Skip to main content

What Keeps Death Anxiety Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, they provide an easy way for clients to understand at a glance why their disorders persist, and how they might be interrupted. What Keeps Death Anxiety Going? is designed to help clients experiencing death anxiety understand more about their condition.

Download or send

Choose your language

Professional version

A PDF of the resource, theoretical background, suggested therapist questions and prompts.

Client version

A PDF of the resource plus client-friendly instructions where appropriate.

Translation Template

Are you a qualified therapist who would like to help with our translation project?


Languages this resource is available in

  • English (GB)
  • English (US)

Problems this resource might be used to address

Techniques associated with this resource

Mechanisms associated with this resource

Introduction & Theoretical Background

Worries about dying or losing a loved one are a normal part of life, but if your thoughts about death (or dying) are extremely distressing, time-consuming, or stop you from doing important things, you might be experiencing death anxiety. Some of the key signs of death anxiety include:

  • Feeling extremely distressed about death and dying.
  • Spending lots of time dwelling on your death or other people dying.
  • Having unwanted and distressing images related to death (‘intrusions‘). 
  • Avoiding places or activites that remind you of death or dying.
  • Going to extreme lengths to prevent or minimize the risk of dying.

Research studies indicate that cognitive behavioral therapy (CBT) is an effective treatment for death anxiety. CBT therapists work a bit like firefighters: while the fire is burning they’re not so interested in what caused it, but are more focused on what is keeping it going, and what they can do to put it out. If they can work out what keeps a problem going, they can treat the problem by interrupting the cycles that maintain it.

The What Keeps Death Anxiety Going? information handout describes some of the key factors which act to maintain death anxiety, illustrating them in a vicious flower format in which each ‘petal’ represents a separate maintenance cycle. Helping clients to understand more about these processes is an essential part of cognitive therapy for death anxiety. Therapists can use this handout as a focus for discussion, or as a template from which to formulate an idiosyncratic model of a client’s experiences.

Therapist Guidance

"One interesting way of thinking about death anxiety is to look at why, for some people, it does not get better by itself. This handout shows some of the most common reasons why some people keep experiencing symptoms of death anxiety. I wonder if we could look at it together and think about whether it describes some of what is happening for you?"

References And Further Reading

  • Agras, S., Sylvester, D., & Oliveau, D. (1969). The epidemiology of common fears and phobia. Comprehensive Psychiatry, 10, 151-156. DOI: 10.1016/0010-440X(69)90022-4.
  • Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.
  • Menzies, R. E., Zuccala, M., Sharpe, L., & Dar-Nimrod, I. (2018). The effects of psychosocial interventions on death anxiety: A meta-analysis and systematic review of randomised controlled trials. Journal of Anxiety Disorders, 59, 64-73. DOI: 10.1016/j.janxdis.2018.09.004.
  • Noyes Jr, R., Hartz, A. J., Doebbeling, C. C., Malis, R. W., Happel, R. L., Werner, L. A., & Yagla, S. J. (2000). Illness fears in the general population. Psychosomatic Medicine, 62, 318-325.