fear of dying

Death anxiety is anxiety caused by thoughts of one's own death, and is also referred to as thanatophobia (fear of death). Death anxiety differs from necrophobia, which is the fear of others who are dead or dying.

Psychotherapist Robert Langs proposed three different causes of death anxiety: predatory, predator, and existential. In addition to his research, many theorists such as Sigmund Freud, Erik Erikson, and Ernest Becker have examined death anxiety and its impact on cognitive processing.

Death anxiety has been found to affect people of differing demographic groups as well, such as men versus women, young versus old, etc.   

Additionally, there is anxiety caused by death-recent thought-content, which might be classified within a clinical setting by a psychiatrist as morbid and/or abnormal. This classification pre-necessitates a degree of anxiety which is persistent and interferes with everyday functioning. Lower ego integrity, more physical problems and more psychological problems are predictive of higher levels of death anxiety in elderly people perceiving themselves close to death.

Death anxiety can cause a person to become extremely timid or distressed when discussing anything to do with death.

Findings from one systematic review demonstrated that death anxiety features across several mental health conditions.

One meta-analysis of psychological interventions targeting death anxiety showed that death anxiety can be reduced using cognitive behavioral therapy.

Types

Robert Langs distinguishes three types of death anxiety:

Predatory death anxiety

Predatory death anxiety arises from the fear of being harmed. It is the oldest and most basic form of death anxiety, with origins in the first unicellular organisms' set of adaptive resources. Unicellular organisms have receptors that have evolved to react to external dangers, along with self-protective, responsive mechanisms made to increase the likelihood of survival in the face of chemical and physical forms of attack or danger. In humans, predatory death anxiety is evoked by a variety of dangerous situations that put one at risk or threaten one's survival. Predatory death anxiety mobilizes an individual's adaptive resources and leads to a fight-or-flight response, consisting of active efforts to combat the danger or attempts to escape the threatening situation.

Predation or predator

Predation or predator death anxiety is a form that arises when an individual harms another, physically and/or mentally. This form of death anxiety is often accompanied by unconscious guilt. This guilt, in turn, motivates and encourages a variety of self-made decisions and actions by the perpetrator of harm to others.

Existential

Existential death anxiety stems from the basic knowledge that human life must end. Existential death anxiety is known to be the most powerful form of death anxiety. It is said that language has created the basis for existential death anxiety through communicative and behavioral changes. Other factors include an awareness of the distinction between self and others, a full sense of personal identity, and the ability to anticipate the future. The existential psychiatrist Irvin Yalom asserts that humans are prone to death anxiety because "our existence is forever shadowed by the knowledge that we will grow, blossom, and inevitably, diminish and die."

Human beings are the only living things that are truly aware of their own mortality and spend time pondering the meaning of life and death. Awareness of human mortality arose some 150,000 years ago. In that extremely short span of evolutionary time, humans have fashioned a single basic mechanism through which they deal with the existential death anxieties this awareness has evoked: denial. Denial is effected through a wide range of mental mechanisms and physical actions, many of which go unrecognized. While denial can be adaptive in limited use, excessive use is more common and is emotionally costly. Denial is the root of such diverse actions as breaking rules, violating frames and boundaries, manic celebrations, directing violence against others, attempting to gain extraordinary wealth and power, and more. These pursuits are often activated by a death-related trauma, and while they may lead to constructive actions, more often than not they lead to actions that are damaging to self and others.

Theories

Thanatophobia

The term ''thanatophobia'' stems from the Greek representation of death, known as Thanatos. Sigmund Freud hypothesized that people express a fear of death as a disguise for a deeper source of concern. He asserted the unconscious does not deal with the passage of time or with negations, which do not calculate the amount of time left in one's life. Under the assumption people do not believe in their own deaths, Freud speculated it was not death people feared. He postulated one does not fear death itself, because one has never died. He suspected death related fears stem from unresolved childhood conflicts.

Thanatophobia is not only death anxiety, but can mean an intense fear, feelings of overall dread in relation to ones thinking about death. Usually as it relates to their personal death. Death anxiety can mean: fear of death, fear of dying, fear of being alone, fear of the dying process, etc. Different people experience these fears in differing ways. Klein in 1948 states that Humans are the only species that have a have a sense of what the limitations associated with life are and because of this, , having a fear of death as what the root of anxiety is. There continues to be confusion on if death anxiety, is referring to death itself, or the process of dying.

Those who are in the last stages of physical existence will undergo a series of stages in the winding up scenes of life. In Kubhler-Ross book ''On Death and Dying 1969'', she states what the stages a person experiences in preparation of death. These are the stages: 1) denial that death is soon to come, 2) resentful feelings to those who will yet live, 3) bargaining as was of coping with the idea of dying, 4) feeling depressive that death is inescapable, 5) then finally acceptance.

