Michael R Leming. Handbook of Death and Dying. Editor: Clifton D Bryant. Volume 1. Thousand Oaks, CA: Sage Reference, 2003.
It is commonly believed that normal people are afraid to die and that death anxiety is a cultural universal. As a result, some people also assume that the threat of death should serve as a deterrent to the kinds of behaviors that are deemed to be undesirable, inappropriate, and/or threatening to the society. Such thinking seems to abound. For example, international travelers are frequently confronted with signs in some countries warning them that the possession and use of illegal narcotics is punishable by death. In many parts of the United States, people who commit murder may be sentenced to die at the hands of the state—again, the assumption is that the existence of the death penalty will deter individuals from committing such violent crimes. All capital punishment laws are based on the assumption that, because normal people fear death, the threat of capital punishment will deter the commission of heinous offenses.
Moreover, the assumption that it is normal to fear the dying process seems to permeate the American cultural fabric. In nursing homes and hospice programs, for example, it is not uncommon for neophyte caregivers, whether nurses, aides, or volunteers, to become anxious when patients express a desire to die. Inexperienced caregivers often cannot understand why patients express such a desire, and in turn they express their own need to learn how they can deter their terminally ill patients from this feeling.
The taken-for-granted assumption is that the fear of death is universal and that death anxiety is a cultural component of all societies. My purposes in this chapter are to evaluate such assumptions and to present evidence that serves to challenge this thinking.
The Assumption of a Fear of Death
If the fear of death were universal, it would be difficult for terrorists planning suicide attacks to overcome their own anxiety as they prepare to sacrifice their lives for the sake of their belief systems. It would also be impossible for professionals and laypersons to address the consequences of disastrous events by risking their lives to save the lives of others. If death fear were natural, then issues relating to the so-called instinct for self-preservation also would require intense examination. In fact, serious evaluation of the validity of the concept of the fear of death reveals many actions on the part of humans that demonstrate that death anxiety may not be a cultural universal.
The ancient philosopher Plato denies the universality of death anxiety, claiming that philosophy serves to prepare people for death:
Those who really apply themselves in the right way to philosophy are directly and of their own accord preparing themselves for dying and death. If this is true, and they have actually been looking forward to death all their lives, it would of course be absurd to be troubled when the thing comes for which they have so long been preparing and looking forward. (Phaedo 64a, in Tredennick 1969:107)
A more contemporary example of this type of thinking comes from psychologist B. F. Skinner. When he was approaching death from leukemia, the 86-year-old Skinner said with a laugh, “I will be dead in a few months, but it hasn’t given me the slightest anxiety or worry or anything. I always knew I was going to die” (quoted in Bjork 1993: 229).
If the fear of death were universal, we would not expect to find much in the way of differences when we compare populations or subpopulations of people. Such is not the case, however. Anthropological research into death-related customs and rituals has found that not all cultures hold death as something to be feared. Where death fears do exist, their intensity and form appear to vary by culture. An extensive body of cross-cultural thanatological literature suggests that people from different cultures have different views of death and dying, and that not all cultures posit that death and dying need be viewed as something to be feared (see Abdel-Khalek 2002; Lester and Becker 1993; Demmer 1998; McLennan, Akande, and Bates 1993; Reimer, 1998; Reimer and Templer, 1995-96; Roshdieh et al. 1999; Saunders 1999; Suhail and Akram 2002; Tang, Wu, and Yan 2002; Thorson and Powell 1998).
When considering death fear, many analysts begin with the premise that death per se has no meaning other than the meaning that people give it. Sociologists, for example, assume that fear of death is learned through social interaction. In U.S. culture, popular horror movies depict death—as well as ghosts, skeletons, goblins, bogeymen, and ghoulish morticians—as something to be feared. Rather than providing positive images of death and dying, these products of popular culture reinforce fearful meanings; for example, they portray cemeteries as eerie and funeral homes and morgues as scary places that are best avoided.
