of death. If we ask the patient just what danger they stand in dread of, they draw upon all sorts of well rationalized possibilities:-the fear of sudden death, of being stricken with apoplexy, of fainting, and being run over. Often these patients offer statistical proofs of the dangers of the street; some take careful note of every traffic accident,-of every collision between street-cars or automobiles. All methods of suggestion which persons of the patient's environment may use to combat such arguments are useless, and roll off him without effect. The fear of the agoraphobe may be banished under two conditions only:-if the patient does not go into the street at all, or if he goes out accompanied by a protecting escort. There are certain conditions attached to the choice of this escort. Noticeably often it is a member of the family (father, mother, brother, sister, husband, or fiancé). If, for any cause, the patients are forced to a compromise in the choice of their escort, they make a fine distinction in the degree of fear which they experience when in the street, and secure at last, by dint of endless complaining, the companion of their choice. The despotism of these patients (they are typical tormenting, subconsciously aggressive spirits-the more so as their fear in untreated cases may persist for years, and even for a lifetim