This case describes the cognitive-behavioural treatment of a 40-year-old woman with a 22-year history of infrequent fainting episodes. It highlights three features: 1) the potential importance of undiagnosed medical conditions in people presenting for anxiety disorders; 2) a somewhat unusual comorbid diagnosis of Agoraphobia Without History of Panic and Panic Disorder with Agoraphobia; and 3) the importance of modifying attitudes about performance and responsibility to reduce the chance of relapse.