The Naked Lady Who Stood on Her Head (23 page)

THE FOLLOWING WEEK, SUSAN AND RAY RETURNED
for their second session. She looked tired and stressed. As we got started, I asked Susan how she was doing, and Ray answered for her. “Not well, Dr. Small. She’s getting worse.”

I turned to Susan and asked, “What’s going on?”

“I don’t know…I can’t stop thinking about Ray, the yacht, why he really bought it…I mean, what’s he really doing on that thing? It’s even distracting me at work.”

“So you’re having trouble trusting Ray?” I asked.

“No, I don’t know why I’m so suspicious. It’s like I’m having a bizarre conversation with myself. It’s better when he gets home in the evening and we’re together. But then it happens again the next day.” She shook her head and looked away. “Jesus, I sound like I’m depressed.”

Ray spoke up. “Maybe Susan needs medication, Dr. Small.”

“It’s possible,” I said. “But we don’t want to jump into medication too quickly. Let’s find out more. Susan, what’s your appetite been like?”

“It’s down, and you don’t have to go through the list of depression symptoms. I have a lot of them. I do appreciate your holding back on the medicine, because I still think we have a marriage problem that isn’t resolved.”

Ray sighed. “Not again. And what would resolve it, Susan? My selling the yacht? Wouldn’t it be less drastic for you to take a couple of Prozacs?”

She glared at him. “I don’t appreciate your tone, and no, I don’t think taking Prozac is easier than finding a real answer to our problem.”

He shook his head. “Darling,
we
don’t have a problem. You do.”

“Let’s slow down a bit,” I interjected. “It sounds like we’re back to the basic disagreement about who’s got a problem and how to go about fixing it. Susan is worried about the situation and may be depressed. But
why
she’s feeling this way, and how to help her, is still unclear.”

“Look, I love my wife dearly,” Ray said as he turned to Susan. “And even though I need it for business, and it’s been my lifelong dream to have a yacht of my own, if your happiness depends upon it, I’ll sell it right now.”

Ray’s professed love for Susan seemed sincere, but his perfunctory offer to sell his yacht didn’t ring true. I wondered if he was holding something back.

She looked at him tenderly. “Honey, no one is saying you have to sell your yacht, but Dr. Small is right. Let’s slow things down and try to get a better idea of what’s going on. Maybe it does have to do with the way I was brought up, but we need to be able to talk about it.”

We did talk about it for the rest of the session, and I began to see a pattern of how Susan and Ray interacted. Every time she got anxious and expressed her concerns about the relationship, he initially got defensive but then came around and was able to calm her and bring them back together. At times he struck me as a regular family man who really cared about his wife. But other times he seemed a bit too polished and ready with an answer for everything. Something was stirring up Susan’s anxiety now, and I wasn’t sure what that was. If it had to do with her career,
why didn’t this problem emerge earlier? Also, Ray had bought the yacht several years ago, so why was it an issue now? It was hard to believe it all went back to an empty-nest syndrome.

That evening, Gigi prepared a fabulous pasta feast for the four of us. The kids and I made pigs of ourselves, and I figured I’d better walk off the extra carbs. No one wanted to join me and the dog, so I took off up the street with Jake in tow. The sun was about to set, and as I caught a breathtaking view of the hillside and ocean, I heard my neighbor Bob say, “I didn’t know that they let psychiatrists out after dark.”

“Didn’t you get the memo about our special night passes?” I asked.

“Hey, did the Wagners ever call you?” he asked as he crossed the street toward me, obviously not wanting Jake back in his yard.

“How well do you know them?” I asked.

“Well, like I said, the wife has a busy Westside practice. I met the husband once at a fund-raiser. You know, I shouldn’t say anything, but…”

“But what?” I asked, curious to get a colleague to weigh in.

“There’s something about him. I mean he’s very personable and everyone seemed to be drawn to him at this event, but I don’t know.”

“What is it?” I asked.

“I just don’t trust the guy,” Bob said.

“Really? Why not?”

“He was flirting with other women every time his wife’s back was turned. Anyway, what’s happening with them?” he asked.

“You know, the usual midlife marital issues.” I didn’t want to give up too much, to avoid breaching my patients’ confidentiality.

