Benjamin Ball introduced the term "claustrophobia" into the field of psychiatric semiology in 1879. It is derived from the Latin claustrum (enclosed place) and the Greek phobos (fear). Claustrophobia is defined as the fear of enclosed spaces. Faced with the impossibility of escape, the person suffering from claustrophobia fears being suffocated, being crushed, losing consciousness, or losing control of his actions or sphincter muscles. Avoidance techniques are then developed together with counterphobic behavior (being accompanied by another person, carrying a key) or behavioral modifications (opening doors and windows, positioning oneself near an exit).
The word is part of psychiatric semiology. Albert Pitres and Emmanuel Régis (1902) classify claustrophobia as a phobia of place, and Pierre Janet as one of the systematic anxieties constituting psychasthenia. Recent British and American clinical practice includes claustrophobia among the simple phobias, often associated with agoraphobia, which predominantly affect women and are rare in children (Freud, A., 1977).
For Sigmund Freud claustrophobia is one of the phobias of locomotion, similar to agoraphobia. Its metapsychological status evolved along with the development of his theories of anxiety and the construction of phobias. Freud first considered it as one of the chronic symptoms of neurasthenia (Manuscript B, 1893, in 1950a). Later he distinguished it, along with the other phobias, from the obsessions ("Obsessions and Phobias," 1895c), ultimately associating it with anxiety hysteria (1905d). In his early writings, he interpreted claustrophobia as the result of an excess of unused libido. He related it to castration anxiety, produced by the repression of oedipal desire. Here, the emergence of free anxiety was displaced and projected onto the phobic object, in this case an enclosed space.
Melanie Klein (1932/1975) believed it involved a projective identification with the dangerous body of the mother, with the anxiety of being enclosed there and castrated by the father's penis. Bertram D. Lewin (1935) proposed a similar definition of claustrophobia, in which he refers to an unconscious fantasy of return to the maternal breast, accompanied by oral fantasies of being devoured. For Otto Fenichel (1953) the enclosed space that is feared represents the patient's body and the sensations the patient is trying to get rid of through projection of excess excitation onto the claustrum. The phobogenic situation mobilizes infantile anxieties, the fear of solitude, and the temptation to masturbate. François Perrier (1956/1994) saw claustrophobia as being organized like speech, where, symbolically, a key held in the hand enables one to avoid the anxiety, thus escaping the enclosed world of the mother and making access to the father possible. Some authors explored other aspects of claustrophobia, analyzing its associations with depression (Gehl, R. H., 1965) or agoraphobia (Weiss, E. 1964).
See also: Phobic neurosis; Phobias in children. Bibliography
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