Death, Society, and
Human Experience
9th Edition
Robert Kastenbaum
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Copyright © Allyn & Bacon 2007
Chapter One:
As We Think About Death
This multimedia product and its contents are protected under copyright law. The following are prohibited by law:
•Any public performance or display, including transmission of any image over a network;
•Preparation of any derivative work, including the extraction, in whole or in part, or any images;
•Any rental, lease, or lending of the program.
•
Copyright © Allyn & Bacon 2007
Not Thinking About Death:
A Failed Experiment
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Avoiding the topic of death
• Educational systems
• Professional schools (including medical,
graduate, and seminary training)
• Media outlets (including news and movies)
• Fatalism (no need for discussion because the
outcomes are determined in advance)
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Listening and Communicating
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Timothy E. Quill, M.D.
• Known for his article, “Doctor, I want to die. Will
you help me?”
• Advocates for physicians as personal guides
and counselors to their dying patients
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Today physicians and families feel more
empowered
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Your Self-Inventory of Attitudes,
Beliefs, and Feelings
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Four Self-Inventory Questionnaires provided
in the textbook
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#1,
#2,
#3,
#4,
My
My
My
My
Knowledge Base
Attitudes and Beliefs
Experience with Death
Feelings
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Attitudes, Experiences, Beliefs, &
Feelings
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Attitudes: our action tendencies
Beliefs: our worldview
Feelings: our total sense of being
All are influenced by personal experiences
with dying and death
• Experiencing a death that “got to us” changes
us
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How Does State of Mind Affect
Death-Related Behavior?
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Hesitancy to initiate a Living Will
Hesitancy to sign an Organ Donor Card
Choosing to engaged in high-risk behaviors
• Example: Stepping off the curb
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Found that those who took greater risks in crossing
the street also reported high risk driving, and were
more likely to have contemplated suicide and
express greater frustration with life.
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Man is Mortal: But What Does That
Have To Do With Me?
The Death of Ivan Ilych, by Tolstoy
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Peter Ivanovich realizes he is vulnerable
Peter focuses on his own death
Peter evades death by leaving (escaping)
Peter differentiates himself from Ivan
Peter discusses Ivan’s death as factual,
creating a barrier between himself and
death
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Anxiety, Denial, and Acceptance:
Three Core Concepts
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Death Anxiety: Emotional distress,
insecurity, tension, and apprehensiveness
Denial: A response that rejects certain key
features of reality in an attempt to avoid or
reduce anxiety
Acceptance: Coming to terms with death
and easing anxiety (different from
resignation or depression)
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Difficulties in Interpreting
Death Anxiety Scales
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Can we interpret death anxiety out of
context of religious, cultural, and personal
beliefs?
Do low scores mean low death anxiety or
denial?
What is a normal score for death anxiety?
What level of death anxiety is most adaptive
and productive?
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Difficulties in Interpreting
Death Anxiety Scales
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Do the participants’ responses reflect the
general population?
Can a one-time sample of an individual’s
thoughts give an adequate indication of
death anxiety?
Can researchers assume that individuals
would behave in a way that is consistent
with their attitudes towards death anxiety?
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Major Findings from Self-Reports:
Levels of Death Anxiety
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Low to moderate levels of in the general
population
Women report higher levels
Adolescents and Young Adults report high levels
Elders report low levels
People diagnosed with psychiatric disorders report
higher levels
No clear pattern established with religious beliefs
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Situational Death Anxiety
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Trait anxiety: General apprehension and
restlessness
Situations that often increase death anxiety:
• Transitional situations, such as divorce
• Exposure to death, such as a neighbor or
parent
• Life-threatening Illness
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Theories of Death Anxiety:
Early Psychoanalytic Theory
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Our unconscious system does not respond
to the passage of time, nor have the concept
of negation, so there is no death to erase life
Thanatophobia is a disguise for the real
fear: Castration Anxiety
Death Anxiety comes from a fear of losing
value, love and security by being less than a
whole person
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Theories of Death Anxiety:
Existentialism
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Awareness of our mortality is the source of anxiety
• Society’s primary function is to help us pretend
that life will never end
• Protect us from ontological confrontation
• Provide a belief system to produce a sense of
coherence, predictability, and meaning
• Provide rituals connecting us with something bigger
than ourselves
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Theories of Death Anxiety:
Terror Management Theory
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Part of Existentialist Theory
Emphasizes strong self-esteem as
protection from death anxiety
Emphasizes our investment in socio-cultural
constructions of life and death (including
religious belief systems)
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Theories of Death Anxiety:
Edge Theory
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Our survival and adaptation functions take
control when we feel we are on the edge of
what is safe and known
Rather than remain anxious all the time, we
use our built-in biomechanisms and
cognitive/social skills to respond in
dangerous situations
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Types and Contexts of
Acceptance and Denial
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Selective attention: Redirecting attention to
whatever seems most salient in the
immediate situation
Selective response: The individual feels this
is not the time or place to discuss death, or
the person may be working very hard at
completing tasks in full awareness that time
is running out
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Types and Contexts of
Acceptance and Denial
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Compartmentalizing: Much of the dying and
death reality is acknowledged, but the
person stops just short of realizing the
situation by putting all the information
together
Deception: Deliberately giving false
information to others is deception (for
whatever reason)
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Types and Contexts of
Acceptance and Denial
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Resistance: The individual comprehends the
reality of the situation but chooses to fight
for life as long as possible
Denial: A primitive defense mechanism that
totally rejects the existence of threat or
death-laden reality
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Anxiety, Denial, and Acceptance:
Kastenbaum’s Premises
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Most of us use both acceptance and denial-type
strategies
Total acceptance and total denial-type strategies
occur only in extreme situations
Much of what is called denial is adaptive, selective
responses
Interpersonal context must be considered
We must understand what the person is trying to
accomplish
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In the Shade of the Jambu Tree:
An Example from Taoism
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Tao (pronounced dow) is translated as The
Way
Emphasizes the unity of nature
The Taoist answer to death lies in the sense
of an affinity or communion between life and
death
Life can be extended by drawing upon the
power of the tao (natural energy)
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Glossary: New Terms
•
Uniform Anatomical Gift
Act
• Collective Representations
• Death Anxiety
• Denial
• Edge Theory
• Existentialism
• Fatalism
• Living Will
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Mortality Salience
• Ontological Confrontation
• Schizophrenia
• Self-Efficacy
• Taoism
• Thanatophobia
• Terror Management
Theory
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