Bob was about to ask me another question, but his cell phone rang and he had to take the call. I waved good-bye and headed home. Hearing Bob’s misgivings about Ray’s character began to fuel my own.

At their next session, Susan showed up alone. Ray had to handle a business emergency down the coast. She sat across from me on the couch, and we looked at each other, professional to professional.

“Have you ever wondered why Ray has so much business out of town?”

“No. Why should I?” she asked.

I cut to the chase. “Do you think Ray is having an affair?”

“No,” she said. “I think he’s just taking a vacation from our marriage, which I don’t appreciate.”

“Have you ever directly asked him?” I asked.

“Of course not. I don’t think there’s another woman; I think he’s just lost interest in me.”

I was in an awkward position. I had outside information from my neighbor that supported my own suspicions about Ray’s infidelity. My guess was that he was a pro at covering it up.

Susan went on for the rest of the session praising Ray for his many virtues. She didn’t want to talk about her depression and seemed to minimize the loneliness she felt whenever he was away.

THE NEXT WEEK I WAS PREPARING A
lecture for an international Alzheimer’s meeting in Europe, so I tried not to schedule too many patients. As I was sorting through my presentation, my assistant buzzed me and said that a Francesca Wagner was waiting to see me, but she didn’t have an appointment.

“I’m really busy right now. Could you schedule her to come back another time?”

“I tried that, but she insists on seeing you now,” Laura said. “She says she drove up from San Diego and only needs a few minutes of your time.”

I checked my watch and said, “Okay, give me a minute and I’ll be right with her.” I closed my PowerPoint file and straightened up the desk before buzzing Laura to send the woman in.

Francesca looked to be in her late twenties and resembled Penélope Cruz with a few extra pounds. She walked briskly into the office, took a seat in front of my desk, crossed her arms, and glared at me. She seemed angry, and I had no idea why.

I tentatively asked, “What can I do for you?”

“I’ll tell you what you can do for me, Doctor. You can stop screw
ing up your billing and sending statements to people who never came to see you.” She paused and took a breath before continuing her rant. “Or maybe you’re pulling some type of insurance scam and sending out phony bills to see what comes back.”

“What are you talking about?” I asked. “I’m not following you.”

“Do you have any idea how much this can mess up people’s lives? It can cause fights, break up marriages—and for what, a few bucks from an insurance company?”

I was getting worried. This woman seemed unstable. How did she pick
me
out? Was she dangerous? She could be psychotic and have a knife or a gun in her purse. I tried to remain calm and figure out what was going on, but her intensity and anger were clouding my thinking.

“I’m sorry, Ms. Wagner, I still don’t know what you’re referring to.”

“I’m referring to this.” She pulled a piece of paper out of her purse and slammed it down on my desk so hard that I jumped. It was my bill to Susan and Ray Wagner. I quickly checked the address, and it matched the one in my records. So how had this woman gotten it? Was she a relative? Did the post office screw up? And why was she so angry about it?

“I’m not sure how you got this bill, Ms. Wagner, but it wasn’t intended for you,” I said, relieved that all of this was probably just a clerical error.

“You’re damn right it wasn’t,” she said.

“So why do you have it?”

“I found it in my husband’s coat pocket when I picked up his dry cleaning.” She folded the bill back up and put it in her purse.

“Maybe it was from another Ray Wagner’s jacket,” I said, grasping for a plausible explanation.

She looked at me indignantly. “I live in San Diego. My dry cleaner is in San Diego. The bill is addressed to a Ray and Susan Wagner in Los Angeles for couples therapy. What kind of con are you trying to pull?”

“Listen, Mrs. Wagner, I’m not pulling any con, but let’s try to figure this out. Would you like a glass of water?” She nodded and I got up to pour each of us one. She was starting to calm down.

I sat back down. “Now, you said you’re from San Diego?”

“That’s right. My husband, Ray, and I live in La Jolla with our baby.”

“So your husband, Ray, had this bill in his coat pocket?” I asked.

“I already said that. But I’d like to know who the hell Susan Wagner is,” she said as her anger started building again.

I made an effort to sound calm. “Francesca, tell me about your husband.”

“He’s a successful businessman and a wonderful father.” She brightened when she spoke about him.

“And how long have you been married?” I asked.

