Thanatophobia

— Or the Fear of Dying, May Prevent You From Actually Living

BY Mara Santilli

Despite the best efforts of the death positivity movement, most people do not have a good time going to wakes or memorial services, and that’s completely normal. But for others, the thought of death—whether it’s a loved one dying or themselves—sparks intense fear and panic. “Fear is a natural and important human emotion,” says Mitchell L. Schare, PhD, ABPP, director of the Hofstra University Phobia and Trauma Clinic. But sometimes that fear of dying can be taken to extremes. “When it becomes inhibitory to living life, it becomes a phobia,” says Dr. Schare. Specifically, that phobia is known as thanatophobia, or the intense fear of death and dying.

“Fear is a natural and important human emotion. When it becomes inhibitory to living life, it becomes a phobia.” —Mitchell L. Schare, PhD, ABPP, director of the Hofstra University Phobia and Trauma Clinic

Thanatophobia (also called “death anxiety”) can be considered the “master fear,” says Dr. Schare, since so many other phobias—from fearing spiders to airplanes to illness—can be traced to a fear of death. But as with any kind of phobia, thanatophobia is more serious than just a distaste for thinking about death. It can cause avoidance of anything that might theoretically lead to death or situations in which family members or friends are dying.

There’s so much to unpack when it comes to thanatophobia. Here’s what you need to know about the fear of death, where it comes from, and how someone can cope with thanatophobia.

Is thanatophobia a mental illness?

Like other specific phobias, thanatophobia is considered a type of anxiety disorder1. According to the DSM-5-TR (aka the Diagnostic and Statistical Manual of Mental Disorders, the tool mental health professionals use to make diagnoses), a phobia is a “marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).” For people with phobias (like thanatophobia), their fear or anxiety is way greater than the actual danger they face from their phobia, they go to great lengths to avoid it, and it cannot be explained by another mental health disorder.

Because thanatophobia is a type of anxiety disorder, mental health professionals will apply some of the same techniques used to treat anxiety disorders, such as cognitive behavioral therapy (CBT). (More on that in a bit!)

How common is thanatophobia?

There’s not a ton of data available on the general population, but an estimated 3 to 10 percent of people experience thanatophobia, according to the Cleveland Clinic.

Interestingly, research suggests that the prevalence of death anxiety changes with age in unexpected ways. One 2007 paper published in the journal Death Studies found that death anxiety spikes in young adults in their early ‘20s2, and then dips off. It also found that in women (but not men), death anxiety surges again in their ‘50s. While you might assume that older adults might have more fear of death (because they’re, you know, closer to the natural end of their lives), other research suggests that elderly patients have lower levels of death anxiety3 than their children.

What are the symptoms of thanatophobia?

“Thanatophobia [symptoms] can vary in prevalence depending on cultural, personal, and situational factors,” explains clinical psychologist Alexander Alvarado, PsyD, phobia specialist at Thriving Center of Psychology. Here are some of the common emotional and behavioral symptoms of thanatophobia:

  • Obsessive thoughts, including checking things constantly about your health and well-being (or that of your loved ones)
  • Avoidance behaviors around death or potentially dangerous situations (like refusing to drive or fly in airplanes, for example, out of fear of fatal accidents)
  • Severe anxiety (like feelings of dread, panic, etc.) when thinking about death. This might manifest as physical symptoms of anxiety in the form of heart palpitations, dizziness, chills, nausea, shortness of breath, etc.

This might seem a bit confusing initially; isn’t everyone afraid of dying, at least a little bit? “Having some degree of a fear of death can be functional—it might make you drive more carefully, or take extra care of yourself when you’re sick, so you can live a better quality of life,” says Dr. Schare.

But the tipping point into death anxiety can be how the anxiety manifests. Being so afraid of being in any situation that could involve death (no matter how remote the possibility) that you isolate yourself and never go out is likely closer to thanatophobia, Dr. Schare says as an example.

What causes thanatophobia?

As with any type of anxiety disorder, thanatophobia doesn’t always have a clear-cut cause. But experts believe there are some risk factors or potential triggers worth knowing.

A history of trauma or mental illness

“There isn’t a clear medical cause of thanatophobia, but it’s believed to be related to existential concerns and possibly a history of trauma,” says Dr. Alvarado. The trauma history could be related to significant life changes, such as a personal illness or near-death experience. (This could explain, for example, why nurses and emergency-services personnel had very high levels of death anxiety4 during the early years of the COVID-19 pandemic.) It’s also more likely to be prevalent in people who have a history of anxiety disorders.

Loved ones dying early

People who have experienced the death of a loved one, especially if they did not have a thorough understanding of death at that time, could be susceptible to developing thanatophobia, says clinical psychologist Tirrell De Gannes, PsyD, anxiety disorder specialist at Thriving Center of Psychology. It might be more pronounced for people who have an over-reliance on loved ones, he adds, and therefore fear what could happen if that person were to die.

Religious, spiritual, or philosophical beliefs

People have different religious, spiritual, and philosophical outlooks on death and what the aftermath of that process might look like, says Dr. Schare, whether that’s a spiritual “better place” that someone believes in, or a rebirth. Those beliefs might moderate the fear in some respects, he adds.

