Happy New Year, We’re All Going To Die: Death Anxiety and What To Do About It.
“Death, however, does itch. It itches all the time. It is always with us, scratching at some inner door. Mirroring, softly, barely audibly, just under the membrane of consciousness. Hidden in disguise, leaking out in a variety of symptoms. It is the wellspring of many of our worries, stresses, and conflicts.”
The above quote by renowned existentialist psychotherapist Irvin Yalom cuts to the heart of many anxiety presentations that show up in therapy. Most anxiety, sooner or later, is about our awareness of death; in particular, awareness of our own death and those of the people we love. Understandably, the thought of our own demise causes anxiety: anxiety about when death will come, what it will be like to die, what happens after death, whether we will be remembered, and what will happen to the people we leave behind. It’s something we have no power over at all.
Menzies and Veale (2022) write that “death anxiety is a term that is used to describe people’s fear or negative feelings towards death or dying. It is part of being human but becomes a problem when it is sufficiently time consuming, distressing or interfering in one’s life…”
In my clinical practice I’ve noticed an uptick in death anxiety as we’ve come out of the COVID “experience.” People have started to re-evaluate the meaning of the life they were living pre-lockdown. We in the death-phobic West have suddenly all been placed in very close proximity to mortality, either through personal loss or via the stream of upsetting news stories that were woven into the already distressing trauma narrative(s) of the epidemic.
For some in the LGBTQ+ community, this is our second epidemic (at least.) One thing that we’ve all experienced (in the West) as death has become more visible and less hidden away, is the realisation that we will die, we’re not immortal and we’re vulnerable to unpredictable catastrophe. It reminds me of Laurie Anderson’s dog Lolabelle realising that she could be attacked from the air by birds of prey.
Don DeLillo’s masterful, darkly comic novel “White Noise” (also a very funny film on Netflix) explores death anxiety in the face of an airborne toxic event and the search for a pill to cure our fear of death itself. He uses the metaphor of a supermarket and its sliding entrance doors to illustrate the threshold “bardo” state between life and death itself. Meanwhile, the products of consumerism on the shelves demand that we take more than we want or need. He writes:
“Isn't death the boundary we need? Doesn't it give a precious texture to life, a sense of definition? You have to ask yourself whether anything you do in this life would have beauty and meaning without the knowledge you carry of a final line, a border or limit.”
The Buddhist “Five Remembrances” from the Upajjhatthana Sutta also drive the point home:
“I am of the nature to grow old. There is no way to escape growing old.
I am of the nature to have ill health. There is no way to escape having ill health.
I am of the nature to die. There is no way to escape death.
All that is dear to me and everyone I love are of the nature to change. There is no way to escape being separated from them.
My actions are my only true belongings. I cannot escape the consequences of my actions. My actions are the ground upon which I stand.”
In essence, death anxiety concerns how we respond to, and make space for, the uncertainty and fragility of being alive. A friend of mine whose dad died recently summed it up: “I know it’s a cliché, but the difference between being alive and being dead is quite literally the difference between breathing in and breathing out: it’s as small as that…” No wonder then, that death freaks many of us out: it’s coming for us all and in the words of an old Buddhist meditation practice “death is real, it comes without warning, this body will be a corpse.”
Death anxiety shows up for people in a number of ways:
Spending lots of time every day thinking about death to the extent that we lose touch with the present moment, struggle to focus on work/relationships or other responsibilities;
Unwanted intrusive images about ways we might die or what happens afterwards;
Overly safe behaviours – avoiding things that most people would not ordinarily avoid such as driving, going out, eating certain foods;
Avoiding any reminders of death such as cemeteries, hospitals, media and/or suppressing any thoughts of death when they pop up;
Frequent seeking of reassurance that you and your loved ones are safe: consulting medical experts, Googling for many hours.
Overpreparation for worst-case scenarios (rehearsing the “bad news”);
“Compulsive” behaviours to ward off the threat of death: excessive exercise/diet, using certain words, phrases or objects to increase feelings of safety, rituals “Touch my feet, touch my nose, I don’t want to go in one of those” on seeing an ambulance…
Looking for certainty about death or what comes next by reading many, many opinions about death;
Becoming super-good and super-moral in order to avoid damnation or being judged as bad after death.
Death anxiety is maintained through a combination of avoidance, intrusive imagery, compulsion, rumination, seeking reassurance, and mental or physical checking. All of which give temporary relief from the thought of death, but ultimately make it worse by continually keeping us focused on the very thing we’re trying not to think about!
Facing Death Anxiety.
Ways to deal with death anxiety can include Cognitive-Behavioural tools such as developing alternative ways of thinking about death, and learning to recognise the ways in which unhelpful thought habits drive and distort our fear. In addition, exposure therapy and behavioural experiments can help us to update our beliefs about death by deliberately and repeatedly facing our fears until they no longer cause the trouble they once did.
Finally, there are also the existential challenges that are thrown up to us in the face of death. The philosopher Soren Kierkegaard argued that anxiety in general (and we can apply this to death anxiety in particular) reminds us that while we’re alive, we have choices, self-awareness and personal responsibility.
The feeling of anxiety is an invitation to live our best lives, an indicator that we may have become stuck or wandered away from a full realisation of our own potentiality. Death anxiety then, is also an invitation for us to reflect on how best to live, here and now, in the life we’ve been thrown into alone, knowing we are going to die, by creating meaning, and expressing the values that are important to us, through our actions.
Yalom refers to the idea of “rippling”; the “concentric circles of influence” that we create simply by existing and being in contact with others. Think about that teacher, colleague, artist or writer who made a massive impact on you when you were young, and about whom you still think. These ripples can carry on for generations: “some piece of ourselves gets passed on and on and on…” and perhaps this is a more useful way to think about “what happens afterwards” for those of us who abstain from religious beliefs about an afterlife.
As I was writing this blog, I had also been watching the BBC Series “His Dark Materials” which in many respects is an exploration of meaning, actions, life and death, and what it means to live a valued life in the face of suffering and hardship. The wonderful lines written by Philip Pullman and expressed by Lyra Silvertongue echo the Stoic (and Taoist) view of death as an eternal and universal process of change and regeneration. As Lyra says goodbye to Will, promising to find him again after death, she says:
“I’ll drift about for ever, all my atoms….every atom of me and every atom of you... We'll live in birds and flowers and dragonflies and pine trees and in clouds and in those little specks of light you see floating in sunbeams...”
Turning towards, rather than away from death anxiety can help us to live a more vital life right here and now. One day we will return to whatever flow of atoms we were part of before we existed, and this is nothing to be fearful of, because we don’t know what that was like either. This is often referred to as the Epicurus ‘symmetry argument.’
The Zen Master Dogen makes a similar point too: we won’t know anything about death when it happens, and we won’t be there to experience and reflect on it, so there’s no point trying to over analyse it :
“Firewood becomes ash and does not become firewood again. Yet, do not suppose that the ash is after and the firewood before. Understand the firewood abides in its condition as firewood, which fully includes before and after, while it is independent of before and after. Ash abides in its condition of ash, which fully includes before and after. Just as firewood does not become firewood after it is ash, you do not return to birth after death.”
As Menzies and Veale write at the end of their book: “You have only one life. Live it fully and live it well.”
If you feel that the time has come for you to face your own death anxiety or you’d like some help with managing the ways in which anxiety is disrupting your life generally, we’d be more than happy to help here at Rhizome practice.
