Panic Attack

by Jason Starr

  David had cried before during sessions—he was a sympathy seeker—and Adam gave him tissues and reassured him, saying things like “It’s okay” and “I know how hard it is.” David, as usual, was blaming himself for his behavior, playing the victim, saying, “I feel like such a piece of shit. I don’t know what the hell I’m doing with my life anymore.” Adam advised him not to beat himself up about it too badly and reminded him that the Internet could be very tempting for anybody and that these things happened, using the same tactics he’d employ in any similar therapy session, trying to support and reassure his patient. All the time, though, he couldn’t help feeling like a total fraud. Who the hell was he to counsel anyone when his own life had been such a mess lately? And trying to treat David for philandering was the biggest joke of all, what with David sitting on the very couch where Adam had screwed Sharon Wasserman. Adam was telling David, “You don’t have to feel like you always have to be perfect,” and meanwhile he couldn’t help imaging Sharon on top of him, riding him, his hands on her breasts. Adam told David, “Just because you want to have sex with another woman doesn’t mean you have to actually do it,” remembering how he’d said Sharon’s name again and again when he came.

  When the session ended, Adam felt guilty for charging David. Normally Adam was extremely attentive and used his instincts to anticipate where a session was headed and find the right openings to challenge his patients’ behavior, but he felt like he hadn’t helped David as much as he could’ve. For example, instead of letting David go on with his self-loathing, Adam should have been tougher and said something like “It sounds like you’re ready to leave your marriage.” Adam knew that David had no desire to get a divorce, but this could have helped David begin to acknowledge his reasons for philandering. But today Adam had been so distracted with his own thoughts and self-doubt that he’d felt off, out of sync, like he’d missed all of the obvious openings.

  He had two more morning sessions and, as with David, Adam felt out of sorts, off his game. He had no doubt that the shooting and related issues were seriously affecting his performance at work. If this continued and he couldn’t work through it, he’d have to take some time off to clear his head, maybe go down to Florida after all.

  During a break in his schedule, he went around the corner to the deli to get a cup of coffee and a muffin, and on his way back he checked his voice mail and saw that he had three messages and four missed calls from Dana. She had called and left a message on his work voice mail as well. Jesus Christ, what was going on now?

  He called her, and she picked up during the first ring and said, “I’ve been calling you.”

  “I’ve been with patients all morning, what’s going on?” “She’s HIV positive.”

  He thought she was talking about Marissa. Feeling like he might pass out, he managed to say, “What the hell’re you talking about?”

  “Detective Clements just called and told me they found out Gabriela had HIV. They found her medicine or whatever in her apartment.”

  “Jesus,” he said, catching his breath. “I thought you meant . . .” “What?” Dana said.

  “Never mind,” Adam said, still light-headed.

  “Can you believe it?” Dana continued. “Clements said even her sister didn’t know. She might’ve been infected for years.”

  Adam didn’t understand why Dana was calling him so urgently to tell him about this. “So is that it?” he asked.

  “Aren’t you shocked?” Dana asked.

  Actually Adam wasn’t shocked. Her boyfriend had had HIV, so why was it out of the realm of possibility that Gabriela had been infected?

  “Oh, and that’s not all,” Dana went on. “They found out she was a drug addict, too, heroin, just like her boyfriend. Can you believe it? She was a junkie and had AIDS while she was working for us.”

  “Let’s not start with that again,” Adam said. “That’s not how AIDS, HIV, is transmitted.”

  “I’m talking about the deceit,” Dana said. “That woman lied to our fucking faces for years. I can’t tell you how furious I am.”

  “You have a right to be furious,” Adam said. “Aren’t you furious?”

  “Of course I’m furious.” “You don’t sound furious.”

  “I’m standing on the corner of Fifty-eighth and Madison,” Adam said. “Sorry, but there’s a limit to the amount of furiousness I can express right now.” Dana didn’t seem amused and said, “Well, it was nice talking to you, too,” and hung up.