Other times, people believe in none of the above, and that doesn’t mean that they automatically have thanatophobia. It’s just that the fear of dying could be more pronounced if people emphasize the “unknown” aspect of what happens after death.

Interestingly, a 2017 meta-analysis published in the journal Religion, Brain & Behavior found the people who were least likely to have death anxiety were the atheists and the extremely religious5. “It may well be that atheism also provides comfort from death, or that people who are just not afraid of death aren’t compelled to seek religion,” said the researchers in a press release.

How is thanatophobia diagnosed?

If a mental health professional suspects you could have thanatophobia, or any phobia, the diagnosis involves clinical interviews. The therapist will ask you questions to assess how your fear (and its symptoms) impact your life, Dr. Alvarado says. They will take notes on how much death is a focus, adds Dr. De Gannes, whether or not the person has any sense of relief, and whether or not it affects their behaviors, such as isolating from other people or not participating in activities that could be a risk of injury or illness.

How is thanatophobia treated?

As with other specific phobias, thanatophobia is often treated with CBT. This research-backed practice will help patients challenge and change their negative thought patterns around death, says Dr. Alvarado.

Exposure and response prevention therapy (ERP) is a specific type of CBT that is commonly used with phobias. The goal is to help someone learn to manage their phobia by getting exposed to it gradually in a safe, controlled setting. “The goal is to reduce avoidance behaviors, and potentially introduce mindfulness practices to help cope with existential concerns,” adds Dr. Alvarado. No, this doesn’t involve seeing a dead body in therapy or something. Dr. De Gannes says a therapist might try the following exposures instead: talking about the topic of death, practicing having an end-of-life conversation with a loved one, and/or imagining consequences after the death of a relative.

ERP has varying intensities and styles, says Dr. Schare. It can be very literal, done in real-world environments. Think: a therapist taking someone who is afraid of bridges on a walk over a bridge, and speaking with them afterward to recap what happened and help the person understand that they are safe, he explains. Exposure therapy can also be done in virtual reality or imaginary environments, where the person, guided by a mental health professional, enters a scenario in which they could have a near-death experience, allowing them to confront that anxiety around it head-on.

Coping with thanatophobia

It is possible that the fear of life gets more pronounced with age, as people start to have more prominent health issues and start to become closer to death, says Dr. Schare. But the bottom line is that phobias and anxiety disorders can be cured, he says. The cognizance that you and your loved ones will die at some point does not go away, but people can become better equipped to cope with it.

Some coping strategies can include daily mindfulness, meditation, and journaling to help you stay present and focused on the here and now, as well as to process the fears, suggest Dr. Alvarado. You also might find relief and some additional coping skills from talking to other people in support groups about phobias, and of course from individual therapy.

Avoiding death and anything to do with it is not the most helpful way to cope with thanatophobia. “Shying away from the topic of death only increases the mystery and fear of it,” says Dr. De Gannes. He emphasizes that it’s important to normalize the concept of death in conversations to demystify the fear and help you continue to live your life.

Complete Article HERE!

Terror Management Theory

— How Humans Cope With the Awareness of Their Own Death

By Cynthia Vinney, PhD

Terror Management Theory (TMT) suggests that human beings are uniquely capable of recognizing their own deaths and therefore they must manage the existential anxiety and fear that comes with knowing their time on Earth is limited.

The theory was developed by psychological researchers Jeff Greenberg, Sheldon Solomon, and Tom Pyszczynski, who published the first TMT article in 1986.1 They based TMT on the writings of Ernest Becker, who spoke of the need to protect against the universality of the terror of death.

In this article, we’ll review key concepts of TMT, look at empirical evidence in support of TMT, explore real-life examples of TMT, and discuss how it is used across different fields.

Key Concepts and Principles of Terror Management Theory

Terror Management Theory explains that people protect themselves against mortality salience, or awareness of one’s own death, based on whether their fears are conscious or unconscious.

If they’re conscious, people combat them through proximal defenses by eliminating the threat from their conscious awareness. If they’re unconscious, distal defenses, such as a sense of meaning, like cultural worldviews, or value, like self-esteem, diminish unconscious concerns about death.2

Cultural worldviews and self-esteem are key concepts of TMT. They are both central to protection against mortality salience. David Tzall, PsyD, a licensed psychologist in New York, notes, “TMT suggests that individuals gravitate towards and defend their cultural worldviews more strongly when confronted with thoughts of mortality.”

Through cultural worldviews, people can achieve literal or symbolic immortality. Literal immortality, the idea that we will continue to exist after our death, is usually the domain of religious cultural worldviews. Symbolic immortality is the idea that something greater than oneself continues to exist after their death, such as families, monuments, books, paintings, or anything else that continues to exist after they’re gone.

TMT suggests that individuals gravitate towards and defend their cultural worldviews more strongly when confronted with thoughts of mortality.

