Fear of Death Anxiety*
Is fear of Death the of all anxiety?
Can Psychospiritual Therapy allay this fear?

By Michael Isaacs


I believe that the fear of death is not the underlying source of all anxiety, but it is the underlying source of some anxiety. Let me add that fear of death is a greater source of anxiety than most of us realize.

Some people just do not have fear of death as their core anxiety. Their predominant anxiety might be loss of livelihood or money; deep guilt over what has been thought, said, or done in their lives; existential loss of purpose and meaning in life; lack of love and connection; grief over the loss of loved ones; and failure or fear of failure.

Here is an example where the fear of death may have been partially a source of anxiety. Dan was a male teenager who was bullied unmercifully and threatened with serious physical harm in high school because he was gay. He became extremely anxious coming to school daily. Since he had not come out of the closet he felt alone. He became depressed and eventually committed suicide. It is doubtful that fear of death was a major cause of anxiety. However, we might speculate that his high level of anxiety about being hurt and attacked included an unconscious fear of death.

Why does fear of death cause anxiety ranging from very high, moderate, and light? Why are thoughts of death so fearful that they are often denied and repressed into our unconscious mind?

We are anxious because we are understandably facing loss of what we hold so dear. We only know the human life that we know. There will be inevitable loss of home, family, possessions, and health. The future is uncertain and unknowable. Death is beyond our control and understanding. As the well-known psychotherapist Erich Fromm wrote: “Man is the only animal for whom his own existence is a problem which he has to solve.”

Especially when we age, we look around and see those that are involved in chronic pain, who have life threatening diseases, who suffer, who decay, and die. We ourselves may be currently involved in such anxiety conditions. In both cases we are prone to be anxious about our mortality. We worry about when we will die and what disease or condition will “do us in.” We feel helpless. Sometimes even our minor illnesses are feared. For, if they became worse, it might mark the beginning of our death path.

When my father started his 60’s he joked that every day when he woke up he would read the newspaper obituary column in bed. If he wasn’t on the list, he relaxed and got out of bed to start his day!

There are other dimensions of death fear and the anxiety it evokes. That is, what happens close to or immediately before the actual time of death? Will there be trepidation, loss of control, or panic? Losing our human identity into the unknown is a first time experience.

The last dimension of death fear and anxiety is a big one. What happens after death? Who knows? That’s the anxiety! However, materialists, agnostics, and atheists that I know don’t seem to care that much about death. They didn’t know why they were born. They are here on earth and they don’t seem to care about what happens after death. Maybe they are in a state of denial. Or maybe, they’re right!
No prior death anxiety was illustrated to me by my consultation with a well know teacher of Chinese Medicine, Doctor Nan Lu. He told me he has no anxiety about death because the day of death is already ordained for everyone. There is no use worrying at all. Go about your business and don’t be afraid of death. Don’t be anxious.

An example of no fear of after-death comes to mind. A much older friend of mine died at 104 years of age. Let’s call her Joan. After she turned 100, she wanted desperately to die. All her friends had died and she had no relatives. She missed her recently deceased younger beloved brother every day. She wanted to be with him in the grave site right next to him. She was relatively in good health. She did not want to do anything to end her life by giving up or by her own hand because she felt that her death should evolve whenever death happened naturally. Joan not only had no fears about an afterlife, but actually yearned for it.

Some religious adherents are assured that by leading a pure religious life they will go to heaven and not hell. No fear. Some devout Hindus believe that if their bodies are burned on the banks of the Ganges River in India their souls will escape the constant cycle of rebirth and attain Mosha, or Salvation.

Do we believe that the likes of Buddha, Jesus, Lao-Tzu, and Ramakrishna, after illumination, were anxious or fearful of death? I doubt it, and if so, very little concern. Buddha stared a whole religion when as a young man he first saw on the streets of India, the suffering of a sick man, a dying man, and a dead man. Most of us are not illumined, but by pursuing our spiritual paths, we can make strides to gradually reach higher levels of consciousness. There is hope thereby, to reduce the anxiety over fear of death and by grace, have a glimpse of immortality and eternality.

