FOR NEARLY 30 years, Marjorie Goff did not leave her Washington apartment.
She was afraid to walk 10 feet out the door to her mailbox. She was afraid to answer the phone. Sometimes she was afraid to walk from the bedroom to the living room, where she would sit -- often in the dark -- unaware of the seasons changing, the months turning into years, the years into decades.
She lived in a state of suspended animation, crippled by a baffling disease no doctor could cure.
"I was dead," she says now. "They just hadn't buried me yet."
At the age of 64, Goff recently returned to the world after seeking treatment for her disorder: agoraphobia. It has only been understood and treated by mental health professionals during the last 10 years. Often referred to as the "house-bound" syndrome, agoraphobia comes from the Greek word meaning "fear of the marketplace." It affects nearly 2 million Americans, two-thirds of them women, in various degrees of intensity and often runs in families, according to recent studies. Without warning, the victim suddenly experiences heart-pounding "panic attacks" in certain situations. The agoraphobic is terrified of having another attack and, as the "anticipatory" anxiety sets in, the fears begin to multiply.
Like Marge Goff -- once an ambitious young Washington career woman with a bright future -- the victim gradually cuts off all contact with the outside world.
Now she seems like a woman from another planet, a modern Rip Van Winkle, amazed and delighted by what she sees: supermarkets with automatic doors, newspaper vending machines on street corners, department stores with racks of clothes and computerized cashiers.
"How long have they had those?" she asked an acquaintance, walking across Columbia Road one day last week.
"What?" he answered.
"Those walk and don't walk signs," she said, pointing to the flashing neon traffic light.
"About 20 years," he said.
"Gee whiz," Goff sighed. "That long."
She lived on the allowance her father sent her every month. For 30 years, she bought her clothes from a Sears catalog. For 30 years, her groceries were delivered by understanding neighbors. For 30 years, her perception of the world -- like Chauncey Gardiner in "Being There" -- was formed by the media, mostly newspapers and books. She rarely watched television.
Her skin, untouched for 30 years by the sun and wind, is smooth and surprisingly supple. She is bright and charming, a small, pixieish woman with animated hands and clear, gray-blue eyes with only slight traces of the dark shadows that once gave her face an eerie, zombie-like quality.
She often speaks of her former self in the third person. "The old Marge is dead," she says. "I feel sorry for her. For all that she missed."
It is almost impossible to comprehend. Twenty-seven hundred summer nights, and endless, crisp autumn days. Ten thousand nine hundred and fifty sunsets. The Fifties. The Sixties. The Seventies. Integration. Women's Lib. Drive-in banks. Vietnam. Watergate. Fast-food restaurants. The smell of freshly mowed grass. The crunch of snow on the sidewalk. Love. Marriage. The decline of her once-fashionable neighborhood. From the sublime to the serious to the ridiculous, all the elements that define one's generation, one's lifetime, Marge Goff experienced from behind her apartment door.
"It's a different world for me. It's a new world," she says now, eyes misting over.
She has been waiting for 30 years to tell someone the story. The Torch Singer
Born in Edgewood, R.I., a suburb of Providence, on April 28, 1917, Marjorie Goff was the youngest of three children. Her father, a possessive, doting figure, was a salesman for the Hood Rubber Company, a subsidiary of Goodrich. The Goffs were fairly well-off, able to give their children ballet lessons, elocution lessons, servants and a sense of their own self-worth in the world.
Margorie Goff remembers being afraid of nothing.
"I was very self-sufficient and ambitious," she says, recalling that her talent for drama made her the featured entertainer at family gatherings.
Give us a reading, her father would call. Marge, stand up and give us a reading.
She says she has blocked out much of her past, though several scenes still haunt her memory. At the age of 10, she contracted tuberculosis. She doesn't remember her convalescence. She does remember being the youngest child.
I remember one day I had done something wrong and had a terrible fight with my father.
"I never asked to be born," I screamed.
"Well you were never wanted," my father answered.
She recalls that her mother was a very nervous, intelligent person who was afraid of elevators and often felt anxious driving the car. "I think people thought she was a little off or something, but we just put it down to nerves. Of course, no one knew about agoraphobia. I remember my aunt would take me shopping, but half the time she couldn't go downtown. She was afraid to go downtown."
