Reminders of Death
Everyone eventually dies. Despite this commonality, psychologists like Gordillo et al., (2007) have found that being reminded of our own demise (i.e., mortality salience) can change several of our thoughts and behaviors due to the emergence of imminent death anxiety.[1] Whether we are aware of it or not, we typically become more fearful and sad following death reminders, and our behavior is subsequently impacted[2] as we work towards protecting ourselves through self-preservation. Fritsche et al. (2007) found an increase in reproductive behaviors and desire for offspring and Rosenblatt et al. (1989) found an increase in the defensiveness of culturally-upheld values after mortality becomes salient.[3,4] These findings relate to the evidence-based Terror Management Theory (TMT), which states that death anxiety is a primary motivator for all human behaviors.[5] TMT adds that every culture preserves ideas of immortality to reduce the feelings of this “terror” or anxiety such as memorials, symbolic afterlives and statues. Death anxiety and its impacts on people provide insight into several processes of the human condition as well as mental health treatment and practice.
Mortality Salience in Everyday Life
Presentations of mortality salience (MS) may appear as: viewing a cemetery on the way to work, witnessing constant sickness and death as a healthcare worker, viewing violence and danger on television, seeing an ambulance on the freeway, or anything that may remind someone of their own danger. By fMRI (functional magnetic resonance imaging), the parts of the brain that can be activated after MS include the prefrontal cortex (involved in self-regulation), to regulate and motivate defense of concerns of death.[6] The right amygdala (important for emotional processing), and the behavioral inhibition system (BIS) as well as general anxiety systems, are also involved.[7] Xu et al. (2022) found that MS also increases activation in areas of the brain regarding guilt and shame as one experiences death anxiety.[8]
Changed Behaviors
Cultural Values
A person’s thoughts and behaviors typically change after they are reminded of their mortality. When self-esteem (i.e., a person's sense of their worth) is high, it is found to be a protective buffer against fears surrounding death.[9,10] Furthermore, Basset & Bussard (2021) found that the strength of one’s religious beliefs and actions increases as fears of death conversely decrease, suggesting that religion can help protect oneself from death anxiety and boost self-esteem.[11,12]
The impact of the perceived mortality reminder also depends on whether it was felt individually or collectively. Utilizing data across 79 countries, Fog (2023) found that mortality salience of individual danger (danger to oneself) reveals increased religious behavior but no effect on religious beliefs, less regard toward authorities and less nationalism.[13] On the contrary, perceived collective danger (danger to a group of people including oneself) tends to result in increased nationalism, traditionalism, security, religiosity and strict sexual morals.[14] Additionally, Rosenblatt et al. (1989) found that after mortality salience, judges fined prostitutes more and declared harsher punishments, upholding negative views toward prostitution while promoting culturally conservative values.[15] Rosenblatt et al. also found that people promote “heroism” following MS. They found that college students that were primed with a death reminder (when compared with a control group) gave three times as large of a reward to a fictional hero as well as a more severe punishment to a fictional non-violent criminal.[16]
Decreased Altruism
Possibly in an effort to maintain self-preservation, reminders of death tend to lessen a person’s altruism (i.e., behavior that is unselfishly beneficial to others).[17] Kheibari et al. (2023) found that those with low self-esteem, tend to develop increased stigma about suicide once they face MS.[18] In addition, respondents reported a lower likelihood to intervene and try to prevent another’s suicide, and they responded that they would allocate less money to suicide prevention organizations.[19]
Risk-Taking and Safety Behavior
Being reminded of death has risk-taking implications. Weng et al. (2023) found that among publicly traded firms in the United States, MS inflicted on the director or CEO led to decreased long-term investment by firms.[20] Bessarabora & Massey (2023) also found that MS produced adaptive opinions towards texting and driving, resulting in greater attempts at safe driving and self-preservation.[21] Li et al. (2023) note that people were impacted by the death anxiety caused by negative media exposure during the COVID-19 pandemic.[22] As a result, employees were shown to follow increased human resources practices (e.g., workplace safety behaviors) during the pandemic.[23] In an effort of self-preservation, death anxiety also enhances consumer purchasing desires, alluding to practical applications regarding marketing and advertising.[24] Emergency-related death anxiety from the COVID-19 pandemic additionally led to studies involving panic shopping (i.e., “consumer misbehavior”) as people feverishly sought to stock up on perceived essentials necessary for survival.[25] By collecting responses from 400 consumers that shopped during the pandemic, Scarpi et al. (2023) found that death anxiety impacted customers’ awareness of their shopping misbehavior and individual responsibility.[26]
Relationships and Attachment
Following a death reminder, Plusnin et al. (2018) note that close relationships were found to be a way of reducing death anxiety similar to self-esteem’s buffer function.[27] Mental accessibility of words related to attachment is also increased after MS, in addition to commitment to a partner and the desire for psychological intimacy.[28]
Death Anxiety’s Purpose and Relevance
Many elements of an individual’s life are impacted by a reminder of death, yet how this actually functions is less known. Many models are proposed based on sociological, anthropological, philosophical, and neurological evidence (including TMT) making this field extremely interdisciplinary.
