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Recent Articles

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Having Conversations About Death Anxiety – the fear of dying

Brief Description:

Discover the reasons for death anxiety, including the patient’s response, the family’s response, why it is so difficult to have these conversations with loved ones and where to get help if you find it difficult to have these conversations.

The occurrence of death anxiety

Many people who have life-limiting illnesses use their time, at some point, to reflect on their behaviour and purpose in life, and often feelings of death anxiety comes up as well during this time.  This rise in feelings of the fear of dying is natural and perfectly normal.  And people in this situation typically need someone to process these thoughts and feelings with because if often brings up big life (existential) questions about their purpose and identity.  For some, they end up having to re-think their purpose or integrate a new sense of identity.  The fear of dying brings up big feelings within themselves, about themselves, but also brings up big feelings about their relationships with family and friends.

Why this work to help alleviate death anxiety?

The services I offer have been borne out of the needs of people I have come across in my places of work in the primary healthcare and secondary social care sector as well as in the community.   I hope that what I write will be, not only of interest, but of benefit to you or people whom you know within your networks.  I also hope that this website will be an interactive space whereby people can comment and respond to the blogs I have written, so that a community of shared wisdom grows here.  I have been working in the field of trauma, loss, grief and bereavement with different age groups for over 25 years.

And it is always a pleasure to create a space for people to be emotionally connected to a deeper part of themselves in order to grow courageously stronger in themselves and in their connections with others again in more deepening and meaningful ways.  I find it very fulfilling and satisfying work to help people find ways of coping and alleviating their spiritual and emotional pain, worries and anxiety.  In my work in companioning and supporting people in hospice care, I would come across people who were scared of dying – for different reasons.  So, I would have a conversation with them to explore what their ‘death anxiety’ was about and the reasons will vary.

Reasons for death anxiety

  1. a) unresolved guilt for having done or said something they should not have done or said:

Should they try to broach the subject again many years on?

How would they bring it up again?

What if it brought up old wounds for either of them?

What if they were not effective in resolving the matter this time around?

  1. b) unresolved conflict:

What would the consequences be of not resolving it?

What impact would it have on the current and future generations after they died?

  1. c) the process of dying:

Will there be physical pain?

Will they be able to cope with the pain as their body deteriorated?

  1. d) existential concerns:

What would happen to them at the moment of death?

  1. e) family concerns:

What would happen to their family and how will they cope (or not) without them?

This blog relates to the Transition Companioning service I provide at  If you would like more information about this service and how I could help, please go to the Transition Companioning page.  You can also subscribe on the Home page to receive more blogs about this topic and other related topics.

Patient’s response to death anxiety

There are many, many reasons why people might be anxious about dying.  These concerns, worries or anxieties can be quite strong, and understandably so, because the transitioning of the spirit out of the body at the point of death is a significant rite of passage.  Having or talking about death anxiety is not something to be ignored or dismissed lightly, because for some, it can become a spiritual crisis.  This can leave people feeling ill at ease, restless and sometimes with manifestations of physical symptoms that can’t be diagnosed and ‘cured’ with medical interventions.  Predominantly, this anxiety is about uncertainty.

There are many uncertainties in life – some are relatively minor in the grand scheme of things, such as worries about exam marks; some of them are major, such as who to marry, if at all, or what country to live in.  But death anxiety is a much bigger anxiety because it is about the Great Uncertainty of what will happen to our spirit and soul when it leaves our body.  What happens to our animating energy that keeps us upright, moving, working and laughing?  If you have ever seen a person in an open casket, that question hits you immediately.  Where does that animating spirit go and what does it do after it leaves the body?  These are fascinating questions.  And worthy questions to explore in terms of where the dying person would like to go and what they would like to do after their animating spirit leaves their body.