Marge Goff attended Cranston High School and was known for her low, throaty singing voice. Dubbed "The Torch Singer" by her classmates, she dreamed of a career in show business and sang with a few bands around Providence. She also was a star tennis player and avid Glee Club member. Next to her high school graduation picture in the 1937 Cranstonian is the following sentiment:
"Although Marge is undecided whether or not to be a dramatist, we are certain that she will be a success in any field. She finds much entertainment in her English, which is rather a surprise to some of us. Happy landings!"
Her family disapproved of her career choice so, after graduation, Goff was sent to a small secretarial school to learn typing and shorthand.
Her mother died when she was 20, and Goff remembers "going to pieces." The housekeeper took care of the family, and she was, by Goff's description, a stern, cold woman who pampered Goff's father and ignored the children.
In January 1941, to prove to her father that she could be independent, Goff traveled to Washington for what was supposed to be a three-week visit. She applied for a job at The Washington Post and was hired as a typist for $18 a week.
"You won't have maid service," her father warned.
Goff lived with a roommate and, for the next five years, worked her way up the wartime career ladder as a government employe. She was ambitious and highly capable, she says, winning raises and promotions until that spring Saturday in 1946 when she went down the street to Antoine's Beauty Shop to have her hair set.
"I was sitting under the dryer, and all of a sudden this feeling swept over me. I'm losing my mind, I thought. I'm going crazy. My heart started beating fast. My legs felt weak. My body trembled. It was the most incredible feeling of fear. I wanted to scream, to run out of there. I got up with all the pins in my hair, slapped a five dollar bill on the counter and ran all the way home. I was white. I felt that everyone was looking at me. That everyone knew. I didn't know what was wrong with me."
When she got home, she buried her face in the pillow and sobbed. "All I kept thinking was, 'It's going to happen again. It's going to happen again . . . ' " Prisoner of Fear
She sits on the large armchair, chain-smoking Salems, trying to recall the details of her life. It is a painful, cathartic exercise. She recreates conversations and acts out scenes from her past in vivid detail, jumping from the chair, choking back tears, slumping back again, exhausted.
She remembers returning to work that Monday after her first panic attack, feeling better. But three months later, standing in line at the grocery store, the uncontrollable fear swept over her again. She panicked, dropped the groceries and ran home. Her roommate asked what was wrong. She didn't know how to explain it. I can't go back to the beauty shop. Now I can't go to the grocery store . . .
She was beginning to lose her self-confidence. She was beginning to feel uncomfortable at work. "All of a sudden, one day while I was typing a letter, my heart started beating wildly. I had to go home, but I couldn't make it alone. I was afraid to go home alone. I was so ashamed. The next day I couldn't go to work. I was so embarrassed."
When it happened again while riding a bus, Goff was convinced she needed help.
"Doctor, I think I need to see a psychiatrist," Marjorie Goff said, sitting in the chair across from the internist.
"Marge, you don't need a psychiatrist," the doctor said.
"But there's something wrong. I'm losing my self-confidence."
"No, you have a very good outlook on life. You just have a nervous heart. Perhaps you need some nerve pills. These will relax you. Take one before you go to bed."
She began having more "spells" and missing more days at work. Finally, she went to her boss and resigned.
I can't go into the beauty shop, I can't go to the grocery store, I have to take cabs because I can't take the bus. Now I can't work . . .
But she wanted to work, so she got a job with the Reconstruction Finance Corporation, located on the top floor of a Washington building. One day in the elevator, Marge Goff experienced her fifth panic attack within a year. She decided to resign.
"Marge, I don't want you to resign," her boss said. "I'm being promoted next week, and I want to take you with me as my personal secretary."
"I can't," she said.
"What's wrong?," he asked her.
"I don't know," she said. I can't admit to him that I'm afraid to go into elevators, she thought. I'm the only one in the world with this condition . . .
"I know what's wrong," her boss said. "You've been working too hard. You need a rest. Go home. Take a plane and go home for two weeks."
"All right," she said, knowing she would never return to her job.
It was 1949, the last time Goff went on an airplane. She stayed in Rhode Island for one week, afraid to tell her family she had resigned her job. She couldn't tell them why she was afraid to ride on the bus, why she couldn't go into a grocery store, or ride an elevator or live a normal life without the debilitating fear that had sunk it's teeth into her psyche.
She returned to Washington on the train, and in the next few months went from one job to another. Finally, she wound up at the Department of the Navy.
"I did my work very well. I was a perfectionist. But they noticed I was nervous, losing time on the job," she recalls. "I'd go into the ladies' room to collect myself. I remember this woman in there one day, washing her hands. She kept washing her hands, putting alcohol on them. When she opened the door, she had a napkin in her palm so her hand wouldn't touch the knob. I felt like I was crazy, but she was really crazy."
