Death Anxiety: What It Is, Why It Happens & How Therapy Can Help - Thanatophia

Dr Marianne Trent (: 00:00

What if I told you that your fear of death might be quietly shaping your choices, your relationships, even your worldview? In today's episode, we are diving into the psychology of death, anxiety, what it is, how often it crops up, and what happens when it starts to interfere with daily life. Whether you've ever had a passing fear of dying or you find yourself avoiding the topic completely, you're not alone. And the good news, there are always ways to find more peace and to work through this and stick around right to the end because we are sharing a top tip for thinking about your own mortality and helping you to have more control. Hope you find it super useful. If you do, please like and subscribe for more.

(: 00:46

Hi, welcome along to the Aspiring Psychologist Podcast. I am Dr. Marianne, a qualified clinical psychologist. Thank you for being here. And if you are watching on YouTube, please do bear in mind that currently only 11.2% of you are subscribed to the channel. Please do come along and subscribe to my channel, Dr. Marianne Trent, and watch the content, like engage, comment, get involved, because it really does help me to create bigger and better content and to secure bigger and better guests so that you get more from this podcast too. And following a show or subscribing to a YouTube channel really is the kindest thing you can do for any creator that you rate. So if you're not already following the show on your favourite podcast platform, please do. Okay. With no further ado, let's dive in. Meet our guest for today, Tia and I will see you on the other side. Hi Tia, welcome along to the podcast. It's lovely to have you here.

Tia Urgasova (: 01:44

Thank you so much for having me. Hello Marianne and everyone,

Dr Marianne Trent (: 01:48

Thank you for being here. So we are thinking today about where you are right now, which is that you are an end stage trainee clinical psychologist who yesterday completed her Viva and past. Congratulations. And we are thinking about specifically your research today, which is on death anxiety. Is that right?

Tia Urgasova (: 02:11

Yes, that's right.

Dr Marianne Trent (: 02:13

Amazing. So what is death anxiety?

Tia Urgasova (: 02:17

I mean, death anxiety really is the fear or the unease about our own death or the dying process. And this can show up as worry of losing control or the unknown. Most of us don't know what's going to happen after we pass and kind of what happens after life. And it can be a quite common thing as well. Of course some people experience at some point, but we don't really talk about it very much. So that's kind of where the research stemmed from.

Dr Marianne Trent (: 02:45

So we're not necessarily thinking specifically about people who might have a palliative diagnosis or who think that they might not live as long as people around them. We're thinking about the general Dawson's Creek style existential ponderings of our own mortality. Is that right?

Tia Urgasova (: 03:05

That's exactly right, yes. I mean, it's the one thing in life that is inevitable to all of us, and that's exactly what the thesis focused on.

Dr Marianne Trent (: 03:13

Okay, absolutely. Can you tell us a bit more about your thesis then and the Terror Management theory? What is that?

Tia Urgasova (: 03:22

Yeah, of course. So Terror Management Theory is a psychological theory that really tries to explain how we cope with the knowing that we will one day die. And terror management theory states that because we're the only aware animal that's aware of their mortality, it's quite unique and hence the term terror, because if we went through our life day-to-day just thinking about the fact that we will want has cease to exist, that is quite terrifying to think about. But the terror management theory states that basically we'll build up systems to buffer this terror, this fear, this death anxiety that we have. And we do this through systems like our culture, our personal values and relationships that act as buffers in a way. And these buffers give us a sense of meaning. They help us feel secure so that the death anxiety doesn't overwhelm us. It's a bit like having an emotional toolkit for that death awareness.

Dr Marianne Trent (: 04:13

Okay. So terror management theory, TMT, is that something that's your own baby or is that already in the literature?

Tia Urgasova (: 04:22

Oh no, that's been in the literature since I want to say the eighties. It was three social psychologists who came up with this theory and it really started this idea of why do we need self-esteem? And that's kind of what I've already touched upon in terms of these buffers. So self-esteem help us buffer certain difficulties, and one of those difficulties is the awareness that we may one day die. If we are living up to our worldview or our values, then it gives us a sense of meaning that we are life is worthwhile, that we are worthwhile people, and that then buffers that the things I do for self-esteem.

Dr Marianne Trent (: 04:53

Okay, so if things are going wrong and we have high feelings about our own mortality, what might we be seeing in ourselves or perhaps in someone we care about or someone that we work with clinically?

