11/15/17

What It’s Like to Learn You’re Going to Die

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Palliative-care doctors explain the “existential slap” that many people face at the end.

By Jennie Dear

Nessa Coyle calls it “the existential slap”—that moment when a dying person first comprehends, on a gut level, that death is close. For many, the realization comes suddenly: “The usual habit of allowing thoughts of death to remain in the background is now impossible,” Coyle, a nurse and palliative-care pioneer, has written. “Death can no longer be denied.”

I don’t know exactly when my mother, who eventually died of metastatic breast cancer, encountered her existential crisis. But I have a guess: My parents waited a day after her initial diagnosis before calling my brother, my sister, and me. They reached me first. My father is not a terribly calm man, but he said, very calmly, something to this effect: “Your mother has been diagnosed with breast cancer.”

There was a pause, and then a noise I can best describe as not quite a sob or a yell, but feral. It was so uncharacteristic that I didn’t know then, and I still don’t know, whether the sound came from my father or my mother.

For many patients with terminal diseases, Coyle has observed, this awareness precipitates a personal crisis. Researchers have given it other names: the crisis of knowledge of death; an existential turning point, or existential plight; ego chill. It usually happens as it did with my mother, close to when doctors break the news. Doctors focus on events in the body: You have an incurable disease; your heart has weakened; your lungs are giving out. But the immediate effect is psychological. Gary Rodin, a palliative-care specialist who was trained in both internal medicine and psychiatry, calls this the “first trauma”: the emotional and social effects of the disease.

The roots of this trauma may be, in part, cultural. Most people recognize at an intellectual level that death is inevitable, says Virginia Lee, a nurse who works with cancer patients. But “at least in Western culture, we think we’re going to live forever.” Lee’s advanced-cancer patients often tell her they had thought of death as something that happened to other people—until they received their diagnosis. “I’ve heard from cancer patients that your life changes instantly, the moment the doctor or the oncologist says it’s confirmed that it is cancer,” she says.

The shock of confronting your own mortality need not happen at that instant, Coyle notes. Maybe you look at yourself in the mirror and suddenly realize how skinny you are, or notice your clothes no longer fit well. “It’s not necessarily verbal; it’s not necessarily what other people are telling you,” Coyle says. “Your soul may be telling you, or other people’s eyes may be telling you.”

E. Mansell Pattison, one of the early psychiatrists to write about the emotions and reactions of dying people, explains in The Experience of Dying why this realization marks a radical change in how people think about themselves: “All of us live with the potential for death at any moment. All of us project ahead a trajectory of our life. That is, we anticipate a certain life span within which we arrange our activities and plan our lives. And then abruptly we may be confronted with a crisisWhether by illness or accident, our potential trajectory is suddenly changed.”

In this crisis, some people feel depression or despair or anger, or all three. They grieve. They grapple with a loss of meaning. A person’s whole belief system may be called into question because “virtually every aspect of their life will be threatened by changes imposed by the [disease] and its management,” Lee has written. In a small 2011 Danish study, patients with an incurable esophageal cancer reported that after their diagnosis, their lives seemed to spin out of control. Some wondered why they had received a fatal diagnosis, and fell into despair and hopelessness. “I didn’t care about anything,” one patient said. “I had just about given up.”

In the 1970s, two Harvard researchers, Avery Weisman and J. William Worden, did a foundational study on this existential plight. Newly diagnosed cancer patients who had a prognosis of at least three months were interviewed at several different points. At first, for almost all the patients in the study, existential concerns were more important than dealing with the physical impacts of disease. The researchers found that the reckoning was jarring, but still relatively brief and uncomplicated, lasting about two to three months. For a few patients, the crisis triggered or created lasting psychological problems. A few others seemed to face the crisis, then return to a state of denial, and then double back to the crisis—perhaps more than once. In the study, the researchers describe a patient who was told her diagnosis, only to report to interviewers that she didn’t know what it was—and then make it clear she wasn’t interested in receiving a diagnosis in the near future.

Palliative-care doctors used to think that a patient was either in a state of denial or a state of acceptance, period, Rodin says. But now he and his colleagues believe people are more likely to move back and forth. “You have to live with awareness of dying, and at the same time balance it against staying engaged in life,” he says. “It’s being able to hold that duality—which we call double awareness—that we think is a fundamental task.”

Whether or not people are able to find that balance, the existential crisis doesn’t last; patients can’t remain long in a state of acute anxiety. Coyle has found in her work that later peaks of distress are not usually as severe as that first wave. “Once you’ve faced [death] like that once, it’s not new knowledge in your consciousness anymore,” she says.

The existential slap doesn’t always entail mental suffering, and medical professionals who work with the dying say there are rare cases in which patients seem to skip this phase altogether, or at least experience it in a much less painful way. “People can gradually come to the realization,” Coyle says. “No one has to go through the sudden shock of awareness.”

