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Space and the secure base in agoraphobia: a qualitative survey

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Abstract:

An important aspect of agoraphobia is a fear of being in crowded public spaces. This inherent spatiality means that it has aroused geographical interest. Feminist geographers have argued that the underlying dynamic of agoraphobia is the patriarchal structuring of public space. Using Attachment Theory, which draws on ideas from psychoanalysis and ethology, agoraphobia is conceptualised as a response to perceived threat in the absence of a ‘secure base’, represented by a known person or space. In an attempt to elicit the lived experience of agoraphobia, vignettes were constructed typifying aspects of agoraphobic experience. Participants (n=123) were recruited from Internet agoraphobia self-help forums. Males experiencing agoraphobia (18) formed a significant minority of respondents. Using qualitative methodology, responses to these vignettes, as well as transcripts of parallel telephone interviews, were analysed. Participants’ responses were synthesised into a composite narrative, ‘Charlotte's Story’. The study suggests the central dichotomy in agoraphobia is not that between public and private space but between threat and security. Individuals experiencing agoraphobia feel secure when in space (a ‘secure base’) that is private, bounded, and where they feel sovereign and active. Threat arises in the absence of these conditions, exacerbated by the gaze of strangers, and is mitigated by the presence of a trusted companion. Further qualitative evidence supported feminist accounts of the fragility of the agoraphobic self, and suggested that self-experience is intimately connected with the experience of space. This study extends previous geographical and psychological accounts of agoraphobic ‘life worlds’.

Keywords: Attachment Theory; agoraphobia; public space; secure base; vignettes

Document Type: Research Article

DOI: https://doi.org/10.1111/j.1475-4762.2008.00820.x

Affiliations: The Tavistock and Portman NHS Foundation Trust, Tavistock Centre, London NW3 5BA, Email: holmes.josh@gmail.com

Publication date: 2008-09-01

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