Dr Pamela Prince Pyle

Facing your Fears on Death and Dying Part 2

Fear creeps up on you as the day progresses. You may begin your day with hope and confidence that today, you will just try and make it through the day living in the moment. Yet, as rising suns bring hope, the approach of the mid-day is shrouded by clouds of fear. You can’t help it. 

Your diagnosis will lead to your death and dying. You have forgotten how to live. Fear overwhelms you at times. 

The Biology of Fear

The sensation of fear is a biological event. It is driven by a small area of the brain called the amygdala which stimulates the sympathetic nervous system. When fully activated it is preparing the body for a fight-or-flight response.

 Fear’s primary function is to signal us to the threat of danger and to trigger an appropriate protective response. Fear is experienced in the mind and yet, your body has a strong physical reaction. 

As the amygdala has increased activity, the cerebral cortex has decreased activity. The cerebral cortex is the location of creating judgement and rational thinking.

Fight or flight is an instinctual response and is meant for specific threats such as accidentally stepping into the path of an oncoming car. In a moment, your brain has registered the threat, determined that it is not a fight circumstance and has calculated the safest flight path of running forward or returning to your original location.

When fear is generalized and consuming as it often it with a serious or terminal diagnosis it can create a cycle of activation of the amygdala and activation of the cortical brain. Hence, the rising sun brings hope of a new day and a trigger that may even be subliminal stimulates the amygdala. Rational thought becomes foggy and a sense of dread with the development of anxiety and sometimes panic occurs. 

Identifying our specific fears and addressing them will help us gain a sense of what activates our thought cycles. As with all knowledge, its value is increased with wisdom. Knowing the biology of fear is only helpful, if we can apply it with wisdom to our personal story. 

Identify Your Fears

President Franklin D. Roosevelt comforted the nation with the words; The only thing we have to fear, is fear itself. Yet, he was a man who had fears that affected his life. 

He had deep-rooted fears of being consumed by fire. He would not allow his door to be locked as previous presidents were required and would practice dropping from the bed and crawling to the floor in the event a fire was to occur.

He also had a mild case of triskaidekaphobia, fear of the number thirteen. He would not start important trips on Friday, the thirteenth and did not like a dinner table set with the number thirteen.

What is important to note about each of these fears is that he had created a construct which allowed him to manage his specific fears while leading the free world. In our humanity, we share common fears when we approach the dying process and death. Much like FDR many of the fears that are associated with dying and death can be managed to lessen their effect in our lives.

The most common are:

  • Fear of pain
  • Fear of physical suffering beyond pain such as shortness of breath
  • Fear of emotional pain
  • Fear of isolation
  • Fear of loss of dignity
  • Fear of being a burden to others
  • Fear of loss of control
  • Fear of being unconscious
  • Fear of not having had a meaningful life
  • Fear of the unknown
  • Fear of faltering faith
  • Fear of what happens after death

Over the next few weeks I will be sharing truths that will help you with the fears that can be  managed and hope for the ones that can be believed. I will leave you with the Serenity Prayer as you work to identify your fears.




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