REPOST: Getting Better Can Be Risky by Mark Rubinstein

05 Mar

Getting Better Can Be Risky

How therapy can upend a relationship.

A 55 year old man came to my office, asking me to help his wife. I thought it odd his wife didn’t accompany him to the consultation. It soon made sense why he’d come alone.

Mrs. L had always been socially fearful. Some might call it being shy or retiring, but it was much more. They had few friends, spent nearly every evening home, and settled into a predictable and uneventful life. Despite these limitations, the couple developed a comfortable psychological equilibrium.

When Mrs. L turned 52, her shyness escalated. She became completely avoidant of people; stopped answering the telephone; refused to go to a movie or local store; and the couple ceased dining out. In fact, Mrs. L’s avoidance became so extreme, she spent all her time in the bedroom. The thought of being anywhere else, even in other rooms of her house, aroused panic-level anxiety. Her condition had escalated to severe, incapacitating agoraphobia.

Each day, Mr. L went to work while Mrs. L remained in the bedroom. He did the grocery shopping; picked up dry cleaning; and attended to chores requiring any contact with people. The couple lived separate and apart from humanity.

Mr. L didn’t protest. In fact, he acknowledged the situation gave him ample time for his abiding passion: reading American history. Mr. L didn’t understand why his wife wanted to see a psychiatrist. I found this shocking, since the couple’s life appeared to be so compromised. He’d adapted to his wife’s condition, and was content with their lives. I wondered if he feared a changed Mrs. L would upend their relationship.

Some days later, despite terrible anxiety during the trip to my Manhattan office, Mrs. L began treatment. She was tired of her bedroom-bound existence. Though she reveled in dependency on her husband, there was some part of her wanting to change. And change she did: a month later, with medication and psychotherapy, she began wanting to dine out, go to a movie, and engage in normal interactions with people. It was clear her phobia was being extinguished. She also confided Mr. L seemed “not so happy” with these changes. Tensions were developing between them. I began wondering who really was the sicker partner.

After a few weeks of the new and improved Mrs. L, her husband called to say she would no longer be coming for treatment. Knowing Mrs. L would deteriorate without medication and therapy, I asked to speak with her directly. Mr. L told me, “She doesn’t want to talk with you.”

I’ll never know whether or not that was true, but what I do know is change can be a threat to any relationship. To preserve what they had, Mrs. L would be heading back to the bedroom.

Originally Published on February 5, 2013 by Mark Rubinstein, M.D. in Tales from the Couch





A Novel

Mark Rubinstein

Thirty years after escaping his hell on earth—a harrowing childhood in Sheepshead Bay, Brooklyn—Roddy Dolan is grateful to be living the life of his dreams. He has a successful, fulfilling career as a surgeon, a beautiful family, and a lovely home in Westchester County, New York. His past is now just a bad dream.

When he was young and living in Brooklyn, Roddy had an explosive temper and shady friends, which nearly landed him in prison at 17. If it weren’t for a compassionate judge and the Army, Roddy might have ended up going nowhere. But that’s the past, gone for good. Today, at age 45, Roddy is a different man—worthy of the respect he has earned. He is in control of his destiny and rage is no longer part of his life. Or, so Roddy thinks…until a character from his past turns up and re-evokes his long-buried “Mad Dog” alter ego.

A gripping, harrowing, and provocative psychological thriller, MAD DOG HOUSE (Thunder Lake Press; October 23, 2012,  12.99, 978-0-9856268-4-6), revolves around three men—Roddy “Mad Dog” Dolan; his best friend, Danny Burns; and Kenny “Snake Eyes” Egan—who grew up in hell together and never thought their pasts would come back to haunt them. Throughout the novel, Mark Rubinstein provokes people to think about the haunting power of the past and the demons lurking inside their loved ones…and perhaps themselves.




MARK RUBINSTEIN is a Huffington Post and Pscyhology Today blogger who grew up in Brooklyn, New York, near Sheepshead Bay. After earning a degree in Business Administration at NYU, he served in the U.S. Army as a field medic tending to paratroopers of the Eighty-Second Airborne Division. After his discharge, he went to medical school, became a physician, and then a psychiatrist. As a forensic psychiatrist, he was an expert witness in many trials. As an attending psychiatrist at New York Presbyterian Hospital and a Clinical Assistant Professor of Psychiatry at Cornell, he taught psychiatric residents, psychologists, and social workers while practicing psychiatry. Before turning to fiction, he coauthored five books on psychological and medical topics.  He lives in Connecticut with as many dogs as his wife will allow in the house. He still practices psychiatry and is busily working on other novels. To learn more, please visit

Mark Rubinstein

328 pages, $12.99

ISBN 978-0-9856268-4-6


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