Sometimes people who have had traumatic deathrelated experiences (such as witnessing a fatal auto accident, discovering the body of someone who has committed suicide, or being present at a funeral where the emotional outbursts of some mourners created feelings of discomfort for others) develop very fearful attitudes toward death, but such occurrences are rather uncommon. Certainly, such experiences do not account for the prevalence of death fears among Americans.
As Erving Goffman (1959) observes, first impressions are important; our initial impressions tend to dominate the meanings that we attribute to situation-specific experiences. Goffman’s work is germane to my argument in this chapter in that many individuals tend to maintain the meanings of death that they first learned in childhood, even when they are confronted by more positive images later in life. Fear of death is also affected by age, gender, and occupation. For example, research has shown that older people tend to have less death anxiety than do younger people. (For an overall perspective on the relationship between death anxiety and age, see Suhail and Akram 2002; Swanson and Byrd 1998; Galt and Hayslip 1998; Fortner and Neimeyer 1999; Davis-Berman 1998-99.) Studies have also found gender differences in death anxiety; men and women tend to have different types of fears related to death, and, in general, women tend to fear death more than do men (see Howze 2002; Cotton 1997; Gantsweg 2002; Suhail and Akram 2002). Thorson and Powell (1996) investigated occupational differences in levels of death anxiety and found evidence that, in general, male funeral directors tend to be more fearful of death than males in other occupational groups.
Researchers have also conducted studies concerning fear of death in people of different religions and people of different levels of religious involvement, and the findings appear to be mixed. Some analysts report an inverse relationship between religiosity and death anxiety (e.g., Alvarado et al. 1995; Chibnall et al. 2002; Suhail and Akram 2002), whereas others have been unable to establish such a relationship (e.g., Rasmussen and Johnson 1994; Shadinger, Hinninger, and Lester 1999). Researchers have also explored religious variables, documenting differences in death anxiety among people of different religious groups (see Shadinger et al. 1999; Howze 2002; Reimer and Templer, 1995-96; Saunders 1999; Swanson and Byrd 1998). In one such study, Reimer and Templer (1995-96) found that Roman Catholics have higher death anxiety than do Protestants.
In summary, death fears do not appear to be instinctive or universal. It seems that fear of life’s end is learned from and perpetuated by culture. Such meanings occur because death is not an ordinary experience. In challenging the order of everyday life, firsthand encounters with death are so unusual that the prospect of the experience can be traumatic. (For discussions of the relationship between the dying and death experience and levels of individual death fear, see Cotton 1997; Straub 1997; Chung, Chung, and Easthope 2000; Evans, Walters, and Hatch-Woodruff 1999; Demmer 1998; Brubeck and Beer 1992; Ireland 1998; Hayslip et al. 1997; Firestone 1993; Mikulincer et al. 2002.)
Content of Death Fear
Death anxiety is a multidimensional concept that is based on four concerns: (a) the death of self, (b) the deaths of significant others, (c) the process of dying, and (d) the state of being dead. Fears related to the process of dying can be further elaborated into concerns about dependency, pain, indignity, and isolation and the fear of leaving loved ones. Additional sources of fear include the finality of death, the fate of the body, and afterlife concerns such as divine judgment. In this model’s more elaborated form (documented in Leming and Dickinson 2001), eight types of death fears can be applied to the death of self and the death of others:
The Process of Dying
- The pain in the dying process
- The indignity in the dying process
- The isolation, separation, and rejection that can be part of the dying process
- Leaving loved ones
The State of Being Dead
- The finality of death
- The fate of the body
- Afterlife concerns
As shown in Table 1, the content of fear is influenced by the identity of the person whose death the individual is considering. From the perspective of one’s own death, one may have anxiety over the effects that one’s dying (or being dead) will have on others as well as many concerns about how one’s body might be treated by others. From the perspective of a survivor, concerns might include financial and emotional problems related to the death of a significant other.
