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bring him to his knees, and watch him weep. By the time we’re done, he’ll rue the day he ever laid eyes on you!”
    I looked at her. “Wouldn’t it be easier to just tie him to the rear bumper of my car and drag his body through the streets?”
    â€œNot good enough,” Mona said. She eyed me critically. “Boy, have we got our work cut out for us. You’ll need a complete makeover. You’ll need a new dress. You’ll need a manicure.”
    I heard the door open in the reception room down the hall. I glanced at the clock on the wall.
    â€œThat’s probably Screwy Lewey,” Mona said. “He’s got a nine o’clock appointment.”
    I was too distracted to remind Mona that it was rude to talk about patients that way. I swallowed the rest of my coffee and hurried down the hall, where I found Mr. Lewey pacing.
    He was in his late fifties, owned an auto parts supply store, and suffered from claustrophobia. My therapeutic intervention had included talk therapy, relaxation, and desensitization. My goal was to get him on an elevator, but just thinking about it often sent him into a panic attack.
    â€œGood morning, Mr. Lewey,” I said, leading him into my office. I motioned toward the sofa, and he perched on the edge, poised to bolt.
    â€œI’m a little anxious,” he said.
    I took the chair next to him. I noted his shallow breathing. “What’s going on?”
    â€œI wanted to take the elevator. I stood there for twenty minutes trying to work up the courage to get on, but I couldn’t. I ran up the stairwell as fast as I could. By the time I got to the fourth floor, I could barely breathe, and I was dizzy, and my heart was pounding.”
    â€œRunning up four flights of stairs would leave most people breathless and light-headed,” I said.
    He met my gaze. “Oh. So maybe I wasn’t really on the verge of a panic attack?”
    â€œMaybe it was just your body warning you to slow down.” I saw him relax. “Have you been listening to the relaxation tape we made?”
    â€œI missed a couple of days because we had company. My wife’s brother visited. I don’t want him to know about my, um—” He paused. “My problem.”
    I nodded sympathetically. People who suffered from panic attacks and phobias felt a lot of shame. They went to extremes to hide their fear. I knew from experience, because after my dad died, I’d had my share of them. It had taken three years of therapy to get them under control by learning to focus on something else until they passed. In my case, it was multiplication tables.
    â€œWhat might your brother-in-law think?” I asked.
    â€œHe’d think I was nuts. Bad enough my wife has to know.”
    â€œYou’re close to your brother-in-law, aren’t you?”
    Mr. Lewey nodded. “I’ve known Ben for some thirty years now.”
    â€œWhat if the tables were turned? What if Ben had your problem? Would you think he was nuts?”
    â€œOh, no. I’d want to help if I could.”
    â€œBut you’re depriving him of the right to be helpful and understanding to you.”
    Silence.
    â€œSuppose you had taken the elevator,” I said. “And suppose it was full of people, and you had a panic attack. What’s the worst that could happen?”
    â€œI could die.”
    â€œOkay, what’s the second-worst thing that could happen?” I asked, wondering if I’d ever be able to convince him he wouldn’t die.
    â€œIf I had a panic attack, I would humiliate myself.”
    â€œHow could you reduce your stress to lessen the odds of having one?” I asked.
    He just looked at me.
    â€œWe’ve discussed this many times, Mr. Lewey.”
    â€œYou mean where I get on the elevator and tell everybody what a nutcase I am? I’d rather jump from the top of this building.”
    I thought I’d go into a panic attack just