Self-esteem plays a significant role in TMT too. “When faced with the awareness of death,” Tzall says, “people often engage in activities or behaviors that boost their self-esteem as a way to manage the anxiety associated with mortality.” In so doing, they provide the sense that they are a valuable participant  in a meaningful universe.3

These have led to two important hypotheses in TMT. First, the mortality salience hypothesis says we have negative reactions to individuals from a different group, called “outgroupers,” who present a threat to our group, and have positive reactions to those who represent our cultural values, referred to as “ingroupers.” Second, the anxiety-buffer hypothesis says strengthening our anxiety-buffer by, for example, boosting self-esteem, should reduce the individual’s anxiety about death.4

Review of Empirical Evidence Supporting Terror Management Theory

There are over 500 studies conducted in countries around the world supporting TMT. For example, one study found that raising self-esteem reduces anxiety in response to images of death.5 Similarly, increasing self-esteem reduces the effects of mortality salience on the defense of one’s worldview. When the researchers provided positive personality feedback instead of neutral feedback, their preference for a US-based author was equivalent to that of the control group, whereas participants who received neutral feedback far exceeded the control group in preference for the author.6

Another study found that worldview threats increase accessibility of death thoughts. When Canadians were exposed to a website that either derogated Canadian values or Australian values, they had far more thoughts about death when they encountered the anti-Canadian information.7

Real-Life Examples Illustrating the Application of Terror Management Theory

There are many ways that terror management theory can be applied to real life. Tzall provides some examples, such as “religion where religious beliefs and practices offer explanations for life’s meaning, purpose, and what happens after death. People will turn to religion to alleviate existential anxiety and find solace in the idea of an afterlife.”

Believing in religion may provide a chance at literal immortality, but beyond that, it can provide a cultural worldview that brings meaning and purpose to life and can alleviate mortality salience.

Likewise, Tzall gives the example of belonging to a nation that “provides a sense of identity and belonging, which can help individuals feel connected to something enduring. People may strive to achieve success, create meaningful relationships, or contribute to society in ways that leave a lasting impact.” There are all sorts of ways that people can find meaning and achieve symbolic immortality, including being part of a nation that will go on after their death.

In addition to feeling like a part of the nation, people will want to put their own stamp on the nation whether through success in industry, meaningful relationships that have a lasting impact, or other options like volunteering, having a family, or writing a book.

Implications of Terror Management Theory across Different Fields

Different fields can use TMT in different ways. For example, the most obvious may be the field of therapy and counseling. As Tzall explains, “TMT sheds light on how individuals’ psychological well-being, self-esteem, and behavior are influenced by thoughts of mortality.” Tzall continues, this “can help therapists understand existential anxiety and develop strategies to address it.”

The theory can similarly be used in marketing and advertising, but the emphasis is different. “TMT can inform advertising strategies that tap into consumers’ desires for symbolic immortality,” Tzall says. In this conception, marketers and advertisers advertise goods or services in a way that communicates their desire for symbolic immortality can be met.

Similarly, political science “can help explain the polarization of political ideologies,” explains Tzall, “and the ways in which leaders appeal to their followers’ existential concerns to gain support.” Through cultural worldviews that appreciate others like them but reject others that are not like them, leaders can exploit their followers and even lead them to rise up against others that do not agree with them, in wars, conflicts, or events like January 6th, where a small group of like-minded citizens stormed Congress.

Significance of Terror Management Theory in Understanding Human Behavior and Beliefs

Though some studies about TMT have failed to be replicated, Terror Management Theory has continued to resonate with many people. And researchers still use it to describe various events.

For example, a group of researchers used TMT to detail the COVID-19 pandemic during its height, explaining that regardless of how deadly the virus is, the risk of dying was highly salient.8 As a result, in response to the pandemic, people responded to the constant fear of death in both proximal and distal ways.

In proximal ways: drinking and eating in excess to arguing that the virus isn’t nearly as lethal as health experts claim. And in distal ways: affirming an individual’s cultural worldview to maximizing one’s self-esteem, in line with the TMT literature. As threats that remind us of our own deaths continue and expand, TMT will continue to be a leading source of understanding human behavior and beliefs.

Complete Article HERE!

Deadass Podcast’s host Bryan Perry on mission with Nicholas Smithson to talk about death openly

Deadass Podcast host Bryan Perry (left) talks with Nicholas Smithson openly about death.

By Jasmine Hines

When Nicholas ‘Nicko’ Smithson was diagnosed with stage 4 cancer, he would lie awake at night terrified of dying.

The tradesman spent years labouring in the sun and was diagnosed with melanoma when he was 38 years old.

He was given just six months to live.

“I was quite petrified of whether there was life after death,” Mr Smithson said.

“They didn’t catch it (the cancer) in time … it spread throughout my entire body, my bones, my liver, everything like that.”

Mr Smithson, who lives in Rockhampton in central Queensland, underwent intense immunotherapy and two years later is in remission.

A man with brown hair, a mustache and arm tattoos lies in a hospital bed
Nicholas Smithson at a hospital in Brisbane.

He has teamed up with his best friend, Bryan Perry, who owns a crematorium business to help demystify and start the conversation about death through their Deadass Podcast.

In denial about death

Leading palliative care researcher Adjunct Professor Elizabeth Lobb said Australians live in a “death-denying society”.

