Using the works of Merleau-Ponty and of Heidegger, this paper argues that our spatial experience is rooted in the way we are engaged with and in our world. Space is not a predetermined and uniform geometrical grid, but the network of engagement and alienation that provides one's orientation in the inter-humanworld. Drawing on a phenomenological conception of space, this paper demonstrates that the neuroses of agoraphobia and, more unexpectedly, hypochondria must not be understood as mere "psychological" problems, but rather (...) as problems of one's overall way of spatial being-in-the-world, that is, of "dwelling." With respect to both neuroses, the paper argues that subjects experience a sense of spatial contraction that mirrors a contraction in their abilities to engage with the people, the environment, and the situations that surround them. (shrink)

Agoraphobia is commonly considered to be a fear of outside, open, or crowded spaces, and is treated with therapies that work on acclimating the agoraphobic to external places she would otherwise avoid. I argue, however, that existential phenomenology provides the resources for an alternative interpretation and treatment of agoraphobia that locates the problem of the disorder not in something lying beyond home, but rather in a flawed relationship with home itself. More specifically, I demonstrate that agoraphobia is (...) the lived body expression of a person who has developed an inward-turning tendency with respect to being-at-home, and who finds herself, as a result, vulnerable and even incapacitated when attempting to emerge into the public arena as a fully participatory agent. I consider this thesis in light of the fact that since World War I agoraphobia has been diagnosed significantly more in women than in men; indeed, one study found women to be 89% more likely than men to suffer from agoraphobia. I conclude that agoraphobia is a disorder that stands as an emblematic expression of the ongoing pathology of being a woman in contemporary society–a disorder that reflects that even today women belong to a political world in which they are not able to feel properly at-home. (shrink)

We review the distinction between sense of agency and sense of ownership, and then explore these concepts, and their reflective attributions, in schizophrenic symptoms and agoraphobia. We show how the underlying dynamics of these experiences are different across these disorders. We argue that these concepts are complex and cannot be reduced to neural mechanisms, but involve embodied and situated processes that include the physical and social environments. We conclude by arguing that the subjective and intersubjective dimensions of agency and (...) ownership cannot be considered in isolation from one another, but instead form an interdependent pairing. (shrink)

Anxiety is sometimes thought of as either a state of mind, lacking a thick spatial depth, or otherwise conceived as something that individuals undergo alone. Such presuppositions are evident both conceptually and clinically. In this paper, I present a contrasting account of anxiety as being a situated affect. I develop this claim by pursuing a phenomenological analysis of agoraphobia. Far from a disembodied, displaced, and solitary state of mind, agoraphobic is revealed as being thickly mediated by bodily, spatial, and (...) intersubjective dimensions. (shrink)

How is our experience of the world affected by our experience of others? Such is the question I will be exploring in this paper. I will do so via the agoraphobic condition. In agoraphobia, we are rewarded with an enriched glimpse into the intersubjective formation of the world, and in particular to our embodied experience of that social space. I will be making two key claims. First, intersubjectivity is essentially an issue of intercorporeality, a point I shall explore with (...) recourse to Merleau-Ponty’s account of the prepersonal body. The implication of this claim is that evading or withdrawing from the other remains structurally impossible so long as we remain bodily subjects. Second, the necessary relation with others defines our thematic and affective experience of the world. Far from a formal connection with others, the corporeal basis of intersubjectivity means that our lived experience of the world is mediated via our bodily relations with others. In this way, intercorporeality reveals the body as being dynamically receptive to social interactions with others. Each of these claims is demonstrated via a phenomenological analysis of the agoraphobe’s interaction with others. From this analysis, I conclude that our experience of the world is affected by our experience of others precisely because we are in a bodily relation with others. Such a relation is not causally linked, as though first there were a body, then a world, and then a subject that provided a thematic and affective context to that experience. Instead, body, other, and world are each intertwined in a single unity and cannot be considered apart. (shrink)

This chapter examines the control capacities of individuals with certain mental disorders and how, specifically, their reasons-responsiveness improves with treatment. Successful talk therapy, in particular, can bring individuals with disorders of agency closer to full-blown agency. The discussion focuses, first, on Agoraphobia and Exposure Therapy and, second, on Borderline Personality Disorder and Dialectical Behavior Therapy. We can see effective techniques of talk therapy, such as gradual exposure or radical acceptance exercises, as operating on the ability of patients to respond (...) appropriately to reasons. In this way, reasons-responsiveness is a lens through which both to better appreciate the flourishing of patients, via improved control in both moral and nonmoral contexts. The chapter bridges philosophical concepts of reasons-responsiveness with key psychiatric constructs, such as distress tolerance and experiential avoidance. (shrink)

Imagery is one of the new, exciting frontiers in cognitive therapy. From the outset of cognitive therapy, its founder Dr. Aaron T. Beck recognised the importance of imagery in the understanding and treatment of patient's problems. However, despite Beck's prescience, clinical research on imagery, and the integration of imagery interventions into clinical practice, developed slowly. It is only in the past 10 years that most writing and research on imagery in cognitive therapy has been conducted. The Oxford Guide to Imagery (...) in Cognitive Therapy is a landmark book, which will play an important role in the next phase of cognitive therapy's development. Clinicians and researchers are starting to recognise the centrality of imagery in the development, maintenance and treatment of psychological disorders - for example, in social phobia, agoraphobia, depression, PTSD, eating disorders, childhood trauma, and personality disorder. In the fields of cognitive psychology and cognitive neuroscience, researchers are identifying the key role that imagery plays in emotion, cognition and psychopathology.The Oxford Guide to Imagery in Cognitive Therapy has been written both for clinicians and researchers. For clinicians, it is a user-friendly, practical guide to imagery, which will enable therapists to understand imagery phenomenology, and to integrate imagery-based interventions into their cognitive therapy practice. For researchers, it provides a state-of-the-art summary of imagery research, and points the way to future studies. Written by three well-respected CBT researcher-clinicians, it is essential reading for all cognitive therapists, who have recognised the limitations of purely 'verbal' CBT techniques, and want to find new ways to work with clients with psychological disorders. Readership: CBT therapists. (shrink)

