Death Anxiety (Thanatophobia)

While fear of death is a common existential fear, some people have intense fears of themselves or a loved one dying. An extreme fear of death or the dying process, known as thanatophobia is considered as a specific fear, or phobia that is under the broader category of anxiety disorders.

As with other phobias, when thinking about the specific fear or encountering an aspect of the fear that is triggering, automatic physiological responses such as feelings of panic may be experienced. Avoidance of fear triggers, along with impairment in day-to-day activities is also present. People who experience death anxiety often avoid conversations about death. They try to avoid thinking about death, can experience dread, or have heightened anxiety about their health which may include excessive safety behaviors to avoid death.

You may be more susceptible to death anxiety if one or more of the following are present:

• You are a caregiver for a loved one who is in the process of dying.
• You have witnessed highly stressful or traumatic experiences surrounding someone’s death.
• You recently lost a parent or loved one.
• You had or witnessed a near-death experience.
• You experience psychological responses to triggers that involve topics of death.
• You avoid situations that cue death anxiety such as hospitals or funerals.

Fear of the dying process and death can be particularly scary due to the fears of the unknown and loss of control. Deathcan create many existential questions surrounding topics such as existing and then not existing, questions and fears surrounding life after death with those who remain, and beliefs about the afterlife.

Talk therapy is often a form of exposure therapy for thanatophobia since talking about death and the dying process gradually exposes the individual to increasing comfort with avoided conversation.

Cognitive behavioral strategies will help work with the thoughts, feelings, and behaviors that are present while exploring existential fears. Your therapist will work with unrealistic fears and teach relaxation strategies to help regulate and move through moments of panic. Basic exposure interventions are often incorporated to gradually help face avoided situations. While reaching out to discuss the one topic you’ve been dreading the most can be very difficult, it is a courageous first step (and can also be considered an exposure).

Written By: Charlotte Johnson, MA, LPCC