The Navy Department sent Goff to a psychiatrist. "He just sat there and stared," she recalls. "He said, 'If you come to me once a week I can help you, but if you stop coming to me you will lose your job at the Navy Department. I went to him for a few weeks. He kept asking me questions about my sex life. Finally, I left."
She stayed in her apartment for weeks, extremely depressed, crying for hours. What am I going to do? Her roommate finally called her father, who spoke tenderly to his daughter. "How would you like to come home?" he said.
"Yes, please come and get me," she replied.
Her father drove down to Washington, picked her up and put her in the car. "I was in a daze," she recalls. "I just wanted to be alone. I sat in the back curled up like a frightened animal. I thought I'd end up in a mental institution. I sobbed. I prayed."
The first thing her father did was take her to the family doctor, who examined the young woman. "Your whole problem is this," he said, pointing to a lump on her throat. It was a goiter. The doctor told her father that they wouldn't operate because Marge was too nervous. She began to blame all her problems on the goiter. Her father finally took her to a psychiatrist.
"I wanted people to like me," she says now, tears streaming down her face. "I just wanted to be liked. To be needed. I wanted to be wanted."
She stayed in Rhode Island for a year, first living with her older sister, then getting a small apartment. Since she was afraid to take a bus, she used to walk everywhere. One night, she accepted a ride home with a young man she had met. He drove to a deserted road and raped her. Terrified and half in shock, she ran from the car to a house several hundred yards away. She doesn't like to talk about it, but the event sent her reeling back to Washington with a new set of fears: men. Buried Alive
In June, 1950, she took the small one-bedroom apartment in Adams Morgan. The area was a very fashionable, quiet residential part of the city. Now, the walk in front of Goff's building is strewn with trash and broken bottles. "Gee, will ya look at this?" she says, leading a visitor to her front door.
It wasn't like that 30 years ago, when the rent on the one-bedroom apartment was $62 and Goff remembers leaving her screen door unlocked on hot summer nights. Now, she pays three times that amount, and the door is always bolted. The original 1952 gas stove is still working, she says, refusing to have the landlord replace it with a newer electric range. The apartment itself has been preserved for three decades. Brocade sofa, small wooden tables, a comfortable rocker, brass floor lamp, black and white flecked wallpaper. On one wall is the only concession to modern decor: squares of mirrors tacked up in a diamond pattern. The heavy gold drapes are drawn.
"It's so hard for me to remember," she says, lighting another Salem.
Back then, she still had a few friends in town, and managed to live comfortably on the $300 a month her father sent her. Eventually, she took a roommate by the name of Dixie, who worked as a waitress.
Several years later, Dixie's 80-year-old father, a former coal miner from West Virginia who had lost both his legs after being run over by a train, came to live with them.
Although Dixie didn't know what agoraphobia was, she understood Marge's fear of going out. "She said to me once, 'I'll do the outside work. You do the inside work.' " Of course, there were problems. One of Marge's phobias involved eating at a dinner table. She was convinced she would have a panic attack.
"I don't like eating with anyone else," Marge told Dixie one day.
"That's funny," said Dixie.
"What's so funny?" Marge asked.
"Neither do I."
Marge doesn't remember much about those years. She does remember asking Dixie if it was a cold winter or a hot summer. Sometimes, if she got depressed, she would sit in the darkened living room, thinking. Most of the time, she sat with her the pet parrot, "Buddy," and her chihuahua, "Tina," entertaining friends who dropped by.
Most of it, however, is a blur.
"My body was there, but my mind had gone. I was buried alive. I thought, 'I'll never see the outside world again. I will never be part of society.' "
In 1960, Goff was pursuaded to go to Rhode Island to visit her family. Dixie drove her. Goff was unable to leave the house. They stayed a few days and drove back. It was the last time she saw her family.
Two years later, she had to leave the apartment again. She spent two weeks in a hospital after having the toxic goiter removed. She doesn't remember much, only an intense need to return to the apartment.
In 1967, her father died. In 1973, Dixie's father died. The next year, Goff's older sister died; and in 1977, her brother died. Goff was unable to attend any of the funerals.
In 1976, Dixie became ill with cancer of the esophagus. When Dixie came home from the hospital, the nurses told Goff that her roommate would need constant care.
"You can't leave her alone. You can't leave this apartment. Do you realize what that means?" one of the nurses said.
Goff smiled. "You won't have to worry about that," she said.