The comedian, writer, and movie actor-director Woody Allen has a lot to say in his works and interviews about his many anxieties and fears about death. He does this through his humor. He covers all the areas of lifetime fear, act of dying, and after-death anxieties.

In one of his films he has a headache. He is frozen with fear that he has a deadly tumor. A panic attack sets in and he runs to a hospital for a scan. Three of his quips in his standup comedy and movies are known to many Allen fans because he makes fun of death anxiety fears. One is that he is not afraid of death- he just doesn’t want to be there when it happens. Next is that he is not sure if there is life after death but just in case there is, he will bring a clean set of underwear. Lastly, is that he doesn’t want to achieve immortality by his work, but that he wants to achieve immortality by not dying.

Allen, in a fairly recent television interview, explained why he keeps so busy. As a workaholic he crams in directing a movie each year, plays the clarinet in a band regularly, and writes essays frequently. As a young adult he realized how much suffering there was in getting older and facing the decline of the and mind. He freaked out when he realized the inevitability and reality of death. He made up his mind to keep extremely busy in his career to ward off depression. body

Actually, Allen’s comments show how anxiety and fear of death can have a positive function. Awareness of mortality can motivate us to give more priority to such changes as improving family relations, writing that book, and having more joy in life.

How can Psychospiritual therapists help clients deal with anxiety that is caused by fear of death? The key is awareness of this fear. During my Psychoanalytical training I was taught that the two subjects that clients were most afraid to talk about were sex and money. Now I realize that death should be added to the list! There is resistance to talking about death because most of us cling to the idea that we will never die. The unconscious defense of denial comes into play. Besides, it is not a pleasant subject to talk about. This taboo is why many keep delaying executing or updating a will! Therefore, we should not expect the client to open up about the subject until ready. Maybe dream material will come up to reveal death fears that might lead to curiosity and memories.

Death concern and anxiety arise more with age. Obviously older clients have more physical and mental challenges. Also, the subject is more likely to be relevant for clients of all ages if they have had traumatic experiences involving serious illness of self or others, life threatening incident from abuse or accident, and other body invasions. 

Psychospiritual therapists, like all therapists, should encourage clients to talk about their anxieties and fears about death and dying. We can assure them that their concerns and fears are prevalent and normal.

We can also ask clients to see if they can think of any cognitive, positive thoughts which would allay their anxieties to a degree. These examples are highly personal and may be rationalizations. They may not substantially reduce death anxieties but they may be comforting nevertheless:

 “Do I remember anything before I was born? No. So the same will happen to me after death. It will just be a nothing, like a peaceful forever sleep.”; “If no one died there would be no room on the planet for everyone and the world would become extinct. I’ve had my human life chance to live. In due time I will be glad to turn over the baton for someone else.”; “Dying can be a relief if I am in incurable mental and physical anguish.”; Death can have the advantage of me predeceasing my wife and my children so I can avoid the anguish of seeing them die.” ; I won’t have to endure the pain of observing continual acts of man’s cruelty to man, including but not limited to violence such as murder, war, and hatred.”; And lastly, on a lighter vein, “I can avoid the effects of global warming.” 

In my own early psychoanalysis my analyst commented that I had anxiety about death. I vehemently insisted he was wrong. I said I was not afraid of death, but admitted I was afraid of life! As the years have gone by though, I have realized that I do have body fears that wouldn’t worry me so much if I had no death anxiety.

As Psychospiritual therapists we can help and encourage clients to explore death concerns. I refer to such fields as religion, MY PRACTICE, and poetry. They often embody guidance, solace, and understanding. Psychotherapy has been around for relatively few years, but coming to grips with death issues has been around for thousands of years. For example, the Twenty Third Psalm has given countless people down through Centuries assurance that they are not alone in the death experience. Furthermore, that we can have faith that dying will be peaceful.

The spiritual attribute of forgiveness can also be discussed with clients before death if the client is open to bringing up the subject. If forgiveness can be implemented before death this can bring peace of mind and closure to both the one dying and the one being forgiven. 

* Michael Isaacs,LCSW, JD, Berkely, CA
Published in Summer Issue, 2014, Association of Spirituality
and Psychotherapy

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