Page 88 - IDF Journal 2023

IDF – Webinar Series IDF News – Spring 2023
Understanding and Treating Death Anxiety and Fears of Dying
Professor David Veale
Death anxiety is a term
used to describe people’s fear or negative feelings towards death or dying. It has been a central part of the human condition throughout recorded history. It was described by William James as “the worm at the core of our existence”.
The skull in Hamlet represents inevitable death and decay. In previous centuries it was common for an individual to keep
a skull on their desk as a reminder
that they will die (memento mori). Attitudes towards death have changed and there is often denial or a sense of immortality amongst some people. Equally, others may be extremely anxious about their death. Some people may focus on their own death, such as ruminating on all the things
they will miss out on after they die, or what it will be like to not exist anymore. Some people may experience doubts about the nature
of existence itself, such as questioning what will happen to them after death. Others may worry about the process of dying,
such as whether their death will be painful, or what their final moments will
be like.
Some may be distressed at the idea of losing a loved one. They may worry about how they will cope with their loved ones’ death or that they will somehow cause the death of their loved one without meaning to. For some, there is a phobic avoidance and fear of anything related to death, going near cemeteries or funeral parlours. Many people with death anxiety have an intolerance of uncertainty (the “not knowing”) about what will happen when dying or after death. This is a visceral sensation that people may try to get rid of by various types of checking on the internet and seeking reassurance.
All the experiences above are in
many ways part of being human,
but death anxiety is a problem when
it is either sufficiently time-consuming
and distressing or interfering in one’s
life. The concept cuts across different diagnoses including some types of Health
Anxiety, Obsessive Compulsive Disorder, specific phobias, and panic disorder. Unfortunately, death anxiety may not be adequately targeted in standard protocols for these disorders. There is evidence
that Cognitive Behaviour Therapy, with a specific focus on the fears of death and dying, can improve quality of life. This includes helping patients to develop an alternative way of thinking about death and use of appropriate exposure tasks. These including reading books about death, watching videos about inspirational figures who are about to die, writing
out one’s funeral wishes and obituary, collecting ‘memento mori’, visiting a death café or painting your coffin. Even lying in a coffin can be great way of contemplating your current life. The focus needs to be on living life to the full now as an alternative to focussing on not wanting to think about death and dying.
REFERENCES
Menzies, R.E., & Veale, D. (2021). Free Yourself from Death Anxiety: A CBT Self-Help Guide for a Fear of Dying. Jessica Kingsley Publishers London and Philadelphia
Menzies, R.E., & Veale, D. (2021) Creative approaches to treating the dread of death and death anxiety. In: Existential Concerns and Cognitive-Behavioral Procedures: An Integrative Approach to Mental Health. Menzies, R.G, Menzies, R,E, Dingle, G. (Eds). Springer: New York.
Menzies, R.E., & Menzies, R.G. (2021). Mortals: How the Fear of Death Shaped Human Society. Sydney: Allen & Unwin.
Professor David Veale
MD MPhil FBPsS FRCPsych
The Nightingale Hospital, London and South London and Maudsley NHS Trust
T: 020 3137 9911
E: secretary@veale.co.uk and prof.david@veale.co.uk
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