But for most, figuring out how to adapt to living with a life-threatening disease is a difficult but necessary cognitive process, according to Lee. When patients do emerge on the other side of the existential crisis, she finds that many are better off because of it. These patients are more likely to have a deeper compassion for others and a greater appreciation for the life that remains.

To arrive there, they have to squarely face the fact that they’re going to die. “If you’re an avoidant person, and you don’t like to think about these things, that works better when life is going well,” Rodin says. “It just doesn’t work well in this situation because reality doesn’t allow it. It’s like trying to pretend you don’t need an umbrella or something, or it’s not raining, when it’s pouring. You can do that when it’s drizzling, but eventually, you have to live with the rain.”

Complete Article HERE!

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11/1/17

What Is Day Of The Dead, And What Can It Teach You About The Grief Process?

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The Mexican holiday has nothing to do with Halloween, but lots to do with normalizing death.

This summer, it seemed like death was everywhere. In the course of a few short weeks I had a miscarriage and watched my dog be struck and killed as we walked down our dead-end road. Two weeks later, my aunt unexpectedly passed away in her sleep.This trio of tragedies would have left anyone reeling, but I realized that I was hurting deeply in part because I didn’t have an adequate vocabulary to talk about death. This was especially evident when I tried to answer questions posed by my 3-year-old daughter, who kept inquiring about our dog and her great aunt for months. I wanted her to understand that death was normal and even expected, but I was having a hard time remembering that myself. (Here are 5 reasons you should talk about death, even if you don’t want to.)

And then, by chance, I stumbled upon information about Dia de Los Muertos—Day of the Dead—and I was captivated. Day of the Dead is most commonly celebrated in Mexico, although other South American countries celebrate as well. It’s believed that spirits arrive on October 31 and leave on November 2. November 1, however, is the main day of celebration, and the day most commonly referred to as Day of the Dead.

Most Americans, if they have even heard of the holiday, associate it with Halloween and colorfully painted skulls. But despite the coincidental timing, it’s really a fun-filled but complex acknowledgement of death as part of life, and it combines the Catholic All Saint’s Day with indigenous traditions and beliefs.

People who celebrate it believe that, on and around November 1, spirits can easily pass between our world and the afterlife. Families might set extra places at the table, exchange stories, and prepare gifts for their deceased loved ones. But mostly the day is about fun, since many people believe spirits would be insulted if they came back to find everyone in mourning.

This seemed vastly different from how many Americans view life, death, and grieving, so I wanted to learn more. It turns out there’s a whole lot that we could all learn from Dia de Los Muertos about the grief process.

Death is a part of life.
I’ve always thought of life and death as opposites. However, Day of the Dead celebrates death as a part of life, rather than the end of it. And recognizing that life and death go hand-in-hand can ease the grieving process, says Kriss Kevorkian, PhD, an expert on grief.

“Day of the Dead connects life and death in a way that, generally speaking, Americans don’t often do,” says Kevorkian. People who celebrate it realize that their loved ones are still present in their lives, even if they aren’t physically there. “You’re not taught to believe that once your loved one dies that’s it.” By normalizing death, the grieving process also becomes normalized and less of something to fear.

A relationship doesn’t end just because someone has died.
“The first chapter of grieving is really recognizing that someone is gone from this world, and your relationship with them is changing” rather than ending, says Tracee Dunblazier, a spiritual empath and grief counselor based in Los Angeles. Whether you believe like Dunblazier does that it’s possible to communicate with the dead, or you merely believe in keeping them alive through memories, recognizing that some sort of relationship can be maintained can be very healing.

“When you think of death as final, you’re looking from a specific sliver of a perspective that does not show the whole story,” Dunblazier says.

Grief doesn’t follow a strict timeline.
When someone you love dies, everyone expects you to struggle—but only for a little while. The problem, of course, is that people don’t heal on schedule, and sometimes it takes months or even years to “move on,” especially after someone passes unexpectedly. This idea is known as complicated grief, and Western cultures usually view it as something to treat (perhaps with therapy and/or antidepressants).

Cultures that celebrate Day of the Dead, however, don’t try to force a sense of closure. Having a holiday that acknowledges the presence of the dead can make complicated grief easier to address, particularly on November 1, when the spirits are thought to be nearby. Believing that your loved ones can hear and understand you on this holiday means that you have the chance to say anything that was left unsaid before they died, says Merrie Haskins, a counselor and psychotherapist based in Minnesota.

Funerals (or at least memorials) can be fun.

