“Life asked Death, ‘Why do people love me but hate you?’ Death responded, ‘Because you are a beautiful lie and I am a painful truth.’” — Author unknown

Most people don’t like to think or talk about death. Even though it’s inevitable that every one of us will die, dread, anxiety, and fear still surrounds death — even the word alone. We try to avoid thinking about it. But in doing so, we actually affect our mental and physical health negatively more than we know.

There’s even a term for it: death anxiety. This phrase defines the apprehension people experience when they become aware of death.

“This idea,” says Lisa Iverach, PhD, senior research fellow at The University of Sydney, “is based on evidence that death is a significant feature across a range of anxiety-related disorders.”

Death anxiety can be perfectly normal. The fear of the unknown and what happens afterward is a legitimate concern. But when it starts interfering with how you live your life, it becomes problematic. And for people who don’t find the right coping methods, it’s possible for all that anxiety to cause mental pain and stress.

Iverach lays out a few scenarios in which the fear of death adversely impacts healthy living. You may recognize some:

  • Separation anxiety disorder in children often involves excessive fear of losing people important to them, such as their parents, through accidents or death.
  • Compulsive checkers repeatedly check power switches, stoves, and locks in an attempt to prevent harm or death.
  • Compulsive hand washers often fear contracting chronic and life-threatening diseases.
  • Fear of dying from a heart attack is often the cause of frequent doctor visits for those with panic disorder.
  • Individuals with somatic symptom disorders engage in frequent requests for medical tests and body scanning in order to identify serious or terminal illness.
  • Specific phobias involve excessive fear of heights, spiders, snakes, and blood, all of which are associated with death.

“Death is not something we talk about often. Perhaps we all need to become more comfortable discussing this almost taboo topic. It shouldn’t be the elephant in the room,” reminds Iverach.

Talking about death is Karen Van Dyke’s life’s work. In addition to being a professional end-of-life consultant working with elders in assisted living and memory care communities, Van Dyke hosted San Diego’s first Death Cafe in 2013. Death Cafes serve as friendly, welcoming, and comfortable surroundings for those who want to talk openly about death. Many are in actual cafes or restaurants where people eat and drink together.

“Death Cafes’ purpose is to lighten the load of the mystery of what your experience may or may not be,” says Van Dyke. “I definitely do life differently now, more in the moment, and I am much more specific about where I want to put my energy, and that’s a direct correlation about being able to talk about death with freedom.”

This expression of death is far healthier than other habits and actions we may have adopted in order to avoid death. Watching television, drinking alcohol, smoking, and shopping … what if these were just distractions and habits we engage in to avoid thinking about death? According to Sheldon Solomon, professor of psychology at Skidmore College in Saratoga Springs, New York, using these behaviors as distractions isn’t a foreign concept.

“Because death is such an unwelcome topic for most people, we immediately try to get it out of our head by doing things to distract ourselves,” says Solomon. His research suggests that the fear of death can set off reactions, habits, and behaviors that seem normal.

To counter these behaviors, having a healthy approach and perspective of death could be a start.

Death Cafes have sprung up all over the world. Jon Underwood and Sue Barsky Reid founded Death Cafes in London in 2011 with the goal of making discussions about death less daunting by presenting them in socially friendly environments. In 2012, Lizzy Miles brought the first Death Cafe in the U.S. to Columbus, Ohio.

It’s clear a growing number of people want to speak frankly about death. What they also need is a safe and inviting space, which Death Cafes provide.

Maybe it’s the fear of the word that gives it power.

Caroline Lloyd, who founded the first Death Cafe in Dublin, says with the legacy of Catholicism in Ireland, most death rituals are centered around the church and its long-standing traditions such as funerals and religious ceremonies. A notion some Catholics also believed in was that knowing names of demons was a way of taking away their power.

What if, in today’s world, we could use that approach to death? Instead of saying euphemisms like “crossed over,” passed away,” or “moved on” and distancing ourselves from death, why don’t we embrace it?

In America, we visit graves. “But that’s not what everyone wants,” says Van Dyke. People want to speak openly — about their fear of death, their experiences of being terminally ill, witnessing the death of a loved one, and other topics.

The Death Cafe in Dublin is held in a pub, Irish style, but no one gets drunk when these sobering conversations take place. Sure, they might have a pint or even tea, but the folks in the pub — young and old, women and men, rural and urban — are serious when it comes to addressing death. “They also have fun as well. Laugher is a part of it,” adds Lloyd, who will soon be hosting her fourth Death Cafe in Ireland’s capital city.

It’s clear these cafes are doing good work.

“It’s still very much what the community wants,” says Van Dyke. “And, I’ve become a little more at peace that death is going to happen after doing this for such a long time.” There are now 22 Death Cafe hosts in San Diego, all mentored by Van Dyke and with the group sharing best practices.

While Death Cafes are still relatively new in the U.S., many other cultures have long-standing, positive rituals around death and dying.

Rev. Terri Daniel, MA, CT, has a certificate in Death, Dying, and Bereavement, ADEC. She’s also the founder of the Death Awareness Institute and the Afterlife Conference. Daniel is experienced in using shamanic rituals of indigenous cultures to help heal people by moving the energy of trauma and loss out of the physical body. She’s studied death rituals in other cultures as well.

In China, family members assemble altars to recently deceased relatives. These might contain flowers, photos, candles, and even food. They leave these altars up for at least a year, sometimes forever, so the souls of those who have departed are with them every day. Death isn’t an afterthought or a fear, it’s an everyday reminder.

Daniel cites an Islamic ritual as another example: If a person sees a funeral procession, they must follow it for 40 steps to stop and recognize the importance of death. She also mentions how Hinduism and Buddhism as religions and attending cultures teach and understand the importance of death and preparation for death as a path to enlightenment, instead of regarding death with fear and anxiety.

Changing attitudes about death is definitely in order. If living our lives in fear of death adversely affects our health, then we need to make an effort to embrace positive, healthy thinking and behavior around the topic. Transforming the narrative about death from anxiety to acceptance, whether through Death Cafes or other rituals, is certainly a good first step in opening up the conversation. Perhaps after that, we can openly embrace and celebrate death as a part of our human life cycle.

Stephanie Schroeder is a New York City–based freelance writer and author. A mental health advocate and activist, Schroeder published her memoir, “Beautiful Wreck: Sex, Lies & Suicide,” in 2012. She is currently co-editing the anthology “HEADCASE: LGBTQ Writers and Artists on Mental Health and Wellness,” which will be published by Oxford University Press in 2018/2019. You can find her on Twitter at @StephS910.