Embodying and Theorizing Agoraphobia
Drawing on in depth interviews with agoraphobics, geographical studies have stressed that the phenomeno logical aspects of agoraphobia of overwhelming signifi cance for its sufferers relate primarily to the experience of panic. A panic attack involves a wide range of terrifying mind–body symptoms, including: chest pain, palpitations, and shortness of breath; feelings of going crazy and losing control of one's thoughts; sensations of nausea, pins and needles, and intense shaking; a sense of fading away and merging with surroundings (clinically referred to as derealization and depersonalization). All of these symptoms can be experienced simultaneously and combine to make the sufferer fear that she will die or, at the very least, suffer irreparable damage and complete humiliation in public.
Existentialism and Being Bound
Geographical accounts have shown that these symptoms cause sufferers to question their ordinarily taken for granted sense of themselves and their bodily boundaries. Derealization and depersonalization, for example, are commonly understood to involve strange and disturbing feelings relating to both inner and outer reality. This aspect of panic entails a horrendous sense of dissolution of self into one's environs, and a simultaneous feeling of invasion by one's surroundings. It severely disrupts our unconscious sense of ourselves throwing the relation we have with our bodies into profound question. Some aspects of agoraphobic panic can be described as existentialist in nature, causing sufferers to question the very grounds of their existence. Existential philosophies – for example of Sartre and Kierkegaard – have thus been employed to shed light on the nature of agoraphobic disruption to the sense of being in the world, helping us understand how it feels and what it means to be agoraphobic.
Following the onset of anxiety as a way of life, studies suggest that there is a loss of trust in the integrity of the body. Sufferers fear being betrayed by it, and are constantly on the lookout for breaches of bodily boundaries that might be visible to others. These include, for example, minor discrepancies such as blushing, trembling, or sweating, in addition to more extreme examples, such as screaming out loud, or the loss of bowel or bladder control; manifestations of their fear on the surface of their bodies which, sufferers explain, would be mortifying. In agoraphobia, our sense of embodied subjectivity is inescapably conspicuous (as indeed it is with many other manifestations of chronic illness and disability). The intensely embodied nature of these emotional states necessitates a reconfiguration of the subject's conception of herself. The disorder seems to initiate a sense of separateness from one's body, not just momentarily, as in the fleeting depersonalization of the panic attack, but in the more general sense of creating a constant anxiety which hovers over the question of our bodily and mental identity.
Phenomenology, Subjectivity, and Space
From a phenomenological position (such as Merleau-Ponty's) it is unsurprising that anxiety should manifest itself both bodily and mentally since phenomenology assumes a model of subjectivity which regards the body as the self expressed. Such phenomenological insights have been highly influential for geographies of agoraphobia, as the approach enables us to return to, and concentrate on, the accounts of women's actual lived and embodied experiences, to take seriously their own voices and the stories they tell, rather than requiring us to posit specific external causes. For feminist geographers, a nuanced understanding of the nature and constitution of social space is required if we are to understand the complex interactions between self and space that sufferers' narratives highlight again and again.
For agoraphobics and nonphobics alike, space is never simply abstract and detached from the self. It influences and is influenced by one's own and others' emotions and actions. The sufferer's apparent gut reaction to social space should be seen as an interaction, as an embodied, emotional exchange, arising from a complexity of meanings, meetings, and movements between particular selves and spaces. Geographical approaches to agoraphobic phenomena clearly move beyond the search for either internal (self) or external (space) explanations, and are open to relational reconfiguration of both. By conceptualizing boundaries as relationally configured, permeable rather than fixed, geographers have been able to conduct sympathetic and meaningful explorations of agoraphobic landscapes, the spaces and places that partially produce (and are partially produced by) feelings of panic in susceptible individuals. Geographical accounts often highlight sufferers' felt need to reinforce their weakened boundaries, to render self space relations more predictable and so take some control over their disordered experience.