Unexpected Death in a Patient who Wished to Die

The literature regarding spontaneous death from unknown causes at the time of severe emotional stress is briefly reviewed. In each instance hopelessness and a deep conviction that death would ensue was present. The cited case presented material from the analysis of a middle-aged woman who felt hopelessly trapped in an impossible life situation. Accompanying a growing conviction that

death would be the only solution was such intense desperation and panic that physiological processes were increasingly disrupted, finally leading to spontaneous ventricular fibrillation and eventual death. Evidence suggests that she was actively taught as a child by her rejecting parents to block all external channels of emotional expression. Her lifelong history of manifold physiological disturbance at times of stress gives evidence to the belief that the only route psychologically available for discharge of emotional tensions was internal and somatic. It is postulated that massive internal discharge overwhelmed the regulating mechanisms of the autonomic nervous system to the extent that vital functions could no longer be sustained.