In America, death is a very somber event. We wear black to funerals and talk in hushed tones. However, anyone who has ever listened to a lovingly-delivered eulogy knows that smiles and laughter are an important part of the grieving process. Although South American cultures have sad funerals as well, they incorporate happiness and fun into Day of the Dead to honor their loved ones in a more spirited way. That’s something that’s not common in American culture. (See how these 3 alternative therapies can help heal your grief, according to Prevention Premium.)

“We don’t usually have a celebration with levity, happiness, song, and dance,” says Shoshana Ungerleider, MD, chair of the End Well Symposium, an organization that focuses on quality end-of-life care. “People who celebrate the Day of the Dead take this lightness very seriously, due to the belief that spirits who come to visit would be insulted if they found everyone in mourning.”

Haskins suggests adopting that focus on fun as a way to celebrate your loved ones. For example, each year she attends an Academy Award viewing party given in honor of a particular deceased family member who used to love watching the awards show. “That makes it fun for us to remember her and for new people to get to hear about how wonderful she was,” she says.

Stop fearing death, and your own death will be better.
Everyone dies, but many people are too terrified to think about it—to their detriment. “In America, we often shy away from talking about death, loss, and grief. As a physician, I see many gravely sick people in the hospital who have never considered what they want at the end of life,” Ungerleider says. As a result, their final days can be stressful for them as well as their families, because everyone is struggling to make decisions that align with their beliefs while simultaneously dealing with the grief of imminent loss.

A celebration like Day of the Dead can make people think about their own death and plan for what they want at the end of their lives. “By accepting and discussing openly that death is a part of life, you make sure you receive the care you want.”

Complete Article HERE!

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09/13/17

Why being aware of your mortality can be good for you

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It is only nothingness … for ever and ever.

By and

Nobody likes to think about lying on their death bed. From health anxiety to midlife crises, it seems like thoughts about ageing and death can often unleash some level of neurosis. But is that the whole story? We have examined mortality awareness – the realisation that we are all one day going to die – and found that, although the prospect of death is often scary, it can also have positive effects.

Perhaps unsurprisingly, research on death awareness so far has focused largely on the negative aspects of realising that we will eventually stop living. Indeed, until now, the dominant psychological theory has been “terror management theory”, which assumes that contemplating our demise invokes fear and anxiety. For example, studies using this framework have found that thinking about death can make us more punitive and prejudiced.

However, throughout the years, literature from various fields has offered other explanations. For example, “positive psychology” proposes concepts such as “post-traumatic growth” – the idea that people can grow psychologically through traumatic experiences. Thinking about the fact that we will die may be hard, but according to this theory it could also help us to get stronger psychologically.

In our recent study, published in OMEGA – Journal of Death and Dying, we asked 356 participants from 18 to 80 years old questions about their experience of mortality. We asked them to indicate the extent to which they agreed with 89 statements which covered a wide variety of possible attitudes to death awareness. These included “I do not let the fear of dying rule my life”, “I want to be remembered for doing great things for the world when I am no longer alive” and “I am scared of dying before I am old”. In this way, we explored how many aspects of such awareness we could identify.

To see how the results might align with positive or negative features of their experience, we also asked our respondents about how interested they were in their health, how prone to taking risks they were, and how eager they were to conform (such as obeying rules).

Some of the attitudes we identified were negative. These included being fearful, feeling disempowered (realising personal vulnerability in the face of death), and feeling disengaged (refusing to acknowledge death). We found that those people who reported higher levels of disempowerment and disengagement also reported taking more risks and were more reluctant to conform. It may be that people who report taking greater risks do so because they feel that they will die regardless of what they do. Those refusing to conform on the other hand may be attempting to empower themselves in the face of the inevitable.

We also discovered that younger individuals and people with lower levels of education attainment were more likely to have negative attitudes to death. However, it is not all bad news for these individuals. For example, we found there was a relationship between mortality fearfulness and placing a high value on staying healthy. So it would appear that fearing death may cue attempts to control its unpredictability.

The power of legacy

Interestingly, we also found a few positive aspects of pondering mortality. One is accepting it rather than running away or fearing it, which can help us to make the most of our time-limited existence.

We also identified what we call mortality legacy awareness. This is a form of mortality awareness that drives the need to leave something behind after we have gone – thereby outliving and transcending death. This could be a highly creative force.

Having children can make us feel better about ageing and death.

The need for a legacy turned out to be an important contributor to dealing effectively with the prospect of demise, lessening feelings of hopelessness and a lack of purpose. In the study, legacy awareness was found to be correlated with both trying to be healthy and striving for spiritual growth (such as believing that life has purpose).

This suggests that those who are interested in passing down their succession to future generations as a way to transcend death are also likely to take responsibility for their health and place value on their internal development. Artists are the perfect example of this: through their creative legacies, they live on and are never totally gone. Working on leaving a legacy – whether it be producing art, raising a family, passing on family history or helping others – can also be a way for people to better tolerate ageing and face the prospect of death.

