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Death anxiety and HIV disease.

An understanding of death anxiety is essential to conducting HIV-related psychotherapy. Often, one of the most important tasks of the therapy is the process of coming to terms with death while focusing on the here and now. Appreciating the role of death anxiety in mental health is particularly useful in light of advances in HIV-related medical treatment and the extension of life that these drugs may offer. It is difficult to place death anxiety— used synonymously with fear of death— into any theoretical orientation of psychology. Prior to the appearance of the concept in the literature a quarter of a century ago, the topic of death was seldom mentioned in the mental health literature. For example, Freud said very little about the matter and viewed death anxiety as stemming from phenomena he saw as more fundamental such as castration anxiety or separation anxiety. The concept of death anxiety can be better understood by a very brief description of the broader concept of anxiety. All of us have experienced anxiety. The somatic components of anxiety include heart palpitations, sweating, breathing difficulty, dizziness, muscle tension, hot flashes, cold chills and difficulty swallowing. The cognitive components of anxiety include fear of passing out, worry, obsessive fear of losing control, concentration difficulty, dwelling on traumatic experiences and feeling something terrible is going to happen. The difference between anxiety and an anxiety disorder is a matter of degree. Anxiety is often associated with a particular object or situation, for example, fear of spiders or test anxiety. As are such phobias, death anxiety is a specialized instance of anxiety. Death anxiety includes: preoccupation with death, fear of death, fear of having surgery, cancer, or a heart attack, being troubled by the matter of life after death, preoccupation with the shortness of life, and fear regarding the death of other persons.