A middle-aged woman obsesses about death and she begins asking everyone the same question, “Do you think about it, too?”
Carol, a woman in her mid-sixties, who had a history of medical complaints, aches and pains, and worries of illnesses, was repeatedly diagnosed over the years as both hysterical and hypochondriacal (always thinking she had some illness). Despite her complaints, she was always given a clean bill of health.
Carol had been married to a man who was more than twenty years her senior, and who had died several years earlier. When her husband died, her hysterical reactions and complaints of worrying about having a variety of illnesses increased. The only exception to her anxious condition regarding her health was seen when she went to work in her business.
Carol’s husband, along with his business partner, owned a physical therapy practice. When her husband died, she took over his share as partner and became the administrator of the practice, while the partner conducted the actual clinical practice.
Whenever Carol worked in the practice, she was happy and never complained of anything. Her business gave her an overwhelming sense of well-being and feeling of power. She only became obsessed with death sometime after both she and her partner agreed they would need to close down the business because the patient clientele had decreased significantly.
Carol had two daughters who were quite attentive to her. They indulged all of her medical concerns. They chauffeured her here and there, and with them she was passive and dependent, and even childlike.
Based on our symptom code of one (the wish), two (the anger), and three (the who), we would guess that Carol:
1. had her wish blocked;
2. got angry about it; and,
3. didn’t know she was angry at someone in particular—a who.
At first, Carol was upset and depressed over the loss of her business and, in fact, she was unsure about why the business failed in the first place. She stated that her feeling of depression was always accompanied by some vague sense of dread, that there was something wrong. Then at some point, and quite accidentally, she met a former patient of the physical therapy practice who told her that he had been her former partner’s patient for several years now—but in his private practice, beginning some time even before her partnership with the former partner had been dissolved.
At that point, Carol began an investigation and discovered that her former partner had been siphoning patients into his own practice and that this thievery had been ongoing since her husband’s death. Yet, after uncovering this subterfuge, rather than becoming consciously angry, this woman began to feel terrible and it was then that she began to obsess about death.
A neighbor whose apartment was directly below Carol’s apartment began complaining that this woman was flooding her apartment—water was damaging her bathroom ceiling and pieces of the plaster were peeling off. After the third such incident, the neighbor called one of the woman’s daughters and described the situation. She indicated that each time the ceiling was damaged, she had to wait until the ceiling dried before the painters could come in to repair and paint it. She also indicated that the woman always paid for the damage and repair, but that obviously something was wrong because it kept happening. The neighbor further indicated that she thought the daughter’s mother was constantly taking baths, that she could hear the water running sometimes two or three times a day, and had begun anticipating that her bathroom ceiling could be flooded again at any time.
When confronted with this complaint, our death-obsessed, worried woman readily confessed that she often bathed because she only felt reasonably okay when sitting in her bathtub filled with very hot water. She said that the hot bath was relieving and that it gave her a sense of safety and security to feel not just warm, but very warm. She said she knew it was abnormal to want to feel so warm all the time and added that it was obvious to her that it was about needing her husband back; the hot baths actually made her feel protected. In addition, she stated that along with feeling good about the baths, she also felt bad about them because whenever she stepped out of the tub after having soaked for long periods of time, her skin was all wrinkly and she hated that as well.
Needless to say, she was informed that she filled the bath too high—to the brim. Normally, the excess water would have left through the overflow drain but it, for whatever reason, didn’t do its job of draining the water. Rather, the overflow of water damaged the ceiling of her neighbor’s bathroom below. This explanation made all the difference and the problem was cleared up. But the hot baths she was taking continued for a much longer time.
She further added that when she was out and about, she felt distant, remote, and almost cold. That feeling made her feel vulnerable and exposed, and she hated it, and that was the reason she gave for needing to feel warm all the time. Of course, this kind of feeling she had of being cold and distant correlated with the onset of her obsession in asking people her repetitive question, “Do you think about it [death], too?”
