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

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?

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?

c) the process of dying:

Will there be physical pain?

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

d) existential concerns:

What would happen to them at the moment of death?

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 https://griefsupport.co/. 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:

they don’t want to upset the dying person any further with such talk
the relationship itself could be fraught with tension and has been that way for many years
family estrangement
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
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.