Such legacies also help those who remain to cope with their loss. On a more basic level, being aware of our ability to provide a legacy that outlives us can be an excellent way to motivate ourselves to accomplish more, stay healthy, focus on the here and now, and maintain good relationships.

Of course, the results are all based on correlations – we don’t show conclusively that striving for a legacy actually does make people feel more fulfilled. Our latest research project (currently under peer review for publication) has therefore studied 10 people’s experience of mortality awareness in depth – through one-to-one interviews. The outcomes of this work confirmed the findings from our first study and offer additional support to the claim that legacy awareness is a major element in people’s search for meaning – helping to manage death-related anxiety.

So the next time you face a haunting reminder of your death, remember that focusing on what you would like to leave behind could help you turn something terrifying into a positive motivational tool.

Complete Article HERE!

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09/6/17

Confronting Death and Dharma at Brooklyn’s Green-Wood Cemetery

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Can we shift our perspective on the reality of loss?

By Lauren Krauze

When I arrived at the main gate of Brooklyn’s Green-Wood Cemetery, I was greeted by two talkative green birds hopping and flapping about in the grass. I was surprised; the birds seemed bright and exotic compared with the pigeons, jays, and sparrows I normally see. I later learned that these playful birds are monk parakeets—a very fitting name given that I was attending an event called Death and Dharma, a lecture and meditation series co-presented by the Brooklyn Zen Center and Green-Wood Cemetery.

Green-Wood’s high, rolling hills and shady lawns offered a cool and quiet respite from the heat and hum of downtown Brooklyn. A group of about 40 people gathered on the grass near the cemetery’s Modern Chapel, a serene space for meditating and contemplating death and dying.

“Death is a fundamental question. It’s sometimes called ‘the big question,’” said Rev. Francisco (Paco) Genkoji Lugoviña, the founder and guiding teacher at the Hudson River Peacemaker Center. “There are lots of questions, actually, and no real answers. However, at age 78, I try to live each day with as much involvement and obedience to what emerges and go with it.”

Joining Lugoviña was Rev. Daiken Nelson, the founder and guiding teacher at the Pamsula Zen Center in Harlem. Nelson and Lugoviña are both teachers and priests in the White Plum Lineage of Taizan Maezumi Roshi and the Zen Peacemaker Order. As a pair that often teaches together, they were invited to share their insights with the Brooklyn Zen Center community.

“In the West, and particularly in the U.S., people don’t deal with death until they have to,” Nelson said. “They don’t think about it until someone they know passes away. I think it’s important to at least think about it before that happens and try to realize that it’s everyone’s fate.”

While the discussion was rich with teachings, stories, and koans from the Zen tradition, Nelson and Lugoviña also created space for people to briefly talk about their own relationships with death and dying. At the start of the discussion, they asked individuals to share one or two words that reflected their thoughts on the topic. While many people expressed a cautious wonder and curiosity about the topic, others shared words like “fear,” “uncertainty,” and “dark.”

Lugoviña didn’t seem very surprised. As a Zen teacher, he said that he often ventures into this very territory, especially in his conversations with people struggling with anxiety, depression, and suicidal thoughts. He also relayed a poignant story about his grandson, who passed away at age 23 after a methadone overdose. That experience taught him to reevaluate his intellectual understanding about death and shift toward a deep experience of gratitude.

“A friend of mine once told me she that she used to count her life by the number of summers she had left,” he said. “I think that’s a very poetic way to look at what we value in our lives and cherish what’s important to us.”

In a short work titled “Vulnerability,” acclaimed poet David Whyte writes, “The only choice we have as we mature is how we inhabit our vulnerability, how we become larger and more courageous and more compassionate through our intimacy with disappearance.” Nelson echoed this by imparting a teaching about impermanence and what can come of embracing the transient nature of experience.

“What I’ve been working with in my own practice is accepting whatever is arising,” he said. “We can learn to accept our inevitable passing, the passing of others, and the passing of this moment. Realizing something is just how it is—that it’s ‘just this,’ without it having to be any different—can give rise to freedom.”

At Green-Wood, humble gravestones and elaborate mausoleums dot the landscape, crowding some of the hills and valleys. The root of the word monument is the Latin word monere, which means “to remind.” These markers remind the living of the deceased’s name, life, and family, but for Nelson, the monuments reflect a more complicated reality that attempts to honor both the teachings of impermanence and the reality of human connection and loss.

“Once we are born, we exist, and then we spend our lives going to great lengths to express that in the world,” he said. “We spend a great deal of time and energy thinking about this self, or the ideas we have about awareness, consciousness, our connections with others, acceptance, and impermanence. Then people die, and afterwards, we want to live in the memory of them, whether it’s through their accomplishments, their stories, or things we build to honor them.”

