Sometime around age 6 or seven, most children realize something about death.  Often it's the death of a grandparent or a family pet.  But pretty soon children figure out that their parents could die.  And then there is a flash of realization that they could die. 

This death anxiety usually goes underground because it is just too much for us to deal with.  And it stays underground for a long time.  But it is always there and often revisits as we age more when we become ill.  Such is the case with Ken.

On Tuesday's blog, we will be speaking about living life while facing death and finding meaning in the process.  My guest will be psychologist James Coane who specializes in trauma and as special interest in existential aspects of personality.   

Dr. Dan:  I just turned 50.  I developed a case of health anxiety (which I guess is ultimately death anxiety) after a pulmonary embolism episode two years ago.  At one point, they thought a tumor might have caused the clot.  Thus, I had to endure the mental anguish of several tests and body scans, etc.  Fortunately, I came out of that episode fine physically but a month or two later I started getting severe health anxiety and cancer phobia.  I've seen two therapists, one who pushed "thought records" on me so I'd think more rationally.  Intellectually, it helped but emotionally I was still messed up.  The next therapist said I needed to "expose" myself to my worst-case scenario (terminal cancer, wasting away, leaving my young children and wife, and an early death).  This made me cry several times and I eventually "habituated" to it but the fear remains. 

\I believe my challenge is dealing with my ego and living by my Soul.  

 I believed this even before the clot episode.  Now it's even more important in my mind.  You talk about managing the ego and opening your heart and living from that space. I would greatly appreciate any recommendations you might give me regarding how to address my ego/fear issue. 

 Dear Ken,

Yes, the anxiety you describe is called existential anxiety and it is both ego-based and universal.  You see, the ego cannot tolerate the idea of no longer existing, so it drives us to form this big identity, leave our mark or "be all that we can be". The ego's demands are relentless, and in a way, inevitable.  "You have to be somebody before you can be nobody" is a well-known Buddhist saying.  It's really saying that we have to see how big and how strong we can get before we can let go of all of those ego-based acquisitions.  But that's easier said than done. Because we might age, but that ego doesn't necessarily make sure along with us so that the demands continue.  "After all" the ego might say "I cannot imagine this world without me in it." 

 Cultural anthropologist Ernest Becker wrote a seminal work in 1973 called "The Denial of Death". In it, he suggested that all of our social structures are about protecting us from death anxiety.  Certainly all organized religions address that anxiety by promising us some form of afterlife or rebirth.  So we struggle to make sure we are important, leave a mark, or make sure people are dependent on us.  I recently accepted a lecture invitation for a year from now and jokingly said to someone that I have this obligation so I cannot die before that!  Of course, I was playing with my ego because the ego wants us all to think we are important.  I have good news and bad news.  We are not, so we can stop fighting that battle.! So what now? 

I have been thinking about these things for the last 30 years since I've become a quadriplegic.  And in those 30 years, I have faced death many times.  And as I age, I feel it getting closer.  That's beyond knowing that it's getting closer, I feel it.  And because of that, I can answer the question "so what now?"  Live.  The facts of your life can not change.  You are older and more fragile than you want to be, and death moves closer.  So between now and then, your job is to live your life as fully as possible, mourn what you have lost, love what you have and who you have and consolidate the wisdom you have accumulated over your years.  Then teach your progeny is what you've learned in life and how you've learned it.  That could be your way of saying thank you for this wonderful journey.  Remember, you fear death because your life is precious to you, but when your mind races to the future you miss out on your life.  So when you feel anxiety, just let yourself feel it until the next emotion crops up in a few seconds.  But also notice the temperature in the room moment by moment, noticed your breath and the way your body feels.  Notice the color of the sky and when you get quiet, simply notice how sadness and joy and fear and love all dance around inside of you moment by moment and none of them last very long.I wish you peace