Family member’s response to death anxiety

Friends and family members might, understandably, find it uncomfortable to talk with the dying person about their death anxiety – for various reasons:

  1. they don’t want to upset the dying person any further with such talk
  2. the relationship itself could be fraught with tension and has been that way for many years
  3. family estrangement
  4. a family member may have a different kind of spirituality from the dying person and so may not have a similar spiritual language in order to converse in a way that can be understood between them
  5. they may not have the knowledge or the practice-based experience of having these types of conversations

It can be hard to know how to respond.  So, even if the topic is brought up in discussion, some people find themselves discussing it in a hurried fashion, without many pauses for deep reflection in order to help the dying person process their emotions.  After all, no one wants to see a loved one in distress or in a state of anxiety so the topic could be discussed quickly then ‘swept under the carpet’.

Why is it so difficult to have conversations about death anxiety?

Recently, I came across two comments from different places in the community setting which came from daughters who were concerned about their parent’s death anxiety but didn’t know how to broach the subject with their parents.  One person was commenting about it on Twitter, so I didn’t have an opportunity to say much in response (given the limited letter count!)  The other person, who reached out to me and commented about it, was someone I knew from the NHS (National Health Service) so I was able to have a longer conversation her.  I reassured her by asking if she had attempted to broach the subject before her parent died, and if her parent had said yes to having death anxieties, would she know how to respond?  She admitted that she wouldn’t know how to respond.

Having a conversation about matters such as death anxiety, the spiritual world in the afterlife (and whether there is one or not), forgiveness and being absolved of any lingering guilt that the dying person might have (which some people crave & need) is not the kind of skill set that most people have developed and honed over their lifetime; not unless it is specifically part of their job and/or training as a spiritual care provider.  So why beat yourself up over it, I asked her.  That seemed to help in alleviating her guilt about missing the opportunity to have ‘the conversation’ with her mother before she died.

Getting help for death anxiety

But for some, the very idea might nevertheless be too close, too emotionally raw, too uncomfortable a discussion to have.  And there’s nothing to be embarrassed about, nor feel guilty about.  It simply isn’t a topic that some people relish discussing.  But for those who have entered this specialised profession, this is very meaningful and satisfying work.  From my professional experience, I have found that these opportunities to discuss a person’s death anxiety has provided emotional regulation and perhaps even healing for the dying person.

If you know of someone who might benefit from a conversation or two to alleviate their anxieties about dying, so they can be more at peace within themselves before transitioning out of their bodies, then have a look at the Coaching page for more info.

If you know of someone who might benefit from having regular, longer, ongoing conversations as they near the end of their life then have a look at the Transition Companioning page for more info.

As I continue to blog, I will be writing about issues that you tell me concern you and each aspect of the services I provide on my website.  If you would like to receive more of my blogs or to ask a question that you’ve been wondering about then please subscribe on the Home page.  I might be able to refer to or address it briefly in a future blog.

Further Reading

If you would like to read more about this topic, here is another article you could read

Written by Santou Carter – to view Santou’s CTUK directory listing, please click here.

Letting Go of Being Right – Why it’s Important in Your Relationship

Written by Geoff Lamb – UKCP Registered Therapist specialising in working with individuals, couple and groups (5 min read)

There are areas in life when it’s really important to get things right – if you’re a brain surgeon or an air traffic controller for instance. Even then though, the importance isn’t personal, but a matter of others’ safety. In relationships, being right really isn’t that important. Neither is it personal, but so many couples I see spend a lot of time and energy arguing about who’s right, often about quite trivial matters such as how to load the dishwasher correctly, but sometimes about more serious things like money, sex and how to educate or discipline the children.

To blame the couples themselves isn’t helpful and misses the point. The culture we live in supports what’s called ‘dualistic thinking’. In other words, things are either right or wrong, black or white. If I’m right, then you must be wrong and if you’re right I must be wrong. Apart from the fact that most life situations just aren’t like this, it’s the significance we attach to being right or wrong that’s most damaging for couple relationships. This is when it becomes personal. It doesn’t need to be, but somewhere along the line, many of us have learned to value ourselves according to whether we’re (seen to be) right or wrong. It’s not just about getting something wrong, but about being wrong, in other words there’s something wrong with us if we’re seen, or even thought, to be wrong. Our whole being is on the line.

