“Agoraphobia is a fundamentalist form of belief. If it was a religion I would be scared of it. Agoraphobes are zealots, crazed clairvoyants; we can predict the future. Terrifying things will happen when we go out, because terrifying things always happen when we go out. Just wait and see.”
Brief, aphoristic, and surprisingly funny at times, this memoir is an unconventional one, as Caveney spends more time discussing others than himself. The work is short on the autobiographical details that one expects and even on the causes of and treatment for agoraphobia, and longer on the history of the condition, famous creative individuals who suffered from it, and its representation in the visual arts, film, and literature. Ford Madox Ford, Emily Dickinson, Shirley Jackson, and Edvard Munch are a few of the famous agoraphobes Caveney writes about, and Miss Havisham and Boo Radley are among the many fictional characters who also make an appearance in the book.
Caveney doesn’t focus much on biological aspects of the phobia, beyond stating that the internal clocks of agoraphobics are damaged. The internal receptors that are supposed to respond to the external world don’t work properly; their malfunctioning impacts hormone production, brainwave activity, and eating and sleeping patterns. According to the author, a single event typically gets the ball rolling, and once rolling, the phobia is mightily resistant to treatment. In fact, in the late 1960s and early 70s, modified lobotomies were performed on those with intractable agoraphobia. It was apparently easier to desensitize an agoraphobe once part of his prefrontal cortex was destroyed.
Hippocrates noted the condition in the third or fourth century BC, but it became better known in the nineteenth century when all manner of mental disorders were being assiduously catalogued by clinicians. In 1871, German neurologist Karl Westphal used the term “agoraphobia” for the first time to indicate the fear of large, open spaces. Initially considered a phobia primarily afflicting men, it’s now seen more often in women. Caveney says that as many as two-thirds of today’s agoraphobic patients are female. Even Freud had some experience of it as a young man. His view was that “the agoraphobic is always afraid of his impulses in connection with temptations aroused in him by meeting people on the street . . . In his phobia he makes a displacement and is now afraid of an external situation.” Some nineteenth-century clinicians linked the emergence of agoraphobia to industrialization and urbanization.
The details the author provides about his own life are disappointingly limited and vague. He appears to be aware of this, acknowledging that “agoraphobia insists it has always been there. It has a scorched-earth policy towards personal history.” The author recalls walks in nature with his father but admits that “the more pastoral aspects” of his early life don’t easily come to mind. Born in Lancashire to working-class parents who doted on him, in time he became a concerning puzzle to them. Looking back, he sees himself as a sickly, awkward child. Because he had no siblings, he did not need to learn to negotiate for personal space and he was “unschooled in [resolving] boundary disputes”. Quiet and retiring, he liked being indoors rather than outside and preferred reading over engaging with other children, whom he disliked. Intellectually gifted, he won a place at a Roman Catholic grammar school. There, as a young teenager, he was groomed and sexually abused for two years by the headmaster/priest of the school. It’s an experience that obviously contributed to his later developing agoraphobia.
Caveney’s agoraphobia grew out of a panic attack he experienced at age 19 while riding by coach to Coventry, where he attended Warwick University. He could not escape the vehicle when he was suddenly flooded with intense anxiety. The bus made a scheduled stop in Manchester, and Caveney sobbed for 20 minutes in a bathroom cubicle, believing something terrible had happened.
Back at school after that episode he turned down offers of rides and outings with friends; motorways had now become a source of fear. He also had more panic attacks. Caveney says it’s not the panic attacks themselves that lead to agoraphobia: “The fear of them recurring does. Agoraphobia is a meta-fear, a pre-emptive strike against the fear yet to come.” The fear of going out isn’t the problem either; rather, it’s the “fear of something dreadful happening whilst being out.” By age 20, Caveney’s fear of travel broadened to include bridges, parks and open ground. He routinely made detours to avoid them. At the time of writing, Caveney hadn’t been on a motorway for 36 years.
By age 21, the author’s world had shrunk. He returned from university to his childhood home, confining himself to his bedroom. Eventually—the details are unclear—he seems to have moved out of the house. (How he later managed to form a relationship with his partner, Emma, and how he gained employment as a writing instructor remain great mysteries.)
Not long after his diagnosis, Caveney turned to alcohol in an effort to dampen his anxiety, but this self-medication only caused more trouble. By the age of 23, he was fully alcoholic. He explains that he cycled in and out of rehabilitation facilities for years. Only at the age of 44, when he was a non-functioning alcoholic whose liver was giving out, did the treatments and therapy finally take. He has maintained sobriety ever since.
Caveney eschews a linear approach to memoir writing. One might even say he’s averse to to a form that requires him to be the main character. Readers are called upon to figure out who he is not by what he remembers about his own life but by what he chooses to report about the lives of others and the facts that seem to interest him. The author’s style is also unusual and idiosyncratic. Chapters and paragraphs are short. There’s a staccato, fragmented feel to prose that is laced with literary allusions. Caveney has obviously read widely and deeply.
Having finished his memoir, I wish I had a better sense of how the author’s agoraphobia progressed, what he thought was going on, how he tried to cope . . . before resorting to alcohol, that is. My guess is that Caveney believed that attempts to reconstruct experiences (as memoirists typically do) would be dishonest. He says that over the course of his life, he’s seen ten psychiatrists, a score of counsellors, and two dozen psychotherapists. He has chosen to say little or nothing about those experiences here. He’s been prescribed various pharmaceuticals (one class of which— benzodiazepines—he became addicted to). He’s equally mum on whether any of these medications helped. Ditto on the herbal and vitamin supplements he’s tried. But what of the cognitive behavioural, desensitization, and biofeedback therapies? He does not say. It’s evident that his life has become more manageable and fulfilling in recent years. It sure would have been interesting to learn how that was achieved.
Rating: 3.5 rounded down