me recently.”
“Melissa,” she said. “Such a
“She has a lot to be serious about.”
“Yes. Of course she does. The family pathology is deep-rooted. I’m glad she’s finally reached out for help.”
“Her main concern seems to be her mother,” I said. “Separation. How her mother will deal with her going away to Harvard.”
“Her mother is very proud of her. And eager for her to go to Boston.”
“Yes, Melissa’s told me that. But she’s still worried.”
“No doubt she is,” she said. “But those worries are Melissa’s alone.”
“So there’s no chance of her mother’s relapsing if Melissa goes away?”
“Hardly, Dr. Delaware. In fact, I’m sure Gina- Mrs. Ramp- would appreciate her newfound freedom. Melissa’s a bright girl and a devoted daughter, but she can get a bit… cloying.”
“Is that her mother’s term?”
“No, Mrs. Ramp would never say it that way. But she feels it. So I hope you’ll be able to confront Melissa’s ambivalence head-on and do it quickly enough for her to make the break. I understand there’s a deadline involved. Harvard tends to be impatient- I know from experience. So she’s going to have to commit. One would hate to see a technicality get in the way of forward movement.”
Thinking of McCloskey, I said, “Does Mrs. Ramp have any other worries that might be transmitting themselves to Melissa?”
“Transmitting? As in emotional contagion? No, I’d say it’s just the opposite- the risk is of Melissa’s anxiety transmitting itself to her mother. Mrs. Ramp presented as one of the most severely phobic patients we’ve ever treated, and we’ve treated many. But she’s made extraordinary progress and she’ll continue to do so. Given the chance.”
“Are you saying Melissa’s a threat to her progress?”
“Melissa means well, Dr. Delaware. I can certainly understand her concern. Growing up with an ineffectual mother would give her a stake in being hypermature. At some level, that would be adaptive. But things change, and at this point in time, her hovering serves only to reduce her mother’s self-confidence.”
“How does she hover?”
“She tends to make herself rather conspicuous during crucial therapeutic moments.”
“I’m still not sure I understand.”
“Okay,” she said, “I’ll spell it out. As you may know, treatment for agoraphobia needs to be
“Have you ever talked to her about this?”
“I’ve tried, Dr. Delaware, but Melissa shows no interest in talking to me.”
“Funny,” I said. “She sees it differently.”
“Oh?”
“She perceives herself as trying to obtain information from you and getting rebuffed.”
Silence. Then: “Yes, I’m sure she does. But that’s a neurotic distortion. I’m not without compassion for her situation, Dr. Delaware. She’s dealing with a lot of ambivalence- intense feelings of threat and jealousy. It can’t be easy for her. But I need to focus on my patient. And Melissa could use your help- or someone else’s, if you’re not so inclined- in sorting things out.”
I said, “She’d like me to talk to her mother. In order to clarify her mother’s feelings so she
“That’s wise of you. What, exactly, would you discuss with Mrs. Ramp?”
“Just her feelings about Melissa’s leaving- which, from what you’ve told me, sound pretty clear. After hearing it firsthand, I’d be able to deal with Melissa’s doubts.”
“Using your advocate role to propel her forward?”
“Exactly.”
“Well, I don’t see any harm in that. As long as you keep your discussion circumscribed.”
“Any particular topics you’d like me to stay away from?”
“At this point, I’d say everything other than Melissa’s college career. Let’s just keep things simple.”
“Doesn’t sound as if anything about this case has been simple.”
“True,” she said, with a lilt in her voice. “But that’s the beauty of psychiatry, isn’t it?”
I called Melissa at nine and she picked up on the first ring.
“I checked with my contact- he’s a police detective on temporary leave so he has some free time. If you still want McCloskey looked into, it can be done.”
“I want it,” she said. “Tell him to go ahead.”
“It may take a bit of time, and investigators usually bill by the hour.”
“No problem. I’ll take care of it.”
“You’re going to pay him yourself?”
“Sure.”
“It could end up being substantial.”
“I’ve got money of my own, Dr. Delaware- I’ve paid for things for a long time. I’m going to pay
“Melissa-”
“No problem, Dr. Delaware. Really. I’m a very good money manager. I’m over eighteen, meaning it’s totally legal. If I’m going to go away and live independently, why not start right now?”
When I hesitated, she said, “It’s the only way, Dr. Delaware. I don’t want Mother even knowing he’s back.”
“What about Don Ramp?”
“I don’t want him involved, either. It’s not his problem.”
“All right,” I said. “We’ll work out the details when I see you tomorrow. Speaking of which, I spoke to Dr. Ursula and she says it’s fine for me to meet with your mother.”
“Good. I already talked to Mother and she’s willing to meet you. Tomorrow- isn’t that great? So can we cancel our appointment and do that instead?”
“All right. I’ll be there tomorrow at noon.”
“Thanks, Dr. Delaware. I’ll have lunch set out for you. What do you like to eat?”
“Lunch isn’t necessary, but thanks anyway.”
“You’re sure?”
“I’m sure.”
“Do you know how to get here?”
“I know how to get to San Labrador.”
She gave me directions to her house.
I copied them and said, “Okay, Melissa, see you tomorrow.”
“Dr. Delaware?”
“Yes, Melissa?”
“Mother’s worried. About you. Even though I told her how nice you are. She’s worried about what you’ll think of her. Because of the way she treated you years ago.”
“Tell her I understand, and that my horns only come out during the full moon.”
No laughter.
