Art of Humaning

Death Contemplation as a Mental Health Practice

I’ve repeatedly called mainstream psychology out for merely addressing psychological symptoms, impotent and therefore negligent before the underlying issue of meaninglessness that spreads throughout our modern society. In fact, the problem of meaninglessness has been voiced out throughout the past century by philosophically-minded psychologists who reflected deeply on their own existence, but it has fallen on the deaf ears of those operating upon institutional knowledge and authority.

Meaninglessness has variously been characterized by philosophers as absurdity (Albert Camus), the void (Jean-Paul Sartre), existential vacuum (Viktor Frankl), and by psychologists as disorientation (Kenneth Pargament), the lack of significance, purpose and comprehension (Frank Martela and Michael F. Steger). In plain language, it’s a state of feeling lost and empty, not knowing who one is.

From the framework of mainstream psychology, general anxiety, depression, and OCD are presented as separate mental “disorders.” From a philosophical standpoint, however, these are in fact different manifestations of the same root cause of meaninglessness, which is not itself a mental illness. When one (unconsciously) feels lost and empty, one lacks the motivation to maintain the quality of life and relationships, making even basic living feel impossibly heavy, which then lead to anxiety and depression over time. Or, the mind searches for something solid to grasp in desperation, obsessively and compulsively creates artificial order to cope with the unbearable chaos of meaninglessness. Or, even more revealing is the case when one feels like something is missing or off despite external success, questioning “why does any of this matter?”

Distracted from Ourselves

Borrowing the metaphor from last blog, if life is a voyage, then psychology is about the mechanics of navigation, whereas philosophy and spirituality are about cartography, using the compass and finding a direction. The state of meaninglessness is akin to not knowing where we are heading in the voyage of life — we’ve lost sight of our north star. Having lost sight of our north star, we are drowning in the sea of distractions.

That we are drowning in a sea of distractions becomes evident as we examine the busyness of everyday life. Entertainment, global news, gossip, material pleasures, possessions, TV and real-life dramas, opinions of others. These things either will be forgotten by next week or have nothing essential to do with us. Yet they keep pulling our attention away from what actually matters: the basic realities of our existence, that we are mortal, our bodies are decaying beyond our control, we don’t know when our inevitable passing will happen, and that we will have to face it alone.

This reality is so basic yet so vast and monstrous that we take great lengths to refuse to acknowledge it. In The Denial of Death, Ernest Becker describes how we shrink our worlds to avoid mortality’s towering presence and tranquilize ourselves with manageable trivialities. Or, we might engage in what he called “immortality projects”: the relentless pursuit of power, fame, and wealth or the fanatic devotion to a religious or political ideology as a way to cheat death by symbolically merging with a bigger, longer-lasting identity. These insights are empirically confirmed: it is shown by hundreds of studies that death anxiety does drive us toward hedonistic escape and “heroic” striving1

Expanding on Becker’s thesis, the authors of Worm at the Core developed Terror Management Theory (TMT) to describe in detail how the fear of death powers most of our unconscious behavior that constitutes the everyday life of every civilization. Dr. Yalom, the pioneer of existential psychotherapy, similarly contends that among the four ultimate concerns of human existence (freedom, isolation, death and meaninglessness), the fear of death is the most ubiquitous cause of psychopathology.2 Studies have indeed found empirical evidence that death anxiety appears to be a transdiagnostic construct lying at the core of a range of mental disorders and lingering across the life span, driving the “revolving door” phenomenon where the individual keeps coming back for a “new” mental disorder after the old ones are treated. 3 4 Naturally, when the hidden “worm,” the root cause of psychological distress is overlooked by clinical attention, it would simply find a new, superficially different outlet.

More importantly, Becker and other existentialist thinkers all recognize a paradoxical truth: death denial is so catastrophic to living a good life because to flee from death is to flee from yourself. Heidegger saw this with piercing clarity when he identified death as our “ownmost possibility”: Death is not an external threat but is the most intimate truth of our existence, the one reality that is utterly and irreducibly ours alone. To avoid accepting our mortality is simultaneously to avoid encountering our authentic selfhood, thus to default to borrowed existence: we adopt pre-packaged identities and follow scripts others wrote for us on how we should live, or we try to imitate everyone else. Moreover, death is the most irrevocable destination and the most unassailable certainty of our destiny. In this way, distraction from death becomes distraction from our north star, from the most infallible source of our inner light.