A close up headshot of a woman with short brown hair smiling
Elizabeth Lobb says it is important for people to talk about their feelings after a diagnosis.

She has spent 28 years of her life dedicated to the psychological impact of oncology, palliative care and grief.

She said people avoid the topic because it is confronting and people fear the unknown.

“It’s not something that we talk about, [but] certainly when someone receives a diagnosis of cancer, it’s one of the first things that comes into their mind,” Dr Lobb said.

She said when you did not know how to respond or help those with life-limiting diagnoses, the first step was to give people a chance to talk about their feelings.

“I often say to family members that sometimes words aren’t needed, it’s just important to listen, we can’t solve this,” Dr Lobb said.

“People who are facing a life-limiting illness can become very isolated and it can be lonely because no one wants to talk about it.”

Sharing eulogies

Mr Smithson, now 40, works for the podcast creating digital content and has been featured in episodes to share his life story, or “eulogy”.

He has been warned by health professionals that his cancer could return, and he has decided he will not seek further treatment because of the harsh impact on his body.

a man with brown hair, a mustache and blue eyes is in front of a microphone
Mr Smithson has shared his story with the podcast.

Mr Smithson said the double doses of immunotherapy led to ulcerative colitis, and his colon had to be removed.

He said working on the podcast has helped him come to terms with death.

“It’s kind of shed a bit of light and helped ease the anxiety a little bit of, if it does end up happening, I’d be OK with that,” he said.

Mr Perry, who hosts the show, said he wanted a platform to share his mate’s story, as well as other people’s eulogies before it was too late.

“We were contemplating his own mortality and discussing some of the things we’ve done together over the years and taking the opportunity to record those memories,” Mr Perry said.

“The intentions were to either keep those or to share them and even potentially have his own funeral.”

A man with facial hair and tattoos smiling bending down and posing with his medium sized white dog
Mr Perry spends so much time with death, he even named his dog Rigor Mortis.

Preparing for death

Mr Perry, who has worked in the funeral industry for more than 20 years, said people were hesitant to think about death.

He urged more people to think about it practically.

“Jot down what you want, put down what sort of songs you want, where you want to have it,” he said.

“It’s just peace of mind for the people that you’re leaving behind so that when your time does come, the family knows exactly what you want and it just lessens the burden for them.”

A man with facial hair and tattoos looks at a casket. There are stacks of caskets in the background
Mr Perry says he wants to capture more people’s eulogies while they’re still living.

Dr Lobb said not everyone was able to communicate their final wishes but she recommended those who could to consider their financial affairs and where they want palliative care to take place, whether it be at home or in a hospital.

“There’s no right or wrong and it’s very individual,” she said.

“Yes, it is devastating, it’s overwhelming, but not necessarily as fearful as [it’s] perhaps being portrayed.”

Complete Article HERE!

Psychedelics gave terminal patients relief from their intense anxiety

— End-of-life cancer patients in a therapy group in Canada used psilocybin to reduce their fears. It helped some find peace.

Valorie Masuda, left, Gail Peekeekoot, center, and Barb Fehlau participate in a grounding ceremony for staff members at Roots to Thrive, a wellness center in Nanaimo, British Columbia, in August.

By Meryl Davids Landau

When Brian Meyer received a Stage 4 prostate cancer diagnosis three years ago at age 62, he was determined to make the most of his remaining years. He immediately retired from a decades-long career in the grocery business and took every opportunity to hike, camp and — his all-time favorite — fish for salmon. Brian and his wife, Cheryl, regularly visited their two grown children and three grandsons and spent time with their many friends.

But it was sometimes hard to keep his mind off his pain and the reality that life was nearing an end. “It tugs at the heart all the time,” Meyer, from Vancouver Island, British Columbia, said in August. A calm person by nature, he found his anxiety skyrocketing.

By November, though, despite a new, highly aggressive liver cancer that shrank his prognosis to months or weeks, Meyer felt calm much of the time. The prime reason: a 25-milligram dose of the psychedelic drug psilocybin he had taken several months earlier, due to a Canadian program being watched elsewhere for the emotional benefits it may offer people nearing death.

In mid-August, Meyer and nine other people with terminal cancers had gathered in two rooms, and there, lying on plush floor mats with blankets covering their bodies, their eyes covered by sleeping masks and music piped in over headphones, they swallowed the psilocybin capsules. The consciousness-altering drug, administered by the nonprofit Vancouver Island wellness center Roots to Thrive, set Meyer and the others on a six-hour journey of fantastical images and thoughts. The hope was that this “trip” would lead to lasting improvements in mood and lessen their angst around death. It was accompanied by weeks of Zoom group therapy sessions before and after, along with an in-person gathering the evening before for a medical clearance and the opportunity for participants and their spouses to meet in person.

Canadian health-care providers have been able to offer this otherwise illegal drug since 2022 when the country’s national health-care system began a special access program for certain patients with serious or life-threatening diseases. To date, 168 Canadians have been authorized to receive the drug under the program. Similar access is not available in the United States, because a terminal patient’s right to try experimental therapies excludes psychedelics, which are banned by the Controlled Substances Act. Oregon and Colorado are in the early stages of allowing psilocybin-assisted psychotherapy due to ballot initiatives passed in the states, but people who receive the drug there could be charged with a crime under the federal law.