He then introduced a teaching from Bankei, a 9th century Chinese Zen master. While recovering from a serious illness as a young man, Bankei realized his existence was nothing more than a moment-by-moment experience. He framed his realization about life as “the unborn.”

“He taught us that nothing is ever born and nothing ever dies,” Nelson said. “Life is a moment-by-moment arising and falling away. So, he said, don’t get born. Don’t fall into identification as me or you, as young or old, as a woman or a man. Even our habits are not part of our original being. Everything is unborn. Why not abide in that?”

He then looked around and chuckled.

“What better place to talk about the unborn than a cemetery?”

Many of us laughed, too. Later, during meditation, I tried to focus on the sounds and sensations I was experiencing: the gentle breeze rolling off the back of my neck, the cool grass under my feet, the soft breathing of my friends around me. At one point several birds cried out, asserting their place in the world before settling in for the evening.

I began to realize that it is possible to sit in a cemetery—a place so deeply associated with death and loss—and feel very much alive. I also understood this as something I can practice on a regular basis; when I find myself sinking into mental, physical, or emotional places of decay, I can work to more directly experience my own vitality as I honor the complicated thoughts of fear and doubt swirling within me.

By the end of meditation, the sun had dipped below the Upper New York Bay. In the lingering warmth of the afternoon, I found myself wondering how many more summers I have left. In that same moment, however, I was able to shift my perspective and realize: I am here, right now, breath-filled and conscious and capable of so much. As my friends and I walked out of the cemetery, I took comfort in their singsong voices echoing in the open twilight sky. I also noticed a pigeon’s glowing red feet, the cemetery security guard’s half-smile, and the first fireflies brave enough to shine their lanterns and welcome the night.

Complete Article HERE!

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08/20/17

Death anxiety: The fear that drives us?

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Death is often a taboo subject, so when death anxiety comes into play, it is hard to know how to face it.

Death is something that we all, sooner or later, have to face. But how do we respond to it? Why are some of us more afraid than others? And what is it, exactly, that scares us about death? We offer an overview of theories related to death anxiety, and what you can do to address it.

To a greater or lesser extent, it is likely that we are all scared of death – whether it be the thought of our own cessation or the fear that someone we love might pass away. The thought of death is not a pleasant one, and many of us avoid such morbid musings, naturally choosing to focus on what life has to offer, as well as on our own wishes and goals, instead.

Yet, as Benjamin Franklin once famously wrote, “In this world nothing can be said to be certain, except death and taxes,” so it is no surprise that death-related worries sometimes take us by storm.

Fear of death is sometimes referred to as “thanatophobia,” deriving from the Ancient Greek words “Thanatos,” the name of the god of death, and “phobos,” meaning “fear.”

Notably, thanatophobia – which is called “death anxiety” in a clinical context – is not listed as a disorder in its own right in the Diagnostic and Statistical Manual of Mental Disorders. Still, this rarely spoken-about anxiety has the potential to seriously affect people’s lifestyles and emotional health.

Thanatophobia: Natural or trauma-driven?

Thanatophobia was first tackled by Sigmund Freud, who did not consider it to be fear of death, as such. Freud thought that we cannot truly believe in death as a real occurrence, so any death-related fears must stem from unaddressed childhood trauma.

But it was the theory put forth a little later by an anthropologist called Ernst Becker that ended up informing most current understandings of death anxiety and its causes. Becker believed that death anxiety comes naturally to all people who find the thought of death and dying unacceptable.

That is why, he argued, everything everyone does – the goals we set, our passions and hobbies, and the activities we engage in – is, in essence, a coping strategy, and that these are things we focus on so we that need not worry about our eventual death.

Becker’s work gave rise to “terror management theory” (TMT), which posits that humans must constantly deal with an internal conflict: the basic desire to live against the certainty of death. TMT emphasizes individuals’ self-consciousness and their drive to achieve personal goals, motivated by the awareness of mortality.

Also, according to TMT, self-esteem is key for the degree to which individuals experience death anxiety. People with high self-esteem are better at managing fear of death, while people with low self-esteem are more easily intimidated by death-related situations.

Some newer approaches suggest a “middle way” between TMT and another theory referred to as “separation theory,” which highlights the importance of early trauma, reinforced by an awareness of mortality later in life.

Another recent approach to understanding and explaining death anxiety is that of “post-traumatic growth theory” (PTG). According to PTG, going through a distressing event – such as the death of a loved one or receiving a worrying health diagnosis – can actually have a positive effect, causing individuals to appreciate the small things in life a lot more, or to become more goal-oriented.

Death anxiety as a disorder

Although it is likely that we will all be worried about death or a death-related situation at some time in our lives, death anxiety is only pathological when it reaches extreme levels, disrupting the normal lifestyle of an individual.

