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Mark Dombeck, Ph.D.Mark Dombeck, Ph.D.
Essays and Blogs Concerning Mental and Emotional Health

Randy Pausch and Death Anxiety: It's okay to feel terror in the face of death

Mark Dombeck, Ph.D. Updated: Jul 26th 2008

If I don't seem as depressed or morose as I should be, sorry to disappoint you.

Dr. Randy Pausch (from an ABC News clip)Randy Pausch, the CMU Computer Science professor who gave the "Last Lecture" that was so talked about in the media last Winter ago has died today (July 25th, 2008). You'll recall that Dr. Pausch had cancer and was given 3 to 6 months to live. In his last lecture, he talked about the life lessons he had learned, and tried to communicate to others and for posterity to his own young children what he thought the meaning of life was about.

The Last Lecture video was very well received. A look at YouTube's reported statistics shows over 3 million views (of a video that is over one hour's duration!), over 11,000 comments and a five star rating. Very few communications of any sort are so unanimously received. I can't help but think that part of the reason for this incredible reception is the way that Dr. Pausch presented himself to be a role-model for how to handle death.

Death is just about as scary a thing as you can think of. If you don't' believe me, listen to this podcast Interview with Dr. Irvin Yalom on Death Anxiety and he'll convince you. Think of the normal reaction a person would be expected to have upon learning that they have a terminal illness and will not survive even one more year. Most people would be panicking, pleading with God, depressed, paralyzed, drinking, spending money. People are as a rule "scared to death" of dying.

But Pausch presents in his lecture as very much calm and accepting, and even grateful. More than anything he is optimistic as he talks about the best way to achieve one's dreams. By being so calm and so accepting of his own death, Pausch helps other people to feel temporarily free of their own death anxiety. A weight lifts off everyone's shoulders just a little, and it feels good; it feels inspiring.

Except, as I watch Dr Pausch's message for the third time now, I can't help but feel that his calmness and optimism itself has a somewhat forced quality to it; that there is a feeling here of performance; that he is trying to present himself a little more as he ought to be rather than how he probably was.

In the ABC interview with Diane Sawyer he makes the following observation:

I've never understood pity and self-pity as an emotion. We have a finite amount of time – whether it is short or long doesn't really matter. Life is to be lived and I've never met anyone who was pitying themselves or pitying others who was making the best and highest use of his time.

A good sentiment for sure, but one that seems to me to be problematic if taken too far. I'm with him that it isn't productive to wallow in self pity, but he seems to go further, implying that self-pity is not okay as an emotion to feel. Which seems odd to me because I think feeling some self-pity when you are dying is a perfectly normal and reasonable thing. Allowing yourself permission to feel self-pity is a type of relaxation of vigilance. It's allowing the organic terror of death to be expressed; an acknowledging of what is happening. It isn't good for mental health reasons or many other reasons to stay in that feeling and wallow in it, but I think that people could experience a different sort of avoidable mental health problem if they experienced themselves as not allowed to feel and accept the feelings they are actually experiencing. Even if those feelings are terrifying, they are still emotional reality.

Many people write us to share their emotional state. Frequently, people writing us are depressed and despondent, self-pitying and pessimistic. This is a painful way to exist, and we give what guidance we can to those who write so that they can help themselves feel better. Quite consciously, we never do this by suggesting that it isn't okay to have these feelings. However inadvertently, I think this is what Pausch may have ended up communicating. 

If Pausch was censoring or controling his emotions, he had his reasons, I'm sure. I'm very conscious, for one thing, of the fact that Pausch and his wife have three very young children, and that his activities with regard to his lecture and the book based upon that lecture are dedicated to those children and ultimately intended to convey a message to them. Pausch may have appropriately decided to present an optimistic face for them, with the idea or hope that this they might suffer less if he did that.

