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In 1999, 19-year-old Jack sought treatment after dropping out of college and experiencing intrusive thoughts about death since the death of a friend in a car accident. He had lost motivation and believed his friend was trying to contact him through the TV. Jack appeared scared and lost, only identifying fear as a thought. He also mentioned having vocal tics and twitching as a child, which stopped when he was 10. Jack was 19 years old in 1999 when he first came for treatment. He had just dropped out of college and was living with his parents. Six months prior, a friend was killed in a motor vehicle accident and since that time, Jack experienced increasingly intrusive thoughts about death. He had lost almost all motivation and believed that his dead friend was trying to contact him through the television. When he told me this, he appeared frightened and lost, as if he was desperately looking for something or someone. The only emotion he had any awareness of was fear, but he did not identify this as an emotion, more as a thought. In passing, Jack mentioned that as a child, he had vocal tics and twitching that stopped when he was 10.