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FEAR is one of the basic and self-protective emotions and is shared by all species of thinking animals. Fear is one of the most important of the survival instincts and is an impulse which is responsible for caution, forethought, prudence. In the case of our primitive ancestors it no doubt served a valuable purpose. On the other hand, in connection with our modern civilization, unwarranted fear many times is the cause of much sorrow and sickness.
Already we have devoted a chapter to the subject of complex formation. It will now be in order to explain just what we mean by the word complex when we use it in such designations as fear complex, inferiority complex, conscience complex, etc. When we refer to a fear complex we are using the word complex for the purpose of designating a system or group of related ideas and connected memories which have "strong emotional tone", and which unfailingly exhibit the power of so influencing our conscious thinking as to direct our reactions and behavior into certain uniform and definite channels.
A complex of this order, of course, can be either normal or abnormal, and we judge it in accordance with the nature of its functioning. Our psychological terms of sentiment and convictions are hardly strong enough or sufficiently all-inclusive to designate a complex. A complex is rather a working association of a group of sentiments and correlated convictions.
There are many physical causes of fear, not the least of which are the various poisons or intoxicants. We are all familiar with the fears of an intoxicated man under certain conditions. In delirium tremens the drunkard fully believes that his horrible fantasies are real, and in this state he may plunge out of the window of a high building to certain death. He so thoroughly believes in the reality of what he apparently sees that he will stop at nothing in his effort to escape.
Fatigue contributes greatly to the aggravation of fear. We are always more likely to succumb to our fears when we are tired out. Our sensations seem to affect us more unfavorably at such times. The ductless glands also exert an influence along these lines. We are more subject to acute fears when the thyroid is indulging in excessive secretion, while we are more subject to chronic worries when the adrenal function is deficient. Pain augments our fears, and disease sometimes aids in predisposing us to certain fears, dreads, and phobias. This is particularly true of severe infections.
While the general tendency to be afraid is inherited, specific fears - aside from the fear of falling and certain loud and shrill noises - are not inherited. The fears of after-life have all been suggested to us directly or indirectly. We might speak of them as being "conditioned". We must remember that children are very prone to pick up the early fears suggested to them in stories, and they are quick to take on the fears of their elders. Fear is highly contagious, especially to the young mind.
Fond mothers thoughtlessly suggest fear to their children when they are so agitated about the children being left alone. These young minds get the idea that something might happen if they were left alone, and fear, to them, has none of that fascination which sometimes comes to the older and more sophisticated intellect. In adult life we sometimes become reckless in the presence of fear. We get a sort of thrill, a "kick", out of daring adventure. We deliberately court danger in order to get the thrill that is born of recklessness, to enjoy the fascination of daring to defy danger.
We should remember that fear is not necessarily abnormal. It is only when it becomes an obsession that it is able to harass us and interfere with health and happiness.
Aside from those fears of childhood which we pick up by direct suggestion from our elders, I think most of our fears come to take tyrannical possession of the mind at times when the nervous system is over-worked or over-wrought; and these fears become abnormal only when we allow them to take such possession of the mind that we refuse to permit our friends to reason with us and thus dispel our obsessions.
We know from laboratory experiments that fatigue prevents normal thinking, and when we are fatigued we are more likely to suffer from emotional depression. And so the vicious circle starts: fatigue leads to depression, depression leads to worry, worry fatigues us, and so on.
When we are tired out or over-wrought, when we are a bit depressed and some worry starts in to swing around the circle, especially if we are very suggestible, the stage is all set for picking up new fears. Any newspaper or magazine, either in its news articles and stories, or in its advertising pages, can supply the material for new fears; for that matter, neighborhood gossip can in a few minutes supply enough seeds of dread to produce a year's harvest of worries.
Our feelings, when we are over-sensitive, tend to breed fears. At such times we are always examining the body to find explanations for our feelings, and it behooves us to remember that we are not subject to reason when our fears are allowed to progress to the point where they produce emotional disturbances. We are subject to reason as long as our fear is purely psychic, but when it gets hooked up with emotions, it is more likely to develop into a blind and unreasonable affair. It has been repeatedly said that man is ruled by his heart and not by his head. You can reason with notions but not with emotions.