Self-pity is a private emotion, and Pausch's last lecture is anything but private. We can't know what he experienced in the privacy of his own mind, or in front of family alone. But I expect that his private experience was richer and more varied than the unwavering optimism we see in the lecture. I make this point because I fear that some people watching the Last Lecture may compare themselves to Dr. Pausch and find themselves wanting because they are not so fiercely optimistic. Therefore, it's important to keep the following in mind if you are not naturally an optimist yourself and you want to watch the lecture without starting to feel cynical or hopeless in comparison to the guy. It's in part a performance he's putting on. He's a human being; he's likely terrified of dying just like you are; he's making the best of it; you only get to see his public face. It's not realistic for you to hold yourself to his standard, because you don't have all the information about how he really felt privately that you'd need to make a fair comparison.

I don't mean this as an attack on Dr. Pausch in any way, though I realize it could easily seem like one. More to the point, I'm suggesting that there is likely more to the story then we have been allowed to see, and that sometimes what looks like a natural strength is also a form of coping.  The guy was incredibly courageous, thoughtful and compassionate and forced to cope with a worst case scenario that would test anyone. I understand that Pausch spent the last period of his life doing what he could (such as securing a book deal) to provide for his family after his death. I respect the hell out of that. I have only sympathy for his wife and children, who are surely in a lot of pain right now.

Anyway, I'm interested in how people have responded to the Last Lecture; if I'm the only one out there who felt there was an overly positive quality to it, and if in general people have found it to be inspiring, or intimidating.  If you care to leave a comment, that would be helpful.


Mark Dombeck, Ph.D.

Mark Dombeck, Ph.D. was Director of Mental Help Net from 1999 to 2011. Presently, he is an Oakland Psychologist (Lic#PSY25695) in private practice offering evidence-based acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT) and addressing a range of life problems. Contact Dr. Dombeck by calling 510-900-5123, send Dr. Dombeck email or visit Dr. Dombeck's practice website for more information.

Reader Comments
Discuss this issue below or in our forums.

Integrity - Becky - Jun 2nd 2013

Knowing something about a terminal diagnosis, both the terror and the newfound appreciation of life, I believe that "putting the best face forward" is part of taking  a break fom the sadness. This was a relatively short but broad look at a man's life.  It is, well, quite narrow minded, and even mean spirited  to ignore or demean how Dr. Pausch presented himself here. He knew what many extroverted, conscientious people know.  You help yourself best by helping others.  You live long after you are gone, and you always strive for integrity. It isn't forced optimism you saw, it was integrity and bravery. 

The Great Fighter of all time - Elizabeth Lim - Apr 27th 2010

The Last Lecture is the first book that I was able to finish reading in one seating. It is the most inspiring and heartfelt book that I have read and highly recommend it to all my friends and family.

What stood out was Randy's strength and courage in the face of adversity. With an end in mind, he decided to live his life to the fullest. His life experiences has been a great lesson for me as a single parent. His concept of the brick wall, how we should play the card we are dealt with, loyalty, teamwork, have fun, live life, be patient with people...these are valuable lessons.

Despite the excruciating pain he felt in March 2008, he continued to champion for more money to be pumped into research on pancreas cancer. And when asked if he has any regret in life: it was that he did not find a cure for it.

I hope his message will continue to carry far and wide and that someday his wish for a cure will soon come true.

Rest in Peace, Randy.

Randy - a real life hero - Shilpa Chahal - Aug 10th 2009

I actually read Randy's book a month before he died.  After that first read, I read it two more times. I can literally quote most of the book at the most opportune moments.  If I have to pick someone for an inspiration, it rather be someone like Randy, who taught us to live in face of adversity.  I know of another such, Randy Pausch like person in our community who has a grade IV brain tumor. So he is not writing a book or giving lectures, but continues to inspire us and has taught us to live life well. There are a few Randy's out there. I hope when my time comes, I will be brave and resilient like Randy and my friend Steve.  

Its heart wrenching to even think of him gone, not for anyone else but for his family, his wife and young children.  To have a father like Randy and to not get to know him well in his life time, is sad for his kids. But I bet, Jai will make sure his children eventually know him, through his book, his videos and his stories.

Randy Pausch, you are a hero and I salute you and the message you left for the rest of us to live life to the fullest.  

