False Memory

Rather than reinforce Susan’s agoraphobia by solicitously asking how she had handled the trip from her apartment, he spoke eloquendy about the beauty of the storm, as though the soggy morning were as luminous as a painting by Renoir. As he described the pleasures of a walk in the rain, the chill and the damp sounded as soul-soothing as a sunny day at the beach.

By the time Susan stripped out of her raincoat and handed it to Martie, she was smiling. All the anxiety was gone from her face, if not entirely from her eyes. As she left the waiting room for Dr. Ahriman’s inner office, she no longer moved like an old woman, but like a young girl, apparently unintimidated by the expansive view of the coastline that awaited her from his fourteenth-floor windows.

As always, Martie was impressed by the instant soothing effect that the doctor had on Susan, and she almost decided against sharing her concern with him. But then, before he followed Susan into the office, Martie asked if she might have a word with him.

To Susan, he said, “I’ll be right with you,” and then shut his office door.

Moving to the center of the waiting room with Ahriman, keeping her voice low, Martie said, “I’m worried about her, Doctor.”

His smile was as comforting as hot tea, sugared shortbread, and a fireside armchair. “She’s doing well, Mrs. Rhodes. I couldn’t be more pleased.”

“Isn’t there medication you could give her? I was reading that anxiety medication —”

“In her case, anxiety medication would be a very grave mistake. Drugs aren’t always the answer, Mrs. Rhodes. Believe me, if they would help her, I’d write the prescription in a minute.”

“But she’s been like this for sixteen months.”

He cocked his head and regarded her almost as if he suspected that she was teasing him. “Have you really seen no change in her, especially over the last few months?”

“Oh, yes. Plenty. And it seems to me. Well, I’m no doctor, no therapist, but lately Susan seems to be worse. A lot worse.”

“You’re right. She’s getting worse, but that’s not a bad sign.”

Baffled, Martie said, “It’s not?”

Sensing the depth of Martie’s distress, perhaps intuitively aware that her anxiety arose not entirely from her concern about her friend, Dr. Ahriman guided her to a chair. He settled into the seat beside her.

“Agoraphobia,” he explained, “is almost always a sudden-onset condition, rarely gradual. The intensity of the fear is as severe during the first panic attack as during the hundredth. So when there’s a change in the intensity, it often indicates the patient is on the edge of a breakthrough.”

“Even if the fear gets worse?”

“Especially when it gets worse.” Ahriman hesitated. “I’m sure you realize I can’t violate Susan’s privacy by discussing the details of her specific case. But in general the agoraphobic often uses his or her fear as a refuge from the world, as a way to escape engagement with other people or to avoid dealing with particularly traumatic personal experiences. There’s a perverse comfort in the isolation —”

“But Susan hates being so fearful, trapped in that apartment.”

He nodded. “Her despair is deep and genuine. However, her need for isolation is even greater than her anguish over the limitations imposed by her phobia.”

Martie had noticed that sometimes Susan seemed to cling to her apartment because she was happy there more than because she was too frightened of the world beyond.

“If the patient begins to understand why she’s embracing her loneliness,” Ahriman continued, “if at last she starts to identify the real trauma she’s trying not to face, then sometimes, in denial, she will cling to the agoraphobia more fiercely. An intensification of symptoms usually means she’s making a last-ditch defense against the truth. When that defense fails, she’ll finally face the thing she really fears — not open spaces, but something more personal and immediate.”

The doctor’s explanation made sense to Martie, yet she couldn’t easily accept the idea that an ever steeper decline would inevitably lead to a cure. Last year, her father’s battle with cancer progressed along a relentless downward spiral, and at the bottom there had been no joyful breakthrough, only death. Of course a psychological illness could not be compared to a physical disease. Nevertheless.

“Did I set your mind at rest, Mrs. Rhodes?” A twinkle of humor enlivened his eyes. “Or do you think I’m full of psychobabble?”

His charm won her over. The impressive array of diplomas in his office, his reputation as the finest specialist in phobic therapy in California and perhaps in the nation, and his keen mind were no more important to building patient trust than was his bedside manner.

Martie smiled and shook her head. “No. The only babble is coming from me. I guess. I feel like I’ve failed her somehow.”