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.
Irvin D. Yalom
The link between death anxiety and mental health
This is a quote by existential psychotherapist, Irvin Yalom. It highlights that death anxiety is something that can impact on our every day sense of well-being. There is a strong link between mental health conditions and death anxiety. For example, those suffering from panic attacks worry that they may be dying or having a heart attack. And those with specific phobias worry that certain places or animals are not safe. In fact, recent research shows that death anxiety may worsen or even cause several mental health conditions.
Over the past few years, the spread of the COVID-19 pandemic heightened people’s awareness of death. The continually updating ‘death clock’ is one example of how death anxiety became salient worldwide! It is no surprise that there has been a huge surge in people seeking mental health support.
Terror Management Theory (TMT)
Terror management theory is a social psychological theory developed by the cultural anthropologist Ernest Becker. This framework helps us to explain how fears of death impact on human behaviour. TMT suggests that when we are made aware of our own death, our anxiety heightens. Humans then choose between two distinct coping strategies in order to reduce this fear: cultural worldviews and self-esteem.
- Firstly, if one has shared cultural worldviews then one can achieve a sense of symbolic immortality in the face of death (e.g. belief systems such as belief in an afterlife).
- Secondly, if one gains a sense of self-esteem as a member of this shared cultural worldview, then death anxiety can be mitigated by the idea of being remembered.
If used in helpful and hopeful spaces these mechanisms can be a helpful buffer. However, if used excessively and with avoidance as the main tool, then these coping mechanisms can have negative consequences. For example, wealth and consumerism is an important value for a capitalist worldview. But if this leads to a gathering of wealth and belongings to temporarily reduce anxiety, with the belief that you will keep on existing through your possessions, it can lead to financial problems and perhaps a loss of contact with people and nature.
What is the antidote to death anxiety
So if death anxiety is bubbling under our unconscious all the time. And if some of our in-built coping strategies can be harmful. Then how can we possibly help ourselves through it?
Here are a five ideas that can be a balm to the fear of death:
- Rippling effect: In his book Staring at the Sun, Irvin Yalom talks about a ‘rippling effect’. He describes how each of us creates circles of influence that impact on those around us for years afterwards. In this way, the effect we have on people is passed on to others, just like ripples in a pond continue outwards. Therefore, this idea that we leave parts of ourselves in others offers a salve to the seemingly transient idea of life and death.
- Connection: Yalom also speaks about how true closeness in relationships and empathy can be healing. By connecting with others we can feel seen and therefore less alone. Loneliness and loss are often triggers to fears of death.
- Meaning and purpose: Vickor E. Frankel, a psychiatrist who developed Logotherapy, stated “Those who have a ‘why’ to live, can bear with almost any ‘how'” in his book Man’s Search for Meaning. This quote highlights how important it is to have a sense of intention or direction in one’s life.
- Death acceptance: Neutral acceptance of death involves seeing death as a natural part of life. Death cannot be avoided and is something outside of our control. Neutral acceptance produces the lowest levels of death anxiety.
- Therapy: Psychological approaches can be helpful to unpack one’s worries in order to reduce the impact of anxiety on their functioning. Helpful interventions include both existential and cognitive-behavioural approaches. Interventions that focus on creating meaning have been shown to be the most effective at shifting attitudes towards death and improving mental health.
If you or a loved one is struggling with anxiety and distressing thoughts about death, please reach out for support from a mental health professional. The clinicians at the Centre for Effective Living are able to help you manage this complex and pervasive experience to live in more effective and present ways.
Michelle Nortje (M.A. Clin Psych, B.Psych Hons, B.Ed.Psych Hons, BA) is focused on establishing a therapeutic relationship that is safe, trusting and supportive. Michelle aims to use integrated psychological tools and approaches in order to help her clients make sense of their difficulties, gain insight into their patterns of behaviour and relating, and work towards co-constructed and workable goals. She uses Solution Focused Brief Therapy (SFBT), Cognitive Behaviour Therapy (CBT), Positive Psychology, mindfulness-based approaches, Dialectical Behaviour Therapy (DBT), Attachment theories and psychodynamic theories in order to tailor the therapy to best suit the client’s needs.
Michelle’s clinical training and diverse experience have equipped her to intervene in a variety of mental health issues and age groups. She has gained experience working as a clinical psychologist across non-profit, government hospital, school-based and private settings. Across all her roles, Michelle has expanded on her interest in working with children, adolescents and adults experiencing a range of mental health difficulties such as anxiety, depression, relationship difficulties, adjustment difficulties, trauma and grief.
Michelle is dedicated to consistent professional development by engaging in peer consultation groups, receiving regular supervision and expanding her knowledge through frequent webinars and courses in order to ensure effective interventions with her clients.