For the first time in her life, she had a reason for staying home. She nursed her friend, watching the cancer "eating away Dixie's face."
One night, Dixie said she wanted some ice cream and there was none in the apartment. In a daze, Goff ran out the door and up to the drugstore. She doesn't remember what she saw. She only knew that it was for Dixie. She could do this one thing for Dixie. It was the first time she had left the apartment in 10 years.
Seven months later, Dixie died in Marge Goff's arms. "I couldn't cry," said Goff. "I was numb."
For the next two years, she lived in a private hell. "I felt like I wasn't part of the world. I was just existing."
One night she found herself in the bathroom, staring at herself in the mirror, holding a handful of tranquilizers. This is it, she thought. This is the end . . .
But her fear of dying was greater than her fear of living. She put the pills away. Dixie had always taken care of her. Her father had always taken care of her. Now she had no one. Neighbors brought her food, but after awhile they became suspicious of the old woman in the first-floor apartment. They told her there was nothing wrong with her. They told her to push herself. To get out. She had shrunk to 90 pounds. She would have to start depending on herself.
Goff decided to get food stamps. But in order to do so, she needed to obtain an identification card. Since she couldn't leave the apartment, the agency sent a man with the I.D. card picture-taking machine to her apartment.
Finally, in the summer of 1978, with no money and nowhere to turn, she called Protection for Elderly People, a senior citizens' group in the city, and asked if she could take in typing in her home. She spoke to a young woman named Sally Walther. Although there was no employment available, Walther -- a tall, bespectacled young woman with an easy manner -- wanted to know more about Marjorie Goff. At first, Walther didn't understand the old woman's troubles. It was difficult for Goff to talk on the phone. She rambled on, her thoughts spilling out like marbles on a glass-top table. One thing she was adamant about: She refused to leave her apartment. It was then that Sally Walther remembered seeing a program on "60 Minutes" about agoraphobia. She asked to visit Goff. Reluctantly, Goff agreed.
Walther walked several blocks to the apartment and was let in. Goff, like a frightened child, sat in the armchair staring at the stranger on the green brocade couch. Walther had done some research and found a magazine article on agoraphobia. She handed it to Goff.
Slowly, Marjorie Goff read the article. Finally, tears streaming down her cheeks, she looked up. "That's what I have," she cried, in disbelief. "That's what I have." Coming Out
The first thing Sally Walther suggested was that Goff begin receiving Social Security benefits. She arranged for a medical evaluation.
Goff, clinging to Sally Walther's arm in a daze, went to George Washington Hospital, where she was examined by a doctor. The three-page medical report concluded that Goff was "a dependent personality with chronic neurotic anxiety and agoraphobia. The symptoms are reasonably well-controlled; but in the process of coping with the anxiety, the patient has been rendered practically invalid. The adjustment, although marginal, does however satisfy the patient's needs, unfortunately nurtured by her family's past interventions; and there is little motivation to change now, and little chance that a change could be induced at this stage."
But Walther didn't give up. She was convinced that Marjorie Goff could be succesfully treated. "She saved my life," Goff says now.
Walther had heard of Dr. Robert DuPont's phobia clinic in Bethesda, a new type of treatment based on "contextual therapy," in which the therapist accompanies the agoraphobic to the feared situations.
The 20-week program, with group and individual therapy, cost $1,000. Walther arranged to borrow the money through a church group, and drove Goff to the clinic for an interview. DuPont remembers their first meeting.
"She was dragged in by Sally. I'd never seen anyone as clinically hopeless as Marge," DuPont recalls. "She was from another world."
Goff remembers crying throughout the interview. DuPont said he felt "gloomy" about the prospects of Goff's recovery.
"She was very upset and frightened," said Jerilyn Ross, DuPont's assistant and phobia therapist. "We had never seen anyone who had been house-bound for as long as 30 years."
At Walther's urging, DuPont accepted Goff into the program. Later, he would say she was his most successful patient.
At the first group meeting, Goff -- still clinging to Sally -- was loud and disruptive. "She had a low level of trust in herself and the rest of the world," said DuPont. "Here's someone who had hit the bottom. She couldn't control herself. She had no social skills. People liked her, but people didn't understand her. She wouldn't listen to anybody else."
Goff's story, he said, is a story of hope. "Marge is the heroine, but Sally Walther deserves an awful lot of credit."
So does Jerilyn Ross.
