I find I get angry at myself all the time, and sometimes I cry for no reason at all. It's probably my frustration at myself. I keep thinking how my parents hurt and humiliated me. I don't keep friends for very long. I have a pattern of cutting off whole groups of friends at a time. I guess I don't want them to find out how bad I am.

Kate, 40, a blond, stern-faced quality-control manager for a large corporation, came to see me at the recommendation of her family physician. She had been having panic attacks in her car and in the elevator of the building where she worked. Her physician had prescribed tranquilizers but was concerned about Kate's aversion to leaving her apartment except to go to work. He urged her to seek psychological help.

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