Tia Urgasova (: 05:08

Well, I mean I think a lot of us fear death anyway because it's a big unknown. Our brains try to keep us safe. It's a big don't get eaten machine. So it's normal to have these thoughts pop into our mind or to have reminders day to day. You may see a scene on TV or hear about someone's passing, and that does trigger these thoughts of mortality or reflection on life in ourselves. But normally we are pretty good at buffering those thoughts, like I said, through those mechanisms. But for some people, they may have not had the opportunity to develop the buffers as well as others. For example, this could be from things like early loss, trauma, insecure attachment styles. So a lot of the things that we see in people who also develop mental health difficulties, those early childhood adverse experiences, and when we don't have those buffers or perhaps we manage our mortality in a way that's not productive or not helping us, it can, or the literature at least says that it can definitely lead to an increase in mental health difficulties. The reschedule also states that the anxiety can be a trans diagnostic factor across different mental health disorders,

Dr Marianne Trent (: 06:17

And it does crop up more than you might imagine. So I dunno if you've ever read any of the Hunger Games books, but I'm reading the new one at the moment, the one that was published in 2025, and it's focusing in on Hamit, who in the first Hunger Games is Kane's kind of mentor, but it's focusing in on his story when he was in the Hunger Games. And it's interesting, one of the participants is kind of saying, actually, my hope is that I will die quickly and that my family won't have to watch this protracted, horrific death. And that's almost like hoping for that good death that we sometimes speak about. But obviously in a game show, a good death is perhaps different than the millionaire's death, which I think you've spoken about, which is lying in a bed when you are a hundred surrounded by people that you love.

(: 07:08

That's kind of sometimes thought of as a millionaire's death. And then of course, squid games as well. Squid games is around in our culture currently. I've just literally finished season three yesterday, a bit disappointed actually. But yeah, thinking about people's death and whether that's quite a violent death or whether it's something actually that we hope we will live till our older years, we hope that we will, I guess, hit some of those milestones that are different for each of us, but certainly for many people might include finding a life partner or maybe having children or not having children or starting a business or making a success of your career, making yourself proud, making others proud. There's certain things that we might want to do, some people might want to go on and become a grandparent or just those self-imposed life goals. And is it measuring ourselves up to how well we feel we have or haven't measured up to those goals that leads to us having this terror response?

Tia Urgasova (: 08:22

Yeah, I think you're absolutely right there. So what the research also states, and I think what you've started to describe here, we have different ways of dealing with our mortality and of course we have different worldview. So for example, if we take religion into account, of course that kind of gives us a quite nice framework to work from and sets out if you do certain things, you will have a good life or perhaps you will go to heaven or be reincarnated after life. And then outside of religion, we can also think about these other ways of buffering other anxiety through what we call symbolic or literal immortality and what you've described of having a life partner, having children in a way that kind of buffers the death anxiety because our legacy lives on so we can live on through our children, through our family. So in a way that is a really nice buffer to have. But I think what you are also describing is right in terms of if you value family and closeness relationships in your life and you are finding that you are meeting those values or those goals in your life, then that does increase your self-esteem, or at least that's of the research the literature states.

Dr Marianne Trent (: 09:28

And it is strange, isn't it? I don't think my grandfather would've been ready to die. Is that an okay thing to say? Ready to die 80. He spent his 90th birthday on his shed roof fixing it. So he was very much not what you'd expect for your average 90-year-old. He died when he was 95, but he was so done by then. He was ready. He would say, my wife died, my girlfriend died, all of my friends have died. And in my book, the Grief Collective, Dave, one of the contributors thinks about the tree of life, the family tree. And actually as we grow, rather than looking up for our family connections, we begin to have to look across. But then ultimately that might not be enough either, and we have to start looking down. And even if we don't have our own children, it might be that we're looking down to our nephews or our nieces or our cousin's children. And if being part of a family is important to you, then you almost need to readjust your gaze because I speak to you as the daughter of one living parent, and it does just alter things. And yet I definitely have experienced more of the sideways connections. And it is a very strange existential. Dawson's Creek is for me, my first grounding in existential angst. And it's what I come back to time and time again, which probably isn't a very popular cultural reference these days, but it's a whole process, isn't it?

Tia Urgasova (: 11:16

Yeah, definitely. And I think when we are going through such a big change, perhaps if we lose a close family member, we may need to adjust and think about where I am in life now. How can I meet those if family and relationships are important to do, which for so many of us, they are think about how can I adjust? And actually if you feel like you're not able to adjust, or perhaps as a society we don't really speak about these things, perhaps with family, sometimes we do. Or when there's an event like that that happens, we do speak about it, but not so much day to day. And I think it can be a bit of a shame because where do people need support for that go? And of course therapy is a fantastic opportunity to think about it, but even as clinical psychologists, we're not often trained in how to have these conversations outside of people going through palliative care. And I think that's when the difficulties can come up. If you're trying to adjust, but not having the right support around the adjustment to death and reflecting even on your own mortality, then we can start to mismanage those fears.