Emotional disturbance may be in the nature either of depression or of exhilaration, and it is all but impossible to reason with a person in either of these states. The same is true of a hypochondriac or a depressed type of neurotic ailer. It is equally difficult to reason with young lovers when in a state of emotional exhilaration. They are all but insusceptible to reason. The mind is the victim of emotional sway. The head is under the rule of the heart. When the emotions are team ed up with our fears we become increasingly unreasonable and illogical.
Other severe emotional disturbances, such as hate and anger, are equally difficult to reason with; but we usually construct alibis for these outbreaks by means of rationalization. We gloss over such temper manifestations as righteous indignation, on the one hand, and as devotion, loyalty, patriotism, or friendship, on the other.
After worry has once started, after the habit is formed, it is easier for the victim to carry on than to explain exactly what he is worrying about; and when the habit becomes chronic, it is very difficult to induce him to sit down and reason with you in a sane and logical manner. You have the same difficulty in trying to talk him out of his notions as you would in getting an ardent lover to sit down and reason logically about his affections. Both are up on the clouds, and it is hard to reason with them until experience brings them down to earth again.
This matter of allowing emotions, even of exhilaration, to control the mind can be carried to injurious extremes, especially in connection with day-dreaming and a life of fantasy. It is capable of carrying one to the borderland of paranoia. An individual may get it into his head that he is the wealthiest man in the world, or some highly neurotic woman may imagine she is queen of Egypt. On the other hand, the reaction of depression, after such a state, may drop the unfortunate victim to depths where he labors under the delusion of having committed "the unpardonable sin".
One of the common goals of worry is hypochondria, that wretched state of mind in which the victim thinks of nothing but himself and seems to be conscious of nothing but his own external sensations and internal feelings. Some hypochondriacs complain of water running under the skin, prickly burs on the hips, fire burning under the feet, the stomach filled with lead or entirely missing from the body; others have sensations of angels knitting in the abdomen or of demons carrying on high jinks in other vital organs.
When we com e to analyze the effect of emotions on health and happiness, we are forced to recognize that fear plays a far greater part in human affairs than any other emotion, not excepting love. The master fear, of course, is the dread of death. In common with our animal cousins we have inherited the fearful emotions as a part of the price of our ancestors' survival, and, as will be shown more fully in subsequent chapters, the purpose of our many and varied religions is to assist us in tempering this fear of death.
Our forest-dwelling ancestors were not only warlike in their tribal relations, but they lived in the midst of a hostile environment; at any moment, especially during the night, they might be attacked by their human or animal enemies. This primitive fear has come on down to modern times, and its physical aspects are what we are now discussing. In its milder manifestations fear is largely a psychic proposition, without physical symptoms. But when fear is more acute or more profound in the emotional sense, or when it comes to form what might be termed a "physical complex", producing "stage fright", then we do have definite and profound physical symptoms.
The purpose of fear is to assist us in our flight from a dangerous situation, or, if flight is impossible, to contribute that state of mind and body which will render us more efficient for the fight which will be precipitated by our inability to retreat to safety. And this is where the physical aspects of fear come to the fore. Old Mother Nature has provided a mechanism which is the connecting link between the psychic experience of fear and the physical body, and this connecting mechanism is the sympathetic nervous system. When fear dominates the mind, the sympathetic nervous system pulls the adrenal trigger and a very small amount of the marvelous secretion of the supra-renal glands, called epinephrine, finds its way into the circulating blood stream; the effect of this ductless gland secretion, or so-called endocrine, is almost instantaneous. This substance is able to produce measurable effects in the animal body when it is present in amounts of less than one part to one million parts of water, as shown by laboratory experiments. Now, what happens when the adrenal trigger is pulled and this potent substance finds its way into the blood stream? Physical symptoms instantly appear, and they are just such symptoms as would be of value for either fight or flight. The muscles are rendered tense, or sometimes there is alternation between relaxation and tension, even trembling, if one is compelled to stand still. The respiration is quickened; the heart begins to gallop at a rapid pace; the sweat glands begin to work profusely. This is a sketch of the physical manifestation of fear when it is highly acute or bordering on terror. Of course, fear can become so over-whelming that it defeats itself: one can be so terror-stricken that he stands perfectly motionless.
