29th Sept 2011

Death by terminal illness is an everyday concern in our human existence. We can truly sympathise from afar, acknowledging how awful and how unfair it is for other families but it is only when it comes to our own door, so to speak, that we realise it’s impact. Think how shocked we can be to hear of the death of someone of the same age or younger. It brings the issue of death a whole lot closer to home. ‘It could be me’, as a fleeting thought is abruptly dismissed. We look for reasons why that person might have died that don’t apply to us… a heavy drinker, a heavy smoker, cancer in the family and we can feel the relief at our not fitting into this category. We are safe from death anxiety. This week at Counselling Connections, we take a look at how it is for people who are dealing with their own terminal diagnosis.

Yalom (Professor of Psychiatry & author) talks about facing our own death and the anxiety this evokes in us as human beings. We may think about how it would be if someone close to us dies, like a partner or spouse and we may wonder how we would survive without them. But our own sense of mortality is difficult to conceive. As children we are brought up to believe we are individual and special. This doesn’t fit in with the inevitability that we will all suffer the same fate eventually, that is, death. As children we are brought up to believe that we will be protected from things that frighten us by our parents….as adults we realise we cannot avoid our own death, a frightening concept.

Being told one has a diagnosis of terminal cancer is hard to grasp. In fact most people do not grasp it on first hearing. Even if it is heard, it is not truly believed and most people enter a phase of denial…. ‘Maybe they are wrong’, ‘Maybe they were looking at someone else’s results’, ‘Maybe I should get a second opinion’….all very understandable reactions in the face of death. It is not unusual to feel numb or to experience a whole range of emotions like anger, sadness, fear and anxiety.

A study by Hinton correlates satisfaction with life lived to the lessening of death anxiety. It is much easier generally for us as a society to accept the death of an older person, i.e. one we see as having ‘lived life’ ther than one in his prime,. This is not meant to undermine the pain felt by those who lose older relatives and friends with whom one may have had a close relationship. Often our perspective on our lived life shifts with a terminal diagnosis. We see things differently and can come to terms with regrets in life in a few short days or weeks. Ambivalent relationships are often repaired in the face of death.

As part of therapy, coming to terms with one’s own death requires that the person approach his dread and anxiety over and over again until he has become so familiar with it that it isn’t so scary anymore.  This is why it can be helpful for some people to talk about their death, which isn’t always easy to do. It is important that this is in line with the person’s wishes. Many individuals find it difficult to come to terms with the feelings of helplessness surrounding dying, the lack of control over one’s destiny. While this is a fate we must all face in one way or another, it can help to take control over some of the things in one’s life that are controllable even at this time. Choosing what type of treatment or Doctor, organising one’s funeral and making a will can give a person a sense of accomplishment and peace.  However, making these final decisions is difficult when one’s own death as a reality hasn’t quite sunk in.  There is no right or wrong approach to facing death and no two people do it in exactly the same way. The important thing is that we each do it in a way that feels right for us.