E li was back.

One of my favorite patients — the attorney with the history of panic attacks and the difficult in-laws whom I’d written about previously — had run across town again and was banging on the office door yelling my name.

I was still in session with another patient who was initially startled to hear someone screaming “Dr. Freedman! I need your help!” Luckily I was able to reassure the patient that it wasn’t anything dangerous and that I would be back in a moment after addressing the issue.

“Eli ” I said calmly opening the door and patting him on the back. “It’s all good. Just grab a chair in the waiting room and pour yourself a cup of ice water.”

When Eli opened his mouth to object to my inability to drop everything and prioritize him over my other patient I was forced to shush him lovingly. I’d known him for enough years to be confident he would survive and as I had to return to the individual in session I told him “Take a few breaths and remember the mindfulness strategies we’ve discussed.”

Eli acquiesced and I left him to practice deep breathing in the waiting room while I finished treatment with the patient in my office. After wrapping up this session I returned to the waiting room to find Eli sitting slightly more tranquilly and invited him into my office.

But Eli’s apparent calm was superficial and momentary. He started breathing rapidly again and yelling “You don’t understand my in-laws are suddenly coming for Rosh Hashanah and it’s going to be a disaster!”

“Time out Eli ” I responded taking his hand in mine and taking his pulse. “Your heart is beating very fast but you’re not going to die. You’ve been through infinitely more stressful situations and you’ll also get through this.”

We took deep breaths together. We focused on the air going in and the air coming out. We each took a drink and after a few minutes Eli had managed to relax.

“So I heard that your in-laws are coming for Rosh Hashanah Reb Eli?”

“Yeah! It’s awful. First they torture my wife about never coming to visit them in Manchester and now they’re torturing her by springing this visit on her ” he moaned.

I had to stop the spiral so I figured I’d use some humor. Eli and I had been working together for long enough that it wasn’t going to hurt his feelings and frankly keeping the big picture in mind — by making light of the situation — was a very solid Cognitive Behavioral Therapy tool for the kind of anxiety that Eli had.

“Torturing her ” Eli repeated again out loud.

“Of course that’s why they’re coming Eli. Your shver and shvigger aren’t interested in coming to Eretz Yisrael or seeing their grandkids at all. They just found a good deal on tickets and realized that they hadn’t made your wife’s life miserable recently.”

“I don’t know if I can bear witness to it Dr. Freedman.”

“Then you should probably go to Uman. I heard that there are lots of litvishe guys headed this year for the same reason.”

“Dr. Freedman it’s really rough and I hate to see her like this — so I told her they just can’t stay with us they’re too crazy.”

“Right and renting a place in Yerushalayim for them is exorbitant. Get them a bed-and-breakfast place in Gaza where it’s cheaper.”

“Okay Dr. Freedman I get it. I’m calm now.” Eli took a few deep breaths.

“If you’re so calm now then maybe we can talk about how criticizing your wife’s parents gets you nowhere and only makes the situation worse.”

“You’re right Dr. Freedman but they always hurt her feelings ” he responded somewhat defensively.

“I get that Eli but how does criticizing them make it any easier for her? You need to support her and tell her how wonderful she is and how proud you are of her.”

“And let them walk all over her?”

“No. But criticizing them is really criticizing her making her feel she can’t stand up to the challenge of this complicated relationship. Instead of that go with a positive approach and build her up. The more you support her and praise her the more she’ll be able to withstand their challenging relationship. And the more that you argue with her and with them the more she’ll have to worry about. Don’t forget it for one minute that with your current attitude you’re making things worse. She already has to deal with them herself. Now she has to deal with having a husband who hates her parents too?”

“I really hear you Dr. Freedman ” he agreed. “So what do I do?”

“You praise her for all of her hard work. You let her know how much you love her. You find the good in the situation.”

“Well… I guess my shvigger is a great cook and it’s nice that she’s always helpful with the baby.”

“So tell that to your wife. She’ll also stop dreading the visit if she remembers she’ll have some extra help around the house.”

“And her father is a good learner and always gives a nice drashah at the table.”

“Then tell him in advance how much you’re looking forward to hearing his insights. And tell your wife that you’re looking forward to it too.”

“Then what do I do when they start driving her nuts?”

“Ask him to review the Mishnayos Rosh Hashanah with you and your oldest son. He’s good at it and it’ll help to focus on the good. The more you focus on the good the less conflict there will be.”

“Yeah I get it. And it will also help my wife to focus on the good ” Eli replied.

“Remember Eli this is your big chance to make peace with your in-laws before the books close. Hashem would love to write about what a big tzaddik you are this year.”

“I just wish it weren’t so tough Dr. Freedman.”

“You wouldn’t get such a big reward if it weren’t tough. Baruch Hashem now you can really have kavanah when you say the words ‘v’yaasu kulam agudah echas.’ ”

“Agudah echas includes my in-laws too I guess?”

“You got it. Now go out there and make the Eibeshter proud. If you’re not headed to Uman it’s the least you can do.”

Eli shook my hand and wished me a “Gut yohr” as I walked him to the door. I had a feeling it would be.

Originally featured in Mishpacha Issue 678. Jacob L. Freedman is a psychiatrist and business consultant based in Jerusalem. He serves as the medical director of services for English-speakers at Bayit Cham a national leader providing mental health treatment and outreach within the religious community. Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com.)