Clinical trials assessing psychedelics for various mental health concerns tend to administer them to patients individually. But Roots to Thrive prefers to do it in groups. “The group process in psychedelic-assisted therapy allows for a shared experience that helps people realize they are not alone in experiencing difficult emotions, symptoms or challenging life circumstances,” said Pam Kryskow, the center’s medical director.

By the time Meyer swallowed the psilocybin capsule, he felt comfortable with his cohort. Some, like Christine “Cat” Parlee, 53, who has Stage 4 melanoma that has spread to her lungs and throat, had become friends. At a restaurant where Parlee, her husband, Cory, and Cheryl gathered before the in-person meeting, Brian and Cat shared their hope that the drug experience would be joyful and that it would subsequently enhance their peace of mind.

The day after taking the psychedelic, however, sprawled on a couch in the resort room Brian and Cheryl had rented for the week, Meyer couldn’t conceal his disappointment. Although he didn’t have a negative trip, two of the other participants were overwhelmed by the drug’s intense effects and spent the hours yelling for it to stop. This repeatedly pulled Meyer away from the intriguing images filling his mind, including sword-fighting in a medieval castle yard and cooking elaborate meals of lobster and lamb in a massive industrial kitchen.

His mental journey was also interrupted by having to urinate regularly, a symptom of his prostate cancer, although he was struck by the intense spiritual connection he felt with one of the facilitators, registered nurse Gail Peekeekoot, as she touched his hands to guide him to the restroom. “It was like she was me, I was her. We were one together,” he marveled.

Psychedelic journeys don’t always proceed as people anticipate, leaving some feeling dissatisfied immediately after, said Barb Fehlau, a palliative care practitioner on Vancouver Island and the medical facilitator in the room, who herself has pancreatic cancer. Regardless of the experience while the drug is active, though, psychological healing often follows, she said.

That was the case for Meyer. In addition to his enhanced calmness, he remarked in November that taking the drug seemed to have deepened the connection he felt toward the friends and family who had streamed into his and Cheryl’s home following his worsened prognosis. “I have a way more sensitive outlook. I feel more love toward people,” Brian relayed at the time. Three weeks later, in a hospital surrounded by more than a dozen family members, Brian died. “He remained calm, peaceful and joyful” to the end, Cheryl said.

Should psychedelics ever be legalized as medicine — the first, methylenedioxy-methamphetamine, or MDMA, to treat post-traumatic stress disorder was submitted to the U.S. Food and Drug Administration in December by the MAPS Public Benefit Corporation (now called Lykos Therapeutics) — people who might benefit most are those who have a terminal diagnosis, said Anthony Bossis, a clinical assistant professor of psychiatry at New York University.

Psychedelics do not alter the course of the person’s disease, but they can help make the remaining time more meaningful, Bossis said. He is co-author of a 2016 study of 29 cancer patients that found that a single dose of psilocybin significantly reduced depression and anxiety and “led to decreases in cancer-related demoralization and hopelessness, improved spiritual wellbeing, and increased quality of life,” the study reported.

Feeling a sense of connection to something larger than themselves, akin to what Meyer experienced with Peekeekoot, may be especially important, the study found. “After this experience, people often say, ‘I realized I’m not just my cancer. I’m not just this body. I’m something more enduring.’ This is a real gift,” Bossis said.

How psychedelics might change a person’s outlook is under investigation. One study with mice this past summer by Johns Hopkins University researchers found that the drugs reopen “critical learning periods” in the brain for months after their use. Mice studies don’t translate exactly to humans, but this finding suggests that psychedelics may cause people to be especially receptive to new ideas and ways of being.

Still, the research on psilocybin for those at the end of their lives is in the early stage, and whether the drug might prove harmful for some isn’t yet known. Roots to Thrive’s unpublished research surveying 20 people from its prior three psilocybin group sessions found many felt more positive, peaceful, lighter and less stressed. But four felt little to no change.

Cat Parlee, who participated with Meyer in the August session, had taken psilocybin two prior times at Roots to Thrive in the previous 18 months. While some people experience lasting transformation after taking the drug once, Parlee found that after six months her fears and anxiety would return.

Reclining on a comfortable hammock chair on their home’s back patio the day after Parlee’s August session, her husband, Cory, says the two have come to view the psyche as if it were a cookie with pieces bitten off around the edges. “The psychedelics help Cat find the missing pieces that make her more whole,” Cory reflected. “Psychedelics help you answer questions you may not know or give yourself permission to ask.”

Cat Parlee agreed. “Every time I’ve walked out of psychedelic medicine session, I feel like I’ve left weight behind — weight I’ve consciously decided I’m not going to carry anymore,” she said. This included the negative emotions she had felt toward her deceased mother and the people who badgered her to try the cancer “cures” they read about online. “A lot of energy was wasted on a lot of anger, a lot of sadness and a lot of guilt. I realized I don’t have time to waste on that anymore,” she said.

