Written by James Wallace
What is death anxiety?
Death anxiety refers to the fear, unease, or apprehension surrounding the prospect of death or the process of dying. It is a common and natural human response to the awareness of mortality. Some individuals may experience mild, passing anxiety, while others may struggle with chronic and debilitating fear. Several factors that may influence the experience of death anxiety are fear of the unknown, personal beliefs, experiences of loss or danger, and cultural/religious beliefs.
Death anxiety can be considered as transcendent of diagnostic boundaries and can be found in individuals with different mental health issues. For example, someone with obsessive compulsive disorder may report engaging in a compulsion as a way of protecting themselves from germs which will lead to fatality. Someone with a health anxiety or somatoform disorder may engage in frequent medical tests and body checking as a way to calm fears of death. It is possible that someone with unresolved death anxiety may present with numerous different diagnoses or concerns at different stages of life. If treatment does not address the underlying existential concerns, this may continue to manifest in different forms of psychopathology (Iverach et al., 2014).
By acknowledging death anxiety as a transdiagnostic concept, mental health professionals can explore and address the fears that may underlie or interact with specific mental health conditions.
Research has shown that accepting death as a natural part of life is associated with reduced levels of death
fears/anxiety (Menzies, 2018). Research into interventions is still ongoing, however CBT approaches have
demonstrated some effectiveness in reducing death anxiety and hypochondrial symptoms through promoting
neutral acceptance (Menzies et al., 2021).
How can CBT be used to treat death anxiety?
Through challenging and reframing catastrophic beliefs and cognitive distortions, patients can develop alternative ways of thinking about death and dying. For example, a client may examine the evidence for and against the idea that their death will be a horrible and painful experience, with the aim to develop a more balanced belief.
Clients can learn to act against fears through addressing patterns of avoidance via exposure to situations and themes. For example, a client may visit funeral homes, prepare a will and watch death-related films.
The CBT approach may also find benefit from incorporating elements of Acceptance and Commitment Therapy (ACT) in addressing existential concerns through meaning making and living life in accordance to personal values.
Iverach, L., Menzies, RG., & Menzies, RE. (2014). Death anxiety and its role in psychopathology: Reviewing the status of a transdiagnostic construct. Clinical Psychology Review, 34(7), 580-593.
Menzies, R.E. (2018). Death Anxiety: The Worm at the Core of Mental Health. https://psychology.org.au/for-
Menzies, R.E., Sharpe, L., Helgadottir, F.D., & Dar-Nimrod, I. (2021). Overcome Death Anxiety: The Development of an Online Cognitive Behaviour Therapy Programme for Fears of Death. Behaviour Change, 38(4), 235-249. https://doi.org.10.1017 /bec.2014.14