Wisdom: ego integrity vs. despair

Developmental psychologist Erik Erikson formulated the psychosocial theory that explained that people progress through a series of crises as they grow older. The theory also envelops the concept that once an individual reaches the latest stages of life, they reach the level he titled as "ego integrity". Ego integrity is when one comes to terms with their life and accepts it. It was also suggested that when a person reaches the stage of late adulthood they become involved in a thorough overview of their life to date. When one can find meaning or purpose in their life, they have reached the integrity stage. In opposition, when an individual views their life as a series of failed and missed opportunities, then they do not reach the ego integrity stage. Elders that have attained this stage of ego integrity are believed to exhibit less of an influence from death anxiety.

Terror management theory

Ernest Becker based terror management theory (TMT) on existential views which added a new dimension to previous death anxiety theories. This theory ascertains that death anxiety is not only real, but also people's most profound source of concern. He explained the anxiety as so intense that it can generate fears and phobias of everyday life—fears of being alone or in a confined space. Based on the theory, many of people's daily behavior consist of attempts to deny death and to keep their anxiety under strict regulation.

This theory suggests that as an individual develops mortality salience, or becomes more aware of the inevitability of death, they will instinctively try to suppress it out of fear. The method of suppression usually leads to mainstreaming towards cultural beliefs, leaning for external support rather than treading alone. This behavior may range from simply thinking about death to the development of severe phobias and desperate behavior.

Religiosity can play a role in death anxiety through the concept of fear. There are two major claims concerning the interplay of fear and religion: that fear motivates religious belief, and that religious belief mitigates fear. From these, Ernest Becker and Bronislaw Malinowski developed what is called "Terror Management Theory." According to Terror Management Theory, humans are aware of their own mortality which, in turn, produces intense existential anxiety. To cope with and ease the produced existential anxiety, humans will pursue either literal or symbolic immortality. Religion often falls under the category of literal immortality, but at times, depending on the religion, can also provide both forms of immortality. Through Terror Management Theory, and other death-focused theories, there is a distinct pattern that develops indicating that those who are either very low or very high in religiosity experience much lower levels of death anxiety, meanwhile those with a very moderate amount of religiosity experience the highest levels of death anxiety. One of the major reasons that religiosity plays such a large role in Terror Management Theory, as well as in similar theories, is the increase in existential death anxiety that people experience. Existential death anxiety is the belief that everything ceases after death; nothing continues on in any sense. Seeing how people deeply fear such an absolute elimination of the self, they begin to gravitate toward religion which offers an escape from such a fate. According to one specific meta-analysis study that was performed in 2016, it was shown that lower rates of death anxiety and general fear about dying was experienced by those who went day-to-day living their religion and abiding by its practices, compared to those who merely label themselves as a member of a given religion without living in accord to its doctrines and prescribed practices.

A 2009 study on death anxiety in the context of religion showed that Christians scored lower for death anxiety than non-religious individuals, which supports the main tenets of terror management theory, that people pursue religion to avoid anxiety about death by finding comfort in the ideas about afterlife and immortality. Interestingly, the study also found that Muslims scored much higher than Christians and non-religious individuals for death anxiety. These findings do not support terror management theory, the belief in an afterlife for Muslims in the study caused more anxiety than those with no belief in an afterlife. This finding highlights a need for further examination into TMT in the context of different religions/sects as well as the impact of varying beliefs about afterlife on levels of death anxiety. Another study on religions and Muslims stated that death is not a taboo topic for them. This could be another reason as to why they are not as anxious about death.

Heidegger's being-for-death

The German philosopher Martin Heidegger wrote about death as something conclusively determined, in the sense that it is inevitable for every human being, while on the other hand, it unmasks its indeterminate nature via the truth that one never knows when or how death is going to come. Heidegger does not engage in speculation about whether being after death is possible. He argues that all human existence is embedded in time: past, present, future, and when considering the future, we encounter the notion of death. This then creates angst. Angst can create a clear understanding in one that death is a possible mode of existence, which Heidegger described as "clearing". Thus, angst can lead to a freedom about existence, but only if people can stop denying their mortality (as expressed in Heidegger's terminology as "stop denying being-for-death").

The American philosopher Sidney Hook criticized Heidegger's view of death anxiety in his review of Heidegger's book ''Being and Time'' when it was translated into English in 1962. Hook noted that for Heidegger, death anxiety "is a primordial anxiety, not something that waxes and wanes with changes in nature, history or society", and the anxiety is about "the possibility that one's existence may at any moment become finally impossible". Hook argued that Heidegger's claims were wrong:

Meaning management theory

Paul T. P. Wong's work on the meaning management theory indicates that human reactions to death are complex, multifaceted and dynamic. His "Death Attitude Profile" identifies three types of death acceptance as Neutral, Approach, and Escape acceptances. Apart from acceptances, his work also represents different aspects of the meaning of death fear that are rooted in the bases of death anxiety. The ten meanings he proposes are finality, uncertainty, annihilation, ultimate loss, life flow disruption, leaving the loved ones, pain and loneliness, prematurity and violence of death, failure of life work completion, judgment and retribution centered.

Existential theories

The existential approach, with theorists such as Rollo May and Viktor Frankl, views an individual's personality as being governed by the continuous choices and decisions in relation to the realities of life and death. Rollo May theorized that all humans are aware of the fact that they must one day die, reminiscent of the Latin adage ''memento mori

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