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An Interview with Irvin Yalom, MD on Death Anxiety

David Van Nuys, Ph.D. Updated: Feb 20th 2008

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Irvin Yalom, MDDr. Van Nuys interviews Dr. Irvin Yalom, a psychiatrist and Stanford professor about his new book "Staring at the Sun: Overcoming the Terror of Death". This book follows up on a theme previously explored in Yalom's earlier classic work "Existential Psychotherapy", namely that death anxiety permeates life and is a cause of many psychological symptoms and conditions, and that confronting one's own personal death can result in symptom reduction and a generally richer and more fulfilling life.

Dr. Yalom is concerned that modern day therapies are too concerned with technique and too squeezed by economic pressures to pay attention to death anxiety. In his view, therapists are not encouraged to focus on death anxiety any more and so don't notice it when it occurs, or misinterpret it as something other than it is. Therapists who are able to focus on patient's death anxiety can help patients to focus on and reduce that anxiety, which can result in their awakening into a richer, more compassionate, less fearful state of being.

Yalom offers an appreviated overview of how death anxiety develops over the lifespan. Children first become aware of death at a young age through encountering dead animals and attending funerals. Parents tend to hide the reality and finality of death from children (and sometimes from themselves), however, by distracting them, or by offering the fantasy of everlasting life or reunion in heaven. Death is not much of a concern to most children until adolesense at which point in time they tend to conter-act their emerging fear of death by engaging in risk-taking behaviors. Death anxiety tends to submerge again during young adulthood, while career and family are built up, only to emerge again in mid-life as the basis for the "mid-life crisis". He believes that part of the attraction of mid-life affairs is that they provide the illusion of a renewal of life - a new life that can be lived as an escape from a life that seems half-over.

Drawing on his work with patients, Yalom offers several reasons for why people fear death. They fear that they will miss out on parts of life they have not managed to live yet (e.g., that they have not managed to fulfill their goals yet). They have concern over those who will survive them; that they will feel pain or will be unable to care for themselves. They are upset over not knowing how the various storylines they are living will end. They also fear judgement and supernatural torment in hell or similar places. Some people derive comfort from the idea that they will not die and/or that they will be reunited with dead loved ones in heaven, or that they will be reincarnated. While Yalom's book examines death from a secular and existential perspective and does not buy into religious notions of an afterlife, it does not deny the power and importance of these notions either.

Some people confront fears of death by endevoring to perpetuate parts of themselves past the time when they die personally. Children can be an immortality project for some people, while other people will attempt to become famous or influential and thereby pass on ideas and concepts. Wealthy people may fund a building or an endowment as a way to get their name to persist.

Though death cannot be avoided, confronting the fact that you will die has rewards, namely that people who are able to do it tend to become calmer, more centered and aware and more able to ignore distractions and anxieties and focus on what is truly important (e.g., loving relationships). Confronting death makes life more poinient and meaningful in essence. You appreciate life more if you treat each day as your last. This is illustrated quite well by Dicken's classic story, "A Christmas Carol" in which the protagonist, Scrooge, has an awakening into life and compassion only after the Ghost of Christmas Future shows him his grave.

Yalom recommends that people who are experiencing death anxiety seek out a good therapist (by which he means an old-school psychodynamic, psychoanalytic or humanistic therapist and not a cognitive-behavioral sort of therapist). Such therapists can offer patients an authentic emotional connection and relationship which penetrates loneliness, and also a variety of ideas which can help patients to see their problems in new and useful ways.

Links Relevant To This Podcast:

About Irvin Yalom, MD

Irvin Yalom, MD

Dr. Irvin Yalom is Professor Emeritus of Psychiatry at Stanford University and the author of several highly acclaimed textbooks, including Existential Psychotherapy and The Theory and Practice of Group Psychotherapy. He is also the author of stories and novels related to psychotherapy, including Love's Executioner, When Nietzsche Wept, Lying on the Couch, Momma and the Meaning of Life, and The Schopenhauer Cure. His latest non-fiction book is Staring at the Sun: Overcoming the Terror of Death.


Reader Comments
Discuss this issue below or in our forums.

preocupied with death anxiety since childhood - Leona S - Oct 19th 2009

I loved it and I appreciated it as a listener and as a trainee counselling psychologist. I have been preocupied with death anxiety since childhood and as a trainee i wanted to research it for my doctoral thesis but I decided not to in the end for number of reasons. I can resonate with Yalom on many levels! I have a presentation on this soon, so I will share definitely some of the insights with my collegues :o) thank you for the interview!!! Yalom is brave and clear - brilliant work!!

Speech therapist is not a psychotherapist and is not a mental health worker - Parker - Jun 4th 2009

"therapist-fomer patient emoional affair"

Your former "therapist," is a speech therapist, which has absolutely nothing to do with being a psychotherapist.  There may not be any laws barring speech therapists from having romantic relationships with former patients who contact them socially after treatment ends.