Reasons why death anxiety affects so many human behaviors may relate to legacy motivations[29] and the desire for one’s legacy to last through familial and generational knowledge (akin to symbolic immortality). This perceived immortality through remembrance may act as a coping mechanism to overcome death anxiety and[30] many cultures seek symbolic immortality by preserving life as never-ending through modes such as religion, art and rituals.
Psychopathology and Death Anxiety
Death anxiety creates a sense of powerlessness and meaninglessness in life and coping mechanisms to combat these sensibilities can sometimes be more hurtful than helpful (such as avoidance) and are correlated with many psychiatric disorders.[31] For instance, existential anxiety may help drive, cause, or sustain many anxiety disorders including:[32]
Agoraphobia (i.e., fear of leaving one's home or specific situations)
Somatic symptom-related disorders (related to impairing anxiety about health symptoms)
Research with anxiety disorders will typically prime individuals with a death reminder and observe an increased perceived threat and maladaptive behaviors within individuals when presented with anxiety-provoking stimuli, as opposed to when presented with no death reminder.[33] In addition to promoting a range of anxiety disorders, death anxiety can be a factor in:[34]
The frequency of death-related thoughts is typically increased for individuals with such disorders. Additionally, those with substance abuse disorders may engage in self-medication as a form of maladaptive coping with death anxiety, as Menzies & Menzies (2023) note that among people with substance abuse disorders, increased symptom severity correlates with higher existential anxiety.[35]
Treating Death Anxiety
While death anxiety seems to be an inevitable and even unconscious element of being human, an exceeding amount of it may factor into impairment in life. Death anxiety was found to predict psychosis[36] among many mental disorders and targeting death anxiety, itself, may be a way to prevent and treat subsequent life impairments.
Menzies & Menzies (2023) note that Cognitive Behavioral Therapy (CBT) has been useful in reducing death-related anxiety through methods such as Exposure Therapy that allow patients to confront their fears surrounding death.[37] Death “thought-reframing” has also been employed to encourage positive adaptive coping with death anxiety.[38] Acceptance and Commitment Therapy (ACT), a modality used to focus on awareness of mental states and thoughts, may also be a way for clients to reflect on the meaning of their lives and restore this from what was lost in experiences of death anxiety.[39,40] Relating to Buddhist thought and practice, Anālayo et al. (2022) found that mindfulness also reduces death anxiety through facing mortality, which simultaneously increases self-compassion.[41]
Death anxiety takes implicit and explicit forms that range from completely expected to life-impairing. Its empirical insights may lead to a holistic perspective of human behavior. Being mindful of these findings may include applying them to practical situations such as justice systems and hospital employees. Aldiabat et al. (2023) note that consideration for perceptions of death and death reminders is relevant to nurses and other healthcare workers for how MS may impact their actions in practice.[42] Further research in the field, including death anxiety and psychiatric disorders, may also open doors for clinical treatment to target existential anxiety, particularly for middle-aged adults, seniors and those with chronic or terminal illnesses.
