The active and passive fantasy of rape as a specific determinant in a case of acrophobia

Acrophobia is generally understood as a defensive reaction against the wish to lose control of sexual impulses, but the precise nature of some of the fantasies involved has not been extensively elaborated. Associations, memories, and the analysis of a re-enactment in the treatment of a young woman demonstrated that the wish to rape and be raped were specific determinants of her severe acrophobia. The case presented also illustrates that in a true hysterical phobia genital dynamics predominate, albeit coloured and influenced in part by important pre-oedipal determinants.