DEATH Awareness is Life Awareness

Most people think of death as the absolute opposite of life, as the end of it all. In my opinion, however, this cannot be further from the truth. Rather, I see life and death as two sides of the same coin, as two angles to view the very same process. If it takes you 80 years to live, it takes 80 years for you to die. We don’t live 80 years and then only die at the very last moment; rather, every moment we are slowly dying, dissipating away, bit by bit.

My mother used to tell me, every now and then, of an old Chinese saying: you can’t take away anything when you go, but your karma/action will follow you everywhere. Alongside that she’d also remind me that “you came to this world empty-handed, you’ll leave this world empty-handed.” The message is that, nothing material or external we think we’ve accumulated during our lifetime means anything at the end. This is not to say, however, that because everything is ephemeral, everything is futile. My mom is by no means a nihilist; she clearly affirms what truly matters in life: that we become who we are through the internal work of moral labor, which substantiates real effects on ourselves and on the world.

Now, one doesn’t need to subscribe to any metaphysical beliefs to see what she’s talking about. In fact, you need precisely to suspend all beliefs to be able to see it. I might have had the privilege to mirror my mother’s easygoing attitude towards death unconsciously, but a conscious understanding didn’t begin to formulate until I deepened my Vipassana meditation, a practice that allows me to be in touch with myself and stay grounded ever deeper in myself.

Without the actual practice, such ideas would certainly ring nihilistic: if life is finite and transient, then what’s the point of it all? I believe one becomes confused when they mistakenly measure the value of life with the quantity of things possessed, of things achieved or the number of years lived. Although tempted to believe the same myself, I am always reminded by my meditation and my ongoing healing process that the value of life should be measured by the quality of lived experience in terms of intensity, depth and growth.

ESCAPING DEATH IS ESCAPING LIFE

You’re perhaps wincing right now, thinking: what good does it do to speak of such bleak reality?

Yes, everyone who is born has to die. So, trying to run away from death is as futile as trying to run away from one’s own shadow. The only rational thing to do is to turn around to face it, and recognize that it is no menacing monster but merely your own shadow. If one spends the whole life trying to run away from his/her own shadow, one has never truly lived; to evade death is to evade life.

“It is not death that a man should fear, but he should fear never beginning to live”. ⎯ Marcus Aurelius

Yet, since even the therapists themselves are afraid of facing their own mortality, a good amount of psychotherapy unfortunately remains confined to beating around the bush. Informed by Stoic wisdom and years of clinical experience dealing with death anxiety, Dr. Yalom arrives at a powerful conclusion: “although the physicality of death destroys us, the idea of death saves us.” Whether prompted by proximal events (e.g. the death of a friend), or by personal reckoning (e.g. one’s 60th birthday, illness), by voluntarily integrating death into their consciousness, clients subsequently gained a newfound sense of vibrancy and authenticity. The awareness of death serves as an awakening experience, a catalyst for making a major change towards living more fully.

EMBRACING DEATH IS EMBRACING LIFE

“I cannot escape death, but at least I can escape the fear of it.” ⎯ Epictetus

Stoic philosophy once again points to us a sobering but empowering truth that, while death is beyond our control, the fear of it is within our control. It’s not the things that disturb us, but our interpretation of things. The crucial insight here is aligned with the Buddhist teaching of mindfulness, where one attains inner peace through self-mastery. By detaching from one’s thoughts and feelings: “I am not my fear,” one dispels delusions and sees reality as it is. It also constitutes the foundational principle of Acceptance and Commitment Therapy (ACT): by accepting what is uncontrollable, one’s psychic energy is freed up for value-driven actions instead of wasted on defensive anxiety or rumination. Together, these traditions converge on a substantially empirically supported conclusion of modern psychology: a deliberate shift of focus toward inner control for a greater sense of personal agency and responsibility is a direct pathway to better well-being.

“You could leave life right now. Let that determine what you do and say and think.” ⎯ Marcus Aurelius

In a similar vein, recent studies provided empirical evidence on how death reorients our lives. A 2010 study by K.E. Vail5 is echoed by a 2025 study by Y. Wang6 on that the conscious integration of mortality led people to pursue intrinsic goals (personal growth, meaningful work and connectedness) and away from extrinsic goals (image, status, money), which in turn increased life satisfaction. In other studies, terminally ill patients and people experiencing death-related dreams both reported that contemplation on death helped them identify core values and clarify priorities. Subsequently they eagerly sought forgiveness or sought to forgive to mend broken relationships, resulting in a renewed sense of love and wholeness. Tim Kasser’s extensive research corroborates this pattern:7 extrinsic goals correlate with lower well-being precisely because they place the locus of control and meaning outside oneself, while intrinsic goals predict greater life satisfaction because one is actively engaged in meaning creation. Thus, death functions less as a threat but as a catalyst for this crucial turn inward, a key to unlock our innermost power, a teacher that shows us how to love and how to live a meaningful life. A north star, death really is, that guides us back home to our true selves.

