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Heartache

"It’s the third election this year and the pressure is killing him. And his anger is killing me”

I

d seen it too many times to count. An angry husband who’d landed himself in couples therapy once his wife couldn’t take it anymore.

Even when Mickey told me about how her husband had ripped all the doors off the kitchen cabinets in a particularly angry moment, I still wasn’t especially shocked by Avi’s behavior. I’d seen everything – or so I thought.

Over the course of my career, I’ve dealt with my share of angry doctors, lawyers, musicians, architects, accountants, finance guys, contractors, firemen, rabbis, teachers, plumbers, and even a high-end aquarium-installation expert. And just like it no longer shocks me to hear about people swallowing magnets or batteries in order to hurt themselves because I’ve seen it before, hearing the horror stories about how Yossi took a blowtorch to his lawn furniture or how Levi took a sledgehammer to the jacuzzi no longer makes me break my poker face.

Mickey told the story of her own husband, who was slowly demolishing their home with his anger and was in urgent need of help. She’d finally given him an ultimatum: Either he’d attend therapy, or she’d take the kids still at home and leave.

“I understand the issues,” I commented, “but if you don’t mind me asking, why now, after sticking it out with him for so long?”

Mickey almost laughed. “Because it’s the third election this year and the pressure is killing him. And his anger is killing me.”

While Avi’s anger-management issues weren’t unique, what was a bit more interesting about his case is that he wasn’t exactly a low-profile individual. Yet as a major powerbroker in Israeli politics, he certainly didn’t need the negative press associated with a separation or divorce at this point in the election cycle. So faster than you could spell “scandalous separation,” Avi and Mickey were sitting together in my office.

Avi didn’t look particularly thrilled to be sitting across from me, and Mickey was a bit edgy herself. I opened up the floor for whoever wished to begin.

And then Avi got up and started to scream, as if he were mowing down his arch-rival at a political rally.

“I don’t have time for this idiocy!” he shouted, and turned to his wife. “Mickey, you know I have a lot on my plate, I don’t even have the time to shave! My assistant has to do it for me on the way into the Knesset!”

“Avi…” she pleaded as he got up and stormed out, slamming the door halfway off the hinges.

The 46 seconds he lasted in my office might have set the record for the quickest exit from a couples therapy treatment by me. I looked at Mickey, who was uncomfortably fluttering somewhere between vindicated and mortified.

“This is what it’s like at home?” I asked. She nodded.

“Well, we need to set some clear boundaries as to what is acceptable and what isn’t, irrespective of elections.”

Mickey nodded again, and we began to draw up rules for Avi’s behavior and how she could set clear expectations for his outbursts. Mickey confirmed that Avi wasn’t physically abusive to her or toward their teenage sons, but I still provided her with the crisis number for a domestic violence center, which she took. “Maybe,” she said, “it’ll show him that I’m serious.”

We made up to be in touch. She was still hopeful that he’d pull it together enough to come back for a second try.

Just a few minutes after Mickey left, Avi stormed back into my office.

“Did you come to fix the door?” I asked with a smile I just couldn’t quite hold back.

Avi threw a wad of cash at my feet. “This should cover it.”

I kicked it back at him and told him, “Hey, don’t worry, I’m not running to Meet the Press to tell them what a rage-a-holic you are. And anyway, I’m not voting for your party, so you can take the cash back.”

Avi didn’t think I was very funny, but he got the message that I wasn’t interested in his bribe, which he picked up and put back into his coat pocket.

“You gotta relax, Avi,” I said, hedging my bets on how he would react. “These kinds of outbursts aren’t going to get your team reelected.”

“You know what, Freedman?! You think you’re so smart because you went to Harvard?! Well, I got a law degree there and I had plenty of stupid people in my classes!”

“Me too,” I agreed. “I even had a guy training with me who divorced a great woman in the middle of our psychiatry residency.”

Avi missed the subtlety of my response as he was too busy screaming. “And furthermore, psychiatry isn’t even a real science! You probably don’t even know how to read an X-ray!”

I couldn’t really argue with that, as I hadn’t read an X-ray since breaking a finger playing basketball a few years back, but I felt it necessary to defend the field. “Psychiatry is a great discipline and we do our best with the tools we have,” I said a bit self-righteously. “Plus, I’m good at reading electrocardiograms.”

“What a lousy defense! And another thing — you’re not even funny! You’re like a washed-out stand-up comic!”

Avi needed to catch his breath for a moment and I gave him the time while I sipped the last drop of my coffee.

The purple-faced rage-monster in front of me was sweating bullets and had his hand on his chest as he yelled, “And when I googled you, I found a picture of you wearing a cowboy hat! What kind of frum guy wears a cowboy hat?!”

“Now that’s enough,” I stopped him. “I wear it twice a year when we go on our family vacations. But Avi, that’s not up for discussion, and there are more important things to address. Like how you have time to google me but don’t have time to shave — and the fact that you look pretty ill right now sitting across from me.”

I may be a psychiatrist, but I knew that a 50-year-old smoker with too much stress and an anger management problem likely had high blood pressure. Watching him clutching his chest, it was clear that any psychiatric interventions would have to wait until we made sure he wasn’t having a heart attack.

“Who are you calling, Freedman!?” he demanded nervously as I dialed Hatzolah on my phone. “My wife?! She already thinks I’m crazy! What do you have to tell her that she doesn’t already know?!”

I knelt down in front of Avi and took his pulse, which was irregular and racing.

“What are you doing now?!” he snapped.

“Pretending I’m a real doctor, Avi. Even a psychiatrist can recognize cardiac ischemia.”

“What the…?!”

Two chassidishe men with orange Hatzolah vests ran into my office and Avi suddenly broke down crying in a crumpled heap.

“Will you vote for my party if I go willingly?” he asked with a broken smile.

“Only if you agree to deal with this anger issue once they check out your ticker,” I responded as I patted him on the back and helped him out of the half-broken door and into the ambulance. “And you can fix the door next time you come in with your wife.”

Identifying details have been changed to protect the privacy of patients, their families, and all other parties.


Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman can be found learning Torah in the Old City or hiking the hills outside of Jerusalem. Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com

 (Originally featured in Mishpacha, Issue 795)

 

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