“Do you think about it too?” This is what she began asking everyone she met. She couldn’t stop thinking about her life and, several times a day, she would obsess about her death. In addition, she would talk about her husband’s death. She worried about the deaths of her daughters as well. The only person she never seemed to include in these death fears—and this seemed mighty suspicious as well as clearly conspicuous—was her former partner.
The symptom code now could be applied to each element of her story.
One: Her wish was thwarted because in place of needing to be empowered in her business, she wound up feeling quite disempowered and like a failure. Her wish was an avoidant one because she was afraid to confront her partner. She was furious with him but really, because of her fear, wanted to avoid him. Thus, her avoidant or indirect wish produced a symptom—a death obsession—that increased her tension.
Two: Of course she became angry about this but, at first, refused to direct the blame to any specific who, so she repressed this anger.
Three: The who was her partner who was really the one that she well knew was the culprit here, but couldn’t acknowledge as the culprit. It was he who was responsible for the demise of her business—its death!
Carol’s obsession with death really began after her husband died. In this sense, her husband was the original who. This is so because, despite her love for him, she was also quite dependent upon him and, therefore, when he died, this woman felt profoundly abandoned and, of course, angry about the abandonment. The point is that abandonment feelings will usually generate anger at the person who is gone—even despite the fact that the departed person may have been loved.
And so it was in this case; when her husband died, Carol began having flashes of fears of death. Psychologically speaking, she was really angry at him for leaving her, so that her fear of death also meant that under it all this obsessive fear-of-death symptom was a reflection of even her wish for him to die. Yes, this dependent woman was so angry about her abandonment that she herself even wanted to die. Her anger covered everyone—including herself. Basically, however, her obsession, or fear of death, was covering her anger toward the original who, her husband, who had left her. Death or no death, love or no love—he left her!
But that was the past. Now, in the present, her partner’s double-dealing was too much for her even to think about. Rather than being directly furious with him, her reaction to his thievery was to be anxious, to despair, and essentially, to feel entirely helpless and disempowered. Of course, the absence of any obvious anger toward this partner was a sure sign that this woman had suppressed (repressed) great rage toward him.
At this point, her death obsession became practically phobic; that is, she became extremely fearful of death. Of course, her deep down wish (about which she was not conscious), was for this former partner’s death. But because she so desperately needed to avoid the pain of her defeat, she also needed to not face her anger toward this partner—this who.
Her mantra then, referring to her obsession with death and which she posed to just about anyone she knew—“Do you think about it, too?”—was a wish for the partner’s death—and even her own death. She was in great despair and unwilling to face her real feeling—her anger—so that even the thought or fear of her own death may have been easier to manage emotionally.
Finally, Point Four of our symptom code is the to do. Doing something is an in front of the line activity, which in this case would be to encourage Carol to engage in conversation about her situation—to the point of reviewing her feelings toward her former partner. This was accomplished and after a while she began saying that she was “upset” and “very dissatisfied” about what happened to the business. Of course, these expressions of “upset” and “dissatisfied” are code words for anger.
When she began to verbally express her upset and dissatisfaction, everyone noticed that her mantra of “Do you think about it, too?” was being asked less frequently. After a while, her anger became less distasteful to her and she began expressing it more directly. She began actively talking about her partner’s thievery.
One day, in an independent act that was quite unlike her, Carol phoned her lawyer. This was her first in front of the line “doing” act. She wanted to see if there was anything that could be done to gain some justice regarding the partner’s theft of her business.
The one, two, three of symptom cure required knowing:
1. What the wish was;
2. That Carol was angry; and,
3. That she was angry at her former partner—the who.
Once she became more fully aware of the extent of her anger toward her former partner, and after she phoned her lawyer and laid out the bare bones of her problem, only then did she report the final relief from her death obsession. She said, “It was like something lifted.”
She was also not as drawn to her usual hot baths. It’s not that she gave those up completely, but she reported that her need was less. Of course, what that meant was that she was less in need of such consistent comfort that the hot baths afforded her.
And to top it off, what she meant by “something lifted,” was that she no longer had the urge to ask: “Do you think about it too?”
The obsession with death was dealt its own death blow.