The short version of the Bielefeld Partnership Expectations Questionnaire assesses the partner-related attachment dimensions fear of rejection, readiness for self-disclosure, and conscious need for care. The presented study investigated the factor structure in two samples and evaluated the convergent validity of scales. The sample included N = 175 patients with panic disorder and/or agoraphobia and N = 143 healthy controls. Besides, the BPEQ, the Experiences in Close Relationships Questionnaire, and the Brief Symptom Inventory were assessed as well, and the (...) Adult Attachment Prototype Rating was conducted. A confirmatory factor analysis of the three factor model revealed an acceptable model fit for the entire sample, patients and controls in terms of low RMSEA and SRMR. We found metric, scalar, and strict measurement invariance for the presence of anxiety disorder. However, only for fear of rejection and readiness for self-disclosure the reliability was acceptable, and convergent validity in terms of large correlations with the ECR scales was found in both samples. The scale conscious need for care had a questionable reliability and correlated only slightly with ECR-R scales. We conclude that fear of rejection and readiness for self-disclosure of the BPEQ-12 are reliable and valid scales for measuring partner-related attachment in healthy and clinical samples. (shrink)

The number of homebound individuals in the United States is on the rise, causing health-care professionals to expand in-home health services to help meet the increased demand. Due to the prevalence of feelings of isolation and depression in this population, it is imperative that mental health professionals join this effort to increase access to mental health services. Delivering psychotherapy in clients’ homes presents many advantages to these homebound individuals, but there is a dearth of literature addressing how therapists should handle (...) unique ethical issues that arise in this type of setting. This article addresses ethical considerations and guidelines for in-home provision of mental health services. General ethical issues related to home-based psychotherapy include boundaries, confidentiality and privacy, competency, insurance coverage, and autonomy. Issues pertaining to different categories of homebound individuals, including persons with agoraphobia, chronic illnesses, and older adults, are then discussed in turn. Recommendations on how to best manage these issues by applying the American Psychological Association’s, the American Counseling Association’s, and the National Association of Social Workers’ Ethics Codes are provided. (shrink)

The Disordered Mind, Third Edition is a wide-ranging introduction to the philosophy of mental disorder or illness. It examines and explains, from a philosophical standpoint, what mental disorder is: its reality, causes, consequences, compassionate treatment, and more. Revised and updated throughout, the third edition includes enhanced discussions of the distinction between mental health and illness, selfhood and delusions about the self, impairments of basic psychological capacities in mental disorder and the distinct roles that mental causation and neural mechanisms play in (...) mental illness. The book is organized around four questions: What is a mental disorder or illness? What makes mental disorder something bad? What are various mental disorders and what do they tell us about the mind? What is mental health and how may it be restored? Numerous disorders are discussed including: addiction, agoraphobia, delusion, depression, dissociative identity disorder, obsession-compulsion, schizophrenia, and religious scrupulosity, among others. Several neurological disorders are examined. Various problems associated with DSM-5 and with psychiatric diagnosis are explored. Including chapter summaries and suggestions for further reading at the end of each chapter, The Disordered Mind presupposes no special background in philosophy, and as such will be of interest to those in related disciplines such as psychology, psychiatry and mental health, and professions such as nursing and social work. (shrink)

Place is sometimes understood as reinforcing personal and cultural identity in the face of dissipating versions of modernism or postmodernism. However, that identity can also come with a variety of cultural neuroses and manias that are inscribed on place. I consider the ways in which terrorism has become a feature of place, and how we can expect to see the terror of the place in the future. First, we can expect a relative diminishment in 'place-making imagination', the ability to see (...) places as rich, ambiguous, and multi-purposed. Second, we can expect the terror of the place to exhibit itself as an inability to come to terms with the other. Third, we can expect the continuation and development of a triumphalist narrative of place, including a sense of entitlement. Fourth, we can anticipate the death or the fear of the agora, the true 'agoraphobia', as the public space of discourse is closed down, and the private space of patriarchally enforced agreement gains ascendancy. Fifth, we can expect people to regard specific places as having fixed and permanent meanings, and to try to constrain those meanings in such a way as to guarantee that permanence. Sixth, we can expect topophobia, not only the fear of place but also stage fright, as the expression of self on the world stage becomes more and more limited and narrowly focussed. And seventh, we can expect a re-assertion of memory of place, perhaps with a shifted baseline, as the places of terror become exhausted. We can furthermore expect all of these phobias and manias to be rationalized as virtue in a society that cannot deal with the terror of the place. (shrink)

This is a brief comment on Christopher Megone's essay appearing in this issue. Cells, tissues, organs, and human beings qua biological organisms have natural functions, but human beings qua agents do not. Persons-in-society, unlike organs-in-bodies, are the products of culture, not simply of nature. Bodily disease is defined as a deviation from an objectively identifiable biological norm. The natural function of the kidney is to secrete urine; uremia is a literal disease. The social function of adults in American society includes (...) mingling with others in places away from home; "agoraphobia" may thus be called a metaphorical disease. In short, typhoid fever is a literal illness or disease; spring fever is a metaphorical illness or nondisease. Megone, however, rejects the claim that literal diseases "are physical disorders." Would he regard spring fever as a "real disease"? If not, why not? (shrink)