I’ll call her Esther. The plump blonde with the unkempt pubic hair and the penchant for teenage boys. The penchant for me. I met her while working at a bookstore in Plainview, New York, at the rough longitudinal and latitudinal center of Long Island, where I was born and raised. She took an instant liking to me and then she took my virginity, and going on two decades later my mind still hasn’t recovered. Esther set my anxiety off. She was the match that lit the psychic fire. It all starts with Esther.
Either that or it starts with my mother. I can never decide. Losing my virginity in a way that even my most depraved friends find unfortunate had an immediate and profound impact on me. But my mother set up the circumstance whereby there could be a trigger like Esther, whereby it was only a matter of time until something set me off. In every important way—cognitive, behavioral, environmental, genetic—my mother laid the foundation of this intractable problem of mine.
(This is no recovery memoir, let me warn you now.)
• • •
Months ago, when I told my mother I was writing a book about anxiety, she said, “A book about anxiety? But that was my idea. I had that idea. Sheila”—her close friend of many years—“and I were going to do it together. Then she dropped dead, so we didn’t. But we talked about it for years. That’s not fair!”
I didn’t know what she meant wasn’t fair: my writing a book she wanted to write, Sheila dropping dead, or both. I pointed out that writing about anxiety was not an original idea. Freud wrote a book about anxiety ninety years ago. Kierkegaard wrote one eighty years before that. Spinoza wrote one in the eighteenth century. In any case, I hadn’t known she wanted to write a book about anxiety, or about anything for that matter.
“We should do it together!” she said. “We could coauthor. A mother-son book about anxiety? People would eat it up. We’d make a fortune!”
I replied that it was an interesting thought but that it probably wouldn’t work. I’d never written with anyone before. I had trouble writing if a person’s photograph was in the room with me. How would I tolerate a living human being?
Later, before we hugged good-bye, I asked my mother if she would mind if I wrote about her. She didn’t hesitate a moment. “I don’t give a shit. I’m old! I’m tired! I work too much!”
• • •
The first of these three claims is relative, the second hard to believe. In her late sixties, my mother has more energy than most college students I’ve met. She has more energy than most squirrels I’ve met. My brother Scott and I have a nickname for my mother: “Hurricane Marilyn.” We use the nickname when we catch sight of her climbing out of her car just before a visit to one of our homes. We watch her cross the street, arms flailing, keys and receipts and gifts for the grandchildren spilling from multiple bags, a fast-moving storm front of narration and complaint and anecdote and fervent family affection—a Jewish mother, in short, of the first order—and we shout, “Batten the hatches, everyone! Hurricane Marilyn’s about to make landfall!”
My mother’s third claim, however, is true. When my father died, in the late 1990s, of cancer, he didn’t leave much money, and it’s unlikely my mother will ever be in a position to retire. She complains about this, but the truth is she loves her work. She takes pride in her talent and her experience, and in the value she adds to the world. For here is the most telling fact about my mother’s contribution to my psychological life: She is a psychotherapist. She treats all sorts of people with all sorts of complaints. But she specializes in the anxiety disorders.
Like most clichés, it is fundamentally true that the anxious, the melancholy, the manic, and the obsessed are more likely to become therapists than other people. Before she was a therapist, my mother was a sufferer and a patient. She is still a patient, but she claims not to be much of a sufferer anymore. My mother portrays herself as an anxiety success story, a living example of how will, wisdom, and clinical psychology can triumph over nature.
It is a rough nature. To hear my mother tell it, her teens, twenties, and thirties consisted of an almost unbroken chain of hundreds of full-blown panic attacks—a riot of flop sweats, hyperventilation, and self-reproach. Her nerves were so exquisitely sensitive to stimuli that in order to dull them she would sneak shots of vodka before walking to school in the morning. She was scared of driving, public speaking, parties, open spaces, and men. She experienced feelings of unreality and dizziness. She suffered from acid indigestion, heart palpitations, and tremors. She had panic attacks at school. She also had panic attacks at home, at the grocery store, at the laundromat, at the bank, in the shower, and in bed. She had a panic attack when my father came to her work to propose to her. “My hands shook,” she had told me. “The thought of having to stay still while someone put a ring on my finger made me nuts!”
Recently, I asked my mother how this all ended. How had she gotten to the point where she no longer experienced the world as one giant firecracker at her back? She answered with a story.