One account of death anxiety – as reported by a man’s worried wife – emphasizes how this kind of fear can become obsessive and get out of control.

The fear is specifically of death (not pain or dying as such) and the emptiness of it (he’s not religious) and the fact that he will no longer be here. […] this is an irrational, emotional fear that he has trouble controlling. Recently it has got worse – he’s not sure why – but it has made him feel panicky and the thoughts have been straying into the daytime.”

Who is afraid of death?

Dr. Robert Kastenbaum has reviewed various psychology theories and studies related to the concept of death, outlining which populations are most likely to express a persistent fear of death. Drs. Patricia Furer and John Walker summarize the findings in an article published in the Journal of Cognitive Psychotherapy.

Women are more likely than men to experience death anxiety, and this tends to peak twice: once in their 20s and again in their 50s.

  1. The majority of individuals are afraid of death. Most people tend to fear death, but they usually only exhibit low to moderate levels of anxiety.
  2. Women tend to be more afraid of death than men. Additionally, a newer study has found that while death anxiety seems to surface in both women and men during their 20s, women also experience a second surge of thanatophobia when they reach their 50s.
  3. Young people are just as likely to experience death anxiety as elderly people.
  4. There appears to be some correlation between a person’s educational and socioeconomic status and reduced death anxiety.
  5. No association has been found between religious engagement and reduced death anxiety.

Specialists argue that more often than not, death anxiety does not come on its own, and that it is instead accompanied by another type of mental health disorder (such as generalized anxiety disorder, panic disorder, post-traumatic stress disorder, depression, or obsessive-compulsive disorder).

Other studies show that people exhibiting health anxiety, or hypochondriasis, are also affected by death anxiety, as it naturally correlates with an excessive worry about health.

Complete Article HERE!

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08/4/17

We fear death, but what if dying isn’t as bad as we think?

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Research comparing perceptions of death with accounts of those imminently facing it suggest that maybe we shouldn’t worry so much about our own end

Death terrifies many of us, but is, of course, central to the human condition. What if it’s not as bad as we fear?

By

“The idea of death, the fear of it, haunts the human animal like nothing else,” wrote Earnest Becker in his book, The Denial of Death. It’s a fear strong enough to compel us to force kale down our throats, run sweatily on a treadmill at 7am on a Monday morning, and show our genitals to a stranger with cold hands and a white coat if we feel something’s a little off.

But our impending end isn’t just a benevolent supplier of healthy behaviours. Researchers have found death can determine our prejudices, whether we give to charity or wear sun cream, our desire to be famous, what type of leader we vote for, how we name our children and even how we feel about breastfeeding.

And, of course, it terrifies us. Death anxiety appears to be at the core of several mental health disorders, including health anxiety, panic disorder and depressive disorders. And we’re too scared to talk about it. A ComRes survey from 2014 found that eight in ten Brits are uncomfortable talking about death, and only a third have written a will.

But we don’t need to worry so much, according to new research comparing our perception of what it’s like to die with the accounts people facing imminent death. Researchers analysed the writing of regular bloggers with either terminal cancer or amyotrophic lateral sclerosis (ALS) who all died over the course of the study, and compared it to blog posts written by a group of participants who were told to imagine they had been diagnosed with terminal cancer and only had only a few months to live. They looked for general feelings of positivity and negativity, and words describing positive and negative emotions including happiness, fear and terror.

Blog posts from the terminally ill were found to have considerably more positive words and fewer negative ones than those imagining they were dying – and their use of positive language increased as they got close to death.

Kurt Gray, one of the study’s researchers, said, “I imagine this is because they know things are getting more serious, and there’s some kind of acceptance and focusing on the positive because they know they don’t have a lot of time left.”

The researchers also compared the last words and poetry of inmates on death row with a group of people tasked with imagining they were about to face execution. Again, there were fewer negative words from the prisoners. Overall, those facing death focused more on what makes life meaningful, including family and religion.

“We talk all the time about how physically adaptable we are, but we’re also mentally adaptable. We can be happy in prison, in hospital, and we can be happy at the edge of death as well,” Gray said.

“Dying isn’t just part of the human condition, but central to it. Everyone dies, and most of us are afraid of it. Our study is important because it’s saying this isn’t as universally bad as we think it is”.

But before we get too ahead of ourselves, the research prompts a few questions. Lisa Iverach, a research fellow at the University of Sydney, explained that the study highlights how the participants may have been less negative because the mystery around death was removed.

“Individuals facing imminent death have had more time to process the idea of death and dying, and therefore, may be more accepting of the inevitability of death. They also have a very good idea about how they are going to die, which may bring some sense of peace or acceptance.”

But not all of us will know how, or when, we’re going to die in advance of it happening, and therefore will miss out on any benefits to be had by uncovering its uncertainty.