You’ll know if this is the case with you if you find yourself either needing to correct your partner if they say something which suggests that you did something wrong or were wrong about something or you find yourself needing to justify why you did what you did.

‘But’, you might say, ’don’t you think it’s important to correct your partner if they’ve clearly misunderstood something you did or said or maybe didn’t understand why it was so important or justified?’

Perhaps, but just observe what happens when you’re in this kind of situation – notice particularly where your attention is. What you’ll mostly find is that your attention isn’t on your partner or even what he/she said, but on the uncomfortable feeling of being misunderstood, on whether what he/she said is true or what you’re going to say in response. If your partner responds to you in a similar manner, then you have a situation in which neither of you is listening or feels listened to. Responses to this vary, but often, when we don’t feel listened to, we speak louder or longer, or both. Communication becomes impossible.

If you can let go of being right, then something different can happen. There are two possibilities. You may have done or said what your partner is talking about and it may have had an impact on him/her. It’s also possible that you didn’t. If you’ve let go of needing to be right, it doesn’t really matter which it is. Letting go of this need means you can listen in a different way, with curiosity rather than defensiveness. The focus is then not on whether what your partner is saying is true or not, but on your understanding of where they’re coming from.

So, how do we go about letting go of being right and what might get in the way? The answer is that it’s not easy and it’s probably not a good idea to let this become another thing you have to get right! Recognising when you’re doing it is probably the best place to start. Most of us won’t be aware of it when it’s actually happening, mostly, as I’ve said, because our defences have been triggered and we feel under threat. Afterwards, though, it can be good to take some time to reflect on what was actually going on for us. What were we defending and how was this being threatened? Becoming aware of how defensive we’re being in our arguments with our partner will eventually lead to change, especially when we combine this with a commitment to doing something different.

As for what gets in the way, there can be a number of things. Some people might think that, unless both partners in the relationship are committed to this kind of awareness and doing things differently, it won’t work and there’s no point. This seems logical, but it’s only partly true. It’s probably easier if both partners are committed to the same goal, but don’t let that put you off. If you’re ready to let go of being right and your partner isn’t, trying to make or even persuade them could be counterproductive. The message they’ll hear is that they’re ‘getting it wrong’, which could well trigger the very defences that are making your communication so difficult in the first place.

The best advice I can give is, don’t wait for your partner. Do it for yourself. There will be two consequences. First, if you start to listen to your partner with curiosity rather than defensiveness it’ll be very difficult for them to sustain an argument with you about being right. Second, and this is something that can get in the way, in order to listen differently and to let go of your need to be right, you’ll need to find a different way of valuing yourself. This isn’t easy. In fact, it’s actually very challenging as it means going against our culture and often our upbringing. It is very liberating though, not just in our relationships, but in the rest of our lives.

Two more points. The first is that what I’m talking about here isn’t compromise or ‘agreeing to differ’. These may both have their place in business and politics, but they won’t, in themselves, improve a relationship while the defensive communication I’ve been talking about is still in place. All that happens then is that the need to be right just goes underground and surfaces in more negative indirect forms. Examples of this are the ‘I told you so’ moments I’m sure we all recognise and the relationship becoming transactional, where, because I’ve compromised on this, it’s now your turn to let me have my own way about that.

Finally, I’m clearly writing this as a couple and individual therapist. If it was as simple as following the principles in this article, or in some of the many self-help books available, I’d be out of a job. It isn’t. It’s a good start, but sometimes we need support, either as a couple or an individual, with spotting our own patterns as they occur and feeling safe enough to do something different. This is where the help of a qualified and experienced therapist can be invaluable.

To view Geoff’s Directory Listing, please click here.

How to help build your child’s resilience.

