A Clinical Investigation of Phobias

The term “agoraphobia” was coined by Westphal, who in 1872 published a monograph Die Agoraphobie (12) in which three male patients were described with the following symptoms: … impossibility of walking through certain streets or squares, or possibility of doing so only with resultant dread of anxiety … no loss of consciousness … vertigo was excluded by all patients … no hallucinations or delusions to cause this strange fear … agony was much increased at those hours when the particular streets dreaded were deserted and the shops closed. The patients experienced great comfort from the companionship of men or even an inanimate object, such as a vehicle or a cane. The use of beer or wine also allowed the patient to pass through the feared locality with comparative comfort. One man even sought, without immoral motives, the companionship of a prostitute as far as his own door … Some localities are more difficult of access than others; the patient walking far in order not to traverse them … Strange to say, in one instance, the open country was less feared than sparsely housed streets in town. Case 3 also had a dislike for crossing a certain bridge. He feared he would fall in the water. In this case there was also apprehension of impending insanity.