Saturday, April 4, 2015

Mall Phobia and Returning to the Womb Fantasy

A single woman in her mid- thirties, who lives a rather solitary life, and almost never ventures more than 2 miles from her house, brought in the following dream, and, because in it she was driving a car inside a mall, declared it to be weird.

I am driving in a mall. The only detail about the mall I can recall is of there being a bathroom in it. The stores are indistinct and the whole place is painted in a peachy-tan color. Also I don't think there were any people. Just my car. In the dream it did not feel strange driving a car inside a mall. 

When asked for associations to the mall she said she hasn't been inside one in years; they provoke panic attacks.
Another association to malls was her fear of not finding her way out of them; they curve and twist and one gets confused as to which way is to the entrance and exit. Another concern about malls was not finding the car in the parking lot on coming out.
She then expressed her skepticism about the value of the dream. "How could a car have gotten inside the mall?"
As to why the dream showed a bathroom, she could tell nothing. She was not sure if she had used it or not, but remembered that it too was painted inside with the same peachy-tan color so she had at least perceived it from inside.  
She added that it was her car that she was driving because she distinctly recalled its color being red. 
All these associations did not immediately throw light upon the problem and we drifted in to exploring her fears in general. She fears crowds and avoids public places especially where she anticipates running into more than two or three people hanging out together.
She has not driven on highways in 7 years. She drives to work early in the morning when roads are empty, and reaches there 45 minutes before the starting time. Though she does not get paid for putting the extra hours, she likes doing it because that way everything is in order when the doors open for business. This reasoning appeared to be a superficial rationalization (false explanation) for the deeper motive of avoiding rush-hour traffic.
She then expressed anger at customers who come 10 or 15 minutes earlier than 7 and try to make her work before the official opening time just because she is there.   
When asked how far is her workplace from her house she said exact two miles.
She then talked about how her fear of malls does not quite extend to Target [Department Store] and Kroger [Supermarket]. They are large but not quite as big as malls. And in them she knows where everything is, including the entrance doors, and thus can get out quickly if the need arises. And both the stores are within her self-imposed 2-mile-limit. Even at these stores she is in and out, picking only couple of items at a time which she knows beforehand she needs. And she goes there in the mornings, on Sundays, when hardly anyone is in the store and on the roads.
She then talked about her going to the Target to buy incense sticks which she loves, and getting disappointed at not finding them. Her wish to go to the mall perhaps arose from this frustration. For she does not know where she will find those incense sticks now. Target use to carry them but not anymore. She was hoping the incense sticks will be available in some mall because that is where the specialty shops that carry such items exist. 
Now per psychoanalytic theory what one is currently fearful or phobic about is something which was once dearly loved. Our current fears are our former desires. The oedipal love for mother becomes the greatest taboo of mankind. People who once loved getting behind the wheel and enjoyed taking long drives are the ones who usually come down with agoraphobia. The repression targets our strongest suits. The libido tries to find outlet through those functions which we favored the most and were most proficient at. It is the child with great desire to look (hypertrophied scopophilic instinct) that develops eye tics.
So I asked her if she loved going to malls before she came down with her phobias. And she said, "Oh yes, that was my most favorite thing to do. I loved it as a child and I loved it as an adult. But when I moved to this town, away from my old neighborhood, 7 years ago, the fear crept in."
Now I know this patient for some time, and I know too that her agoraphobia was precipitated by two very abusive marriages. She had developed a fear of going out which perhaps had at its root a desire to escape meeting men and getting in to another relationship. Getting involved with men she now had begun to believe invariably turn abusive. So her psyche was thrown into a dilemma. The libidinal wishes implored her to go out and seek men, while the memories of the physical and emotional abuse provoked fear (panic) over fulfilling this desire.  
Knowing how much she seethes with anger towards her ex-husbands, and because of it towards mankind in general, I asked her if the peachy-tan color was not derived from feces. Her fear that she may inadvertently defecate all over the mall to express her anger towards the world. The bathroom was there to lessen the fear that if the impulse to shit upon others becomes overwhelming there is an escape. Encopresis in children, and various forms of colitis in adults, are often expression of undischarged anger. In non-verbal mentally retarded, unhappiness with the way things are is often communicated through smearing the walls with feces.
She did not quite agree with this interpretation, but did confess that whenever she leaves the house she immediately has to worry about going to the bathroom. She wondered if she does not go beyond 2 miles of her house because she fears she may not find a bathroom in time. She added that when she comes to my office the first she thing she does is to go to the bathroom.
But when asked if this worry to find the bathroom is for an urgency to urinate or to defecate she said to urinate.
But it was not clear if she said this because there is greater embarrassment in humans about defecation than urination. Also she may have hidden the real state of affairs because she could sense the hesitancy in my voice when I was trying to search for the right words to convey correctly what I had to say regarding the use of excremental functions as a means to express rage. The patient goes only as far in revealing about herself/himself as the analyst is capable of handling.The analyst has to be completely comfortable with his own body functions before his body language will convey to the patient that he or she can talk about these matters without resorting to distortions and allusions.
She added that the fear of not finding the way out of the mall is similar to her fear of getting lost when driving. She does not trust the GPS. "The voice tells you to turn right or left but only after you have passed the turn."
"Any other association to the peachy-tan?"
"They are the color of your pants." I was wearing khaki pants that day. "And now I know where that color is taken from and why. In Target the employees wear peachy-tan color pants. So the dream was lessening the fear of the mall by showing it also as the Target which does not frighten me as much. And those employees along with tan pants wear red shirts which made the red color of the car noticeable in the dream."
"Was the absence of people in the mall also an attempt to lessen the fear?"
"Yes. I wanted to go to the mall but I am afraid of people. The dream therefore did away with people. And I go there in a car so I can be in and out in a jiffy. The shops were of one color and looked alike for the same purpose. I am scared of malls because it has such a variety of stores and they are on two or three levels. Variety sparks the fear that I will get lost in them and never find my way out while sameness lessens that fear."
"Is going inside and never finding one's way out, derived from the wish to go back to your mother's womb and never leave its security?"
"Sometimes I wish I had never come out of it. For life is so painful and men are so nasty."
So here was the confirmation of the rule that a formerly desired entity is what changes into a phobic object. It was in our mother's womb that we felt most secure and free of all dangers.* Under the spell of phobia it becomes the most dreaded place to seek refuge.
Her fear that she will not find her way out of the mall/womb was a "signal anxiety"/warning that the security of intrauterine existence (death) would be so alluring it would be impossible for you to return back into this stressful world.

* This pull of the intrauterine existence where all our needs were taken care of and where we felt completely safe may lie behind as to why the Las Vegas casinos are huge cavernous entities where all one's needs are taken care of and getting out of which is not an easy affair. The casinos are designed to create the illusion of being in a completely safe place and where fulfillment of every bodily need is immediately guaranteed like it was in the womb, which encourages the gambler to take greater chances with his/her money.
The way IKEA stores are designed, where finding one's way out is so difficult, and where one is tempted to be lost in shopping from one section on to the next, appears to utilize the same human wish to return to the womb.