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Dear Dr. Robert--

I can't afford to go to a psychiatrist on my own and my parents would never take me seriously if I told them about this, so here I go.

Lately, I've been overly concerned about dying. I've tried everything from distractions to religious beliefs about the afterlife to meditation, and nothing has helped. Even more recently, it's gotten worse. Much worse. I have nightmares about nuclear fallout and death constantly. I can't walk around in the dark without panicking that there is someone in the room with me. I can't enjoy the fourth of July this year, because I freak out any time my boyfriend is NEAR a firework and all I ever think about in my free time is death and dying. I can't even function anymore. I won't swim in a pool that has a light for fear of electrocution, I can't even drive, because I'm afraid of getting into a wreck, and the thoughts of these... horrible, grotesque deaths just won't leave me alone anymore.



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It would be different if I was just afraid of it, you know? but now it's taking over my life. I don't know what I'm to do. it's like torture? what is it and is there a way out?

signed,

Ashley











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Dear Ashley--

First let me repeat as I always do on this website that I cannot make a firm psychological diagnosis at long distance, and that nothing I say here should be taken as the last word (only a personal consultation can be that authoritative). That said, however, your worries about dying seem to me to constitute an obsession, a word which psychologists use to mean a troubling thought that occurs again and again and causes severe distress in a person.





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Now I do not mean to say that anyone who is worried about dying or who spends some time thinking about mortality is obsessed. Clearly the fear of "not being at all" is one of humanity's most basic, primal terrors, and having to live with the knowledge that "myself" will come to an end probably constitutes the greatest psychological difference between humans and the other animals. It is this knowledge, along with the need somehow to deny it, which seems to me to provide the raison d'etre, the reason for being, of the many religions which promise an afterlife. And the immense quantity of resources--time and money--which humans devote to such religions testifies both to the depth of death-fear among humans and the urgency with which so many of us seek to deny that fear.




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Since the survival beyond the grave of the personality is a proposition which seems increasingly absurd as detailed brain studies unfailingly indicate that the sense of being resides within the cells of a living brain, and that when the brain dies, that sense must die along with it, we humans seem forced to make a choice. Either we discard the fanciful ideas of an afterlife in heaven with "God," which certainly will raise our anxieties about not continuing to exist, and which will demand that we find other ways besides the hope of some future "paradise" to convey a sense of meaning to our brief lives, or we ignore everthing which has been learned since the scientific age began centuries ago, and cling to the superstitions, born of scientific ignorance, dreamt up by our distant ancestors as a way of mitigating their anxiety. In short, your fears are widely shared, and the traditional way of dealing with them--"God"--has become less and less effective. This is to say that the problem is not that you have such fears and struggle to deal with them, but that they have begun completely to take over your life. That is what makes those thoughts obsessional.




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Now, once the obsessive thought process has begun, it seldom, if ever, can be stopped by the kinds of things you have tried. But the good news is that, unlike some other psychological problems, there is a treatment for obsession which usually shows good results in a fairly short time. This treatment of choice is simple: a combination of good psychotherapy plus the correct medication (once the obsession abates, the medication may or may not need to be continued). In other words, there certainly is a "way out," as you put it, and I urge you to take it before you begin to feel even worse, and find yourself even more limited in the way you are able to live your life.

I do understand that you fear to discuss this problem with your parents, but I think you should, and right away. If it will help, you might like to print out this letter and show it to them.

You did not give your age, but since you mention a boyfriend, I assume that you are in your teens. If this is the case, and your parents really refuse to take your suffering seriously, the next step is to consult your school counselor and ask for help from him or her.

Be well.



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