While many people might benefit from addressing psychological issues that impede their lives, the urge to confront such demons often intensifies when a person is given a few months or years to live, according to Shannon Dames, the founder of Roots to Thrive. Most of us operate under the illusion that we have time to change these things, Dames said. “When you’re at a place when you don’t have that perception of time, there’s a calling that’s really potent.”

About a month before his death, Meyer credited the psychedelic with reducing the discomfort he felt about dying. “I don’t want to say I’m excited, but I am very curious now,” he said. He realized the mushrooms had taken him to an unknown, altered world; death would do the same.

In Parlee’s case, her fear “was that there is nothing — just emptiness — after you’re dead.” During her second psilocybin trip, she watched herself swim in brightly lit, vivid waters amid an intense feeling of love. She was soothed by the sense that experience may be similar to the afterlife.

Since her August session, Parlee has also increasingly found pleasure in standing up for her needs, rather than always worrying about other people as she had previously done. “There’s one thing I want to do before I leave this world: It’s to know that I spent my last few years happy. One thing I can say right now is I don’t have any real regrets,” she said.

Then she took a deep breath and smiled. “I don’t know if I would have ever gotten to that place without this psilocybin journey.”

Complete Article HERE!

Overcoming Death Anxiety

Although death is an inevitable part of life, most people don’t like talking or thinking about it. But for some, the dread and fear surrounding death is so intense that it interferes with their ability to live a healthy life. Here are ways to cope with your fear of death, and move beyond death anxiety to death acceptance.

What is Death Anxiety

Death anxiety, or thanatophobia, is characterized by a fear of one’s own death or a fear of the dying process. Death anxiety can manifest in a variety of ways. While older adults may be confronted by overwhelming thoughts about their own mortality, people of all ages can experience death anxiety. Some may have an excessive fear of losing their loved ones. Some may obsess over the ways they might contract a terminal illness. Others may frequently visit their doctors and request medical tests or body scans, out of fear that they have a chronic disease. Still others may worry about leaving loved ones behind after they die.

Feeling uneasy about the end of life is completely natural. Fear of the unknown and what happens after death is a legitimate concern. But when negative thoughts about death and dying prevent you from living your normal life, it may be necessary to address your anxiety towards death.

How to Cope

The first step to cope with the fear of death is to recognize that fearing death is often a normal part of the human experience. When we accept that death is natural and inevitable, we can come to terms with it and find peace. The Buddhist monk Thich Nhat Hanh’s book No Death, No Fear: Comforting Wisdom for Life is a practical place to start for those looking to overcome their death anxiety. He uses guided meditations and personal stories to help readers live a life free of fear.

People experiencing death anxiety will often avoid talking about it, which in turn negatively affects their mental health. But talking about our fears with our loved ones can be a powerful and healing strategy to overcome the fear of death. If you’re not sure how to break the ice, The Conversation Project offers free toolkits for starting conversations about death and dying. Attending a Death Cafe is another great way to discuss death in an open and supportive environment.

Another helpful way to feel more comfortable with death is to practice rituals. Whether you are religious or not, rituals can help create a sense of meaning and comfort to prepare for your own death as well as the death of your loved ones. You may choose to contemplate the loved ones you have lost and light a candle for them, or practice a death meditation to ease your mind about the inevitability of death. Diving into your family’s religious traditions and exploring new spiritual ideas can also help you move away from death anxiety toward death acceptance.

Finally, focusing on living in the present moment and enjoying every day that you are alive can serve as a powerful tool to curb death anxiety. One of the best pieces of advice from others who have conquered their death anxiety is to focus on living authentically, passionately, and well.

Complete Article HERE!

Solving for X at the End of Life

— In interviews with people who were dying, we learned they wanted to mark their final days with meaningful experiences and leave their affairs in order. It’s time to reset logistics, last days and legacy.

By Thomas Kamber

He died fuller of faith than of fears,
Fuller of resolution than of pains,
Fuller of honour than of days.
Inscription, Westminster Abbey, 1631

Why do we so often die badly? How does it happen that so many of us arrive at the end of life unprepared for the journey? Somehow, we are stumped when it comes to creating a better model of dying. Our unique qualities as individuals are lost in the processes of medical institutions and funeral homes. For those facing our last days, we have a pretty good sense of what’s involved.

A person using a video robot to view various artwork at a museum. Next Avenue
This woman was able to participate in a robot tour of the Whitney Museum by driving a telepresence robot around the museum from her hospice bed in Connecticut.

Twenty years ago, I started a nonprofit organization called Older Adults Technology Services (OATS) based in New York City that helps senior citizens build new models of aging while learning technology skills. We use design thinking methods to create new programs for social impact, using approaches like co-creation, prototyping and customer satisfaction metrics.

We met with people in their hospice beds, in their homes, and on one adventurous occasion, in the Fabergé room at the Metropolitan Museum.

Recently we turned our innovation lens toward what was happening with older people in end-of-life situations to see if we could design new programs to help them. Using a design thinking methodology, we met with people who were dying and asked questions like, “What is a good day like for you?” and “If you could change one thing about your end-of-life process, what would it be?”

