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(1973). Meeting of the Psychoanalytic Association of New York. Psychoanal Q., 42:488-488.

(1973). Psychoanalytic Quarterly, 42:488-488

Meeting of the Psychoanalytic Association of New York

January 17, 1972. INDECISION AND CLAUSTROPHOBIA. Raymond H. Gehl, M.D.

Indecision often poses a difficult problem in initiating the process of analysis or in evoking a long-term commitment to it. Freud studied indecision in relation to the obsessional neurosis which led to the tendency to think of the obsessive when one considers problems of indecision. In this paper, Dr. Gehl points out the ubiquity of states of indecision, delineates the multiple functions they serve, and presents four cases which demonstrate how indecision can be a phobic manifestation often related to claustrophobic symptomatology. The making of a decision and the commitment to it may itself be a source of phobic anxiety. To decide and to act involve an aggressive expression; the decision itself may relate directly to aggressive or sexual involvement, and may have to be avoided. In the more complex phobic avoidance of decision, there is often a displacement of anxiety onto the claustrum with an underlying claustrophobic fantasy. In this situation making a decision becomes a commitment to a nonescape situation, a claustrum that must be avoided, and any movement toward commitment and action raises the anxiety to an intolerable level. Structural elements that contribute to indecisiveness in general are drives and ego and superego factors.

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