Death Anxiety

Death anxiety is a term that describes the discomfort that is generated by the awareness of death. Humans are said to be unique in that they adapt and run their lives in full knowledge that they are finite. As a result, every human culture develops structures and symbols to address the subject of death.

Humans who grapple with the consciousness that accompanies a limited existence find comfort in traditions and ceremonies that help to find meaning in death and perhaps a way to transcend physical existence. The need to confront death is a universal human experience. The knowledge of the inevitability of death poses a psychological dilemma for every human being.

Over the centuries, death as a human concern has served as a powerful catalyst for much of the work of writers, artists, musicians and philosophers. Leo Tolstoy, the 19th century Russian novelist and thinker described the difficulties humans confront as a result of the certainty of death, and the anxiety this knowledge provokes, in The Death of Ivan Ilych. This book details the final three days of Ivan's existence. Tolstoy depicts death through the metaphor of an advancing black sack against which Ilych struggles but cannot resist.

While other living beings may not be conscious of the inevitable quality of death, the possibility of death is an issue to which all living organisms must adapt. Every living organism has the ability to sense and respond to the threat of annihilation. Without these instincts a species cannot survive.

The existence of these instincts and abilities implicate death as an inevitable component of life and at the same time calls forth a number of defense mechanisms designed to foil the inescapable demise of the individual. The perception of death as a danger is the primary source of adaptive and defensive behaviors. From the first breath until the last, the sense of the threat of death helps all beings select and develop protective measures to ensure continued existence.

The success of these adaptive and protective measures appears to be very limited. Evolutionary scientists posit that 99 percent of all species that have ever lived have become extinct. The overwhelming demise of species due to natural selection proves how difficult it is on a biological level to succeed against threats of extermination. In spite of the poor record of living beings against death, every individual wages a private war against the end of life, though no one and no species, including bacteria, can win the struggle. Death, whether it comes from within or without an organism, is a potent force in provoking creative responses meant to defend against the inescapable end.

Medicine is one weapon. Humans use a growing body of medical expertise to combat death or at least lessen its powers. For those in the healthcare profession, death is a reality that is never far away in spite of technological advances in the field. Some life-threatening conditions can now be cured and patients survive for longer, but death is still the eventual result of life. Experts now recognize that helping sick or aging people and their loved ones deal with impending death is an important and even central task for nurses and other healthcare providers.

One research trial by Christina A. Rasmussen and Christiane Brems discovered a correlation between psychosocial maturity and age with death anxiety. The researchers discovered that psychosocial maturity was a better predictor of death anxiety levels. However, both increasing psychosocial maturity and increasing age were associated with decreasing death anxiety. Other experts posit that certain personality traits or strong religious beliefs are associated with decreased death anxiety.

Thanatophobia is the abnormal fear of dying. Someone suffering from thanatophobia may feel afraid or anxious and may be unable to function when thoughts of death occur. This may be due to spontaneous thought processes or because the person with the phobia has read, heard, discussed or seen on television, something related to the experiences of death or dying.

Robert Langs wrote about three classes of thanatophobia in his paper "Three Forms of Death Anxiety." These three classes cover predatory death anxiety, predation death anxiety and existential death anxiety. Symptoms of extreme death anxiety can include breathlessness, nausea, trembling, dry mouth, excessive sweating, palpitations, lack of concentration, a feeling of being out of control, detachment from reality, hyperventilation and anxiety attacks. All of these symptoms are connected to the classic flight or fight response, the typical stress response to attack or the sense that one is threatened.

Selected full-text books and articles on this topic

Death Anxiety and Clinical Practice
Robert Langs.
Karnac Books, 1997
Existential Psychotherapy
Irvin D. Yalom.
Basic Books, 1980
Librarian’s tip: Chap. 2 "Life, Death, and Anxiety"
Advances in Personality Assessment
Charles D. Spielberger; James N. Butcher.
L. Erlbaum Associates, vol.3, 1983
Librarian’s tip: Chap. 7 "The Nature of Death Anxiety"
Dying, Death, and Bereavement
Lewis R. Aiken.
Lawrence Erlbaum Associates, 2001 (4th edition)
Librarian’s tip: Chap. 9 "Death Attitudes, Fears, and Beliefs of Adults"
The Psychology of Adaptation to Absurdity: Tactics of Make-Believe
Rhoda L. Fisher; Seymour Fisher.
Lawrence Erlbaum Associates, 1993
Librarian’s tip: Chap. 3 "What Is Death Anxiety and How Pervasive Is It?"
Fragile Lives: Death, Dying and Care
Beverley McNamara.
Allen & Unwin, 2001
Librarian’s tip: Chap. 2 "Thoughts about Facing Death"
The Yalom Reader: Selections from the Work of a Master Therapist and Storyteller
Irvin D. Yalom.
Basic Books, 1998
Librarian’s tip: Chap. 5 "Death, Anxiety, and Psychotherapy "
Communication and Aging
Jon F. Nussbaum; Loretta L. Pecchioni; James D. Robinson; Teresa L. Thompson.
Lawrence Erlbaum Associates, 2000 (2nd edition)
Librarian’s tip: "Fear of Death or Death Anxiety" begins on p. 295
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