The Fear of Death: Part I. The Avoidance of the Fear of Death

Once I had a patient who could best be described as a living dead man. This title might suit a number of patients who complain of feeling dead or half-dead, but the extraordinary feature in this case was that this man had been declared clinically dead after a coronary thrombosis and, though he had come to life again, death held him fast. Severe anxiety attacks with palpitations were accompanied by homicidal fantasies which sometimes ended up as suicidal ones. He developed a knife phobia which was strongest when his wife was present. He had urges to get rid of his son. He was allergic to every tale he heard or read about murder, suicide, and sudden death. Yet he vehemently denied the fear of his own death. In fact, any attempt of mine to interpret his fears produced symptoms which induced in me the fear that he might have an apoplectic fit, so I became more and more tentative, finally ending up in the same boat as he was, afraid of killing, that is, afraid of bringing on a stroke with an injudicious remark. Inevitably, in our joint anxiety, we reached deadlock and he departed.

It required such a case to induce me to take the fear of death literally for what it was, the dread of personal extinction, of the end of sentient being. How strange it seemed, on reflection, that I could be so surprised in view of the universal, inevitable, and familiar fact of death. Had not death and the overcoming of it been the preoccupation of man since the dawn of consciousness, a central theme in all the great religions, an obsession of poets, a speculation of philosophers, the raison d'être of the medical profession?

I asked myself: what is the psychologist's attitude to death? I remembered attending a case conference some years back the subject of which was a young undertaker who had followed his father into the business. One day when he was measuring a corpse, it suddenly struck him like lightning: “People die! Therefore I may die at any time, of anything!” The unexceptiona