If one is experiencing death anxiety that is impacting daily life and overall well-being, please reach out to a licensed mental health professional (e.g., a psychotherapist, psychologist or psychiatrist) for guidance and support.
Contributed by: Phoebe Elliott
Editor: Jennifer (Ghahari) Smith, Ph.D.
References
1 Gordillo, F., Mestas, L., Arana, J. M., Pérez, M. Á., & Escotto, E. A. (2017). The Effect of Mortality Salience and Type of Life on Personality Evaluation. Europe's journal of psychology, 13(2), 286–299. https://doi.org/10.5964/ejop.v13i2.1149
2 Huang, C., & Hu, C. (2023). The terror management and sorrow management of death consciousness. Acta Psychologica Sinica, 55(2), 318-335. doi:10.3724/SP.J.1041.2023.00318
3 Fritsche I, Jonas E, Fischer P, Koranyi N, Berger N, Fleischmann B. Mortality salience and the desire for offspring. Journal of Experimental Social Psychology. 2007;43:753–62. https://scholar.google.com/scholar_lookup?journal=Journal+of+Experimental+Social+Psychology&title=Mortality+salience+and+the+desire+for+offspring&author=I+Fritsche&author=E+Jonas&author=P+Fischer&author=N+Koranyi&author=N+Berger&volume=43&publication_year=2007&pages=753-62&
4 Rosenblatt, A., Greenberg, J., Solomon, S., Pyszczynski, T., & Lyon, D. (1989). Evidence for terror management theory: I. The effects of mortality salience on reactions to those who violate or uphold cultural values. Journal of personality and social psychology, 57(4), 681–690. https://doi.org/10.1037//0022-3514.57.4.681
5 Greenberg, J., Solomon, S., Pyszczynski, T., Rosenblatt, A., Burling, J., Lyon, D., Simon, L., & Pinel, E. (1992). Why do people need self-esteem? Converging evidence that self-esteem serves an anxiety-buffering function. Journal of personality and social psychology, 63(6), 913–922. https://doi.org/10.1037//0022-3514.63.6.913
6 Silveira, S., Graupmann, V., Agthe, M., Gutyrchik, E., Blautzik, J., Demirçapa, I., Berndt, A., Pöppel, E., Frey, D., Reiser, M., & Hennig-Fast, K. (2014). Existential neuroscience: effects of mortality salience on the neurocognitive processing of attractive opposite-sex faces. Social cognitive and affective neuroscience, 9(10), 1601–1607. https://doi.org/10.1093/scan/nst157
7 Ibid.
8 Xu, Z., Zhu, R., Zhang, S., Zhang, S., Liang, Z., Mai, X., & Liu, C. (2022). Mortality salience enhances neural activities related to guilt and shame when recalling the past. Cerebral Cortex (New York, N.Y.: 1991), 32(22), 5145-5162. doi:10.1093/cercor/bhac004
9 Greenberg et al. (1992)
10 E.G. Hepper, Self-Esteem, Editor(s): Howard S. Friedman, Encyclopedia of Mental Health (Second Edition), Academic Press, 2016, Pages 80-91, ISBN 9780123977533, https://doi.org/10.1016/B978-0-12-397045-9.00076-8.
11 Bassett, J. F., & Bussard, M. L. (2021). Examining the Complex Relation Among Religion, Morality, and Death Anxiety: Religion Can Be a Source of Comfort and Concern Regarding Fears of Death. OMEGA - Journal of Death and Dying, 82(3), 467–487. https://doi.org/10.1177/0030222818819343
12 Szcześniak, M., & Timoszyk-Tomczak, C. (2020). Religious Struggle and Life Satisfaction Among Adult Christians: Self-esteem as a Mediator. Journal of religion and health, 59(6), 2833–2856. https://doi.org/10.1007/s10943-020-01082-9
13 Fog, A. (2023). Psychological and cultural effects of different kinds of danger. An exploration based on survey data from 79 countries, Culture and Evolution (published online ahead of print 2023). doi: https://doi.org/10.1556/2055.2023.00029
