What If You Died?

Tall and thin, with long, straight brown hair, Alicia fidgets in the chair. “I have a new obsession,” she says hesitantly. “I keep worrying about your dying. I feel funny talking about it, but who else can I talk to about something like that?”

I’ve been seeing Alicia for almost five years now. She began when she was 20, when she was so paralyzed by anxiety and by magical, obsessional thoughts that she had to drop out of college. She’s much better now. She’s gone back to school and should graduate in a little over a year.  

She continues. “I know we’ve talked about my being afraid of my parents dying in some horrible accident when they left to go out when I was little. And you said that was because part of me wished they were dead because I was mad that they were leaving me. But I don’t feel mad at you. At least I don’t think I do. Do you think I’m mad at you?”

“I think only you know how you feel, Alicia.”

She pouts. “You could help me.”

There is a childlike quality to Alicia. She looks to me to protect her, to save her, to give her the magical answer. I feel the pull to oblige, but think it best that Alicia find her own strength, her own voice, her own answers. Her mother was overly protective and although both parents pushed Alicia to succeed, there was the contrary message that she stay close to the protection of home.

“I will help you, but I can’t tell you how you feel.”

“All right. All right. Be that way.” She crosses her arms over her chest and glares at me.

I remain silent, but present in the room with her.

“Well now I feel angry. A little. No, not really. I know you can’t tell me what I feel. The problem is that I don’t know what I feel myself.” She pauses. “Scared. I feel scared. I feel scared if I think about your dying. And it’s not like I imagine your dying in some gruesome accident. I just think what if you got sick and died? I mean I know you’re not old. But you’re not young either. Would I even know if you were sick? And how would I know if you died? I wouldn’t want to read it online somewhere.” 

“Do you have any thoughts about what triggered your fears of my dying?” When I look in the mirror I certainly know I’m not getting younger, but I suspect Alicia’s fears have more to do with what’s going on for her internally than with my actual age. 

“I just thought of something. My father’s been talking to me about graduate school. I keep telling him I’m not ready, that I still haven’t finished undergrad, that I have to take one step at a time. I can’t think about graduate school. It scares me. It was after that I started worrying about your dying.”

“So talking about graduate school means growing up, leaving home and that brings up fears about loss, including the loss of me.”

“You didn’t have to put it that bluntly. Now I’m terrified.”

“I’m sorry. I didn’t mean to increase your anxiety, but we do need to know what the issue is before we can work on it.”

“I could never leave you! I’m not even sure I could leave my parents. Oh my God, what happens when they die?” 

“Alicia, let’s put the question of death to the side for a moment. What feels so scary about leaving home?”

“I can’t. I don’t think I could make it.”

“It feels as though you’d die?”

“It kind of does. But when you put it that way, I don’t know, that doesn’t really make sense.”

“So the idea of leaving home feels terrifying, feels like you couldn’t survive. But when you think about it rationally it’s not so clear what you’re afraid of.”

“Yeah. That’s right. That actually makes me feel a little better.”

“You know, Alicia, although leaving home does involve loss, it also involves gains: growth, independence, freedom. It’s about adding to your life, not just taking from it.”

“Yeah. I can see that.”

“On the other hand, I don’t want us to ignore your underlying feelings, including your fear of my dying. I do hear that you feel terrified and we need to talk about those feelings again and again until you’re more sure of your adult competence and your ability to cope.”