Dr Marianne Trent (: 12:22

And actually clinically it might crop up more than we think it does. But if we haven't kept digging, and then what, then especially with OCD, if you keep digging, keep digging, keep digging, keep then and then what you often will get to, well, I worry that I'm going to die and it's going to be horrendous and it will be painful and it will be preventable. And everyone will say, well, you could have done this or should have done that. And so actually, like you said, I think it does crop up, but we haven't always got, like you said, exactly, we haven't got the training or the skills to be able to grapple with that or that it doesn't feel clinical enough. Absolutely. In the services with the access thresholds we have currently, if it's not significantly impacting on someone's wellbeing, if it isn't giving them lots of problems, if it isn't making them risky to themselves or others, then likely they ain't going to meet the threshold. And of course it's something they can explore privately, but actually you still matter. It's still valid, you shouldn't be suffering. And I guess it's when it tips from still being able to be functional to then not being able to get on with your day and do the things that actually you need to do. Is that when it becomes more problematic?

Tia Urgasova (: 13:51

Yeah, I mean, exactly right. So of course, again, if you go and if you think back to the buffers, if you are able to buffer that anxiety through having those close relationships or living up to your worldviews, whatever those worldviews may be, of course they're going to be different based on a person's identity. If we just don't have those sort of foundational strengths or those things that we can reach into, that's when it's going to become a problem. And exactly like we were speaking about that trans diagnostic factor of death anxiety within so many mental health difficulties, and I talked about this as part of my conceptual review within thesis, and essentially most if not all mental health difficulties have this underlying something, well, I will die, something will happen to me or somebody in my life will die, or the process of death itself, or how is this going to impact the people around me? Is it going to be painful or what's even going to happen to me after death? So even if are religious and you feel like perhaps you're not living up to those values that can bring on some really strong fears about what's going to happen to you post death

Dr Marianne Trent (: 15:00

And just as you speak, then it's making me think about my own father's death. And I'm very fortunate that I was able to be with him, but watching someone die is a privilege if that's something that you want, but it's also can be triggering and traumatising in itself. So yes, his death wasn't violent, but it still can be traumatic. And actually I've had to access EMDR to get the kind of traumatic bits of his illness and death to lay flatter, because otherwise that might well have made me fearful of my own death or other. And so it's thinking about actually how much of what you are experiencing is trauma and how much of this is just death anxiety that's not linked to a specific thing. So it's trying to separate the two because you deserve to thrive, you deserve to flourish.

Tia Urgasova (: 15:52

Yeah, of course. And thank you so much for sharing that. I think, yeah, like you said, I think with the experience that you've had, and of course so many people would had a similar experience, one that's quite distressing. I think that's the difference of where it could be a trauma, but I think where it doesn't necessarily lead to, so sometimes we can think of this post-traumatic growth, but that doesn't of course happen to everybody can lead to symptoms of post-traumatic stress disorder instead. And that of course depends on the previous coping that the person had had. And this could be attachment's, coping styles, et cetera previously. But the thoughts that you have enduring the memory or when that event is happening, I think if we are able to talk through and similar to trauma, I think if we are able to talk through and process this event, then I think it makes it easier for our brains to make sense of it.

(: 16:46

I kind of find meaning. And within therapy we also talk about this thing reclaiming your life. I think it's a little bit of that as well. If we were to think existential therapy, I had during this process read a lot of books by Lum, and one of the wonderful things he talked about was when he works with people and their existential worries and fears, he says, if you think back to your life over the past year, how would you feel if you had to relive that past year every single year for the rest of your life? And I think that's a really nice kind of opening into what is it that you value about your life and what would you change?

Dr Marianne Trent (: 17:26

I'm so glad you've mentioned Irv and Yolo. I love his work actually. And I first experienced it when I was on training in Think in my first year, I read Love's Executioner, which really helped me to develop as a clinician, I think. But then of course, staring at the Sun, his book on death Anxiety, I really found as well. And I had the pleasure of actually going to one of his talks. It was remotely, it was during the pandemic, I think it was 2020. And he was talking about his new book at the time, about his wife's death, A matter of Death and Life I think it's called. And he was doing it from home. And obviously he's a kind of world renowned psychiatrist. And it was interesting to see how he has aged. And actually midway through he got up and went for a wee and kind of needed to be supported and kind of shuffled back and just really hard, it's hard to see people age. It's hard to see people that you care about faltering, and even if they aren't old, but they have declining health, it can be really hard to see that in someone you love or you care about. And that was a bit of a shock for me to see this man who I've grown up reading ageing and of course being so open and honest about his grief and the loss of his wife. And it's a privileged age. It is, but it's not always without its difficulties.