Taking Death’s Hand

You needn’t and shouldn’t wait for a life-threatening accident or illness to face your mortality. My stance is clearly laid out in this blog. I’d recommend everyone to start doing that right now. However, one should approach such a task with great care, given its immensity. Dr. Yalom compares facing one’s own mortality with “staring at the sun” (hence the title of his book) — one can only stand so much of it. Although having helped hundreds of clients deal with their death anxiety, Dr. Yalom himself is not immune to it and had to resort to the help of another existential therapist, Rollo May, for his own nightmares and dread. When he was in his 80s, it was finally time for Dr. Yalom to apply his life-long professional insights to his personal life as his wife of a 65-year-long marriage was dying of cancer and his own life was soon coming to an end. In their final time together, the couple co-wrote the book A Matter of Life and Death, documenting their incredibly candid and touching journey of joint exploration of love, grief, identity, and human dignity.

This underscores a crucial point: confronting death is enormously challenging, even for a seasoned therapist who pioneered in the field. Without proper guidance or inner steadiness, raw reminders of mortality act as a negative stressor, worsening compulsive behavior, social avoidance and health anxiety.8

Contrarily, a structured, guided confrontation of death through counselling, art or contemplative practice can foster a shift towards inner resources over superficial concerns in a safe way, pulling us back towards our true power from the tyranny of compulsive-obsessive worries and negative thoughts. The benefits of increased life appreciation and fulfillment are therefore accessible to everyone, anytime, through intentional practice.9 More critically, since death anxiety is the “worm at the core” I believe it is essential to face it to tackle psychological distress at a root level and promote enduring holistic well-being.

Here are some approaches that you can try:

BUDDHIST FIVE REMEMBRANCES

Those who already got used to Buddhism’s no-sugar-coating approach, here is a straight-to-the-fact mantra from the Upajjhatthana Sutta you can recite as a part of Maraṇasati meditation (death contemplation):

  1. I am of the nature to grow old. There is no way to escape growing old.
  2. I am of the nature to have ill health. There is no way to escape having ill health.
  3. I am of the nature to die. There is no way to escape death.
  4. All that is dear to me and everyone I love are of the nature to change. There is no way to escape being separated from them.
  5. My actions are my only true belongings. I cannot escape the consequences of my actions. My actions are the ground upon which I stand.

SHARED JOURNEY

If the wise words of saints and philosophers offer no solace to you because the terror of death is too overwhelming, you’re not alone. Dr. Yalom didn’t miss an opportunity to introduce Stoic quotes to his clients, but often to no avail. Ideas alone are not sufficient, he concludes; it’s the synergy of ideas and connection that generates the necessary therapeutic power. Although drawing examples from the clinical settings, he admits that this can be done equally with a therapist, a friend, a family member or even a fellow patient who has dealt with or is not afraid to talk about his/her own mortality. Therapeutic effect does not necessarily happen within a well set-up office with the aid of a licensed professional with lots of alphabets behind his/her name. Once again, especially for an issue that is so profoundly human, it’s the genuineness of the human connection that counts.

RIPPLING EFFECT

Dr. Yalom did identified the “rippling effect” as the single narrative that worked better with his clients than philosophical ideas in the face of death anxiety. It depicts how one’s virtues, wisdom, pieces of advice… the substance of one’s life is rippled into others’ lives and therefore gets passed on. “Look for her among her friends,” Dr. Yalom borrowed this simple but powerful phrase from one of his clients, which poignantly illustrates the connectedness of human lives and dispels the horror of absolute nothingness. I think this idea does magic for so many people because it addresses the four ultimate concerns all at once. Aside from “resolving” death through the idea of “living on” symbolically through others, it also resolves the existential isolation through community, meaninglessness through legacy and freedom through holding responsibility for others.

EXISTENTIAL PSYCHOTHERAPY & PHILOSOPHICAL COUNSELLING

If you do wish to seek professional help on this matter, existential psychotherapists or philosophical counsellors are your go-to. Existential psychotherapy, a modality dedicated to addressing the ultimate concerns of human existence as a root cause of mental distress, is no doubt heavily founded on philosophy.