Great interview...But.. - Robin - May 9th 2009

Overall this was a very informative interview.  Our culture treats death with distain giving the message that "Grieve for 3 days then back to work".  This attitude is very unhealthy and contributes to the Death Anxiety.  So..I applaud Dr. Yalom for addressing the importance of acknowledging death.  I don't know if it is just me but I felt in this interview he discounted spirituality.   Several comments he made seemed to indicate such. Maybe his book addresses the importance of spirituality. I don't think we can really understand or come to terms with death without looking at the spiritual aspects of who we are. As a Therapist I have found that counseling from a holistic perspective is helpful to most of the clients I have encountered.

The interface of grammar and professionalism - - Apr 1st 2009

In the future please proof-read the text of your written interviews.  The number of gross spelling errors was disturbing and does not reflect well on those of us in this profession. It appeared as if an amateur had read and reflected on Yalom's contributions which diminished the validity of the review.

Reaction to Dr. Yalom's interview about death anxiety - Jerry F. - Apr 1st 2009

If one takes the position that the religions of the world are merely of human construct, then I guess one could write off the existential crisis that the reality of death provides as a means for personal transformation. I would not argue that death anxiety exists, even among the religious, so in that vein, I can appreciate Dr. Yalom's therapeutic approach. One thing this therapeutic approach is deficient in is the client's expectation of what might the after death experience be. It seems to me that not only does death anxiety need to be explored, but also one's beliefs of an afterlife. If I understand this theory, one would focus on client's current life experiences and build on those, but I don't see how this method can build confidence for a brighter future leading to what? Death? If life after death is an axiom of the people, utterly unprovable, then surely the converse is equally true. BTW I love (& use) Dr. Yalom's book, The Theory and Practice of Group Psychotherapy.

sos - - Nov 21st 2008

i need help...i am 21 years old and encounter paralyzing fears of death throughout winter each year...i want to go on medication....but the process is long and expensive i have tried....i cry almost every day at my worst...i cannot function...i also have panic attacks almost every day.... it is hard for me just to live because i don't want to die....


i feel alone.

therapist-fomer patient emoional affair - - Mar 31st 2008
I survived a right hemsphere stroke in november that's left me with left sie weakness.When I came home in december i felt ovrwhelmed and lost. i didn't think my wife could handle all of my mental/behavioral neds so i contcted my formner speech therapist andtold her i needed someone to talk to.After several weeks of looking up Maryland therapist laws we found nothing stating we couldn't be friends outside the hospital.It didn't take too long for our emails to each other to become racy and eventually explicit.My wife found an erant txt message n my phone and confronted me.She maintains that my fomer/therapist tok advantage of mme during a vulknerable time in my recovery a.I munder going therapy wit h my Pastor andwill begiun psychiatric therapy in a couplkr weeks.The affair is now over .But my felings of desolation and loneliness re now just as trong as they wre in december. I handled thia affair badly from the sart this is somthing i never would have done before my stroke. I've told my wife that the therapist wasn't totally at fault . I persued her and a relationship with hrer.My wife says i need to top protecing my former therapist. She needs to answer for this indiscretian so it never hppens again.My wife wrote an email to her teklling her these things which caused the end of the affair . i think my therapist has been sufficintly scared. Filing charges would do nothing more than humiliate her.I'm there now and have no esire to subjext her to the sam thing. Charges wouerld destroy her marriage and derail what until nw has been a stellar career.What should i o?Should I obey my wife and tell my psychiatris all of this or keep it quiet and let my former therapist wok out her own demon?

Wonderful - - Mar 16th 2008

I have been a fan of Dr. Yalom's work for many years and am pleased that he has written this book, bringing a difficult topic out into the open for discussion.

The interview was very enjoyable, thank you so much.


Interesting Interview...but - - Feb 25th 2008

As always, Dr. Dave did a great job interview. Yalom is an intriguing character. It was great to hear such a luminary speak. His approach to death anxiety is fascinating. I was surprised however by their gushing over In Treatment. The show is fun to watch as everyone is beautiful and sexy. Yet, for the life of me, I am not impressed at all with how Weston treats his patients. Other than his own struggles, Weston is voyeuristic. His humanity is only revealed because of his suffering. I have yet to see any dimension of care for his patients except in the case of Sophie. 


Dr. Dave, I'm suprised!

A fan in the Middle East 

Anxiety and Death - Charles Merrill - Feb 24th 2008
I much appreciated the interview with Dr. Yalom.  Being familiar with his work on existential psychotherapy as well as group psychotherapy, his new book specifically addresses the death issue.  There is an openness in the interview that also reflects for me Dr. Yalom's clarity and directness in his writings.  Thanks for this highly relevant conversaton. 

Yalom interview - Hella Merrill - Feb 24th 2008
Timely interview...Dr. Yalom's book was just reviewed in the San Francisco Chronicle today.  I have admired his work and your questions really illuminated his perspective on psychology and death.  Thank you.

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