14 Ibid.
15 Rosenblatt et al. (1989)
16 Ibid.
17 Kheibari, A., & Cerel, J. (2023). The Role of Death Anxiety and Self-Esteem in Suicide Attitudes. OMEGA - Journal of Death and Dying, 86(3), 1069–1088. https://doi-org.colby.idm.oclc.org/10.1177/00302228211000935
18 Ibid.
19 Ibid.
20 Weng, D. H., & Kim, K. H. (2023). Letting go or pushing forward: Director death and firm risk-taking. Long Range Planning, 56(3), 102322. ISSN 0024-6301. https://doi.org/10.1016/j.lrp.2023.102322.
21 Bessarabova, E., & Massey, Z. B. (2023). The effects of death awareness and reactance on texting-and-driving prevention. Risk Analysis, 00, 1– 13. https://doi-org.colby.idm.oclc.org/10.1111/risa.14107
22 Li, S., Young, H.R., Ghorbani, M. et al. Keeping Employees Safe During Health Crises: The Effects of Media Exposure, HR Practices, and Age. J Bus Psychol 38, 457–472 (2023). https://doi.org/10.1007/s10869-022-09837-9
23 Ibid.
24 Menzies, R. E., & Menzies, R. G. (2023). Death anxiety and mental health: Requiem for a dreamer. Journal of Behavior Therapy and Experimental Psychiatry, 78, 101807. ISSN 0005-7916. https://doi.org/10.1016/j.jbtep.2022.101807.
25 Scarpi, D., Pantano, E. and Marikyan, D. (2023), "Consumers' (ir)responsible shopping during emergencies: drivers and concerns", International Journal of Retail & Distribution Management, Vol. 51 No. 6, pp. 791-806. https://doi.org/10.1108/IJRDM-08-2022-0300
26 Ibid.
27 Plusnin, N., Pepping, C. A., & Kashima, E. S. (2018). The Role of Close Relationships in Terror Management: A Systematic Review and Research Agenda. Personality and Social Psychology Review, 22(4), 307–346. https://doi.org/10.1177/1088868317753505
28 Ibid.
29 Waggoner, B., Bering, J. M., & Halberstadt, J. (2023). The desire to be remembered: A review and analysis of legacy motivations and behaviors. New Ideas in Psychology, 69, 101005. ISSN 0732-118X. https://doi.org/10.1016/j.newideapsych.2022.101005.
30 Ibid.
31 Menzies, R. E., & Menzies, R. G. (2023). Death anxiety and mental health: Requiem for a dreamer. Journal of Behavior Therapy and Experimental Psychiatry, 78, 101807. ISSN 0005-7916. https://doi.org/10.1016/j.jbtep.2022.101807.
32 Ibid.
33 Ibid.
34 Ibid.
35 Ibid.
36 Easden, D., Gurvich, C., Kaplan, R. A., & Rossell, S. L. (2023). Exploring fear of death and psychosis proneness: Positive schizotypy as a function of death anxiety and maladaptive coping. Clinical Psychologist, 27(1), 35-44. DOI:10.1080/13284207.2022.2070426.
37 Menzies & Menzies (2023)
38 Ibid.
39 Wersebe, H., Lieb, R., Meyer, A. H., Hofer, P., & Gloster, A. T. (2018). The link between stress, well-being, and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention. International journal of clinical and health psychology : IJCHP, 18(1), 60–68. https://doi.org/10.1016/j.ijchp.2017.09.002
40 Ibid.
41 Anālayo, B., Medvedev, O.N., Singh, N.N. et al. Effects of Mindful Practices on Terror of Mortality: A Randomized Controlled Trial. Mindfulness 13, 3043–3057 (2022). https://doi.org/10.1007/s12671-022-01967-8
42 Aldiabat, K., Alsrayheen, E. A., & Le Navenec, C. -. (2023). Death anxiety among older adults during the COVID-19 pandemic: Implications for nursing practice. Universal Journal of Public Health, 11(1), 89-96. doi:10.13189/ujph.2023.110110