I had chosen not to listen to the lashon hara I’d heard about Effy and his lack of manners. I also tried to judge him favorably when he moved into the neighborhood and I’d seen him in shul, acting with less tact and social graces than one might expect from a frum guy. But it was sure hard to view him in the nicest light when he approached me during davening one night and asked, “If you’re a psychiatrist, can you drug my wife for me?”

Not having ever been formally introduced to him and seeking to avoid a bizarre discussion in public, I encouraged Effy to speak with me about this issue outside after Maariv had finished.

Effy was a wheeler-dealer and was always texting on at least two iPhones in addition to the one he had plugged into his ears. His business was some sort of import-export thing and he didn’t have time for niceties. Effy didn’t seem like a bad guy, but he was known for this kind of cut-to-the-chase style that I’d suddenly been blindsided by.

“Nu?” he asked. “So can you drug her for me?”

“Excuse me?” Clearly I was missing some context here.

“You know, Valium, Xanax, Klonopin. Nothing too strong that she can’t wake up in the morning. I just need to knock her out for a few hours.”

Was this guy for real? “Effy, I think you’ve got the wrong man. I’m a doctor, not a gangster, and this sounds illegal at worst or immoral at best.”

“No, no, no,” he said. “You’ve got it all wrong. She’s afraid of flying and we have a wedding for my brother in France in a month. I just need her to fall asleep for the flight because she’s terrified of planes and won’t go otherwise.”

I guess it was a bit different when he explained it this way. That being said, he could have asked in a more tactful fashion. “Effy, I’ll be happy to see your wife in consultation, but you should know that fear of flying is a normal, treatable condition similar to arachnophobia, claustrophobia, or any of the other common fears that folks might have. The treatment isn’t medications to ‘knock someone out,’ rather it’s a special set of mental exercises related to cognitive behavioral therapy.”

Effy smiled and patted me on the back. “Sure Doc, whatever you say, knock her out or fix her up — I don’t care — just get me to that wedding.”

I didn’t laugh. I didn’t find his callousness charming and I could only imagine that his attitude didn’t help her fear of flying one bit — or the rest of their relationship, for that matter.

Effy’s wife was a fine, sweet woman named Henny who had the good manners of showing up to my office five minutes early and not saying anything rude or absurd when we introduced ourselves. She was initially shy but then told me about how her fear of flying was really a fear of tight places. Like many people who suffer from this condition, she had had a tough experience — getting stuck in an elevator for a few hours once as a teenager — and was subsequently petrified of being trapped. While she looked happy and healthy, she hadn’t stepped on a plane in over a decade, as her last flight experience resulted in a panic attack where she’d thought she was dying.

Henny’s treatment wasn’t especially complicated: First I explained to her the nature of her condition. Her fears were due to an overactive fight-or-flight response triggered in her brain by the experience of being on an airplane in a closed space. I assured her that this was a common thing for men and women of all ages. It wasn’t anything to be embarrassed about. Some people have fear of snakes or spiders and, for others, like Henny, it was aviophobia: fear of flying.

I then taught her how to breathe deeply and calmly in order to trigger a “relaxation response” whereby her brain would enter a state of mindfulness and be able to “chill out” even during stressful situations. This was aided by guided meditations where she thought about peaceful experiences she’d had in the past. Henny enjoyed recalling her walks in the botanical gardens with her grandmother as a child, feeling the dew on the flower petals, and literally stopping to smell the roses at the entrance to the park.

From here we went through a hierarchy of stressful experiences beginning with just considering the idea of flying. At first she felt symptoms of panic — racing heartbeat and shortness of breath. But with a few sessions, and time in between to practice her relaxation and mindfulness skills, the thought of flying was infinitely less stressful for Henny. Before she knew it, Henny was packing her bags and ready to go to France for her brother-in-law’s wedding.

At our last session, two days before their trip, Effy suddenly showed up and burst into my office right in the middle of the appointment. When I asked him if everything was okay, he yelled emphatically, “Yeah, I’m glad she’s not crazy about the flying thing anymore. She’s still crazy, don’t get me wrong, but at least it’s not about flying anymore.” It wasn’t funny, but he laughed anyway. Henny was mortified.

As we still had 15 minutes, I kindly asked Effy to wait outside. Turning to my patient I said, “Henny, you were never crazy, you just had a bit of aviophobia and baruch Hashem it’s better now as you’ve worked hard to address it and overcome it.”

“Thanks,” she said and looked away.

“Is there anything else you want to talk about?” It was certainly the right time to bring up her husband’s manners and how his behavior made her feel. “Sometimes it doesn’t make it any easier when one’s spouse isn’t particularly supportive.”

Henny blushed. My goal wasn’t to embarrass her any further. I just wanted to let her know that here was a safe place to talk about other things that might have been on her mind. Especially the way that her husband makes her feel.

After a moment or two she said, “He doesn’t hit me, you know.”

“Thank G-d,” I responded, and I meant it. “But just because he doesn’t hit you doesn’t mean that it’s acceptable for him to talk to you that way.”

Henny pulled herself together with remarkable speed and told me, “I’m all set now, Dr. Freedman. Thank you so much. I feel confident that I’ll make it to the wedding and home again.”

“I have no doubt that you’ll make it to the wedding and return safely,” I told her. “I’m just bringing up the fact that you might have some other stuff you’d like to talk about when you come home. No one deserves to be mistreated by a spouse, and domestic violence comes in many different shapes and forms.”

“We’ve been married for nearly 15 years and nothing’s changed. What can you do about it now, Dr. Freedman?”

She had a good point. I wasn’t going to promise that I’d be able to stop Effy from being a verbally abusive wildcard of a husband overnight. But this was something that needed to be addressed and there were a number of options available to help Henny move forward. “I think that this is deserving of more attention than we can give it now, but for your wellbeing, I don’t want to let this fall through the cracks.”

Henny stared at the floor for a few long moments and then looked at me again. “Okay, let’s talk again when I get back.”

And we will.

Originally featured in Mishpacha, Issue 664. 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.