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When The Therapist Has A Fear Of Elevators

(Allen Lai/Flickr)
(Allen Lai/Flickr)

The cramped elevator in the office building where I practice psychotherapy makes me uneasy.

The carpet looks stained and worn, fraying in the corner. Faded yellow paint barely covers the walls. When the door slides open, a musty smell hits the nostrils of waiting passengers.

I rode this contraption for the first time nine years ago, the day I decided to rent my office. That first trip felt like a movie in slow motion. The machine noisily inched up its shaft, lurching and wheezing like a drunk asthmatic. The seconds dragged by. When the elevator reached the third floor, it grew oddly still. Nothing happened. While I waited for the door to spring to life, I felt my heart thumping in my chest. Silently, I willed that thick, motionless metal portal to move, imagining myself imprisoned in this tiny cell for hours, mouth parched and desperate for a sip of water.

Finally, the elevator car shuddered, and the door slid open. I bolted out, ran down the hall to my new office and tried to catch my breath.

Trudging Up The Stairs

For the next eight years, I avoided the elevator. Loaded down with a briefcase, laptop and lunch box, I trudged up the 40 stairs to my office in the morning and down again in the evening. Finally, my knees begged for a break, and my physical therapist recommended an alternative mode of transportation up to my office.

I had to face the machine.

As a psychologist who specializes in the treatment of anxiety disorders, I knew that I should be able to calm myself in the elevator. First, I turned to a well-accepted psychotherapeutic technique: correcting thought distortions. “Don’t jump to conclusions,” I whispered to myself as I crossed the threshold into that seemingly airless, small box. Then, like many of my patients whose minds automatically leap to the worst case scenario, I remembered a strong young man who came with his wife for marriage counseling. The session went well. However, the couple left my office and got stuck in the elevator. The husband pried the door open. Later that day, he called me, yelling about the “deathtrap” in my office building. “I know, I know,” I murmured sympathetically into the phone. Needless to say, they did not return for a second appointment.

When I look back on it, necessity paved the way towards improvement. I had no choice but to ride the elevator twice a day, five days a week. The psychological literature promises that repeated exposure to a feared object decreases anxiety. And it worked. At first, I remained vigilant to the machine’s jarring sounds and jolting movements. Then one day I stepped out of the elevator, and I realized that I had daydreamed about a recent vacation to France as this conveyor traveled from the lobby up to the third floor, almost oblivious to its noises and tremors.

Just In Case

But “almost” remains the operative word. Some nights before I step into this dingy people mover, I make one last trip to the ladies room and stick the cell phone in my pocket. I place a bag of trail mix in my purse. Then I fill the water bottle up to the top. Just in case it is a long night in that small cubicle. If I have plans with my son, who only comes to town every couple of months, I will lug my stuff down the steps, regardless of my aching knees. I want to be certain that I get out of the building.

A female patient recently asked me if I ever experienced anxiety. While I am cautious about revealing personal information to patients, I wanted to reassure her that she was not alone, and I nodded “yes” to her question. Her eyes grew wide. Perhaps she mistakenly thought that a psychologist must have licked her demons, if she had any in the first place.

When I told this young woman that the National Institute of Mental Health reports that almost a fifth of Americans have been diagnosed with an anxiety disorder, she smiled broadly and leaned back in the chair — just as I hoped she would. “Many of us learn to manage anxiety,” I added, “few people escape it completely.”

Catastrophizing

Of course, I still have setbacks. Some nights I stand in the hallway, trying to decide if I should turn right and flee down the steps or left and risk a ride in the elevator. Then I firmly remind myself that my fear about being trapped in this machine resembles a thought distortion called “catastrophizing,” expecting the worst to happen. Taking a deep breath, I think about how reliable this elevator has turned out to be. I stand up straighter, press the call button, and bravely stride into this lift for my trip to the first floor.

Recently, to my surprise, I began to see “my” elevator in a new light. Those yellow walls now look warm and friendly; the shabby carpet makes me think of the old, soft rug in my parent’s bedroom where I would watch TV. Then I noticed that the machine’s comfortable temperature warmed me when I came to work on a cold winter’s day.

Not a bad place to spend the night, if I had to.

Ellen Holtzman, Psy.D., is a writer and psychologist who practices in Wakefield, Massachusetts.

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