If you are a parent of someone who is close too or cares for a child then you’ll know how upsetting and daunting it can be when it comes to mental health issues, especially if we have any worries or concerns.

One way we can help our children to deal with what life throws at them is to help them to become more resilient.

Resilience is a child’s ability to cope with an event that is often challenging and brings about change, such as changing school, death of a loved one, divorce, etc.

In times like this it is perfectly normal for children to experience some stress and anxiety and as parents/carers we can do an awful lot to help them through it, to learn new skills and ways of coping that children can carry forward with them into the future.

So what can you do to help?

I’d like to offer you 5 suggestions for helping children to become more resilient.

Here we go….

(1) Feelings

Let your child know that ALL feelings are ok, that there is no right or wrong way to feel, even feelings they may consider bad such as anger, rage and sadness.  Help them to recognise that feelings will pass is time.

So when you ask them how they feel and they say, ‘angry’ you could say something simple such as, ‘You’re feeling angry right now. I understand that considering (insert whatever they have experienced here) and that’s ok, I’m pleased you can tell me how you feel.’

This will show your child that you have heard them, you understand them and it is ok for them to feel however they are feeling.

(2) Respect their right to independence

This can be tough for both parents and children in some ways as although we need to have rules to protect our children, we also need to get the balance right and give them enough space and freedom to grow into mature, responsible and confident young people.

It’s important to allow children to make their own choices and decisions and sometimes they will make mistakes but what this does is gives them the opportunity to learn from experience and gives them room for emotional growth.

(3) Socialise

Children are social creatures by nature and it’s our job as parents and carers to ensure that our children spend enough time with others to learn the social skills they need as they move through life. More so, by building friendships and trust with others will give your child a circle of people they can talk too, to learn from and to turn to in times of need.
So arrange those play dates, get in touch with friends or family you haven’t seen in a while and go spend some quality time together.

(4) Relaxation

In this hectic world of technology and fast moving just about everything, it is important for children to be able to switch off sometimes. Ensure that your child has a range of activities available to them that can help them to unwind such as reading a book, colouring in, playing outside or having a bath. Their little minds need to switch off sometimes too.

(5) Help others

Children can learn a lot about themselves through helping others. Helping others can help childen to develop a sense of who they are, how they matter and how they can make a difference in the world.

Some ideas might be to volunteer at a local charity (with adult supervision), raise money for a charity of their choice or as my own son asked recently, ‘can we take part in a litter picking day so animals don’t get hurt by it?’

Giving back makes us feel good about ourselves, children included and it is particularly good for children who are struggling with self-worth.

I hope you’ve enjoyed reading these tips to help build your child’s resilience and have in mind how you can put them into action now.

If you have any questions or anything you’d like to add please do leave a comment below.

Written by Maria Albertsen –

An Introduction to Trauma Therapy

Trauma therapy can help people recover from a wide variety of traumatic events, such as: war, natural disasters, terrorism, rape and sexual abuse, domestic violence, car accidents, being a victim of crime and witnessing distressing events. People often begin looking for trauma therapy when they are wondering if they have Post Traumatic Stress Disorder (PTSD) but you don’t need to have been diagnosed with PTSD to seek more specialized therapy.

What is PTSD?

PTSD is the name for a collection of reactions and experiences you may have in the weeks following a traumatic event. It is completely normal to feel distressed following a trauma and developing PTSD does not mean there is something wrong with you. It simply means that you may need some help with processing what happened to you so that your mind and body can fully recover. It is important to remember that PTSD responses are NORMAL RESPONSES TO ABNORMAL EVENTS.

A person with PTSD or Complex PTSD (C-PTSD) will have experienced or been exposed to actual or threatened: death, serious injury, and sexual violence. This can be in a number of ways: direct exposure, witnessing the trauma, and indirect exposure to the trauma through the course of professional duties (e.g. psychological therapists, first responders and medics.)

