Stress, Coping, and Adaption

1. Stress, Coping, and Adaption April 14, 2008 Existential Concerns and Death Anxiety Eric Weiser Curry College

2. Topics… • Existentialism • Key Ideas • The Rise of Experimental Existential Psychology • Yalom’s Four Basic Existential Concerns • Death Anxiety • Kubler-Ross Stages of Death and Dying • The Effects of Death on Loved Ones • Terror Management Theory • Key Ideas and Research

3. Existentialism • A philosophy that seeks to explain how humans find meaning in their lives, given the realities of life, death, suffering, and an unpredictable, random world devoid of any true meaning

4. Existentialism Jean-Paul Sartre (1905-1980), pictured left, and Friedrich Nietzsche (1844-1900), pictured right, were two highly influential existentialist philosophers.

5. Existentialism: Key Ideas • “Existence precedes essence” • Existence is just what it is, nothing more nothing less • There is no real “meaning” in the universe; everything (including our existence) is purely a random event, not part of some grand scheme • There is no such thing as a “transcendent force” (e.g., God), so each person is ultimately free and thus responsible for creating their own meaning for their own lives • Any happiness or optimism (although necessary) is just an illusion because you are merely denying the tragic aspects of existence (death, freedom, isolation, and meaninglessness) • Thus, the purpose of life is to find meaning for our existence in a meaningless, random, chaotic universe

6. The Rise of Experimental Existential Psychology • Within the field of psychology, a loosely defined existentialist movement began to emerge in the 20th century, mainly as a reaction to orthodox Freudian theory • This movement sought to explain human behavior not in terms of repressed instinctual impulses (as did Freud), but rather in terms of the phenomenological world of the person • That is, it was based on the premise that “reality” consists of objects and events as they are perceived or understood in human consciousness and not of anything independent of human consciousness

7. The Rise of Experimental Existential Psychology • Irvin Yalom, pictured, helped put experimental existential psychology “on the map” with the publication of Existential Psychotherapy (1980), a classic textbook on psychotherapy Born 1931

8. The Rise of Experimental Existential Psychology • Yalom (1980) • Viewed existential psychology as dealing with the motivational consequences of important human conflicts • These conflicts flow from the individual’s confrontation with the “givens of existence” • In other words, existential psychology attempts to explain how humans come to terms with the basic facts and realities of life with which we must all contend.

9. Yalom (1980)Four Basic Concerns in Life • Death • How do we confront and deal with the fact that deal is unavoidable? • Freedom • Reflects a conflict between the desire for self-determination, and the feelings of groundlessness when one realizes that what happens to us in life is really up to us • There are few rules to live by, and few people have direct control over our lives

10. Yalom (1980) Four Basic Concerns in Life • Existential isolation • Refers to the realization that, despite how close we are to others, entering this world (birth) and leaving it (death) is done alone • We cannot share all our experiences with others, the most significant things in life (birth and death) are done alone • Meaninglessness • In a world in which death is the only certainty, where the only true certainty is death, and where one can never fully share one’s experience with others, what meaning does life have? • Thus, a key to human life is to construct some kind of meaning in a world that may be completely devoid of meaning

11. Making Sense of the World • How do we create meaning in our lives? We do so by believing in things that minimize our acceptance of randomness and uncontrollability. • Belief in a just-world (Lerner, 1980) • Good things happen to good people, bad things happen to bad people • Victim derogation – the idea that people get what they deserve • Illusion of Control (Langer & Rodin, 1975) • People tend to believe that they have control over random events that they have no actual control over • “Illusion of External Agency” (Gilbert, Brown, Pinel, & Wilson, 2000) • People tend to underestimate to what extent they can control certain outcomes • They tend to believe that outcomes are, in certain ways, influenced by a benevolent, insightful, and influential external agent (e.g., God) • Again, minimizes the acceptance of randomness and uncontrollability

12. Making Sense of the World • Creating meaning in our lives (continued)… • Relationships with others (e.g., romantic relationship, marriage, friendships, etc) • Quells concerns regarding existential isolation • Endorsement of cultural symbols (e.g., patriotism) • Enables us to feel as though we are part of something meaning, lasting, worthwhile, and that will continue to exist after we no longer exist (thereby, in a certain way, solving the “problem” of death)