Havi Carel, Professor of Philosophy at the University of Bristol, agrees with the study’s findings on how adaptable we are. “I think you get used to the idea of dying, like we get accustomed to many things. The initial shock after receiving a poor prognosis is horrific, but after months or years of living with this knowledge, the dread subsides,” she said.

However, Carel also pointed out that there’s an important distinction between positive responses and pleasantness, and that there are some unpleasant and painful events we’d still be positive about, such as childbirth.

“Blogs are written for public consumption and they remain there after people’s death. Using blogs and poetry may reveal only the outward-facing emotions people are willing to share, or even simply created to fashion how they want to be remembered. Do people really tell the truth in their blogs? Perhaps, to an extent, but these are very public media,” Carel said.

“Perhaps they are ‘putting on a brave face’. It is impossible to tell, but blogs are clearly not the most intimate mode of communication. It may have better to use diaries, recorded conversations with loved ones, or even personal letters.”

Nathan Heflick, researcher and lecturer at the University of Lincoln, also warns against interpreting the results to mean that dying people view death as a wholly positive experience. “I think that is a dangerous message, and it isn’t a conclusion reflected in the study’s data. Being less negative is different from welcoming it or wanting death,” he said.

“People will fear death. These people dying feared death. They just didn’t fear it as much as people think they would.”

If fear of death is, in fact, as inevitable as the event itself – there’s one change we can make to help. In Western culture, we tend to pretend death doesn’t exist, whereas research has indicated that the East Asian yin and yang philosophy of death – where life can’t exist without death – allows individuals to use death as a reminder to enjoy life.

“I think the UK and the US are death-denying cultures, in that death is mostly avoided as a topic,” Heflick said.

“The less something is openly discussed, the scarier it becomes. While avoiding talking about death can reduce a little discomfort in the short term, it probably makes most of us much more anxious to die in the long term.”

Complete Article HERE!

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07/3/17

Deconstructing Death as a Dying Woman

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by Mackenzie E. Rockcastle

Next week, I have my second scan since being diagnosed with terminal cancer.

 
The thought of the little white masses glowing brightly on my doctor’s computer monitor leaves my stomach unsettled—leaves my mind unsettled.

As my “scanxiety” builds, I find myself leaning on my own advice to approach my fears of dying. A few weeks ago, I gave my therapist a breakdown of what I thought were my general fears surrounding death. She was surprisingly thankful for my analysis of such an enormous concept and fear that is shared by so many. She told me many of her patients held an irrational fear of dying. Breaking death down into the smaller fears that truly comprise the overall terror for the word makes it a little less intimidating.

She believed this mindset could help some of her other patients get to the root of their obsessions. So I thought to myself, perhaps my breakdown of death—one that has helped me unveil my true fears, befriend my own death, and enhance my life—could help others do the same.

To start the process of grasping my fears surrounding death, I first had to ask: Is it possible to create a good relationship with death? And in order to create a good relationship with it, well, perhaps we need to understand why we have such a bad relationship with it.

I personally see four major reasons to feel uncomfortable about death. All of them associate with fear. Fear of the dying itself, fear of what lays beyond death, fear of the life we will never live, and fear for those we leave behind.

At this point, I believe I’ve come to peace with three out of the four. But I had to ask (and continuously have to ask) myself the following questions:

1. What is dying?

Dying is a physical action. It is momentary. Physical pain may be associated, but it is temporary, not eternal. Dying is generally defined as “to stop living.” This definition causes death to be associated with the opposite of life. I don’t like this association, and I don’t believe it properly does justice to the word death.

As a young child in school, I specifically remember doing worksheets to understand opposites: on/off, black/white, night/day, life/death. Looking at a lot of ancient cultures, many have a book of the dead: The Egyptian Book of the Dead, The Celtic Book of the Dead, The Tibetan Book of the Dead, and so on. The way that most of them describe death is not as the opposite of life, but the opposite of birth. I think this shift in language—this shift in the juxtaposition of life and death—is important.

It is an entirely different concept. It suggests that we walk into a room and we walk out of a room, not that the room disappears.

2. What comes after death?

Since this is the most uncertain part of the equation, this question can bring about the most fear. Do we fear an almighty man in the sky? Burning for all eternity? That, maybe, this is it? Religion, upbringing, what we’ve experienced, what we’ve watched, and what we’ve read all play into what we believe happens after death. But the reality is, no one knows for certain. Beliefs, faith, and religion aside, really no one can say without a shadow of a doubt what happens when we die.

In this thought, some people hold fear, and some people hold peace.

For me, this is the most fun part. As a nonreligious, but spiritual person, this is a playground of opportunity. I personally don’t hold a fear for this. Rather, I see the space beyond death as a a beautiful existence where our beings no longer hold their human form. I acknowledge my brain doesn’t have the capacity to understand this fully, and therefore I don’t try too hard to create an image or definition to coincide, rather just a feeling. This is the part of death I feel to be the most reassuring, warm, and whole. It’s the presence that gives full peace.