We met with people in their hospice beds, in their homes, and on one adventurous occasion, in the Fabergé room at the Metropolitan Museum. Some had been told they had months left, while others were living with just a few weeks in their prognosis. We visited other hospices around the country and spoke with social workers, chaplains, elder law attorneys and service providers.  We read books on death and dying by Caitlin Doughty, Atul Gawande and Richard Rohr. We had weekly review sessions and talked to experts on business planning and branding and customer experience design.

We Are Failing at Dying

Here is what we learned.

We are failing at dying. Instead of a time for growth, deep connection, reflection and deliverance, our ends of life are consumed by petty distractions and institutional imperatives. The dying people we interviewed had not given up on life; rather they were full of desire to mark their final days with meaningful experiences and leave their affairs in order.

Yet almost everyone expressed sadness and frustration that they lacked a path for the right kind of death, the kind of passing that would reflect well the kind of life they had lived and the essence of the person they had become.

People described an entrenched group of institutions, resistant to change and wielding enormous power, which have grown to dominate the last stage of life — hospitals, funeral homes, home care agencies, religious organizations. When asked what they wanted instead people asked for three kinds of help: logistics, last days and legacy.

We were expecting ruminations on the duration of the soul, and instead people were preoccupied with getting the sheets clean and arranging pet care.

The Burden of Unmet Tasks

“Do you know someone who can come clean out my attic?” asked one woman in her fifties, fighting cancer and concerned that her overworked and grieving husband was sinking under the weight of daily tasks such as lawn mowing and housework. It was a startling response, in a bedside interview, to the question, “what’s most important to you now?” We were expecting ruminations on the duration of the soul, and instead people were preoccupied with getting the sheets clean and arranging pet care.

Logistics, it turns out, are top of mind for people who are dying. One woman spoke of her satisfaction in having arranged her funeral details and even set aside a dress to wear in her coffin. In an echo of Maslow’s famous hierarchy of human needs, the quotidian tasks form the base of the pyramid, and it seems difficult for people to elevate their thinking while still burdened with a laundry list of unmet tasks.

Many people commented on the need for legal help with logistics; writing wills, advance directives, health care proxies and financial plans. For many people, procrastination on legal matters resulted in family conflicts, loss of control over health decisions and anxiety about financial losses.

Unfortunately, once people were already in hospice, it was sometimes too late to interview lawyers and schedule notaries for important documents. Critical decisions about health, finances and death planning were left to caretakers and service providers, leaving the dying individual with little control over final decisions.

Death Needs a Reset

Being able to choose the location, activities and company of one’s last days was a recurrent theme. Despite being just days from passing, people expressed interest in writing articles, visiting museums, doing last trips with family members and exploring culture. My organization was able to arrange a robot tour of the Whitney Museum for one woman, who drove a telepresence robot around the museum from her hospice bed in Connecticut. At the end of the day, she drove the robot to the window and silently watched the sun setting over the river. 

One clear message emerged from the interviews: death needs a reset. The handoff from doctor to hospice nurse to priest to funeral director is no longer the only path.

Finally, hospice patients were predictably focused on their legacies. We spoke for hours with people about their thoughts on post-death rituals, the value of a personalized funeral and the services that might help them express their individuality after passing. There was a great deal of openness to modern, innovative funeral approaches— “living funerals,” celebratory parties after death and eco-friendly caskets and cremations.

One clear message emerged from the interviews: death needs a reset. The handoff from doctor to hospice nurse to priest to funeral director is no longer the only path. What’s at stake is no less than our self-determination as free individuals. Like any life transition, death is a chance to explore and express ourselves in our mature stage, when we have perhaps the most important things to say. Modern culture offers endless chances for tailoring this most personal of events to our unique needs, but our social discomfort talking about death blocks us from acting.

Time for Innovative Thinking

We need a new approach to this experience, with higher expectations and more focus on dying well, not just expiring.

We found some truly innovative models in our research: “death cafes” where people gathered to explore themes of mortality and end-of-life planning; alternative hospices such as the Zen Hospice in California and Regional Hospice in Connecticut; digital death planning apps and sites such as Everplans and Everest Funerals; community learning programs run by the Plaza Jewish Community Chapel; and a national dialogue and events series sponsored by the San Francisco-based nonprofit Reimagine. Unfortunately, these programs only serve a small percentage of those who want them.

Here is a vision for reshaping end-of-life services and systems in accordance with what people asked for in the interviews.

Logistics: We need insurance and financial products that recognize the need for intensive health and personal assistance during the end-of-life period and provide enhanced benefits for people who need them. Government might create tax-free plans for legal fees associated with end-of-life plans, and the service sector should increase programs to ensure that people over the age of 60 have a legal will, advance directive and other necessary basic documents.

Last days: Incubate and accelerate a new service sector focused on proper preparation and programming for end-of-life. As major life transitions go, dying is on a par with getting married or having children, so let’s build an industry of death services to rival wedding planners and baby showers. Bring on the social entrepreneurs!

Legacy: Encourage innovation at end of life. We spoke to several innovators who had to pursue legislative recourse to overturn outdated regulations that restricted new approaches in hospice and funeral care. New York City has over 10,000 nonprofit organizations but only one nonprofit funeral home. We need to open the sector to more innovation and reduce regulatory barriers to innovation.