Given that many factors related to the experience of death and death-related situations can engender fear, we would expect to find individual differences in types and intensity of death fear, including differences related to social circumstances and past experiences. However, with all of the potential sources for differences, repeated administrations of the Leming Fear of Death Scale yield consistently high scores for the fears of dependency and pain related to the process of dying and relatively low anxiety scores for fears related to the afterlife and the fate of the body. In one study, approximately 65% (N > 1,000) of the individuals surveyed experienced high anxiety concerning dependency and pain, and only 15% experienced the same level of anxiety relative to concerns about the afterlife and the fate of the body (Leming, 1979-80). Thus it is the process of dying, not the event of death, that causes the most concern. Perhaps one explanation for this finding is that many Americans are uncomfortable with death, and society does not provide a supportive environment for those undergoing the dying process. Indeed, approximately 70% of all deaths in the United States take place in hospitals and nursing homes.
Religion As a Means of Coping
Regardless of why death anxiety exists, perhaps a more important question is, How do people cope with such feelings and anxieties? One way has been through the practice of religion. Émile Durkheim, one of the founders of the discipline of sociology, claims that it was the fear of death and the dead that led to the creation of religion. He offers empirical support for this claim in The Elementary Forms of Religious Life ( 1995), in which he discusses the relationship between death and the rise of religious rituals.
He states that individuals construct funeral practices and then develop religious orientations and rituals to support those practices.
Death and the Origin of Religion
Symbolic interactionists assert that meanings are socially constructed. These meanings provide a knowledge base for activities and actions and provide order for those who share a common culture. Peter Berger (1969) suggests that the human world is devoid of any order other than that which is socially created. Life situations challenge the order on which social life is based. Many of these situations are related to what Thomas O’Dea (1966) refers to as the three fundamental characteristics of human existence: uncertainty, powerlessness, and scarcity.
Uncertainty refers to human activity that does not always lead to predictable outcomes. Even careful planning may not allow a person to be in a position to achieve all of his or her desired goals. To an extent, the human condition also is characterized by powerlessness. Many events are beyond humans’ capability to change or avoid them; among these are death and natural disaster. Scarcity exposes humankind to inequity in the distribution of the social and environmental resources that promote life satisfaction. This unequal distribution serves as the basis for perceptions of relative deprivation and frustration. According to O’Dea (1966), experiences of uncertainty, powerlessness, and scarcity “raise questions which can find an answer only in some kind of ‘beyond’ itself” (p. 5). Therefore, marginal situations, which are characteristic of the human condition, force individuals to the realm of the transcendent in the search for meaningful answers.
Berger (1969) claims that death is one such marginal situation:
Witnessing the death of others and anticipating his own death, the individual is strongly propelled to question the ad hoc cognitive and normative operating procedures of “normal” life in society. Death presents society with a formidable problem not only because of its obvious threat to the continuity of human relationships, but because it threatens the basic assumptions of order on which society rests. Death radically puts in question the taken-for-granted, “business-as-usual” attitude in which one exists in everyday life. (P. 23)
It is the transcendent reference, or religion, that helps an individual to maintain a reality-oriented perspective when the order of life is challenged. Contemplating death, we are faced with the fact that we will not be able to accomplish all our goals in life. We also realize that we are unable either to extend life or to control the circumstances surrounding death. It is troubling that some individuals must endure painful, degrading, and meaningless death, whereas others find more meaning and purpose during the final days of life than they experienced in the years preceding the terminal period. Finally, the relative deprivation created by differential life spans raises questions that are unanswerable.
Religious-meaning systems provide answers to the problems of uncertainty, powerlessness, and scarcity created by death. O’Dea (1966) illustrates this function of religion:
Religion, by its reference to a beyond and its beliefs concerning man’s relationship to that beyond, provides a supraempirical view of a larger total reality. In the context of this reality, the disappointments and frustrations inflicted on mankind by uncertainty and impossibility, and by the institutionalized order of human society, may be seen as meaningful in some ultimate sense, and this makes acceptance of and adjustment to them possible. (Pp. 6-7)
Religion as a Means of Providing Understanding
The anthropologist Bronislaw Malinowski (1965) calls religion the “great anxiety reliever,” asserting that it functions to relieve anxiety caused by crisis. According to Malinowski, religion provides individuals with the means for dealing with extraordinary phenomena; it functions to restore normalcy.