When our fears are less acute, when they are more chronic, the individual is aware of these physical symptoms in a milder manner, so that he is led to go from one doctor to another to find a name to give this strange ailment. The doctors, naturally, fail to find anything wrong; but the fear-ridden patient only becomes more and more convinced that something really is wrong, and that all the doctors are in a conspiracy to keep him in ignorance as to the nature and seriousness of his ailment. About this time his case can be truthfully diagnosed as a full-fledged fear or anxiety neurosis.
And so, as time passes, even tho the fear is of a chronic nature, many of the symptoms of acute fright or terror begin to make their appearance, such as tremors, weakness in the knees, shortness of breath, palpitation of the heart, spots flickering before the eyes, dizziness, and uncalled-for perspiration.
The biologic provision to arouse the physical body in connection with the emotions of fear is wholly protective. When an animal starts out to run or to make a desperate last stand for its life, the blood lacks energy to meet this sudden demand. Fear, therefore, is the psychological signal to the sympathetic nervous system to step on the physiologic accelerator, the adrenal gland; and this physical contribution immediately produces tenseness of all the muscles, a tendency to assume that crouching attitude which is contributory to a lessening of the apparent size, and thus to assist in escaping, or, if escape is impossible, to place the body in a better position to act in self-defense and deal telling blows to the enemy. Thus fear induces the assuming of exactly that bodily attitude which will best facilitate a quick take-off in flight or lend itself to most effective defense. Sustained flight calls for increased energy, and this energy is provided by the heightened blood-pressure, which throws the stored-up sugar of the liver into the circulation to serve as immediate fuel for the tense and active muscles. Rapid breathing is to supply oxygen to burn up this extra fuel and thus yield additional energy for these defensive operations. All this, of course, requires increased heart action; hence the palpitation and pounding of the heart muscles in connection with states of fear.
What is the purpose of the sudden perspiration that is pouring out upon the skin? This whole performance greatly increases the amount of heat generated within the body. When fuel is utilized for the purpose of bodily energy, there is an accompaniment of augmented heat production; the stimulation of the sweat glands is for the purpose of increasing the amount of water on the skin, and by this means facilitating heat elimination, thus preventing the temperature of the body from rising above the standard 98.6/ Fahrenheit.
Such is the biologic mission of fear. It is the psychic flare that serves notice upon the sympathetic nervous system to pull the adrenal riot call, thus to facilitate the mobilization of all the powers of mind and body to cooperate in the work of self-preservation.
What happens in the case of the fear neuroses is simply this: Nervous persons entertain an undue amount of fear in the psychic domain, and thus they signal to the sympathetic nervous system, which, in turn, sends in a false alarm to the adrenal glands. When this is once done there is nothing to do but go through this particular attack of terror. When the secretion of the adrenal gland once gets into the blood there is no escape from the muscular tension, trembling, shortness of breath, palpitation of the heart, perspiration, and all the other physical accompaniments of a biologic riot call.
Some nervous people are able to work themselves up to such a state of constant anxiety that almost every waking moment the mind is registering the psychic fear alarm, the sympathetic nervous system is "whooping it up" with a continuous riot call, and the adrenals are more or less continuously over-secreting. Thus sometimes even long after the physiologic stimulus has ceased, the habit reaction continues and many of these symptoms, originally of physiologic origin, continue as the result of purely sympathetic irritability.
When a mischievous lad turns in a false fire-alarm, all the fire-departments of that district come tearing down the street just as if there were a real fire. They turn out just as enthusiastically for a false alarm as for the real thing; and in like manner, when the fear complex of our neurotic patient turns in an alarm, immediately the psychological behavior and the physical reactions of a real life-and-death crisis are more or less in evidence. The adrenal gland and its associated sympathetic nervous mechanism are devoid of reason and judgment. It is their business to respond to the fear alarm, and they, too, mobilize their energies and exhibit all the phenomena of nervous and physical action just as enthusiastically for a false alarm as they would in the case of a real emergency.
I think it now begins to be clear why nervous people suffer from so many symptoms of an apparently physical nature. They are in a condition of chronic false alarm, and when fear reaches this status we call it an anxiety neurosis.
Thus it is that when we foolishly and falsely allow the fear alarm to be sounded - when all these nervous and physical energies are mobilized, while there is no danger to flee from and no enemy to fight - all this defensive mobilization is turned inward instead of outward. And so we see that fear, when perverted, instead of serving as a factor in self-preservation, becomes a tyrannical and enslaving master. The physiology of fear is that of self-preservation; the pathology of fear is that of the neuroses.
