Transcript Psychology 3533 Understanding Human Sexuality

DEATH AND DYING
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Study of Death: Thanatology
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(Thanatos: Greek God of Death)
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Pascal: man is the only animal that knows he will
die some day
 Fear of death uniquely human
 Historically, death part of daily life, high mortality
rate, took place at home
 20 century:
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death in hospital
medical technology
facilitated death denial
funeral parlours
euphemisms
 About
age 9-10 we realize that death is final,
universal and inevitable
 Adolescence: invulnerable, immortal “can’t
happen to me”, risk taking, denial
 Early adulthood: change when becoming
parents
 Middle age: death of parents, friends,
siblings. Highest death anxiety
 Old age: lowest anxiety, though facing death
of spouse and peers
 Role of religion: true believers and atheists
lowest anxiety
What is death?
1. Determined by doctor (if available). Errors
2. Clinical death: heart and lungs stop. But
nowadays resuscitation through
technology: CPR, oxygen, defibrillation,
etc. (NDEs)
3. Brain death: no EEG. New structures
(cerebral cortex) die first, then midbrain,
then medulla and spinal cord (vegetative
functions and reflexes): is this person
alive? Coma
Euthanasia: active or passive
 Active: method used to terminate life, e.g.
drug, asphyxia, etc.
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Special case: assisted suicide (Kevorkian)
 Passive:
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withhold or remove life support
Ethical issue: Nazis
Issue of longevity and economics
Cultural variations, Netherlands
 NDE:
Near death experience, increase since
resuscitations increased
First thanatologist: Elizabeth Kubler-Ross
Process in 5 stages:
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
 Not a typical stage process: individual
differences, order of stages, return to
earlier stages
 Also observed in chronic illness, loss of
body parts, loss of function
Schneidman: alternation of emotions instead
of stages:
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grief
anguish
anger
anxiety
denial
NO acceptance
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Pattison: living-dying interval, prolonged by
technology
 3 phases:
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acute crisis: time of diagnosis
chronic: gradual deterioration, longest phase due to
medical-technological advances
surrender: giving up, not a real acceptance
Variables that affect process:
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age
cause of death
personality
religious beliefs
ethnic background
hospital, home or hospice location
Survivors:
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Grief: feelings
Mourning: behaviours that express grief
Rituals: e.g. Irish wake, sitting shiva
Stages:
1. numbness
2. yearning, anger and denial
3. depression, apathy, disorganization
4. acceptance, adjustment, reorganization
All 4 can coexist and alternate
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Varying time span, influence of culture
 Child and spouse worst
 Widows/widowers: longer grieving if bad
marriage: sanctification of dead spouse
(guilt)
 Increase in morbidity and mortality (one
study in text contradicts)
Double whammy:
1. immune system weakens
2. self neglect (meals, exercise, sleep,
smoking and drinking)
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Psychoneuroimmunology
Psycho: thoughts and feelings
Neuro: brain and nervous system
Immuno: immune system
Logy: study of
People who have supports fare better
Anticipatory grief helps (when death is
expected)