"I began visiting Marge at her home. At the first session, she was terrified that I'd try to drag her out. She sat there in tears, saying over and over again, 'Are you going to make me go out? Are you going to make me go out?' I kept saying no. Finally, at the end of the session, I asked her if she would like to walk me to my car, which was parked right out front. For 20 minutes she put her foot out the apartment door, then back in again. Finally, she broke down, cried and ran out to my car."
During the next session, Ross was able to coax Goff into walking to the mailbox on the corner. Gradually, the territory was expanded to two blocks. Then a store. Ross would walk down the street -- first side by side with Goff, then in front of her, then behind.
Goff at first was terrified, then elated by what she saw.
"I've always thought it would be interesting to know what a baby is thinking when they take their first step. This was why it was so amazing to be with Marjorie during those weeks," said Ross. "Here was a baby taking its first step who could articulate what they were feeling."
For Ross, it was "like bringing someone back from the dead. Imagine thinking you're crazy for 30 years, then suddenly finding out you're not."
At first, Ross said, "you could actually feel her body going into convulsions. You could feel the turmoil inside, like little earthquakes going off."
For Marjorie Goff, it was like a kid with a new toy. Suddenly, she was able to walk to the corner by herself. The first thing she noticed was the way people dressed, especially women. She was shocked by the cars, the noise. She was delighted by the stores, by the variety of products.
"We went to a store one day and she wanted 'hip huggers' ", said Ross. "I had to explain that they were out of style. It was like being with someone out of a time capsule."
Finally, on Christmas Day, 1978, Goff agreed to go to dinner with Ross at a restaurant. She had not been inside one since 1949. When they got to the door, Goff spent 10 minutes putting one foot in, and taking it out again. Ross was getting exasperated. "Finally, she took a deep breath and ran inside. The whole place was empty. She sat down immediately at a corner table where two men were already seated. It was obvious they wanted to be alone, but she wouldn't move to another table. She spent the whole time talking with the young men."
Goff, according to Ross, was the "most bizarre patient they have treated, and her improvement has been the most dramatic."
Ross says Goff would call every day and leave messages on the therapist's answering machine. "I wished I'd kept them," said Ross. "They were amazing. A complete diary of her recovery. 'Today I did this . . . You wouldn't believe what I did this morning, where I went.' "
Goff recalls her first trip to a fast-food restaurant: "I felt like what a person must feel coming from the sticks. I felt very awkward. We walked in and stood in line. I didn't know you had to get the napkins out of the little box. I couldn't find the straws. And when they rang it up on that little computer, I thought, 'My goodness how science has advanced.'
"But what really got me were the newspaper boxes on the corner. I couldn't believe it. You just put the coins in and the box opens."
The escalator at Dupont Circle was another adventure. "I knew what an escalator was," says Goff, "but I hadn't been on one for 30 years. I just rode down that big one, saying, 'Whhheeeee.' It was a ball. I'd never seen anything like that before."
Then there was her first trip to a supermarket. "I didn't know about those automatic doors. When I stepped on the thing, it opened. I jumped. I said, 'Oh my God, what next!' " Instead of dropping the groceries in a panic, Goff now combs the aisles, offering help to other elderly shoppers.
Perhaps the biggest emotional hurdle was going back into a beauty salon. A neighbor had fixed Goff's hair for decades, in her own apartment. Goff wanted to test herself. To see if she could go back to the place where it had all started. There was a beauty shop around the corner. She walked the two blocks and asked if she could have a permanent right away. "It was important I have it as soon as possible. I thought, 'I can't stay in here long.' I was shaking so hard, but I said to myself, 'I've made it this far. Stay.' " So she did, and walked out one hour later with tears of joy. "I was so proud of myself. I did it."
Today, Marjorie Goff is training to be a paralegal at George Washington University Institute of Law and Aging. She works at the 14th Street office of Protection for Elderly People and earns $242 a month. "She's very bright and can go a long way," says Betty Hickock, one of her supervisors. "I think it's really amazing. What's interesting is that we've picked up on many others who were like Marge. If it hadn't been for her, we never would have known about agoraphobia."
Goff walks down the street, head held high, watching other people with fascination and affection. "I laugh and laugh and I couldn't be happier," she says, her face breaking into a wide grin. "I keep thinking, 'Boy, what else have they thought of?' "
But there are still shaky moments, fading twinges of the old fear. One day she was walking down the street to work and started having a panic attack. She knows now that the surge of fear only lasts 20 seconds. "Any other time, I would have run back home," she says. "But I didn't turn around. I just kept going. I kept going. I kept going!"