This is the story of the psychology and physiology of the physical manifestations of the so-called neurotic disorders; and, of course, the muscular tension, mental anxiety, throbbing heart, and shortness of breath, together with trembling knees, inexplicable weakness, choking sensations, throbbing blood vessels, dizziness, and nausea, would make any ordinary human being think there is something radically wrong. And so these symptoms in turn engender more fear - the same kind of fear that called them forth - and this secondary fear produces more symptoms of physiologic reaction. Thus the vicious circle is formed. Our patient is a slave to fear, and the merry whirl goes on until someone takes him in hand and teaches him the truth about himself, reeducates him, and guides him in the reconditioning of the physical reactions to his psychic state, and finally enables him to change his state of mind from chronic fear to normal and health-promoting faith.
It would seem that the biologic purpose of fear is to accelerate flight, to contribute to self-preservation by facilitating escape from danger. Now, in connection with the pugnacious instinct, we have the arousal of anger. Anger is also the result of the ability of fear, through the sympathetic nervous system, to accelerate the output of the secretions of the adrenal gland, which, when they are poured into the circulating blood-stream, never fail to augment anger; and it is this arousal of anger that adds so much to the fighting ability of the animal in case it is unable to escape from threatened attack. What we call hatred is a sort of chronic and confirmed anger, and it sometimes comes to take the place of disappointed and suppressed love.
There was great survival value in this fear-anger mechanism. Those of our ancestors who did not possess this fear, with the corresponding ability to flee swiftly in the presence of danger, or who were not pugnacious or angerful when cornered, did not survive. This hair-trigger fear-anger mechanism was very useful to the human race in its early struggles for survival. As civilization has progressed, this mechanism is not as essential as it was in days of old, but it must be borne in mind that we still have it. Thus every hum an being to-day is confronted with the necessity of training, subduing, and reconditioning this old-fashioned and primitive fear-anger protective mechanism. Some of us are still rather quick on the trigger when it comes to resentment. We have fiery tempers and fly off the handle on the least provocation.
As already mentioned, the throwing of the adrenal secretion into the blood stream adds tremendously to the momentary strength of the individual; in fact, it more than trebles the physical strength for the time being. Blood rushes from the head and more particularly from the internal organs into the large muscles, the very muscles that would be used in fleeing from danger or which would be utilized in combat with an enemy. Thus we come to recognize the fact that the adrenals are the combat glands - that while fear sets this defensive mechanism a-going, the adrenal furnishes the chemical stimulant which enables the animal organism to see the struggle through to a victorious finish.
The adrenal secretion is probably the most powerful stimulant known. Under its influence a man with his fear-anger mechanism thoroughly aroused can vanquish half a dozen of his ordinary fellows. History abounds in extraordinary feats performed under the influence of just the right amount of fear coupled with a thorough arousal of the pugnacious instinct and its associated anger.
We quickly recognize the lack of this adrenal secretion in cases of chronic fatigue and muscular weakness. It is also well known that when we are tired and worn out, we are more or less quarrel-some. This irritability is no doubt an effort on the part of Mother Nature to stir up a little pugnacity in order to revive our jaded spirits. You see, if we can get up a quarrel or start a heated argument when we are in this depressed condition, it enables us to draw on the adrenal combat-glands for a swig of our own internal fight-tonic. I have often wondered if a large number of our less intellectual citizens didn't get more or less of a kick out of their constant fighting and quarreling. They really feel better as the result of their frequent manifestation of mild anger, accompanied by more or less adrenal stimulation.
This master nerve and muscle stimulant, like any other stimulant - whisky, for instance - can do great harm when you take an overdose of it. A little fear in the presence of danger accelerates your pace of escape, but too much paralyzes you. You are frozen to the spot, terror-stricken. Just the right amount of anger strengthens you and nerves you for the fight, makes you more efficient in combat; but too much anger either paralyzes you with rage or causes you to run amuck after the fashion of a lunatic. It acts like strychnine, in that a small dose will increase muscular strength, and pick you right up, but too much will cause tremors, muscular convulsions, or even rigidity, a rigidity that resembles lockjaw.