  Several minutes later, as he rode in the elevator back up to his office, he decided that although hanging up on him had been melodramatic and childish, Dana had made a good point. Being so wrapped up in what was going on with the police and the media, and then, on top of everything, receiving that threatening note, maybe he hadn’t been expressing his anger very effectively lately, and this was likely contributing to all the symptoms of anxiety and self-doubt he’d been experiencing.

  His one o’clock appointment, Helen, didn’t show up. Helen had never missed an appointment before, and Adam assumed that it was related to the shooting and that he had permanently lost another patient. His two o’clock, Patricia, a banker with panic disorder, showed up, but Adam felt he was as ineffective and off the mark as he’d been with his earlier patients. Patricia didn’t seem pleased at the end of the session either, and when Adam asked her if she wanted to make an appointment for her next session now, she said in a somewhat distant tone, “I’ll call you,” even though she normally made her appointments in person. Adam knew that something had to change fast, because at this rate either all his patients were going to stop coming to see him on their own or he was going to drive them away.

  At four o’clock, Adam went down the hallway to Carol’s office for his session with her, and he felt like he seriously needed it. Carol, waiting in her chair, didn’t say hello, just “Come in.”

  She was slim, in her late fifties, always wore her gray hair in a neat bun. She’d been a mentor to Adam and also a confidant. He often discussed patients with her, and she always had sound, rational advice. He was eager to talk to her about everything he’d been going though lately, but first he felt like he needed to express his feelings about her and his other coworkers, so he said, “Before we start, I just want you to know that I feel incredibly attacked and judged by all of you.”

  Carol, holding her pad, was sitting calmly across from him. “Attacked?” she asked as if surprised. “Why do you feel attacked?”

  The problem with being in therapy as a therapist was that Adam always felt one step ahead of Carol. He always knew exactly where she was going with her questioning, what types of feelings she was trying to elicit from him. It was like being a football coach who had access to the other team’s playbook. It was still worthwhile for him to see her—expressing how he felt was important in itself, and simply talking about his problems always helped him understand himself better—but he felt like he’d never be able to make true progress in therapy because he’d always be slightly guarded and would never open up fully. Right now, for instance, he knew that she knew exactly why he felt attacked, but she was asking the rhetorical question to get him to express his anger more fully.

  He knew what she was doing because it was the same tactic he would take with his own patients.

  Going along with it, just to express himself for the sake of expressing himself, he said, “I just felt incredibly judged by everyone, like I was guilty till proven innocent. I felt uncomfortable just being here yesterday.”

  “Do you feel uncomfortable today?”

  “Yes, I do. To a slightly lesser extent, but I feel like I’m . . . I don’t know . . . an outcast.”

  Adam knew that probably sounded very whiney—like his own patients sometimes sounded—but he already felt better, just from verbalizing how he was feeling.

  “Well, I’m sorry if I made you uncomfortable,” Carol said. “That certainly wasn’t my intention.”

  She was backing off, giving him space to continue
to vent. She also wanted to reestablish trust in the therapist-patient relationship, to make him feel safe and relaxed.

  “As you can imagine, this hasn’t been an easy situation for me to be in,” he said.

  “I’ll bet,” she said. “It’s probably bringing up a lot of issues for you.”

  He was surprised she was taking the session in this direction so quickly. “What kind of issues?” he asked.

  “Issues of control or lack of control,” she said. “Issues with your family— your current family and your parents. You grew up in the same house you live in now, didn’t you?”

  “You’re right.” He hadn’t thought much about this connection to his past that now seemed so obvious. “It is bringing up issues with my parents. It’s a very familiar feeling of being blamed, of being judged.”

  “And it’s making you feel like the victim again,” she added.

  He’d told her in previous sessions that he was often picked on as a kid and was unpopular in elementary school and junior high, and they’d talked about how these experiences had scarred him. He remembered that just this morning, with Dana, he’d brought up running away from the bullies in school. There had to be some significance to this.