3. Are we afraid of the things you will miss out on, the things we never did, or the things we’ll never do?

This fear is actually comprised of regret. These are the things in life we always thought we’d achieve or have the time for. The places we wanted to go. The people we wanted to meet. The food we wanted to eat. The adventures we wanted to take. This is bucket-list stuff, and is constantly shifting. It’s understandable to want more time to do more things, but, in fact, more incentive to live fully while we know we are here. Carpe f*ckin’ Diem, right?

The longer we live, we assume, the more likely we are to achieve our dreams and desires. And sometimes this is true. At 21, my initial diagnosis left me thinking I’d never graduate from college. A year later, I graduated with my class. At 23, just two weeks after finding out my cancer had returned, I stood next to my beautiful sister-in-law as she married my brother. I cried a good amount, most tears were of joy, but some of the salty droplets fell from the thought that I may never live long enough to get married. A year passed, and I did.

I realize some of those things can’t always be attained. I have certainly shed a tear or two over the thought of the empty bedrooms in my home that echo with the cries of babies who are not mine, and are not there. While the thought is sad, it too passes. My perspective goes beyond that. I have a lot of dreams. But if I don’t attain them, I am at peace with that. And I think part of that acceptance is the realization that it isn’t those big “achievements” that were my favorite parts of life thus far.

It’s the nitty gritty. The naughty. The unexpected. The unconventional things that are mine. And if that’s what we enjoy about life—the little things and the uniqueness of the bonds we’ve made—then maybe we can take away the bigness of death. Maybe if we break it down into the little things about it we can start to get on the same level as it. Maybe we can start to repair this broken relationship with death.

4. Do we hold a fear for those we’ll leave behind?

Currently, this is my greatest fear associated with my own death. I fear for the pain inflicted on those who will heavily feel my void. I am trying to remedy this by reminding them that my purpose here may be just that: a reminder. A reminder and an inspiration. And whatever is happening, it’s supposed to. It’s fluid and it will make sense. If I were to die soon, I know the little things people will see and think of me for.

Little jokes that will make them laugh. Spaces, patterns, and songs that will make them smile. And that is what makes us immortal: our essence. I believe that’s what we become when we die. And if I can inspire people to pursue the things that make them smile, laugh, and feel joy—feel love—that is a gift greater than I can take credit for. It gives me peace to know I will, in some way, be with them.

But, I can stare into my mothers eyes and tell her how at peace I am over a bottle of wine at lunch. And I am. But when I swivel around that table and look through her eyes, what do I see? My baby girl dying? F*ck, I can’t imagine. Nor, probably will I ever have to (which adds into the f*cked-up-ness of the thought).

I can physically feel the heaviness of my husband’s sadness as he lays his body on top of mine just to make sure I’m still there. I can run alongside my best friend and no empathy is needed, because the thought of losing her is the exact same weight as her thought of losing me. I can talk bucket-lists with my dad, who is battling Stage 3 cancer, with stipulation on both ends on how things are doing in a few months—a most unusual fate not typically shared between a father and daughter simultaneously. I can go out with my brothers or my friends and share meals, drinks, and laughs.

A big part of the problem is we continue to view death as an end—that we’ll never be able to share those same meals, drinks, and laughs again. But we wouldn’t anyways. That’s how time works. Part of making peace with death is making peace with time. Perhaps it’s the most perfect preserver of time—the relationship we had is exactly the relationship it will always be. We will always have shared that meal. We will always have shared that drink. We will always have shared that laugh. Allowing the fleeting to fleet. And letting life slip into death, in the beautiful, exact way it’s supposed to.

But, still, this is where I find sadness: in the sadness of others. I don’t like being the source of peoples’ pain. It’s the part that hurts the most. So no, this piece I am not yet at peace with. But it is a shared burden. And I believe the more at peace those I love become, the more at peace I’ll become. Which is the point of this whole thought: How do we better our relationship with death?!

I suppose a more complicated question then becomes: How do we better our relationship not only with our own death, but with the death of others? And I’m starting to think this is a full circle concept. If we better our relationship with our own death, we better our relationship with the death of others.

I think the first step is talking about it. Often the conversation is met with: “I can’t bare the thought.” But what if we did? What if we did just f*cking bear the thought? What would we do differently? How would we treat each other differently? How would we live differently? Can being friends with death make us have a better life?

I whole-heartedly believe the answer is yes.

I think as we visit and revisit each of these four major parts of death, we continue to delve deeper and deeper into a peace with it. A peace with our own death, a peace with the death of others, and a life more fully lived.

Complete Article HERE!

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