The term is treacherous and sometimes unkind; Graham Caveney imagines taking revenge on it by writing “agoraphobia” in the middle of a page, surrounded by scary white space. In Greek, agora means marketplace and phobos means fear. But the condition is thought of as modern, or as a terror of modern amplitude. Those who experience it are caricatured as horrified by the spaciousness beyond the window. In fact “agoraphobia”, Caveney tells us, “is not so much a fear of going out as a fear of something dreadful happening whilst being out”.
He writes with inside knowledge, as an agoraphobe not a doctor. At 19, travelling home from university for Christmas by coach, he had a panic attack on the M6, his world dismantled by the “horrifying symmetry” of the motorway. An only child, brought up in working-class Accrington, he had always been a little dyspraxic, or “cack-handed” as it was called. But this was new: primal fear – heart hammering, blood pounding, body in revolt. He survived the next three years by staying on campus and living within a 50-yard radius. But to the dismay of his parents, with whom he moved back in after graduating, the condition persisted (“at my most agoraphobic, everywhere outside my front door can feel like that original motorway”). Now in his 50s, he seeks to understand its origins.
Being sexually abused by his head teacher as a teenager – as described in his 2017 memoir, The Boy With the Perpetual Nervousness – undoubtedly played a part: after his body was invaded, he distrusted boundaries. Growing up in a tight-knit Lancashire community, so his partner Emma jokes, was a factor too: his phobia was small-mindedness writ large. Later, for two decades, came booze: where psychiatry failed, alcohol came to the rescue, a coping strategy that “can work right up until the moment it kills you”. These days Caveney is sober, does yoga, is part of a support group, and makes a point of going out even on days he doesn’t feel like it. But dual carriageways still horrify him. His book isn’t a bland tale of how-I-got-cured; it’s intellectually curious, emotionally bracing and immensely erudite.
Shrinks may not have helped (“At the last count I have seen: ten psychiatrists, a score of counsellors, two dozen therapists”) but imaginative literature amplifies his insights: Proust, Kafka, Ford Madox Ford, Anne Tyler, Sue Townsend, Helen Dunmore and many more. Two American writers are of particular interest to him: Emily Dickinson (the words “house” and “home” appear in 210 of her poems) and the novelist Shirley Jackson. There’s a chapter on Sigmund Freud and honourable mention of Carl Friedrich Otto Westphal, a pioneering specialist in the field.
It is only recently that agoraphobia has been recognised as a predominantly female complaint. Two thirds of Caveney’s support group are women. With props to stabilise their instability – walking sticks, headphones, gloves, sunglasses, bags, dogs and wheelchairs – they come over sympathetically. Their presentations are diverse, as Caveney’s have been, variously misdiagnosed as epilepsy, labyrinthitis, vertigo, motion sickness, migraine and post-traumatic stress disorder.
Wary of remedies he has tried – including meds that “instil a perplexed nonchalance, an unenlightened Zen” – he’s also dismissive of one he refused, “flooding”, through which agoraphobes are forced to confront their phobia full-on, “the most counter of counter-intuitive treatments”. Given the pain he has been through, he’d be entitled to a measure of anger. But his book is bright and funny, and full of telling quotes, whether culled from others (Charlotte Brontë’s Villette: “All within me became narrowed to my lot”) or drawn from his own experience: “Agoraphobes are the ultimate squares, arch conformists”; “Safe space: a concept which, for the agoraphobe, verges on the oxymoronic”. Where his earlier memoir was more conventional in form, this book proceeds through short, epigrammatic paragraphs, weighing evidence and testing ideas. It will hearten people who have agoraphobia, enlighten medics and teach outsiders all the lessons Caveney has learned.
• On Agoraphobia is published by Picador (£12.99). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply.