Every important crisis of human life implies a strong emotional upheaval, mental conflict and possible disintegration. Religion in its ethics sanctifies human life and conduct and becomes perhaps the most powerful force of social control. In its dogmatics it supplies man with strong cohesive forces. (P. 70)
Malinowski claims that “death, which of all human events is the most upsetting and disorganizing to man’s calculations, is perhaps the main source of religious belief” (p. 71).
A. R. Radcliffe-Brown (1965) disagrees, claiming that religion induces fear and anxiety—such as fear of spirits, fear of God’s judgment, and fear of the devil and hell—from which people otherwise would be free. According to Radcliffe-Brown, nonreligious individuals experience less death anxiety and cope better with death than do religious persons. Thus he poses an alternative perspective: “If it were not for the existence of the rite and the beliefs associated with it the individual would feel no anxiety, and … the psychological effect of the rite is to create in the individual a sense of insecurity and danger” (p. 81). Radcliffe-Brown argues that religion may serve to increase anxiety for the individual rather than reduce it. His contention is that religion functions to create a sense of anxiety that maintains the social structure of the society, as noted in the following:
Actually in our fears or anxieties, as well as in our hopes, we are conditioned by the community in which we live. And it is largely by the sharing of hopes and fears, by what I have called common concern in events or eventualities, that human beings are linked together in temporary or permanent associations. (P. 81)
According to Radcliffe-Brown, from the point of reference of personal death anxiety, religious beliefs have dysfunctional consequences. Whereas Malinowski notes that the individual may feel anxiety on certain occasions, Radcliffe-Brown asserts that the social expectation is that people should experience anxiety on such occasions. Starting with Malinowski’s reference point, attention is thus focused on the function of religion for the individual. From this perspective, patterns of social integration are contingent on psychological processes. Given that religious rituals help some individuals to find meaning in death, the social function of religion must be anxiety reduction. Malinowski (1965) illustrates this point:
Religion in its ethics sanctifies human life and conduct and becomes perhaps the most powerful force of social control. In its dogmatics it supplies man with strong cohesive forces. It grows out of every culture, because life-long bonds of cooperation and mutual interest create sentiments, and sentiments rebel against death and dissolution. The cultural call for religion is highly derived and indirect but is finally rooted in the way in which the primary needs of man are satisfied in culture. (P. 72)
George Homans (1965) attempts to resolve this problem, declaring that both Malinowski and Radcliffe Brown are correct in their assessments of the role religion has in promoting death anxiety. Homans argues that Radcliffe-Brown’s hypothesis complements Malinowski’s theory in that Malinowski’s observations are at the individual level (the micro level) whereas Radcliffe-Brown’s analysis is directed toward the community (the macro level). Homans argues that when individuals encounter death, the anxiety they experience is socially ascribed, or learned. With its emphasis on immortality of the soul and belief in a coming judgment, religion increases the level of death anxiety for those who adhere to religious teachings. However, once these individuals have fulfilled the requisite religious or magical ceremonies, they experience only a moderate amount of anxiety. Homans brings both these perspectives to bear in the following four propositions:
- Religion functions to relieve anxiety associated with death-related situations.
- Death anxiety calls forth religious activities and rituals.
In order to stabilize the group of individuals who perform these rituals, group activities and beliefs provide a potential threat of anxiety in order to unite group members through a “common concern.”
This secondary anxiety may be effectively removed through the group rituals of purification and expiation.
Summarizing the relationship between religiosity and death anxiety, the following theoretical hypotheses can be derived:
- Hypothesis 1: The meanings of death are socially ascribed—death per se is neither fearful nor nonfearful.
- Hypothesis 2: The meanings that are ascribed to death in a given culture are transmitted to individuals in the society through the process of socialization.
- Hypothesis 3: Anxiety reduction may be accomplished through social cooperation and institutional participation.
- Hypothesis 4: Religious institutions foster institutional cohesiveness by giving participants a sense of anxiety concerning death and uniting them through a common concern.
- Hypothesis 5: If religious institutions are to remain viable, they must also provide means for anxiety reduction.
