Fearing the loss of loved ones

Dear Dr. Neimeyer

I lost my young wife after twenty years of marriage. Since then I feel like I’ve moved on; I found a new wife whom I love completely. We’ve raised terrific children. My problem is that I have an irrational fear of loss. At least once a day I obsess about losing my new wife, our dog, my closest friends, and especially our children. I am consumed with anxiety that I can suffer another great loss at any moment. I resist becoming close with anyone new in my life for fear that they will die. I lose sleep over this. When I try to close my eyes, I imagine something terrible is about to happen to someone I love. If my wife doesn’t call in, I imagine that the police will be knocking on the door to tell me she was killed in a car accident. When the kids fly anywhere, I cannot sleep until they text me that they’ve arrived safely. I wasn’t always like this. I became this way after my first wife’s death. I’ve taken several prescribed medications for depression or anxiety, but none make this problem go away. I am fine with the deaths of elderly relatives; it’s untimely death that obsesses me. I’d appreciate your thoughts.


Dear Harvey,

It sounds like the premature death of your young wife was traumatic by any account, and perhaps more so if her death came suddenly or violently, such as through the sort of accident you imagine might take from you others you love. In view of this, it is not surprising that you are hyper vigilant regarding the safety of all those for whom you care greatly; in a sense, life has cruelly taught you that the fear of catastrophic loss is in this sense “rational.”

But this is not to say that it is benign. As you clearly acknowledge, the anxious preoccupation with further loss through death carries real consequences for your health, as your sleeplessness attests. Just as seriously, your wife, friends and children are likely to be feeling constrained or even suffocated by your need to ensure their safety, perhaps at the expense of their freedom, spontaneity, and autonomy. Ironically, this can bring about innumerable losses that are quite real in their own right, as they may begin to respond to your vigilance with anger and avoidance, or perhaps in the case of the children, with fearful or phobic narrowing of their lives as a way of managing a world that they have been taught is unpredictably dangerous. The sad result can be damaging to the very people and relationships you most want to protect.

Trauma-based learning of the kind you described is not simply something you can talk yourself out of, or have medicated away. It requires “unlearning” in the only school that can effectively teach the lesson: the school of experience. This means that exposing yourself, one step at a time, to the situations that you fear for yourself or others, can help you begin to challenge the obsessive equation of living and traveling freely with deadly danger. It can help to have someone to support us in this hard work, whether the feared situations we need to master are ones we approach in action (e.g., visiting rather than avoiding places or circumstances associated with your wife’s death), or only in imagination (e.g., with detailed mental imagery of your children taking a flight). In seeking a therapist who can provide structure and support for these brave but important steps, ask for someone familiar with “exposure” treatments for anxiety. Ultimately, your family and your health will thank you for it.

–Dr. Neimeyer


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