13. Death Anxiety “Even in the midst of life, we are in death.”

14. Factors Related to Fear of Death • Men typically claim to be less of afraid of death than do women • Strongly religious individuals tend to be less worried about death, compared to others • People high in self-esteem and sense of mastery are typically less anxious about death and dying than are people who lack confidence or a sense of control • Older people typically report (on a conscious level) that they are less afraid of death than younger people • Also, older people have different concerns in relation to dying than do younger people

15. Kalish & Reynolds(1977) • Asked members of 4 ethnic groups in Los Angeles what they would most want to do if they had only 6 months to live. Results are in the table on right.

16. Who’s Afraid of Death? (Feifel & Branscomb, 1972) • N = 371 subjects • 92 seriously and terminally ill • 94 chronically ill and physically disabled • 90 mentally ill patients • 95 healthy individuals • A total of 10 predictor variables (e.g., age, education, religious self-rating, etc) were measured, as were attitudes toward death on 3 different levels • Conscious level • Fantasy level • “Below-the-level-of-awareness (Unconscious level)

17. Who’s Afraid of Death? (Feifel & Branscomb, 1972) • Conscious level • “Are you afraid of your own death? Why?” • Fantasy level • “What images or ideas come to mind when you think of your own death?” • Answers were coded as positive, negative, or ambivalent • Unconscious level • Word association and recall test (10 death and 10 neutral words) • Longer time to come up with a similar word when presented with “death word,” or to recall the death word, indicates more aversion to the death word • Also, color-word interference test • (i.e., present a word and say its color, not content…a longer time to do this to “death words” would indicate more “discomfort” with death word

18. Who’s Afraid of Death? (Feifel & Branscomb, 1972)

19. Who’s Afraid of Death? (Feifel & Branscomb, 1972) • Summary • On a conscious level, people generally do not seem to be concerned with death • Especially older and more religious people • On a fantasy level, the images people have of death are ambivalent (good and bad) • On an unconscious level, people’s responses to death seem generally negative (especially those who are ill or old…close to death, in other words) • These counterbalanced reactions may be adaptive to people

20. Death Anxiety • Elizabeth Kubler-Ross, pictured, was a pioneer in what’s known as thanatology (i.e., the psychology of dying). Her work was very controversial. • In 1969, her book On Death and Dying described the stages of dying, based on interviews with terminally ill patients in Billings Hospital in Chicago. 1926-2004

21. Stages of Death and Dying(Kubler-Ross, 1969) • Denial and isolation • Anger • Bargaining • Depression • Acceptance

22. Stages of Death and Dying(Kubler-Ross, 1969) 1. Denial and Isolation: Used by almost all patients in some form. It is a usually temporary shock response to bad news. Isolation arises from people, even family members, avoiding the dying person. People can slip back into this stage when there are new developments or the person feels they can no longer cope.

23. Stages of Death and Dying(Kubler-Ross, 1969) • Anger: Different ways of expression • Anger at God: "Why me?" Feeling that others are more deserving. • Envy of others: Other people don't seem to care, they are enjoying life while the dying person experiences pain. Others aren’t dying. • Projected on environment: Anger towards doctors, nurses, and families.

24. Stages of Death and Dying(Kubler-Ross, 1969) • Bargaining: A brief stage, hard to study because it is often between patient and God • If God didn't respond to anger, maybe being "good" will work • Attempts to postpone: "If only I could live to see . . ."

25. Stages of Death and Dying(Kubler-Ross, 1969) • Depression: Mourning • Sense of hopelessness, despair as one now realizes the inevitability of his or her impending death

26. Stages of Death and Dying(Kubler-Ross, 1969) • Acceptance: This is not a "happy" stage, it is usually void of feelings. It takes a while to reach this stage and a person who fights until the end will not reach it. It generally involves coming to terms with one’s death, for better or worse.

