Dr Pamela Prince Pyle

Facing your Fears on Death and Dying Part 1

His wife and I stood on opposite sides of the bed, each of us holding his hands which were bony and ice cold. The pallor of his skin barely detectable against the white sheet. He could not tolerate the mask that would deliver oxygen and breaths often used by those who had advanced pulmonary diseases. Therefore, his breaths were labored and shallow, and his words came like ragged whispers spread out between breaths.

He knew he had one of two choices. He could choose to be placed on a ventilator (an artificial breathing machine), or choose a path for comfort measures only. The latter would consist of oxygen and medications to help him relax from air hunger and anxiety. 

He had been on the ventilator many times before and the intervals between hospital visits became shorter and shorter. During his last hospital stay he had made the choice that he no longer wanted to be placed on it and hospice had been offered. However, his wife was resistant and he honored her wishes. He could change his mind at any time and this was the discussion we were having that day. 

“I’m ready to die,” he announced to his wife who was standing at his side. “I know where I’m going and I’m ready to get there.” He had been living in anticipation of heaven for some time. He had no fear, just confidence. 

With tears sliding down her cheeks, she gave a nod that was nearly imperceptible. She was ready to let him go.

His wife held his hand all afternoon until a nurse called me to the room. We watched his heart rate slow and finally stop. As Mrs. G gave Mr. G one last kiss, her tears were gone. His long struggle and suffering were over, and it was time for rest, for both husband and wife.

Fear is Normal

It seems hard to imagine, one going so confidently into their final goodbye sigh. Yet, this was evident as he looked into his wife’s eyes and there was no fear. In fact, with her nod of acceptance, peace seemed to unfurl his brow. 

Yet, when I first met Mr. G., he did have fear and they were the normal fears expressed by many who have been given a terminal diagnosis even despite their strong faith. 

If you, or a loved one has been given a serious or terminal diagnosis, the first step is to acknowledge your fears and share them with those you love. In some cases, it may also require speaking with your clinician, a therapist, or pastoral care to help you identify the source of your fears.

However, this month I will also be giving you tools to help you navigate your fears, manage them, and have an ending in which you are confident of the destination. Let’s begin with the one fear that is not normal. 


A phobia is a sense of anxiety, worry, dread, or panic about certain activities, objects, or circumstances. A specific phobia disorder is often classified as an anxiety disorder. 

Thanatophobia is the intense manifestation of symptoms related to the fear of dying and death. Unlike the normal fears associated with dying and death, those with Thanatophobia, or death anxiety affects the individual’s daily life even when the threat of dying or death are not imminent.

Sometimes the symptoms of death anxiety can be traced to a specific event such as witnessing trauma, losing a loved one, or witnessing someone have a painful or difficult death.

My grandson was six years old when he witnessed the aftermath of a severe accident. Not long thereafter, he was riding in a car with my daughter’s friend coming home from school. While approaching a light another car attempted to enter their lane and a small “bump” between cars took place. 

These two instances created a case of severe anxiety with thanatophobia elements. He developed anxiety that one or both of his parents would die and this happy, well-adjusted child became terrified to leave their presence. It took several months and a lot of prayer, good parenting, and therapy to unwind the damage from these two coinciding events.

In other individuals the onset of thanatophobia cannot be traced to a specific event. However, it is more common in people who have:

  • Are in poor health or receive a diagnosis of a serious illness.
  • Don’t have religious beliefs.
  • Feel a sense of dissatisfaction with their life.
  • Have low self-esteem.
  • Have other phobias or mental health disorders such as depression or anxiety.
  • Have parents or loved ones who are elderly, ill or dying.
  • Lack close family members or friends.
  • Witness illness, trauma or violence in their jobs, such as healthcare providers or social workers.

There are two main types of therapy that are effective in treating this disorder.

Cognitive Behavioral Therapy is a structured and goal-oriented type of talk therapy. Exposure Therapy is controlled exposure to a stimulus that triggers fear and the symptoms associated with anxiety. Both types of therapy are highly effective. If you feel that you may be experiencing thanatophobia or other symptoms mental health disorders, please see the resource lines at the bottom. 

What’s Next

This month we will focus on the topic of fear and how we can find hope in our season of suffering. 

Need Help?

  • National Suicide Prevention Lifeline: Call 1.800.273.TALK (8255)
  • National Alliance on Mental Illness (NAMI) Helpline: Call 1.800.950.NAMI (6264)
  • Substance Abuse and Mental Health Services Administration (SAMHSA) Helpline: Call 1.800.662.HELP (4357)

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