What are we going to do with this fear-anger mechanism, this combat proclivity of the human species? We can't get rid of it. It shows itself in varying degrees in all of us, and it is now a handicap. What are we going to do about it?
At first, we are going to recognize it and reason about it, and seek to put it under control; and, having done the best we can along educational and disciplinary lines, we are going to shift over to substitution and sublimation. We are going to recognize that we must provide something in our experience that we can periodically get angry at - select a number of things that will thoroughly arouse our righteous indignation. Righteous indignation is a sort of semi-civilized, half-Christianized version of primitive animal anger, but it serves a wonderful purpose. It keeps us from engaging in a more direct, brutal, physical fight, and provides us now and then with a liberal dose of adrenal fight-tonic - a stimulant that is not at all bad for one's general health and psychic morale.
When our ancestors indulged this fear-anger-rage complex they were able to work off the resultant muscular energy in a long, fast, and dead-in-earnest foot race, or in a vigorous muscular combat. They got it out of their systems through physical channels; but to-day, when we permit ourselves to get into a rage, we don't usually have the same opportunity to work it off. Of course, mothers get angry and beat up their children now and then; occasionally certain types of married folk have a real knock-down and drag-out, and some of our less controlled citizens engage in old-fashioned fist-fights; but, generally speaking, we don't find many physical channels available for the elimination of our anger complex. Our muscles get tense; we are mad through and through; but we have to suppress our anger, and so the disturbance strikes inward to find lodgment in the subconscious mind, to come out later in disguised and modified form as the fears, phobias, obsessions, tremors, dizziness, anxiety, and fatigue of the various chronic nervous disorders, the so-called psychoneuroses.
One thing is certain: we must either control this fear-anger mechanism and prevent its too frequent and too vigorous arousal, or else we must find some civilized substitute upon which to vent our so-called righteous indignation. Perhaps that is one of the uses of so-called evil. It furnishes a target for surplus wrath. In like manner the conception of a personal devil and all the workings of the nether region provide something for the Christianized man to vent his wrath on; but in this connection let me warn you against becoming over-interested in some reform movement to the extent of making it a vital part of yourself. I have met many a professional reformer who was actually ill because he took all criticism of his pet movement as a personal insult.
Most of us can remember our first recitation at school or the first time we appeared in public. The majority of us were all but terror-stricken. We had all the symptoms of fear, including that one so commonly associated with stage fright - dryness of the mouth; the tongue almost cleaved to the roof of the mouth. This stage-fright complaint is one that seems to be able to set in operation the whole psychic and physical defense mechanism of the body. When we are victims of it we make an exhibition of ourselves such as would be worthy of the last stand in a life-and-death struggle.
Many persons grow up and go through life with an unsubdued stage-fright complex. A feminine patient recently said to me:
"Doctor, you have helped me over all my fears. I can drive an automobile. I can do many things that I one time thought I could not do. In fact, there is not a single fear, dread, or phobia that beset me in years gone by that I have not conquered; and since I have been able to master all these things, why is it that I am still just as much affected by these disagreeable symptoms when I get up in public to say a few words, or when I try to read a paper at the club, or even try to sign my name in public? What is the matter? Why can't I master this? I am going to do it if it takes my life".
But I had to explain to her that she was up against something different from the others. This was no simple fear - it was a fear complex. When she promised to go back to driving an automobile she was not seized by this group of physical fear reactions. It was a purely psychic experience. There was little of physical reaction connected with it, and that is exactly the difference between over-coming a fear and mastering a stage-fright complex. The stage-fright complex is still hooked up through the sym pathetic with the adrenal gland; or it is hooked up with such an associated complex that, with or without the adrenal contribution, it is able to turn in a false alarm and cause the whole defensive mechanism to mobilize for action; and it is all done automatically and instantaneously.
I know a woman of fifty whose husband is fairly well-to-do, and who would like to devote her energies to some sort of social work. She has an extraordinarily keen mind; a very active imagination; takes great pleasure in reading and keeping up with the times; and would be a valuable member of any social organization. She has all the ability to be a chairman of a committee or president of a club. Her advice is always being sought, so that she has every opportunity and every qualification for serving in these capacities. But why is she disbarred? Because she is a victim of habitual stage fright.