Responses (or symptoms) associated with PTSD:

  • Sleep problems
  • A sense of foreshortened future i.e. a pervasive and persistent belief that you will not be alive for very long. Due to this, you may struggle to think in the long term.
  • Hypervigilance (being constantly on alert) & increased startle reflex
  • Reduced tolerance to noise
  • Difficulty concentrating
  • More emotional and more intense emotions which may lead on to big emotional outbursts
  • Avoidance and numbing of anything which may remind you of the traumatic event. This is also having a profound impact on your day to day living.
  • Reliving the trauma through nightmares, flashbacks and intrusive memories.
  • Difficulty remembering all or significant portions of the trauma
  • Risk-taking or risky behaviours.

These responses need to have been present at least a month before PTSD should be diagnosed. It’s worth bearing in mind that children and young people may present differently so if you have any concerns, you can discuss those with a mental health professional or GP.

What is Complex PTSD?

C-PTSD most commonly develops after prolonged or repetitive events from which escape is very difficult or impossible. For example: Repeated childhood sexual or physical abuse, domestic violence, slavery, torture and genocide.

It has the same core features as PTSD but there are 3 additional characteristics present.

  1. “Severe and pervasive problems in affect regulation” (6B41; ICD-11): This is extensive problems in managing mood and emotions, especially to unexpected or spontaneous events.
  2. Persistent difficulties in maintaining any beliefs about oneself as having any worth. As well as deep feelings of shame, guilt, or failure that are related to the traumatic event.
  3. Persistent difficulties in sustaining relationships. Difficulties in feeling close to others. This is pervasive and cause significant impairment in the person’s function in multiple areas; personal, social, educational, occupational and any other important areas.

Both PTSD and CPTSD have dissociative aspects; most often depersonalisation and derealisation

What therapy is available?

You may have heard a few therapies mentioned when you search for trauma therapy. With a few exceptions, most therapy approaches can be trauma-informed. It has always been the case that the relationship ad how you feel about the therapy that is the most important factor in the level of success following a treatment. So often it is a bout find a good match with you and therapist, how you like to work, and what you’re capable of doing at this moment in time. For example, if you are finding it hard to concentrate and focus right now, the best approach might be one where the therapist is able to provide a framework you can work with.

  • Psychotherapy; Cognitive Analytical Therapy – helpful for deeper analysis of trauma
  • Cognitive Behavioural Therapy (useful for helping to identify destructive thought patterns developed in relation to the trauma)
  • EMDR – helps to reduce PTSD responses
  • Person-centered therapy – helpful for going at own pace
  • Mindfulness – helpful in remaining in present and reducing stress

Some exceptions:

If you experience dissociation as part of your PTSD/CPTSD, mindfulness is not advised. Mindfulness mimics many aspects of dissociation. You can, however, learn grounding techniques which are the foundation of mindfulness. Ask your therapist to teach you some or search online to get an idea of what they are.

If you have Dissociative Identity Disorder (DID) then EMDR is NOT advised by the International Society for the Study of Trauma and Dissociation unless the counsellor is knowledgeable in the treatment of dissociative disorders. When being used to treat DID a modified version of EMDR is used. This is not routinely taught. It is okay to ask a counsellor what their credentials are. Your safety is paramount and no EMDR of any kind should be happening if the person receiving treatment isn’t stable or is unable to have internal cooperation between the identities to allow for dual awareness.

Who are we?

UK Counsellors Directory is run by qualified and experienced counsellors from Counsellors Together UK (CTUK). CTUK is the UK's largest counsellors campaign group with almost 8,000 members. Our main aim is to work together to end the culture and prevalence of unpaid work within our profession. We are also the founder of the UK's National Counsellors' Day.

National Counsellors’ Day

National Counsellors' Day takes place on 22nd June. Our aim is to raise the profile of the counselling profession. We also hold a yearly conference and counselling awards.

Counsellors Together UK

The UK's largest counsellors' campaign group with almost 8,000 members.