Tia Urgasova (: 18:59

I love that. Yeah, exactly. You're right. And it's making me think about the book th I'm reading by AAM at the moment, and it's called The Gift of Therapy. And it really is him thinking about the fact that he's coming to the end of his life and what can he sort of leave on as a legacy. And I think in a way that was of course his kind of symbolic or maybe even to an external electoral mortality because continue to talk about someone when they've passed or about the work they've done makes them live on and think in the book that you discussed, I think Staring at the Sun, he talks about this ripple effect as well, how whilst we may be gone, but what's the ripple effect that you've had on people and those around you?

Dr Marianne Trent (: 19:39

Well, there's another book there for me to check out. I wasn't familiar with that one, but what I will do is I'll pop all the links to the books that we are mentioning. I'll pop them in the show notes for people or in the description if people are watching on YouTube. Is mindfulness a good way of keeping our terror management in check?

Tia Urgasova (: 19:57

That's a really lovely question. Again, something that I had discussed throughout the thesis, and I think the thesis kind of focused on how term management describes death or how normally we can deal with death awareness in a avoidant or quite defensive way. But there are of course, other ways of dealing with our mortality, and that is in a more engaging and more reflective, accepting way. And mindfulness is a really nice way of doing that. And of course, mindfulness helps us stay present and accept uncomfortable feelings, uncomfortable thoughts, without trying to run away with them, without trying to push them away. And that in turn, of course, reduces anxiety. And there's a specific meditation on death, on our own mortality. It's called marati, I hope I'm pronouncing that correctly, which helps people to just sit and reflect on the thoughts that they have coming up for them about their own mortality, about other people's mortality around them. And in a way that can of course help reduce the anxiety that people feel. And it's not going to be as easy at the start, right? A bit like any kind of anxiety. It won't be easy to start off with, but the more we become comfortable and the more we s sit through with those feelings, the more reflective and accepting we can become of those thoughts and that reality.

Dr Marianne Trent (: 21:14

And I think the more comfortable we become with our own stillness and the quietness and being able to tune into our thoughts and to maybe not think about them as threatening, harmful, dangerous. Even yesterday I was talking to someone at the gym and she's experienced an injury and she was like, I still just really love coming to the gym. And I said, well, maybe you could do something a bit slower. You could go swimming. She was so boring. So boring. Or maybe yoga or mindfulness stuff or Pilates, oh no, oh no, too slow. Then I'll just be, oh, my mind would be racing. And it's like, okay, it's almost like evidence that actually this is kind of what you need because it's okay to be by yourself that doesn't need to feel threatening. And actually, I have to confess, I confess in training, I quit my mindfulness course because it was too much.

(: 22:15

It was asking this to do too much in my own time, lying down for half an hour by myself in the dark. I had things I wanted to do differently at that stage of my career. I was literally at the stage that you are at now and having to go into university on days that people who were not opting into this free course were not doing. And so it felt like, this is not what I signed up for. I thought this would just be an extra thing that we could just do, but no, this now feels like a punishment. And so I then started to resent that practise and it was just not what I needed at that time, but actually it was maybe just I wasn't ready for that at that time. And actually tuning into our stillness and our awareness can come when you are ready for it, I think. But sometimes, especially when life feels so noisy, these fans are always in our hand. Even during this podcast, I've had a LinkedIn notification come up, come and follow me, connect with LinkedIn. I've had someone try and call me. I've had to know that I've had a text message. I've heard on my computer, I've heard a couple of WhatsApp pings. It's a lot. We'd absolutely need to be able to just have some boundaries, some time, some space for ourselves. We weren't designed to be this on all the time.

Tia Urgasova (: 23:40

Yeah, you're exactly right. We are constantly in a state of doing rather than being right. And then I wonder how that links to these cultural worldviews that many of us hold, especially here in the West, that sort of hustle culture and are we living up to this hustle culture? Are we doing enough? Are we being productive and perhaps comparing ourselves to other people? And of course we know that social media is a highlight reel, but then what is that doing to us? And if we feel like we are not meeting that, then what's that doing to our self-esteem and mental health? And I think it's a nice way of thinking about actually how then that death sort of awareness and our ability to think about that links stood these wider issues that we are experiencing anyway. And you're exactly right, having time to just be or focus on what is important to me.

