“Off in what way?”
“Nervous. Dizzy. My heart started racing, like the time in the closet.”
“What was going through your head during that moment? Do you remember what you were thinking?”
“I was thinking that there had to be at least twenty people between me and the exit door, and that if I did have another panic attack right there on the train, it was going to cause a huge scene.”
More note taking.
“So what did you do?” Dr. Metzel asked.
Victoria shrugged. “I basically said, ‘Screw it.’ At the next stop, I bulldozed my way to the door, got off the train, and took a cab the rest of the way home.”
“Have you ridden the subway since then?”
She tried to downplay this with a smile. “A nice air-conditioned cab ride home isn’t all that expensive. I figured why bother with the subway while it’s so hot?”
From the way Dr. Metzel furiously scribbled something down on his notepad, she had a feeling she’d failed that question.
Crap.
She shifted uneasily in her chair, not enjoying the feeling of being so . . . scrutinized.
“Any other incidents?” Dr. Metzel asked.
“Well, I also walked out of an exercise class the other day.” She blushed, a little embarrassed to admit these things. Not to toot her own horn or anything, but as a lawyer, she had a reputation for being fearless and tenacious in the courtroom. Heck, she’d been called a “ballbuster” by more than one irritated male opposing counsel. Yet here she sat, admitting she couldn’t ride the subway or take an exercise class.
Dr. Metzel cocked his head. “What happened in the exercise class?”
She shrugged. “Basically the same thing that happened in the subway. About twenty minutes in, I noticed how hot the room was getting and everything just spiraled from there. I kept thinking, ‘Uh-oh, am I feeling a little light-headed?’ And, ‘Oh, crap, what if I faint in the middle of this class, because that’s going to look really weird and cause a scene.’ That kind of thing.”
He raised an eyebrow. “Have you been back to the exercise class since that experience?”
“If I say no, are you going to start scribbling on your notepad again?”
Indeed, apparently he was.
When Dr. Metzel was done writing, he looked at her. “What if you had fainted? Dropped right there in the middle of the class and everyone saw. Would that be such a terrible thing?”
Victoria shuddered at the mere thought. “I don’t think anyone wants to cause a scene like that, do they?”
He acknowledged this with a nod. “Probably not. But I notice that you keep talking about ‘causing a scene’ and looking ‘weird.’ Is that something you consider important, how other people view you?”
Well.
That seemed like a bit of a loaded question.
“Um . . . maybe, I guess,” she said, not sure how this particular line of questioning was relevant.
“Can you expand on that?” Dr. Metzel asked.
Do I have to? “I suppose I try to present myself a certain way in front of other people. But doesn’t everyone do that? The point is, Doctor”—when he didn’t correct her, she assumed it was okay to call him that—“I run a successful law practice and have a professional reputation to maintain. I can’t be running out of the courtroom because I’m suddenly feeling woozy or worried about having another panic attack.”
He nodded. “I understand.”
Good. Now they were getting somewhere. “I fully recognize that these lingering . . . fears”—she hesitated over the word, debating whether it was too extreme—“are obviously all in my head. And I’m sure they’ll go away as more time passes from the burglary. But since they’re kind of, well, annoying, I was hoping you might have some tricks to help speed up the process. You know, breathing techniques, relaxation exercises, things of that nature.” She went for a joke. “Feel free to order me to visit a spa or get weekly massages as part of my treatment.”
Dr. Metzel chuckled. “I’m not sure about the spa part, but certainly both relaxation and imagery techniques can be very helpful in the treatment of panic disorder. Now, one thing I’d—”
Wait. “Did you say ‘panic disorder’?” she interrupted.
“Yes. Panic disorder.”
She sat back in her chair. But . . . she didn’t have a disorder. She was just having a few small panic issues. Clearly, the good doctor here needed to get with the program.
Then she realized what was going on. “Ah. Sorry, I should’ve mentioned this up front. I’m not fishing around for some kind of diagnosis in order to get insurance coverage. I’m fine paying out of pocket for these sessions.”
“That’s good to know,” he said. “And, admittedly, this is just an initial assessment. But based on what you’re telling me, I’m comfortable diagnosing panic disorder at this time.”
Huh.
Having deposed and cross-examined several psychologists, her lawyerly instincts took over. “If you don’t mind my asking, what, exactly, are you basing that diagnosis on?”
“I don’t mind at all,” Dr. Metzel said patiently. “In a nutshell, panic disorder is the fear of having a panic attack. Your fear of causing a scene, or looking ‘weird,’ and the changes you’ve made in your behavior—no longer riding the subway and stopping your exercise class—are all very classic symptoms.”
Completely caught off guard, Victoria tried to process this. “But . . . I don’t have any history of anxiety.” Not that Dr. Metzel would know this—because she hadn’t intended, and still didn’t intend, for these sessions to be an all-access pass into certain things from her past, but she was about as mentally steady as they came. She was the rock. Hell, ever since she was ten years old, she’d made a point of demonstrating just how unflappable she was.
“In your case, the break-in was the catalyst for your initial panic attack,” Dr. Metzel said. “And as you said, that’s not a wholly atypical physiological response, given the extreme stress you were under at the time. But as for why that incident has now brought on your fear of having additional panic attacks . . . well, that’s something we’ll want to explore in therapy.”