She showed up at the clinic two months ago, at the forefront of a weeklong rush of about a hundred other prospective patients. They’d all seen Goulding on Good Morning America (“Which time?” he asked each of them; behind his clipboard, Paul rolled his eyes), where he had been invited to discuss his latest book, Torturing Your Way to a Peaceful Mind. It was the third volume in a vague and loose-ish series. The first two, which had been required reading in the Master’s in Psychology program at New York University, where Paul had studied, were titled Killing Your Obsession and (rather distastefully, Paul thought) Murdering Your Compulsion. Wendy, like most of Goulding’s patients, claimed to have pored over each one multiple times, her highlighter poised ready in her gloved hand (“I’ll make sure to tell the doctor,” Paul had said, smiling. He didn’t. He never did). The raves over Goulding’s literature during initial patient interviews never come as a shock to him or any of the other caseworkers—all three books have been runaway hits, thanks in no small part to their incendiary titles and shocking methods.
More conservative members of the psychotherapy community consider Goulding a maverick when it comes to the treatment of obsessive-compulsive disorder. (In the January edition of Psychology Today that Paul had leafed through at the dentist’s office, he had somewhat gleefully scanned a two-page spread in which a cadre of noted analysts likened Goulding to famous villains, ranging from Iago to the Joker. Then he remembered that this was the same Goulding who signed his paychecks, and he traded Psychology Today in for an old issue of Vanity Fair.) There are other therapists practicing similar treatments—in fact, Paul interviewed with another institute outside Boston two weeks before finishing graduate school—but none of them push the boundaries of exposure therapy quite as sadistically far as Goulding does. At those clinics, so far as Paul understands, the sort of immersive practices that Goulding champions are looked at as a final resort—a last-ditch effort desperate doctors try when cognitive behavioral therapy and drugs don’t work. And even then, it’s a matter of the patient being told she can’t wash her hands before dinner; never would she be asked to molest a trash can.
“Can I take my hands away from this filthy thing now?” Wendy asks.
It’s hot for May, even here, in the leafy suburbs of Philadelphia’s Main Line, and the overripe scent of garbage is causing Wendy to pull a face.
Paul shields his eyes from the sun; Goulding forbids his caseworkers to sport any sort of eyewear. “Is your anxiety still at a nine point nine nine?”
“I’ve still got fucking Ebola crawling under my fingernails, haven’t I?”
Paul stifles a grin a second time: he loves it when Wendy swears. She throws so much strength behind her fucks, her shits, her damns that the rest of the sentence is often left breathless and anemic. She looks down and blushes.
“Then no,” Paul says. “You can’t take your hands away just yet.”
She quickly counts to five and then says, “How about now? Can I let go now? I feel much better.”
“Your knees are shaking, and you’re still sweating.”
Wendy looks down at her legs—tan, crosshatched with shadows of varicose veins.
“Think of all those germs,” Paul adds, following Goulding’s script. “Think of all those germs crawling all over your body, and you’re still alive.”
“This isn’t living, kid.”
“Just hang on a bit longer.” He stops himself short of agreeing with her. “You’re doing great.”
He watches her roll her eyes, and he thinks back to when he was first hired, nearly two years ago (God, he thought, could it really have been that long ago?). He’d just been awarded his master’s degree, and he was more or less pure hearted and well intentioned; his actions and decisions were dictated by a sense of goodness and purpose. Or, at least, that’s what he likes to think, now that he has the luxury of hiding behind hindsight. Regardless, the fact is that he had told himself that he believed in the work that Goulding was doing, and that was the important thing. It was controversial, and had a decidedly avant-garde bend, but still he believed in it, which made it the right job to take. Over the past five months, though, he’s been having a tougher time convincing himself that he made the right decision. That purity that he felt, that blithe sense of goodness, has given way to a sort of flailing confusion, a rudderlessness that causes him to sneak cigarettes when Mark’s out of town, or drink more whiskey than he should.
“All right,” he says, “you can let go.”
Wendy rips her palms away from the bin and begins wiping them against her shorts, leaving greasy fingerprints spotting her thighs. When she’s done and her face is red and wet, she thrusts a palm out to Paul.
“The Purell?”
Paul folds his arms. “Not quite yet.”
“You’ve got to be fucking kidding me.”
He follows the script: “Wendy, I want to remind you that you’re here voluntarily. You can leave whenever you want.”
Wendy mutters another breathless obscenity and looks down.
“You people are more awful than Al Qaeda,” she says.