About Pausch. - nando - Aug 5th 2008

His speech was inspiring and very "logic", when words sound just about right and logic, that means that the person who's delivering it is a human being that learned the lessons from life, and stored them in his memory in harmony with all the events he went trough in his lifetime.

Randy speech is about his own life, and life can be experienced quite differently among human beings.

People who read this site, often have some problems in their backgrounds, while they were growing up (mentally) etc. Randy seems to be very grateful with the way his parents raised him, he even didn't have a problem showing his awkward (for weak-mind people) hobby of collecting bears (or puppets) to the audience, he also was a successful scientists, so in a way, his vision of life has been a path that looked like just surrounded by the right people.

But what would have been of Randy if he would have been raised by controlling and violent parents, bullied by peers, while he was forming his character?. 

I guess, that thanks to internet tools like youtube, people that have been going trough very depressing days can see that they can also control a little bit their destiny, by working hard and enjoying the moment. But they have to realize that their way to see life has been modeled by the way they experience the world, which could be quite different from the way Randy experienced it.

RIP to Randy, I'm very greatful that videos like his one are massively famous around the globe.

Dr. Randy Pausch was not going to let his death get in the way of his life. He wasn't going to go down giving up on life. - Shannon - Aug 4th 2008

You need to understand that he went down in this most noble and admirable way I can imagine for someone facing death.

Editor's Note: Dr. Pausch was an optimist and a bit of an extrovert, and the way he chose to die was noble and workable within the framework of someone who is/was an optimist and extrovert.  But we deal on this site with people who are not so optimistic as a rule, and Dr. Pausch's decision to present a positive face to the public in the face of his impending death would not be easy or authentic for many of these people I'm thinking of.  While Dr. Pausch's death was authentic for him, I don't think it ought to be held up as the only noble or authentic way to die.  I don't think people should feel pressured (either by others or by themselves) to hold themselves to the standard that Dr. Pausch offered, becuase it doesn't fit everyone.  That's all I'm suggesting.  

Thank you, Randy - William P. Robbins - Jul 28th 2008
My dad has been gone two years now and Randy's sharing has helped Mom and the family in recovery.  I plan on sharing parts of Randy's book with my 5th grade students this coming school year.  The lessons he leaves are a guide to all.  My prayers to his wife and children.  I have never witnessed such love as what Randy expressed to his family.

- -Susan - Jul 27th 2008
Randy was not without emotions, what he did was not impose his private feelings on a topic that requires strength, courage, its. Randy and his wife are "heroes" and heroes are afraid and mortal. But they rise to heroic actions and thoughts and bring us along. Thanks for sharing a life well lived (which I believe this is all about), the courage to introduce the elephant in the room and move on as the elephants was immovable. And he tought us how to live and be brave with the cards we have. I believe you missed the point, Randy and his wife did not want the "terror of the grave" to rob them of life. So you missed it. You totally missed it. Go read the book again.

He was not without fear - Denise - Jul 26th 2008

In interviews Dr Pausch and his wife both stated that they had very hard times dealing with the diagnosis.  They are both very open about the fact that they sought counseling regularly to better handle their emotions and he has recommended counseling for some seeking his advice.  In his book he talks of how sad he and Jai are that they won't be able to experince the richness of their marriage for another 30 or 40 years.  Jai whispered to him "Please don't die" when they hugged onstage at the end of The Last Lecture speech at CMU (that's about as real as it can get!).   In fact in The Last Lecture he specifically states that he doesn't want to talk about his family "because I'm good but I'm not that good,"  meaning he wouldn't be able to talk about the implications to his family in public because his emotions would take over.

While I agree it is important to recognize that we might not all be the natural optimist that Dr Pausch was (or the pragmatic scientist), I do think he made it very clear that they were devastated.  His broader message though is to do the things that make you happy, whatever those things are; that and living a good life in general, regardless of your own personal nature, will make handling the tough stuff, even death, a little easier.  

Rest In Peace Randy and my thoughts and prayers go to his family.

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