(: 24:29

And one of the things that we talked about, or what I talked about in thesis was this difference between that deeper death engagement and compared to that defensive sort of brief mortality awareness, but we're trying to push away our thoughts of death or mortality. And what the research is sharing actually is that there's, whilst it's not a wake up call for everybody, there are some people who benefit more from having this deeper engagement with mortality and that it seems to be people with higher mindfulness, higher psychological flexibility, higher curiosity, and in one specific experiment, when they ask people about their goals and extrinsic versus extrinsic goals, those people who got to engage more deeply with death actually ended up rating intrinsic goals. So things like health relationships and just wellbeing as more important than previously. But if we had those brief reminders of mortality or the people that in that group that had the brief reminders of mortality, they're more likely to rate those extrinsic goals like fame, money, wealth, all of those things as more important.

Dr Marianne Trent (: 25:37

Yeah, absolutely. And just listening to you talk, actually, it makes me think about my own mortality, and it makes me think about some of the planning that I have already done for that. And one of those things is to have written a will. And we did that during something called the UK Will aid Month, which I know is coming up in October this year. And that's where you get trained legal professionals to draw up a will for free in exchange for a charitable donation. And so if whoever is listening to this or watching this doesn't yet have a will, it's cost doesn't necessarily need to be prohibitive in that. And it is really important, especially if you are not married or especially if you are married, but you are no longer together and you don't want your estate to pass to your spouse, or if you have very specific requests about where you want portions of your estate to go. And actually knowing that that is all set up is another thing that might help or certainly help people when you've gone. But also as therapists, we might want to think about having therapeutic wills. So what happens when we die if we have open cases to us, who should handle that? And so I think there's all these extra layers of mortality considerations for people working in helping professions. Have you got a will tier? Can I ask you that?

Tia Urgasova (: 27:02

I don't actually have a will myself, but I think this is such an important topic to think about. And I wasn't aware of the will aid month, so I might have a think about that. And I really liked your, yeah, I hadn't considered actually, how would we deal with ending therapy if something did happen to us? And that would have such a huge impact on the clients that we work with. And it must be really unsettling. And I think this is why it's so important. And again, a huge part of my thesis focused on, we don't have these conversations enough, and I'm just really grateful to be able to discuss this with you. And thank you so much again for having me on here to raise this awareness and get hopefully people to think about that this is a normal conversation to have and just to make it more accessible.

Dr Marianne Trent (: 27:48

Yeah, it should be normalised, shouldn't it? And thank you so much for being here. Thank you so much for introducing this topic. There is another, there's going to be a little death, a death mini miniseries I have to say. So this is episode one. Episode two is actually looking at the palliative decisions that are happening in court and what the implications are for people, but also what the implications are for us working in mental health services. So if anyone is enjoying this conversation, please do look out for the next episode, which if you're watching this live is coming out next week. Or if you are watching just as a general series, look out for it and watch or listen to that one. So thank you so much for your time, Tia, congratulations on getting to the end of your training and wishing you the very best with what comes next.

Tia Urgasova (: 28:33

Thank you so much. Thank you so much for having me here and wishing you the best too.

Dr Marianne Trent (: 28:38

Thank you so much. Bye, Tia.

Tia Urgasova (: 28:40

Bye-bye.

Dr Marianne Trent (: 28:40

Oh, what a lovely, lovely guest episode that was. I hope you found it helpful. If you have, please drop a comment, drop a like rate and review the episode or the show. It would be so gratefully received thanks to Tia for her time, and congratulations on getting to the stage of her career that she's at. If grief is not your special area of knowledge or expertise, or if you would like to up your levels of insight and awareness into it, please do check out my book, the Grief Collective Stories of Life Loss and Learning to Heal. There will be links in the show notes and in the description, but it gets lovely reviews and it's such a nourishing, wholesome, inspiring read. And if you love people and their stories, it gives you an excellent chance to have a peek behind the curtains of real people's lives and experiences. So it's definitely one not to miss all of the books that we mentioned, including The Grief Collective. There'll be links for in the description and the show notes. What has this episode brought up for you? Let's get involved in the YouTube comments. Let's support one another. Let's inspire conversations to quote Jack from Titanic. Let's make this count.

Jingle Guy (: 30:00

If you're looking to become a psychologist, then let this be podcast psychologist.