  He told her all about the night of the shooting, mentioning that he had been having the recurring dream about the giant black rat who’d transformed from a female patient when Marissa woke him up. He was able to describe all the events in a very clear, matter-of-fact way, and it felt good to talk about it in a safe setting, where he didn’t feel threatened. It was much different than when he talked to the press and the police, when he felt like he had to choose his words carefully because everything was being scrutinized.

  He told her the police believed his maid, Gabriela, had been involved in the robbery, and he made sure that he expressed his anger about this properly. He didn’t just tell her he was angry in a detached way. He made sure that he felt the anger, that he was experiencing the anger.

  “I can’t believe she was able to deceive all of us for so long,” he said. “I’m usually so perceptive, nothing gets past me. I feel so furious. I feel so wronged.”

  This was good—he was expressing himself well, using “I” statements. “You didn’t know,” Carol said.

  “But I feel so hurt by what she did to me,” Adam said. “If I’d just caught on sooner, I could’ve fired her and prevented all of this. They say she was a drug addict, and I don’t know how she was able to keep that a secret. I can always tell when somebody’s lying to me. It’s my best skill.”

  “Addicts can be very clever,” she said. He’d said the same thing many times to his own patients.

  He went on, describing what had happened after the shooting—how he’d expected to be treated like a hero and was shocked when he saw the way he was being portrayed by the media.

  “I know how ridiculous this sounds now,” he said, “but I thought I’d be famous because of this, famous in a good way. I mean, you can’t believe how caught up I got. I thought I’d be the next Dr. Phil. I thought they’d film a movie about my life.”

  “It was an exciting feeling,” she said. “It made you feel confident.”

  “Yes,” he said, “and my glossophobia subsided, which was a very exciting, seductive feeling, too. Also, I have to admit, I enjoyed the attention. I know that’s childish, that as an adult I should want respect, not attention, but it felt very seductive—and addictive, which is strange for me because I don’t have an addictive personality.”

  “It’s easy to feel seduced by your emotions when your self-esteem is low, when you’re unhappy in other aspects of your life. You experienced a psychological high, it was a very powerful feeling. Do you think you don’t get enough respect in your life?”

  He knew what she was trying to do. She was challenging him, trying to draw out a defensive response, but he went with it, saying, “Yeah, sometimes. As you know, this can be a thankless profession.”

  “Well, your colleagues respect you.” “I haven’t been so sure about that.”

  “You can’t expect people not to feel a little awkward,” Carol said. “It was an unusual situation, and I think everyone handles these sorts of things in their own way.”

  He could see her point.

  “What about at home?” she asked. “Has your marriage been good lately? Do you feel respected and appreciated?”

  He thought about his bickering with Dana and his problems with Marissa. “No, I don’t,” he said, “and I know I probably haven’t been doing a lot to change that. What happened the other night certainly didn’t help.” “You said you don’t feel like you did anything wrong that night.”

  “I don’t. Well, except for shooting him so many times. I think that was a mistake.”

  “Every decision you make can’t be the perfect one, Adam. You can only try to do your best.”

  “I know, you’re right,” he said, “but . . . there’s something else.” He sipped some water, collecting his thoughts, then said, “There’s something . . . I didn’t tell anyone yet. I didn’t tell the police. I didn’t even tell Dana.”

  As a seasoned therapist who’d heard it all, nothing usually shocked Carol, but Adam noticed her growing concern. “Something about the shooting?” she asked.

  “Yes,” Adam said.

  She was waiting intently for him to continue.

  “I didn’t lie to the police about anything,” Adam said. “Everything I told them was entirely truthful, exactly as I remembered it. But I . . . well, I omitted something.”

  He paused again, wondering if he was doing the right thing, starting to tell Carol about this. He wasn’t concerned about her talking to the police—she wouldn’t, couldn’t violate their confidentiality—but he was afraid it could affect their professional relationship. Well, it was too late now, and if you couldn’t tell your therapist about these sorts of things, who could you tell?