“To philosophize is to learn how to die” ⎯ Cicero

Philosophy, properly understood, is not an academic discipline but a lived practice, in my opinion. It is an activity that challenges the limits of our conscious life by actively, willingly and courageously excavating and examining our buried assumptions and habitual modes of being, in order to live a life of heightened clarity and freedom. It is no wonder that death is a classic philosophical topic, since death defines the darkest shade of the abyss, the bottomlessness of the bottomless pit, beyond which all our projects, identities, and illusions dissolve. To think seriously about death is to think seriously about everything that precedes it.

This understanding has been tragically lost in the oblivion of modernization, which turned philosophy into a mere academic discipline. The words of philosophers are never meant to be “theories” to be studied, but are their creative answers to life’s ultimate questions, an expression of hard-won visions as the human spirit sails to the edge of existence. They are meant to serve as an inspiration and encouragement for fellow humans navigating the same terrain. To study philosophy for cognitive exercise or intellectual entertainment instead of to obtain wisdom is as much of a distraction as everything else.

A skilled philosophical counsellor is clear about this. They grasp the practical utility of different narratives or schools of thought, Eastern or Western, in promoting well-being as it meets the client’s horizon. Alternatively, existential psychotherapists offer something complementary. Working within a secular worldview, they are equipped with psychological tools for stronger emotional support alongside philosophical inquiry.

But regardless of professional orientation, one criterion remains non-negotiable: the practitioner must have confronted their own mortality; the blind cannot lead the blind. Only someone who has walked this dark path themselves would be able to guide others. Those who still flinch from talking about mortality will not be able to offer the genuineness in the therapist-client relationship so monumental to therapeutic efficacy.

Summary

Are you ready to find your north star? If you’re unsure where to begin, try sharing this article with someone you trust, and simply ask, “What do you think?”

REFERENCES

  1. Ciaramelli, E., Giannetti, C., & Orsini, R. (2018). Does death make us all equal? Materialism and status-seeking under Mortality Salience. International Review of Economics, 66, 57 – 78. ↩︎
  2. Yalom, I. D. (2008).  Staring at the sun: Overcoming the terror of death. San Francisco, CA: Jossey-Bass. ↩︎
  3. Iverach, L., Menzies, R. G., & Menzies, R. E. (2014). Death anxiety and its role in psychopathology: reviewing the status of a transdiagnostic construct. Clinical psychology review, 34(7), 580–593. https://doi.org/10.1016/j.cpr.2014.09.002 ↩︎
  4. Menzies, R.E., Sharpe, L. and Dar-Nimrod, I. (2019), The relationship between death anxiety and severity of mental illnesses. Br J Clin Psychol, 58: 452-467. https://doi.org/10.1111/bjc.12229 ↩︎
  5. Vail, K. E., Juhl, J., Arndt, J., Vess, M., Routledge, C., & Rutjens, B. T. (2012). When Death is Good for Life: Considering the Positive Trajectories of Terror Management: Considering the Positive Trajectories of Terror Management. Personality and Social Psychology Review, 16(4), 303-329. https://doi.org/10.1177/1088868312440046 (Original work published 2012) ↩︎
  6. Wang, Yuanyuan & Pei, Fuhua & Yang, Yisheng & Wang, Junxiu. (2025). Death attitudes and good life experience: the mediation and suppression effects of intrinsic and extrinsic goals. Frontiers in Psychiatry. 16. 10.3389/fpsyt.2025.1567600. ↩︎
  7. Kasser, T., & Ryan, R. M. (2001). Be careful what you wish for: Optimal functioning and the relative attainment of intrinsic and extrinsic goals. In P. Schmuck & K. M. Sheldon (Eds.), Life goals and well-being: Towards a positive psychology of human striving (pp. 116–131). Hogrefe & Huber Publishers. ↩︎
  8. Menzies, R. E., Sharpe, L., & Dar-Nimrod, I. (2022). The development and validation of the Death Anxiety Beliefs and Behaviours Scale. The British journal of clinical psychology, 61(4), 1169–1187. https://doi.org/10.1111/bjc.12387 ↩︎
  9. Das, E., Fransen, M. L., & Oliver, M. B. (2024). Beyond the denial of death: death meditation increases a sense of connectedness and appreciation of life. Frontiers in psychiatry, 15, 1477479. https://doi.org/10.3389/fpsyt.2024.1477479 ↩︎

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