Agoraphobia was originally described as a spatial disease that was borne out of the rise of the metropolis with its wide-open streets and dizzying public spaces. Patients’ fears are to a certain extent alleviated by companionship, but they are seriously exacerbated by the dimensions of the space, especially when there seems to be no boundary in the visual field. As a result, it was previously dubbed topophobia or street fear.
While doctors are inquiring into its etiology (i.e., cause), urbanists see it as uniquely characterizing the psychological condition of the modern city as a whole, a disease, that is, endemic to urbanism and its effect. Furtheremore, agoraphobia is identified not simply as an affliction of the modern city dweller but as proof that contemporary cities are in their very form bad for mental health.
A more in-depth inquiry produces the argument that it is a product of the rapid fluctuation between two characteristic moods of urban life: the over-close identification with things, and, alternately, too great a distance from them. Distance is first and foremost a product of the omnipotence of sight in the city; contrary to the intimacy and oral communication in a small community, metropolitan connections are rapid, glancing, and visual.
The metropolitan inhabitant is visual and intellectual, as opposed to the country-dweller who is oral and emotional. Thus, the intellect takes over emotions, the impersonal replaces the personal, and subjective empathy is replaced by objective distance. Hence, space in the big city acts as an emblem for social estrangement.
Vidler, A., (1991). Agoraphobia: Spatial Estrangement in Georg Simmel and Siegfried Kracauer. New German Critique, 54, 31-45. http://www.jstor.org/stable/488425