  “Before I shot the guy, Sanchez, he said something,” Adam said. “It all happened so fast, it was hard to process it at that moment, but I remembered it afterward. He said . . . I think he said, ‘Please don’t.’ That’s all I heard, those two words. I still know I did the right thing, because even if he was saying Please don’t kill me or Please don’t shoot me or whatever, there was no way in that situation I should’ve believed him. I mean, I did see him reach for something. It might’ve been his flashlight, but it looked like a gun, and he could’ve shot me. He could’ve shot my whole family.”

  “So what exactly do you feel guilty about?”

  “I don’t know if guilt is the right word,” he said. “I feel . . . regret. I feel like I made a mistake.”

  “You’ve made mistakes before, haven’t you?” “None that involved killing somebody.”

  “It happens every day, Adam. You think policemen and firemen don’t regret their decisions from time to time? You have to do the right thing and be forthcoming with the police, but you can’t blame yourself, and you can’t let it interfere with other aspects of your life. Besides, you said you thought he had a gun, right?”

  “Right,” Adam said.

  “So yes, you heard him say those two words, but it happened very quickly, and you don’t know for sure what he was trying to say or why he was saying it. It sounds to me like you’re making a lot of assumptions.”

  He was aware that she was just supporting him, that she didn’t actually believe any of this. Still, the process was helping.

  “I feel shame about what I did,” he said. “I feel anger. I feel . . . foolish.” “Everyone has regrets,” she said. “You don’t have to beat yourself up about it.

  You had a lot of unexpressed anger, and then an event happened, something beyond your control. Someone broke into your house and you had to make a fast decision, but it was the best decision you could’ve made at the time, under the circumstances.”

  “I really need to reparent myself, don’t I?” Adam asked.

  The need for reparenting had been a major issue in previous
sessions. Carol knew all about his emotionally withholding parents and his related propensity toward self-loathing and self-blaming.

  “I think it could be useful to use some of your reparenting techniques,” she said. “Just don’t be so hard on yourself. So maybe you made a mistake, or maybe you didn’t make a mistake. Remember, Adam—you’re allowed to make mistakes once in a while. Every decision you make doesn’t have to be perfect.”

  Her advice was fairly generic and, almost verbatim, what he would have said to one of his own patients. Still, it had resonance for Adam and really seemed to hit home. He thought, Every decision you make doesn’t have to be perfect, every decision you make doesn’t have to be perfect, and he experienced a relaxed yet intense buzz, an emotional high he sometimes had after a particularly productive therapy session.

  He had two more patients in the afternoon—he was supposed to have three more but had another no-show—and he felt much more effective than he had earlier in the day, much more like his usual self. Whenever any self-doubt crept in he’d think, Every decision you make doesn’t have to be perfect, and he’d feel instantly reassured.

  But Adam knew that this was only a temporary ego boost, that he still had major issues to deal with if he wanted to keep his self-esteem high. He had to be easier on himself, not criticize himself as much, and—this was key—he had to stop neglecting himself. He was such a people-pleaser, so focused on patients and helping others, that he hadn’t been paying nearly enough attention to his own needs. He had to start taking the advice he gave to his patients every day and apply it to his own life, and this started with his most important personal relationship—his marriage. He hadn’t been expressing himself well to Dana at all lately, and he’d let too much anger and resentment go unresolved.

  At the end of the day, when the other therapists had left, he went into his office and closed the door and turned on classical music—Bach’s Brandenburg Concertos—very loud. Then he kneeled in front of the couch and started punching the couch cushion as hard as he could. Physical activity was a great way to vent and relieve stress, and he always suggested that his patients express anger in a safe way, like screaming or punching pillows. Imagining that the cushion was people who had done him wrong, like Gabriela, the reporters from the Post and News, and Grace Williams from New York Magazine, gave his punches some extra oomph.