Death Anxiety, Loss, and Grief in the Time of COVID-19

According to TMT, when thoughts of death are conscious we engage in ‘proximal defences’, which include suppressing these thoughts (e.g. turning off a news report about COVID-19 death tolls), denying one's vulnerability (e.g. thinking "I'm not in a high risk group, so I'll probably be fine"), or trying to prevent death (e.g. cleaning down all home surfaces with antibacterial wipes). [...]as fear of the virus increased, mental health declined. [...]death-related losses arising from COVID-19 are compounded by non-death losses, such as global financial strain, massive unemployment, and financial hardship, all of which are also associated with impoverished mental health (Paul & Moser, 2006). In this form of life-vitiating, protracted, and anguishing response to loss, mourners struggle with turbulent emotions of longing, guilt, loneliness, and desolation which tangibly impair their ability to function in the contexts of family, work, and the social world for many months beyond the death, and not uncommonly, years. [...]ongoing ruminative preoccupation with the lost relationship or the circumstances of the death carries real health risks for a variety of stress-related disorders, cardiac problems, addictions, immune system dysfunction, impaired quality of life, and even suicide (Maercker, Neimeyer, & Simiola, 2016).

Death anxiety in the time of COVID-19: theoretical explanations and clinical implications.

The recent COVID-19 pandemic has triggered a surge in anxiety across the globe. Much of the public's behavioural and emotional response to the virus can be understood through the framework of terror management theory, which proposes that fear of death drives much of human behaviour. In the context of the current pandemic, death anxiety, a recently proposed transdiagnostic construct, appears especially relevant. Fear of death has recently been shown to predict not only anxiety related to COVID-19, but also to play a causal role in various mental health conditions. Given this, it is argued that treatment programmes in mental health may need to broaden their focus to directly target the dread of death. Notably, cognitive behavioural therapy (CBT) has been shown to produce significant reductions in death anxiety. As such, it is possible that complementing current treatments with specific CBT techniques addressing fears of death may ensure enhanced long-term symptom reduction. Further research is essential in order to examine whether treating death anxiety will indeed improve long-term outcomes, and prevent the emergence of future disorders in vulnerable populations. KEY LEARNING AIMS: (1)To understand terror management theory and its theoretical explanation of death anxiety in the context of COVID-19.(2)To understand the transdiagnostic role of death anxiety in mental health disorders.(3)To understand current treatment approaches for directly targeting death anxiety, and the importance of doing so to improve long-term treatment outcomes.