A 35-year-old female presents with a 10-month history of intense fear and avoidance of public transportation, open spaces such as parking lots, enclosed spaces like movie theaters, standing in line, and being in crowds. She has never experienced a panic attack. She reports that her fear is centered on feeling trapped or unable to escape if she became overwhelmed or developed embarrassing symptoms such as dizziness or loss of bowel control. She now requires her husband to accompany her to the grocery store and has stopped using the subway, significantly limiting her employment options.