Stephen A. Diamond Ph.D.

Evil Deeds

Anxiety

Dealing with Death Anxiety

Part 1: Coping with the existential crisis of the COVID-19 pandemic.

Posted Apr 21, 2020

Wikipedia
The Grim Reaper
Source: Wikipedia

Around the world, we are confronted today, both collectively and individually, with a profound existential crisis. Generally, an existential crisis  "is some subjective or objective stressor that threatens our basic sense of security, self-esteem, identity, or survival" (Diamond, 2016).

An existential crisis can occur, as psychiatrist Irv Yalom (1989) explains, when existential reality shatters our illusion of specialness: a magical, childish, and typically unconscious belief in our immunity to the tragic side of existence, to suffering, and especially, to death. 

For some, it may feel as if the so-called coronavirus (COVID-19) is stalking and killing us off, one by one. Those of us who do not serve on the front lines in the fevered fight against this virulent and devious foe--medical doctors, nurses, respiratory therapists, paramedics, etc.--or, fortunately, have not yet lost a friend, colleague or loved one to this scourge, may never witness up close and personal the stark reality of death surrounding us as did our forebears, who saw people dead and dying in the streets during the devastating "Spanish flu" (also known as "La Grippe") pandemic of 1918, and, in the Middle Ages, the Bubonic Plague or "Black Death," among numerous other historic catastrophic outbreaks of diseases such as tuberculosis, smallpox, and polio. 

But the grim reality of death is being incessantly hammered home daily on the television news, for all to see. And it is difficult to tear oneself away from watching the graphic reporting on this sad carnage and immense human suffering, much in the same way we cannot help gawking at the car wreck on the freeway. Usually, learning of the death of fellow human beings by way of the news, word of mouth or scanning the obituaries, permits us to continue to perceive and acknowledge death from a relatively safe distance, seeing it as some abstract event that tragically happens always to someone else. But, sometimes, as in this dire situation today, it can, at least momentarily, break through the massive defense mechanism regarding our own mortality, triggering repressed death anxiety. It is no wonder, then, that demand and prescriptions for anti-anxiety medications have skyrocketed since the onset of social distancing, as has, we can reasonably presume, the daily use of alcohol, cannabis, and other drugs in order to help cope with this terrifying situation and grotesque spectacle. 

What is death anxiety? To know we will die is to know death anxiety. Death anxiety can be understood as the self's striving to continue, to survive, to persevere, to prosper, thrive and multiply in a world which makes this difficult and, finally, impossible. The constant threats posed by existence itself to its own continuation, the perception of life's fragility, its inherently tenuous and ultimately impermanent, transitory nature, engender death anxiety. Naturally, all living things--including even the novel coronavirus!-- seek to live as long and fully as possible, to survive all threats to their continued existence. This seems to be an innate, instinctual tendency toward life and its perpetuation. And, in the case of the virulent and parasitic coronavirus, its survival comes at our expense. 

But, apart from human beings, do plants, or insects, or animals experience death anxiety? Perhaps so, particularly immediately prior to the moment of death. But, on the other hand, we human beings are able to think about death, anticipate it, ponder, reflect and wonder about it, and, therefore, fear it. Death, despite what science tells us, remains the great unknown. And humans carry deep within them a powerful primal fear of the unknown. No one really knows what happens when we die. But the burgeoning public fascination with the supernatural, ghosts, spirits, demons and the demonic, and with individuals who claim to be able to communicate with and speak for the dead, indicates our innate need to deny the finality of death, and to try to make meaning of it. Indeed, it could be argued that this universal need underlies our attraction to religion, which, in turn, can be seen as our collective attempts to help humankind confront, accept and make sense of the stark and brutal reality of death.

Intellectually we may acknowledge our own mortality, but deep down, we deny it. Death still tends to be a taboo subject in Western culture, as Ernest Becker brilliantly explains in his book The Denial of Death (1973). There, he argues that almost everything we do (or do not do) in life is designed to avoid consciously confronting the terrifying and terrible reality of mortality. As Sigmund Freud (1915), who wrestled personally with his own death anxiety, observed, "our own death is indeed unimaginable," concluding that "at bottom no one believes in his own death, or to put the same thing in another way, in the unconscious everyone is convinced of his own immortality." 

For many older Americans, such as myself, COVID-19 represents, consciously or unconsciously, no less than the dreaded Angel of Death (Azrael), the skeletal Grim Reaper of souls, stealthily arriving at our doorstep and knocking insistently to come in. We feel like "sitting ducks," at higher risk for sudden death due to this suffocating killer bug. The coronavirus is extremely contagious, sneaky, deadly, and, no matter how careful and conscientious we are in trying to avoid it, despite our best compulsive sanitary precautions, for some of us, infection can and will occur. That is the tragic truth. And death may ensue. Hence, our survival is subject at least as much to the serendipitous forces of fate, luck, or fortune as our own efforts. (See my prior post on luck.)

So, for some significant percentage of us--not only the sick, frail or elderly, but sometimes the strong, young and healthy--this currently incurable and sometimes fatal disease will be the ultimate cause of our own demise. Now or later on. A sobering and scary fact indeed--at least until some effective treatment or vaccine is eventually developed. This lack of complete control over our own health and destiny, being at the mercy of the vicious virus and of sheer chance, is, in itself, a source of deep anxiety for some of us. This susceptibility to imminent death is something we simply just have to live with, and not deny: it was present prior to this crisis and will continue to be even after a treatment and vaccine become available. We just may not have acknowledged and accepted it. Staring down this very real prospect naturally provokes some death anxiety, and requires psychological, spiritual, and logistical preparation. But it doesn't need to keep us from functioning, working, creating, loving, and living as fully and purposefully as we can in the present, nor from taking on meaningful future projects. (See my prior post, Staring at Sixty.)  

This is Part 1 of a 3-part series. See Part 2 here

References

Diamond, S.A. (2016). Existential therapy: Confronting life’s ultimate concerns. In H. Tinsley, S. Lease, & N. Giffin Wiersma (Eds.), Contemporary theory and practice in counseling and psychotherapy (pp. 323-352). Thousand Oaks, CA: SAGE.

Becker, E. (1972). The denial of death. New York: The Free Press.