The role of traumatic experience in panic disorder and agoraphobia

Psychoanalytically oriented psychotherapy and psychoanalysis proper are widely considered by other clinicians to be inappropriate treatment modalities for patients with symptoms of agoraphobia and panic attack. The author presents a clinical hypothesis about the role of traumatic experience for these patients. The hypothesis is compatible with some ideas that have appeared in the clinical literature, and yet it has some distinctive features. Suggestions are offered as to some of the implications of this hypothesis for analytic treatment as well as for analytically oriented therapies that are integrated with psychopharmacological interventions and cognitive-behavioral approaches.