I have had an interesting experience with this patient, having helped her over a great many psychic difficulties. She has been through a neurological maze, until she has come very thoroughly to understand herself. She is unusually intelligent about her own psychic problems and is getting along famously with her nervous difficulties. She has made a successful disposition of her other dreads and phobias, and it is most embarrassing, if not humiliating, to have to appeal for help in over-coming this stage-fright complex. What distresses her is the physical reaction. She never had these physical manifestations in connection with any of her other fears, but at last she is coming to see that we cannot reason ourselves away from physical agitation as we can from the more purely psychic fears and phobias.
This patient has such a firmly fixed and well-organized stage-fright complex that I doubt if it is at all necessary for the adrenal gland to precipitate her attacks. Yet, in the end, she is likely to surmount the difficulty. The vast majority of stage-fright victims do get over it, and still more of them could if they would spend sufficient time in learning how to ignore it. But not all succeed. I talked with an actor the other day who says he still suffers as much from stage fright now as he did twenty-five years ago; on further questioning, however, he admitted that it was not quite so bad as that.
I have been working two years with a young woman, a violinist, trying to help her over her stage fright. In her case it is a life-and-death matter, for it involves her livelihood; yet it is only in the last few months that she has begun to show any improvement at all. Of course, I admit she has an artistic temperament; she really only carries out my instructions now and then.
But what do we do with this stage-fright complex? We have to deal with it in the same way as with any other fear complex, and that is:
We are well on the road to success when we can make a joke out of the whole experience. The other day I had to appeal to a patient by saying: "What would you think of a fool fireman who responded to an alarm which he knew to be false, and insisted on hooking up all the fire apparatus and squirting water all over the place? That is exactly what you do".
Fifteen years ago a man about thirty-five years of age came to consult me. He complained of nervousness, and believed he was suffering from a rather rare form of heart disease. At the time I examined him his heart was all right, but he told me how it would flutter and pound, how it would skip beats, and how he was often overcome by the fear of impending death. It was several years before he succeeded in getting around to the office when he was really having one of these heart spells; but eventually I did succeed in seeing him in one of these attacks. It was a typical case of neurotic palpitation, and he had all the symptoms that go with it - weakness, perspiration on the forehead, choking sensations, shortness of breath. You don't have to have one of these spells, you only need to see a neurotic patient passing through one, to know why they call them "dying spells". A woman once canceled an appointment with me, and then, when she came in a week or ten days afterward, said: "Oh, doctor, I couldn't com e that day. I had one of the worst dying spells I have had in twenty-five years".
It is indeed a sort of a living death that these neurotics lead; but modern science has discovered ways of educating them out of this slavery of fear.
To go back to the man I started to tell about. He has been coming in, off and on, for fifteen years to have his heart examined. It still is all right, but this patient keeps on playing with his stage-fright complex. He continues to have terrifying experiences. If he gets up before an audience, or tries to sign his name in public, or even gets a little over-tired, he has one of these "dying spells". Or, since he has a sharp angle in the colon, with a tendency to form a pocket for the collection of gas, a little gas under his heart making pressure up under the diaphragm is enough to pull the false alarm trigger, and he has all the fun of a first-class stage fright. Every symptom appears - dryness of the mouth, dizziness, faintness, and thumping of the heart. The muscles are tense, he even has nervous chills. And so it goes on, and it is all nerves, just nerves, nothing but nerves. Doctor after doctor has examined this man and found nothing wrong. It is simply the bondage of fear, the slavery of nerves.
The real fear behind all this, of course, is the fear of death. All these terrifying dreads are merely defense reactions - all camouflage - subconscious subterfuge. We are all the while afraid we are going to be killed. We are afraid to die, but are too proud to admit it, even to ourselves; and so the subconscious mind, after its accommodating custom, brings forth fake fears and substitute dreads to take the place of our real and basic fear, the fear of death. Sometimes we come to the point where we frankly admit this substitution, but the average neurotic dislikes very much to admit the three most common fears - the fear of death, the fear of insanity, and the fear of suicide.
And so we suffer on, as the result of certain fears which are pushed back into the subconscious, rather than admit the entertainment of certain other basic and common human harassments. Thus the neurotic, in an effort to avoid frankly recognizing and then displacing or sublimating the fear of death, allows himself to become the victim of this continuous performance of a terrifying phobia; in other words, in an effort to dodge the fear of death, he dies a thousand deaths.