27. Stages of Death and Dying(Kubler-Ross, 1969) • Denial and isolation • “It’s not me! It can’t be me!” • Anger • “Why me?? It’s not fair!” • Bargaining • “I’ll be good…just give me another chance!” • Depression • “I should have been good…now it’s hopeless” • Acceptance • “It’s my time, and I’ll do what good I can before I check out”

28. On Death and Dying • Kubler-Ross pointed out that religious beliefs and social support can be of great value in promoting acceptance • Acceptance is facilitated by counseling (especially cognitive reframing) thought stoppage, and positive self talk (e.g , focus on one’s legacy through one’s work, children, good deeds, etc AND of course religious faith)

29. The Effects of Death on Loved Ones • Research shows that the death of a loved one (especially spouse) leads to serious detriments in physical and psychological health following in surviving (bereaved) spouses.

30. Parkes & Brown (1972) • Interviewed 49 widows and 19 widowers under age 45 who had been bereaved for 14 months (Bostonians) • Follow-up interviews conducted 2-4 years later • A matched control (i.e., nonbereaved) sample was also interviewed • At 14 months: • Disturbances in sleep, appetite and weight were common in bereaved group • Complaints of depression, restlessness, indecisiveness, and sense of strain • Increased consumption in alcohol, tobacco, and barbituates • Bereaved group more likely than control group to be admitted to the hospital the last year • At 2-4 years: • No real health differences now between bereaved and control group, but bereaved group seemed to be more socially disengaged (e.g., going out socially by one’s self)

31. The Effects of Death on Loved Ones • Research has also shown that bereaved spouses (compared to non-bereaved spouses) are more likely to die within a couple years following the death of a spouse • This is known as the broken-heart effect

32. Stroebe, Stroebe, Gergen, & Gergen(1982) • Death ratios by age (divided by married rate) • Men age 20-24 • Single = 1.92 • Divorced = 2.94 • Widowed = 17.25 • Women age 20-24 • Single = 1.63 • Divorced = 3.59 • Widowed = 10.01 Indicates they were nearly twice as likely to die in the next year than were married men

33. Stroebe, Stroebe, Gergen, & Gergen(1982) • Researchers noted that the effects were strongest in the first 6 months • Notice that the effects of bereavement were much more negative for men than for women (higher death rates for men following bereavement) • These rates are much higher than they are for older people (in elderly men, the ratio is 2 to 1) • Researchers pointed out that deaths among the younger are due to psychology and stress-related diseases (e.g., accidents, suicides, CHD)

34. Terror Management Theory

35. Terror Management Theory • Solomon, Greenberg, & Pyczszinski (1990) • A theory dealing with how the fear of death affects our behavior in a variety of situations • It is a broad, generally theory attempting to explain the motivational underpinnings of a broad range of human social behavior • In a general sense, the quest for self-esteem is presumed to mitigate our fears and anxieties associated with death and what death really means • The key ideas of this theory are drawn heavily from the core concepts of existentialism, as well as the writings of Ernest Becker

36. Terror Management Theory • Ernest Becker (pictured), a cultural anthropologist, wrote a Pulitzer Prize winning book called The Denial of Death in 1973. It is still sold in bookstores and makes for very interesting reading. • One of the major contentions of Becker’s work was that death denial is a universal motive underlying human behavior. Cultures and their belief systems are constructed as a means to help us fight off death anxiety by providing us with a prescription for how to live and what to believe. 1924-1974

37. Terror Management Theory: Key Ideas • Human have remarkable intellectual capabilities • Reason • Logic • Determine cause and effect • Self-reflect • Anticipate future events • Think about our own death and what it means • Etc.

