Understanding Death Anxiety

By Joy Nugent author of As Good As Goodbyes Get – a Window into Death and Dying, My Way – One Nurse’s Passion for End of Life and Parting the Veil – Reflections on Soul

My task as a palliative care nurse was to empower people to die with confidence and to support their families in their bereavement. Death anxiety lies buried in the unconscious. I knew that people would remember me by the way I made them feel and vice versa. My intention was to have a non-judgemental attitude and to be a loving presence. There are no tried and true recipes to follow but rather an acceptance of the mystery that is life and non-life. My intention was to meet a dying person’s needs as they saw them. Deep down all people at the end of their life need to overcome fear that is associated with past trauma, unhelpful beliefs and unhealthy attachments. The following are examples of people who died having conquered death anxiety.

1. A person who has had a near death experience or a connection through the senses with a person after their physical death.

Such a person was aware of a world without physical form and enjoyed a knowledge that they would be not be alone when they died. Many reported seeing a bright light and experienced communication via a thought process. In the terminal phase of a person’s life the conversations around the bed often included seeing, or receiving a message, from a person they loved who had already died.

The following quotes come from Amazing Encounters—Direct Communication from the Afterlife - a book written by Elizabeth Keane PhD.

The unexpected appearance or presence of a loved one who has died can be a heart-stopping shock for a person in the midst of grief

Some believe they are grief-induced hallucinations—yet people remembered their encounters very clearly, even after a long time

We are all part of a greater reality—and those who have had these experiences have been blessed to touch and be touched by this greater reality

Life was not the same ever again

2. A person who follows a religion that gives them a sense of belonging.

 “the lamps are different—the light is the same.” – Rumi

In the face of death people’s rational mind may be taken over by irrational ‘knowing’. I liked to validate a change of belief but feel that this is a time when a person is vulnerable to being influenced by other’s beliefs. Each person is an individual soul with his or her own soul destiny. Sharing may be helpful but needs to be respectful and humble—finding common threads rather than attempting to convert. I used to say that God in all languages is love and suggest that an image of what gave a loving feeling be held in the mind’s eye during the dying process. This may have been a loving human connection, a place in nature or the symbol of their deity.

John Martin Sahajananda, who continues to teach in the Ashram where Bede Griffith, the great master of Christian spiritual consciousness taught, writes in his book, The Four O’clock Talks:

The role of any religion needs to be to help people to purify their egos. Converting people from one religion to another is like taking people from one branch of the tree, or from one ego, to another. Is it right to take people from one branch to another, or is it better that we help people to move beyond the branches? Christ was not focused on converting people from one religion to another, but rather on opening the door to go beyond the religions.

The question is - what language to use in religious conversations? For many people traditional religions preaching of hell fire and damnation sent messages of fear and guilt. These emotions are seldom helpful in reflecting on their life. For some the need for confession and absolution is essential. On one occasion a priest visited and gave absolution and a blessing. The man who was dying was scarcely conscious but as the priest made the sign of the cross he did also!

3. A person who follows a spiritual path other than an organised religion and perhaps has a deep knowing and dream life that intuits that it is their time

“we are spiritual beings immersed in a human experience”—Teilhard de Chardin

The following wisdom on spirituality comes from Emeritus Professor of Palliative Care Ian Maddocks AM:

A principal component of spirituality, a sense of belonging, being not alone, being in touch with something greater than self. May be found in religion, in nature, in music, in art; is closely related to love. Can lead to serenity, a preparedness for whatever is to come

M. Scott Peck is a religious psychiatrist and author of the book: A Different Drum. In this book he writes about the 4 Stages of Spirituality. The first stage is the chaos of angry manipulative people (e.g. acting like wilful children or only doing a good deed if there is something in it for them). The second stage is when these people commit themselves to an institution like the church or the army where there are rules and regulations to keep them on the straight and narrow path. The third stage is when these people begin to question these rules and norms and begin to look for good (God) outside the religious or other institutions. The fourth stage is when people discover a direct line with the God within. This is most often through mindfulness and meditation.

Carolyn Myss in her book Entering the Castle—An Inner Path to God and Your Soul writes that the ‘New Age’ isn’t new any longer and while it opened society to many spiritual traditions and alternative healing methods it needs to discover the power of intuition, archetypes and the collective unconscious and spirit. CG Jung, the Swiss psychiatrist, recognised the psyche and unconscious as vehicles for and reflections of the spiritual realm.

4. A person who has trust and faith in their doctor, hospice, nurse or substitute decision maker to make decisions in their best interest.

Palliative care has been described as an approach that improves the quality of life rather than the quantity of life for patients and their families facing the problems associated with a terminal illness, through the prevention and relief of suffering. It requires impeccable assessment and treatment of all pain that is associated with the physical, emotional and spiritual aspects of the person. All contribute to death anxiety. Ideally, this approach incorporates an accepting attitude toward death as a part of life and requires all service providers to work together in a person-centred way. Death may be the result of a life threatening illness or age. It encourages everyone to make an Advance Care Directive so that wishes are known and beliefs shared. All patients have a right to refuse treatment.

Dame Cicely Saunders, the founder of this way of care, confirmed that how people die remains in the memory of those who live on. The memory may become associated with the place of death, who was present, the manner of death or who was deemed to be in charge.

5. A person who describes themselves as neither religious nor spiritual but has taken comfort from the experiences of others in the books they have written.

To mention a few: Proof of Heaven—a Neurosurgeon’s Journey into the Afterlife by Eben Alexander MD, Life Between Lives—Hypnotherapy for Spiritual Regression Michael Newton, Many Lives, Many Masters by Brian L Weiss MD. Visions, Trips, and Crowded Rooms –Who and What You See Before You Die—David Kessler.

6. A person who holds a firm belief that death is the end of everything—dust to dust!

These people have appeared to be just as happy and content as people who have a spiritual belief in life after death. Perhaps expressing a disbelief in a life after death can be a way of just being in the Now without distracting thoughts and feelings? This state of presence is what meditators strive to achieve!

In summary to die without death anxiety, for me, is:

  1. To be prepared to listen to my soul’s prompting as to timing.
  2. To know death as a fulfilment of earth school where the graduating stage is an environment of love and peace and the air is filled with healing sounds.

To participate in the process of dying and to visualise my soul as a capsule of vibrating love and light energy leaving behind a no longer needed physical form to explore the cosmos.

Frank Stillitano