She lifted the paperweight and began toying with it again. I read on.

The article was a profile of Leo Gabney, a Pasadena-based clinical psychologist, formerly of Harvard University, and his psychiatrist wife, Ursula Cunningham-Gabney, alumna and former staff member of that august institution. An accompanying photograph showed the two therapists sitting side by side at a table, facing a female patient. Only the back of the patient’s head was visible. Gabney’s mouth was open, in speech. His wife seemed to be looking at him out of the corner of her eye. Both doctors wore expressions of extreme earnestness. The caption read: DRS. LEO AND URSULA GABNEY COMBINE THEIR SKILLS TO WORK INTENSIVELY WITH “MARY,” A SEVERE AGORAPHOBIC. The last word had been circled in red.

I studied the picture. I knew Leo Gabney by reputation, had read everything he’d written, but had never met the man. The camera revealed him to be sixty or close to it, with bushy white hair, narrow shoulders, dark, drooping eyes behind heavy black-framed glasses, and a round, smallish face. He wore a white shirt and dark tie, had rolled his sleeves up to the elbow. His forearms were thin and bony- almost womanish. My mental image had been something more Herculean.

His wife was brunette and good-looking in a severe way; Hollywood would have cast her as the repressed spinster, ripe for awakening. She was dressed in a cowl-neck knit top with a paisley kerchief draped over one shoulder. A short perm fit nicely around her face. Glasses hung from a chain around her neck. She was young enough to be Leo Gabney’s daughter.

I looked up. Melissa was still turning the crystal. Pretending to be enthralled with the facets.

The knickknack defense.

I’d totally forgotten this particular knickknack. Antique French. A real find, rescued from the back shelves of a tiny curio shop in Leucadia. Robin and me… the amnesia defense.

I resumed reading. The article had the self-consciously laudatory tone of a p.r. release striving to sound like journalism. It recounted Leo Gabney’s pioneering work in the research and treatment of anxiety disorders. Cited his “landmark success treating Korean War G.I.’s for combat trauma when clinical psychology was still an infant science, pioneering research in frustration and human learning,” and tracing his career through three decades of animal and human studies at Harvard. Thirty years of prolific scientific writing.

No blockaroo for him.

Ursula Cunningham-Gabney was described as a former student of her husband’s and possessor of both a Ph.D. in psychology and an M.D.

“We joke,” said her husband, “that she’s a paradox.”

Both Gabneys had been tenured members of the staff of Harvard Medical School before relocating to southern California two years previously and establishing the Gabney Clinic. Leo Gabney explained the relocation as “a quest for a more relaxed life-style, as well as the chance to bring to the private sector our combined body of research and clinical skills.”

He went on to describe the collaborative nature of the Gabney approach:

“My wife’s medical training is especially useful in terms of detecting physical disorders, such as hyperthyroidism, that present symptoms similar to those of anxiety disorders. She’s also in a unique position to evaluate and prescribe some of the more recent- and superior- anti-anxiety drugs that have come along.”

“Several of the new medications look promising,” Ursula Cunningham-Gabney elaborated, “but none is sufficient in and of itself. Many physicians tend to view medication as a magic bullet and prescribe without carefully weighing cost-effectiveness. Our research has shown that the treatment of choice in debilitating anxiety disorders is clearly a combination of behavior and carefully monitored medication.”

“Unfortunately,” her husband added, “the typical psychologist is ignorant about drugs and, even if knowledgeable, unable to prescribe them. And the typical psychiatrist has little or no training in behavior therapy.”

Leo Gabney claims this has led to bickering between the professions and inadequate treatment for many patients with incapacitating conditions such as agoraphobia- a morbid fear of open spaces.

“Agoraphobics need treatment that is multimodal as well as creative. We don’t limit ourselves to the office. Go into the home, the workplace, wherever reality beckons.”

More red circles, around agoraphobia and the home.

The rest consisted of pseudonymous case histories, which I skimmed.

“Finished.”

Melissa put down the paperweight. “Have you heard of them?”

“I’ve heard of Leo Gabney. He’s very well known- has done a lot of very important research.”

I held out the clipping. She took it and put it back in her bag.

“When I saw this,” she said, “it just sounded right for Mother. I’d been looking for something- we’d started talking, Mother and I. About how she should do something about… her problem. Actually, we talked for years. I started bringing it up when I was fifteen- old enough to realize how much it was affecting her. I mean, I always knew she was… different. But when you grow up with someone, and the way they are is the only way you know, you get used to them.”

“True,” I said.

“But as I got older, started to read more psychology and understand more about people, I began to realize how hard it must be for her- that she was really suffering. And if I loved her, my obligation was to help her. So I started talking to her about it. At first she wouldn’t talk back, tried to change the subject. Then she insisted she was okay- I should just take care of myself. But I just kept at it, in small doses. Like after I’d done something good- gotten a really good grade or brought home an academic award- I’d bring it up. Letting her know I deserved to be taken seriously. Finally, she started to really talk. About how hard it was for her, how bad she felt not being a normal mother- how she’d always wanted to be like all the other mothers but that every time she tried to leave, the anxiety just got to her. More than just psychologically. Physical attacks. Not being able to breathe. Feeling as if she were going to die. How it trapped her, made her feel helpless and useless and guilty for not taking care of me.”

She gripped her knees again, rocked, stared at the paperweight, then back at me. “I told her that was ridiculous. She’d been a terrific mother. She cried and said she knew she hadn’t but that I’d turned out wonderful anyway. Despite her, not because of her. It hurt me to hear that and I started to cry, too. We held each other. She kept telling me over and over how sorry she was, and how glad she was that I was so much better than she was. That I would have a good life, get out and see things she’d never seen, do things she’d never done.”

She stopped, sucked in breath.

I said, “It must have been so hard for you. Hearing that. Seeing her pain.”

“Yes,” she said, letting loose a rush of tears.

I reached over, pulled a tissue out of the box. Handed it to her and waited until she composed herself.

“I told her,” she said, sniffling, “that I wasn’t better than she was, in any way whatsoever. That I was out in the world because I’d gotten help. From you. Because she’d cared enough about me to get me help.”

I thought of a child’s voice on a crisis line tape. Scented brush-off letters, calls unanswered.

“… that I cared about her and wanted her to get help. She said she knew she needed it but that she was beyond treatment, doubted anyone could help her. Then she started crying harder and said doctors scared her- she knew that was stupid and babyish, but her fear was overpowering. That she never even talked to you on the phone. That I really had gotten better despite her. Because I was strong and she was weak. I told her strength isn’t something you just have. It’s something you learn. That she was strong, too, in her own way. Living through everything she’d been through and still ending up a beautiful, kind person- because she is, Dr. Delaware! Even though she never got out and did the things other mothers did, I never cared. Because she was better than the other mothers. Nicer, kinder.”


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