A colleague who responded to the victim's screams was seriously injured, and investigators were trying to determine whether the attacker was a patient at the clinic. Three knives were recovered at the scene, including a 9-inch knife and the cleaver, which was apparently bent from the attack, police said.
Kathryn Faughey's office was in shambles: Furniture was overturned, shades torn and blood was on the walls and pooled on the floor. She suffered 15 stab wounds, including a gash to her head believed to be from the cleaver, police said.
"The condition of the room was that of a fierce struggle," police spokesman Paul Browne said.
Investigators do not know the name of the suspect. Authorities released a sketch of a balding, middle-aged man believed to be the killer along with surveillance videotapes of the attacker entering and leaving the building.
He left behind two bags that contained bizarre clues, authorities said.
A roller suitcase was filled with adult diapers and women's clothing, including blouses and slippers, and a smaller second bag was filled with eight knives, rope and duct tape, tools apparently not used in the attack, police said.
Believing the killer might have been injured in the attack, authorities issued alerts to area hospitals and looked through the 56-year-old Faughey's computer files for clues. They also examined surveillance footage to see whether he had been to the office prior to the attack.
The attack rattled residents of the affluent neighborhood. They feared a violent slasher was in their midst. It also shocked the mental health care community and raised questions about safety protections at therapist's offices.
"Everyone in the building is very nervous, because we know that this person is loose. It's very frightening," said Linda Elliott, who lives in the building where the attack occurred.
The attack happened Tuesday night in a 13-story apartment building on East 79th Street, in a bustling neighborhood just blocks from a major hospital complex, police said.
The suspect, carrying the two bags and dressed in a three-quarter-length green coat, knit cap and gloves, breezed past the building's doorman, saying he had an appointment with Dr. Kent Shinbach, a 70-year-old geriatric psychiatrist who worked in the same office suite as the victim, according to police.
The suspect walked into the suite waiting room, where a female patient was waiting to see Shinbach, and at some point went into Faughey's office and started to attack her, police said.
It wasn't clear how long the struggle continued before Shinbach heard Faughey's screams and ran to help. The traumatized female patient, who was in Shinbach's office during the attack, was being questioned by authorities.
The suspect apparently didn't recognize Shinbach when he opened the door and said, "She's dead," referring to Faughey, who was lying behind her desk, police said. He then attacked the psychiatrist, stabbing at Shinbach and pinning him to the wall with a chair before stealing $90 and escaping through a basement door.
Shinbach was in serious condition at New York Hospital with slash wounds on his head, face and hands.
Blood was found on the basement doorknob, and police said the route outside from the first-floor office wasn't very obvious; it was possible the suspect knew where he was going. Surveillance tapes show the suspect deliberately leaving the luggage by the basement door before walking out.
Shinbach screamed out to the street from Faughey's office for help, and the building doorman called 911 around 9 p.m., but by then the suspect had escaped.
The attack sent shock waves through the city's large community of mental health professionals.
"This is, I think, an extraordinary occurrence," said Sharon Brennan, a psychologist in Manhattan and a spokeswoman for the New York State Psychological Association. "It has had a shocking impact on the whole New York community."
Faughey, a licensed psychologist and graduate of Yeshiva University in the Bronx, described herself as a specialist in cognitive behavioral therapy, which focuses on changing thoughts that cause feelings or behaviors. Neighbors described her as a tall, well-dressed woman who was reserved and private but friendly.
On her Web site, Faughey said she treated patients for relationship issues, coping with breakups, anxiety, panic attacks, stress over job changes and online intimacy, such as relationship issues arising from computer and text messaging.
In an interview with The New York Times in 2004, Faughey offered some advice on breaking up in a digital age: "In the old days it was burn the letters," she said. "Today, clear the hard drive."
Serious attacks by patients on their mental health providers are rare, but they do happen - usually in institutions that see more seriously ill patients.
A psychiatrist in Nebraska died of head injuries in August, several days after a patient with a grudge and a history of violence attacked him as he arrived at a medical center.
It is common for therapists who see patients in their homes or private offices to install alarm systems, or even help buzzers, in the event that a patient starts to lose control.
In Manhattan, these safety systems are often complemented by the usual security systems for office buildings, which include doormen and video cameras.
"Safety is always a concern," Brennan said. She added that therapists are thoroughly trained in how to assess a patient's potential for violence, and would normally see patients in a private setting only if they had determined that the safety risk was low.
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Associated Press writers David B. Caruso and Verena Dobnik
contributed to this report.