38. Terror Management Theory: Key Ideas • Being able to self-reflect and anticipate future events is, in a certain sense, a curse • Our ability to self-reflect gives us the ability to consider philosophical and existential issues concerning why we exist, what the meaning of the universe is, and to consider the possibility of how insignificant and meaningless we are in the scheme of things. • We can anticipate the fact that someday we will die and that there is absolutely nothing we can do about it. • Death can come prematurely and unexpectedly • Death will probably not be too pretty

39. Terror Management Theory: Key Ideas • The problem of death • Nobody really knows what will happen when we die • Death could be the absolute end of all existence and nothing more • Complete annihilation from the universe, whereby our physical existence is reduced to rotting flesh, then dust, then nothing • Such an awareness, if contemplated, can “create the potential for paralyzing terror” (particularly in light of the fact that a “spiritual existence” can never be scientifically proven) • As society evolved, we had to come up with ways to help us fight this potential for terror concerning the inevitability of death (and the possibility of eternal meaninglessness)

40. Terror Management Theory: Key Ideas • People combat this awareness of death by subscribing to cultural worldviews (CWs). CWs are beliefs that transcend death by giving our lives a sense of meaning and imparting to us a sense that we are “good” and “valuable” people whose lives mean something. CWs do this by: • Giving meaning and stability to an otherwise meaningless, random, chaotic universe • Helping the person acquire a sense of value if they live up to the prescriptions of the CW • Promising or providing the opportunity for either literal or symbolic immortality if one lives up to the prescriptions of the particular CW

41. Terror Management Theory • Examples of CWs • Religion • Patriotism • Belief in traditional values (e.g., family, marriage, children)

42. Terror Management Theory • CWs help us acquire a sense of self-esteem and thus help keep the awareness of death (temporarily) out of consciousness • Thus, self-esteem serves as a buffer against the awareness of the inevitability of death its terrifying ramifications • Anything that increases self-esteem makes us feel as though we are engaged in a meaningful “cultural drama,” that our existence is somehow meaningful and will transcend death • Fame and fortune • Romantic relationships • Success, accomplishments at work, etc

43. Terror Management Theory • If people are reminded of their deaths, then not only do they cling to these CWs more strongly, but they also become rather hostile to others who violate the ideals of the CWs

44. Terror Management Theory • The Mortality Salience Paradigm • Two groups of participants • One group is asked to write about what they think will happen when they die and their feelings about it • This is done to activate, or “warm up” the concept of death. • This is called the “Mortality Salience” condition • The other group (control group) writes about something unrelated (e.g., favorite TV show) • Later, both groups rate target individuals who either uphold or violate cherished aspects of one’s worldviews (e.g., subjects read an anti-American essay that supposedly was written by a student, and then are asked how much they like this other person, or how much they would want to punish this person.)

45. Terror Management Theory • Study after study has shown that “mortality salient” subjects will rate others who violate their cherished beliefs more negatively than subjects who were not made aware of their death. • MS causes Christians to increase their liking for fellow Christians and to be more hostile toward Jewish people • MS causes American students to increase their liking for fellow Americans and to be more hostile toward Arabs • MS causes law-abiding people to give higher bail to prostitutes and other criminals

46. Theory Management Theory • In these kinds of experiments, the mortality salience condition also causes people to increase or decrease identification with groups or ideas that impinge positively or negatively on self-esteem or sense of values: • MS causes subjects to be less willing to use cherished icons in a blasphemous fashion (e.g., using crucifix as a hammer) • MS causes people to donate more money to charity • MS causes liberals to be more tolerant • Ms causes subjects (Germans) to sit closer to an in-group member (German confederate) than an out-group member (Turkish confederate)

47. Terror Management Theory • Other ways to increase mortality salience: • Gory automobile accident footage • Pictures of funeral homes • Footage of 9-11 terrorist attacks • Subliminal death primes • Subliminal words related to death (presented at 1/20th of a sec.) • Death crossword puzzles (e.g., “coffin,” “skeleton,” “cemetery,” etc)

48. Terror Management Theory • An important means of establishing self-esteem is through romantic relationships • Thus, relationships may provide a buffer against fears of death and meaninglessness

49. Terror Management Theory • Florian (2002) • MS increases intentions to seek out relationships, and it increases self-professed commitment in existing relationships • Mukilincer et al. (2002) • Thoughts of relationship separation increased the accessibility of death-related thoughts • Thus, rejection of any kind may serve as a “metaphor” for death • Perhaps this is the reason why “losses” are highly stressful and hence so depressogenic

50. “One shudders at the thought of the meaninglessness of life ..."