When she was around forty, my mother said, she had a therapist who worked at a renowned clinic for people with phobias, a clinic that was attached to a large private hospital. The therapist was impressed by my mother’s intelligence and pluck; she felt that my mother possessed a strength that, unlike many other people prone to panic, compelled her to do things in spite of her fear of them. She asked, not entirely ethically, if my mother would like to come work for her at the clinic. My mother’s job would involve leading groups of phobics out into the world to expose them to situations that typically made them hysterical with fear. She would be the blind leading the blind, therapeutically.
The first people my mother took out were four elderly patients afraid, in various combinations, of driving, shopping, and generally being among other people. My mother was still afraid of these things, too, particularly driving. She decided to take them to a nearby shopping center. She drove them in her own car. At first things didn’t go badly. No one passed out, no one threw up, no one ran screaming into the parking lot. Then, on the way back to the clinic, the car broke down. This was before cell phones. They were on the narrow shoulder of a busy four-lane road. The cars hurtled past, making unnerving Doppler noises. Everyone’s blood pressure started to rise. Everyone started to pant just a little. What happens when five clinically anxious people have a simultaneous panic attack in a 1983 Buick LeSabre? My mother didn’t want to find out.
She tried to flag down a cab. No one would stop. The drivers took one look at the passengers—all that papery skin, all those wild, rheumy eyes—and pressed down on their accelerators. Now my mother was starting to spin out of control, her mind devising catastrophic tableaus: in police stations, in hospitals, in morgues, local television crews filming the whole thing. She started to shake and sweat and enter a kind of waking nightmare state.
Just then a cab stopped at a red light. My mother hustled the old folks to the corner, flung open the back door, and over the driver’s angry objections shoved them inside. It was only when the light turned green and the driver was forced to submit that my mother saw why he’d been reluctant to take them in. It wasn’t just that they looked like cornered animals or that they had basically commandeered his vehicle. It was that he already had a passenger and that passenger was—I’ve made my mother swear to this fact—a pregnant woman in labor. The driver dropped the woman off first.
• • •
This is not what I thought my mother would say when I asked how she had conquered the worst of her anxiety. I thought she would say something like, “I worked hard, with the help of medication, targeted psychotherapy, vigorous exercise, the support of your father and friends, and various meditative, yogic, and muscle-relaxation techniques, to change the way my mind operates.” All of which is true. To my surprise, however, what helped my mother first and foremost wasn’t a conscious, critical analysis or counterbalancing of her fears, but tossing herself—and in this case being tossed—into direct confrontation with the very things that most terrified her.
Clinical psychology has a term for this sort of approach. It is “flooding.” The first patient on whom flooding was used successfully, in the 1950s, was an adolescent girl who suffered from a paralyzing fear of cars. “She was kept compulsorily in the back of a car in which she was continuously driven for four hours,” reads one description of the treatment. “Her fear soon reached panic proportions, and then gradually subsided. At the end of the ride she was quite comfortable, and henceforth was free from phobia.”
This is a chilling passage, especially that “compulsorily.” How did they compel her, one wonders? Did orderlies hold her down? Did they remove the door handles? In four hours you can drive from Midtown Manhattan to the Washington Monument, if you don’t stop for gas.
My mother’s afternoon with her four elderly phobics was a kind of informal flooding treatment. What greater terror for a woman afraid of losing control than an outing in which she is the authority and control doesn’t hold? All the world conspired to make her panic. Yet she didn’t. She couldn’t. If she panicked, the situation would have disintegrated. Equally as therapeutic was the fact that disaster did not come. Returning her wards safely to the clinic, arranging for a tow truck, and making it home that evening was like a gradual waking from a dream in which she had been pursued and mauled by wolves—and was fine. She scanned herself. No bites? No scratches? No wounds? It had all been in her head.
So began my mother’s career as a therapist, a flooding cure slower yet more radical than anything even the most reptilian of behaviorists might prescribe. In the kingdom of the anxious, those with simple phobias have it easy. If you’re afraid of heights, lean over a railing. If you’re afraid of germs, lick a floor. But what do you do if your greatest fear is of being afraid? This was the essence of my mother’s predicament. She had been diagnosed with “panic disorder,” a condition that comes down to this: panicking about panicking. You have one panic attack and it leaves you uneasy, vigilant for another. You search for threats to your stability and, because this is life, you find them, and have another panic attack. That attack makes you more vigilant, which leads to more attacks, which leads to more vigilance, and so on and so forth until your mental existence is as cramped and airless as a broom closet. There are ways to break out—the world is stuffed with theories on how to escape anxiety—but none as extreme as the one my mother chose.