“Two years now. It was very romantic—we got married on his yacht.”

I felt like a brick just hit me on my thick head. I understood why this Francesca Wagner was so pissed off, and why Susan Wagner had been sensing there was something not quite right in her marriage for the last couple of years. I couldn’t tell Francesca about Susan—I was bound by confidentiality. The only way Francesca was going to get to the bottom of this was by talking with Ray.

“Francesca, there’s no fraud or clerical error, but there’s not much else I can tell you. It sounds like this is something between you and your husband, and I think you should ask him about it.”

She stood, angry again. “So you’re going to stonewall me and just tell me to talk to Ray. Well, I can’t do that because he’s away on his yacht again, and his cell phone doesn’t work at sea.”

That didn’t make sense—I thought cell phones worked at sea. I remember that Gigi and I called my parents at least three times during our cruise to Mexico while they were watching our kids.

“I’m sorry, Francesca,” I said. “There’s nothing else I can do.”

She grabbed her purse and stormed out of the office. I suspected that she wouldn’t be able to confront Ray until the weekend, when he left Susan for one of his so-called business trips. But I had a session scheduled with the Wagner couple I knew the following day, and I could hardly wait to confront Ray about this misplaced-bill incident.

Ray was quite the operator. Not only had he conned Susan and Francesca, but he had pulled me into his ruse as well. Had my
countertransference partly blinded me to his sociopathic maneuvering? He sure had me going—shrewdly dictating my therapeutic responses. Susan should be on meds, Susan should have her own psychotherapy, Susan should explore her career ambivalence, Susan should do this and Susan should do that—but Ray was a saint with a heart of gold and deserved his time alone on his boat. It was one thing for Ray to pull the wool over my eyes for a few sessions, but he had managed to dupe Susan, a trained psychologist, for years. He had been so smooth that I had actually fantasized about going on his yacht.

I knew why Ray had been able to fool everyone for so long. He was a quintessential sociopath. Sociopaths, or what psychiatrists call antisocial personalities, have lifelong patterns of deceitfulness for personal gain. They lack remorse and empathy and are wizards at rationalizing away how they hurt and mistreat others. Usually people think of sociopaths as being habitual criminals—thieves, thugs, and murderers. However, intelligent sociopaths sometimes never get caught and can end up running major companies or billion-dollar Ponzi schemes. It’s the less organized sociopath who can’t hold down a job, is unable to sustain a long-term relationship, and often ends up in jail.

When a relatively successful sociopath like Ray gets caught, those he’s fooled are initially shocked and outraged—they can’t believe that this person whom they trusted for years has betrayed them. They experience shame because they feel they should have known better or sooner. Ray was skilled in recognizing his victims’ emotional needs and fulfilling them in order to get what he wanted. Neither of his wives—at least the two I knew about—wanted to believe that he was capable of living a double life, so they ignored the clues and were quick to embrace his rationalizations.

Most of us have come into contact with people who have sociopathic tendencies—that’s one reason we usually take time to get to know people before we trust them. And even people who do have the capacity for empathy might act in an antisocial manner on occasion, whether it’s fudging on an income tax return or not bothering to go back and pay for a magazine that was forgotten at the bottom of a shopping cart.

However, no one knows what causes extreme sociopathy, which
afflicts 6 percent of men and 1 percent of women. The condition begins in childhood, kids who set fires or torture animals are sociopaths. It persists into adulthood with chronic lying and cheating, and lasts throughout life. Depending on the severity of antisocial personality disorder, some of the symptoms can be treated with medication, psychotherapy, or both. However, when sociopathy is severe, there is no cure.

If, as I suspected, Ray was a true sociopath, why did his bigamy start so late in life? Perhaps he had been cheating on Susan throughout their marriage and gotten away with it. Maybe the empty-nest syndrome or some type of midlife crisis escalated his behavior to a new level of deceit. I didn’t know if I would ever get answers from Ray—he was pretty smooth at avoiding the truth.

I FOUND MYSELF CLOCK WATCHING BEFORE THE
Wagners’ appointment, anticipating my showdown with Ray. At five after, I got worried that they wouldn’t show, but my assistant buzzed and said my appointment had arrived. I opened the door and saw only Susan standing there.