JASON STARR - Panic Attack

Adam returned to the waiting room and said, “David, come on in.” David entered the office and settled on the couch, and he and Adam exchanged their usual small talk. David worked in advertising, and his company had a skybox at Madison Square Garden, so they discussed the Knicks for a minute or so. Adam was hoping the shooting wouldn’t come up, but those hopes were dashed when David said, “Oh, yeah, so I heard about what happened. Is everything okay with that?”

“Yes, thank you,” Adam said. “It was a difficult situation, but my family’s handling it.”

He was trying to sound professional and curt and not to be at all evasive, though he was eager to get on to another topic.

“That’s good,” David said. “I imagine stuff like that gets blown out of proportion in the news.”

“It does,” Adam said flatly. “So how’re you doing?”

David began by talking about an ongoing issue he had with a coworker he didn’t get along with, and Adam noticed that he seemed particularly agitated- shifting around a lot, crossing and uncrossing his legs. It was hard for Adam to be as attentive as he normally was during a session. He couldn’t help wondering if David’s agitation had to do with what he’d heard about the shooting or if it meant he didn’t feel comfortable with Adam as his therapist. Adam was mulling over whether to be assertive and ask David what was bothering him or to ignore the whole thing.

But then Adam realized he was way off base when David said, “So anyway, I, uh, met a woman the other night.”

Well, that explained the agitation; this was a major setback for David.

Wanting to keep his patient feeling reassured and at ease, Adam asked in a very normal, nonjudgmental tone, “Where did you meet her?”

“Online,” David said. He crossed his legs, then uncrossed them again. His forehead was glistening with sweat. “I mean, not online, I mean through an online service… Ashley Madison.”

Adam knew of Ashley Madison and other similar extramarital dating services. Several of his patients frequently met sex partners through these sites.

“Okay,” Adam said calmly, waiting for David to continue on his own.

David explained how he’d registered with Ashley Madison and then had arranged to meet a woman, Linda- who was married with two kids- at a hotel and had sex with her. When he described what had happened, and especially when he mentioned the sex and how “hot and raw” it was, David started talking faster and louder, and Adam could tell how exhilarating the whole experience had been for him. It was very similar to the way a drug addict would behave when describing the experience of doing drugs; in fact, in a previous session David had told Adam about the coke habit he’d kicked several years ago. This had hardly been surprising to Adam, since most sex addicts have other addictions and are frequently codependent. All in all, David was just about as textbook as they get.

As David finished telling the story, his lips started quivering, and then the tears came, flowing down his cheeks, and he said, “I don’t know why…” He was crying harder and had to get hold of himself. Finally he said, “I don’t know why I keep doing this. I don’t know… I don’t know what’s wrong with me.”

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 affecti night.”

Well, that explained the agitation; this was a major setback for David.

Wanting to keep his patient feeling reassured and at ease, Adam asked in a very normal, nonjudgmental tone, “Where did you meet her?”

“Online,” David said. He crossed his legs, then uncrossed them again. His forehead was glistening with sweat. “I mean, not online, I mean through an online service… Ashley Madison.”

Adam knew of Ashley Madison and other similar extramarital dating services. Several of his patients frequently met sex partners through these sites.

“Okay,” Adam said calmly, waiting for David to continue on his own.

David explained how he’d registered with Ashley Madison and then had arranged to meet a woman, Linda- who was married with two kids- at a hotel and had sex with her. When he described what had happened, and especially when he mentioned the sex and how “hot and raw” it was, David started talking faster and louder, and Adam could tell how exhilarating the whole experience had been for him. It was very similar to the way a drug addict would behave when describing the experience of doing drugs; in fact, in a previous session David had told Adam about the coke habit he’d kicked several years ago. This had hardly been surprising to Adam, since most sex addicts have other addictions and are frequently codependent. All in all, David was just about as textbook as they get.

As David finished telling the story, his lips started quivering, and then the tears came, flowing down his cheeks, and he said, “I don’t know why…” He was crying harder and had to get hold of himself. Finally he said, “I don’t know why I keep doing this. I don’t know… I don’t know what’s wrong with me.”

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.