Fear of death and decline holds a strong sway over our minds as we age, and it’s no wonder that we are reluctant to face it. But the longevity revolution means we are living longer and expecting more from each day of our lives, and technology is adding powerful tools for managing our last days and legacies. We need a new approach to this experience, with higher expectations and more focus on dying well, not just expiring.

Complete Article HERE!

Message From A Death Doula

— Everyone Needs A Death Plan (Not Just A Will)

By Hannah Frye

Death is a taboo subject in American culture. So much so that, by the time someone close to you passes, you may not have any idea how they want their affairs handled.

But according to death doula Alua Arthur, getting an “end-of-life plan” in place can make death easier to think and talk about at any age. And this plan goes far deeper than the financial and logistical items covered in a will.

Here’s how Arthur recommends making your end-of-life plan and the benefits it can bring for a well-lived life.

What is an end-of-life plan?

Arthur thinks everybody should have an-end-of-life plan. While the exact contents will be unique to each person, here are some items she recommends including:

  • Your end-of-life care: When you’re nearing the end, what kind of environment do you want to be in? Where would you like to be? What type of food do you want to eat? How do you want to feel? This will help your loved ones make the best decisions for you if you’re physically unable to. 
  • Your body & funeral service: What do you want done with your remains? Do you want a funeral? What does it look like? Any places you’d prefer not to have it? If you don’t know your options, consider looking into it. There are so many innovative and beautiful ways to handle remains you probably haven’t heard of yet. 
  • Your possessions & financial affairs: This tends to be covered in a will, but can be included in your end-of-life plan as well. 
  • Your pets & non-relative dependents: Are there any living beings you take care of that you want to pass on information about but may not be included in your will? If so, add a plan for them in this document. Consider pets here if you have any.

Now, it’s important to remember that these end-of-life plans are meant to change and evolve with you. 

If you learn about a new burial service that interests you, add it to the document. If you went to a funeral and saw something you wouldn’t want for yourself, put it in your document. This way, when you do eventually pass, your loved ones will know it’s up-to-date with your honest wishes.

Why are end-of-life plans important?

For those who prefer to shy away from discussions about death, don’t worry—you’re not alone. But here are a few reasons that making an end-of-life plan and talking more openly about death can actually help us live healthier lives:

1. Too often, we see death as “a failure”

Shoshana Ungerleider, M.D. has a unique perspective on death as an internal medicine physician and the founder of End Well–a nonprofit on a mission to change how the world thinks about the end of life.

Ungerleider says some of the strong distaste toward the topic stems from how Western medicine views death in a hospital setting. “It’s partly because we as doctors see death very, very often as a failure. And we try to do everything we can to avoid failure in medicine,” she explains.

But in the end, she notes, “Death keeps us awake to our lives.” By pushing thoughts of death away, we can actually increase the power they have over us. Making an end-of-life plan is a way to accept death for what it is and take away some of the stigma that surrounds it.

2. Speaking about it can help with death-related anxiety

On an individual level, death can be scary and anxiety-inducing to think about. The unfortunate truth is that we don’t control how we pass or when. But, what you can control (at least a little bit) is how your death is handled, hence the freeing effect of the end-of-life plan.

Knowing this part of the equation is sorted can actually bring an element of known to the unknown, potentially easing death-related anxiety.

3. A plan can help support your loved ones when the time comes

Having these big questions answered ahead of your death is a service to your loved ones who will care for you in your final days. By taking some of the work off your loved ones’s plate through pre-planning, you’ll help them grieve your passing with just a bit less stress related to logistics. Think of it as paying it forward to those who will care for you during this time.

Though it may not be accessible for everyone, working with a death doula could also prove helpful for you and your loved ones (and you can even request that in your end-of-life plan).

4. Acknowledging death can make you more present

Your considerations around death don’t need to stop once you wrap up your end-of-year plan. Instead, Arthur strongly recommends that everyone start talking about death more often. This doesn’t need to involve serious sit-down conversations. In fact, sometimes easing into it with casual topics can take away the initial shock and overwhelm.

Having more casual conversations around death can improve your quality of life and presence. Ungerleider notes that her colleague Lucy Kalanithi, M.D., often says that living and dying aren’t separate things. We’re doing both at the same time. This perspective can make death a bit less scary and unfamiliar since it reminds us that while we are living every day, we are dying every day, too.

Death keeps us awake to our lives

Making an end-of-life plan probably won’t make you completely fearless when it comes to death. But there’s a chance that it can ease your anxiety around it a bit, as well as provide support to your loved ones.

5. Don’t be afraid to ask for help

If you feel strong anxiety or fear when you think or speak about death, consider reaching out to a therapist for help. They can guide you through difficult emotions that come up and process any potential trauma that could be impacting your fear of death.

The takeaway

Death doula Alua Arthur recommends making an end-of-life plan that includes preferences related to remains, funeral services, how you’ll be cared for in your final days, and other important considerations that may not be covered in a will. If you find the topic of death uncomfortable to talk about, you’re not alone. However, getting familiar with your wishes and desires may benefit your mental health and presence, and help those around you in the long run.

Complete Article HERE!