Agoraphobia, conflict in individuation and separation

The source of the agoraphobic syndrome has not been sufficiently analyzed. The present case study was implemented to trace the source of agoraphobia as well as assess the impact it has on the family unit. The subjects are an agoraphobic mother, her spouse, and two children who willingly participated in many family sessions aimed at understanding the family's past and current dynamics. Information was gathered from bi-weekly in-home individual and family counseling sessions, genograms, and non-participant observations of four weekly recorded home visits of 1-1/2 hours duration made during the dinner hour. The collected information from counseling sessions and genograms was organized and presented as family history. The recorded visits were transcribed, coded, and presented in matrix summaries. Object relations leading to unfinished conflicts in individuation and separation beginning in childhood and continuing into adult life was found to be the source of agoraphobia, with the phobic symptoms developing as a conditioned response to the physiological symptoms of stressful conflict. These results were supported in the existing literature. It was concluded that a multimodal theoretical approach is needed in the understanding and treatment of agoraphobics. Implications regarding in-home case studies and naturalistic observations as methods of research are considered.