- Hypothesis 6: Through its promise of a reward in the afterlife and its redefinition of the negative effects of death upon the temporal life of the individual, religion diminishes the fear that it ascribes to death and reduces the anxieties that secular society ascribes to death.
To test the empirical validity of these hypotheses, I surveyed 372 randomly selected residents of a small midwestern city concerning death anxiety and religious activities, beliefs, and experiences (Leming 1979-80). I divided the subjects into four groups, based on the religious commitment scales developed by Charles Glock and Rodney Stark (1966) and Joseph Faulkner and Gordon DeJong (1966). Approximately 25% of the respondents fell into each category—the first group consisted of those persons who were the least religious and the fourth group was composed of those who were the most religious. I then compared the subjects’ death anxiety scores on the Leming Fear of Death Scale (see the appendix to this chapter) for each of the eight different fear content areas with each of the levels of religious commitment.
As the data displayed in Table 2 indicate, the relationship found between the variables of religiosity and death anxiety was curvilinear; that is, moderate religious commitment added to the general death-related anxiety that individuals had learned from secular sources. Those subjects with moderate religious commitment received only the negative consequences of religion—this coincides with Radcliffe-Brown’s identification of religion as a common concern of death anxiety. These persons acquired only the anxiety that religion is capable of producing, and none of the consolation. On the other hand, highly religiously committed individuals had the least anxiety concerning death. This supports Malinowski’s argument that religion provides individuals with the solace they need to cope with death-related fears.
In summary, religiosity appears to serve the dual function of “afflicting the comforted” and “comforting the afflicted.” Thus, for those with a high degree of commitment, religion relieves the anxiety it causes. The theoretical model suggests a curvilinear relationship between the two variables—those persons with moderate religious commitment experience the greatest amount of anxiety in each of the eight areas. In attempting to evaluate this relationship, I found that the theoretical model was supported, with only two curvilinear trend deviations (Leming 1979-80; see Table 2). These deviations are found among the least religious group for the factor of fear of dependency in the dying process. This finding suggests that nonreligious individuals are more concerned than religious persons about being self-sufficient and independent of others, and that they find dependency even more distressing than do persons who are more religious. In terms of the fear of isolation, there does not seem to be a relationship between death fear and religious commitment.
Education, age, and religious preference did not affect the curvilinear relationship (Leming 1979-80). With the exception of the fear of isolation, persons who held the strongest religious commitment were the least fearful. Furthermore, in each of the eight death fear areas, the strength of commitment was the most significant variable for explaining the relationship between religion and the fear of death.
Death fear, or death anxiety, is not universal or inherent; like all other social values and attitudes, death-related meanings are socially constructed and transmitted from one generation to the next. People who fear death do so because they have been taught that death is something to be feared or because their life experiences have taught them to have fearful responses to death-related phenomena. On the other hand, many have little death anxiety or fear. These individuals’ nonfearful responses to death are also conditioned by their social situations and experiences.
Furthermore, among those who fear death, the actual content of their fears may vary widely. Thus it is safe to assume that death anxiety is multidimensional based on four concerns: (a) the death of self, (b) the deaths of significant others, (c) the process of dying, and (d) the state of being dead.
If the fear of death were universal, we would not expect to find many differences across populations, but this is not the case. The intensity and form of death fears vary by culture as well as by age, gender, occupation, and religion. When other factors are controlled for, religion, as a cultural system, seems to have the most influence over the salience and intensity of death fears. Religiosity appears to serve the dual function of “afflicting the comforted” and “comforting the afflicted.”
Religions are systems of beliefs and practices that are related to the sacred. Religious institutions meet basic social needs in that a major function of religion is to explain the unexplainable. Religion plays a significant role in helping individuals to cope with extraordinary events, including death. Not only can religious observance assist in restoring the normative order that was in place prior to the move into disequilibrium, but high religious commitment can enable individuals to cope better with their own dying and with the deaths of loved ones. Society may derive benefits from the fears that people experience, but it also needs to foster coping strategies that people can use when faced with death-related anxieties. Religion serves to meet these social needs.