Existential Challenges - Approach with Scientific Curiosity OR Avoid the "Elephant in the Room"?

     “In a qualitative study of dying patients experiencing a dramatic quality of life (QOL) response to their illness – either ‘profound anguish’ or significant ‘equanimity and peace’ – shared themes within the group were identified at each of these extremes. Themes identified at the ‘anguish’ QOL extreme included: a sense of isolation, an absence of meaning, preoccupation with the future and the past, a sense of victimization, and a high heed for control. Common themes at the ‘peace’ end of the QOL continuum were: a sense of connectedness to something larger and more enduring than the self, meaning discovered, presence in the moment, a sympathetic connection to suffering, and a capacity to remain open to a present potential that is greater than the need for control. ...

     Four potent existential challenges haunt us throughout life: death (existential obliteration), isolation (the unbridgeable gap between self and others), freedom (the unnerving absence of external structure), and meaning (in a world of uncertain meaning). These threats are intensified in illness, yet they lie beyond the clearly drawn limits of our current medical concerns.
     We surely must broaden our scientific curiosity and assess these noteworthy experiences and research findings. The rewards to be garnered by adopting a more inclusive perspective are great. Dame Cicely Saunders reminds us, ‘The way care is given can reach the most hidden places and give space for unexpected development’.”
        Mount B. Healing, quality of life, and the need for a paradigm shift in health care. J Palliat Care 2013; 29(1): 45-8.

     Since "consideration of death affects people intensely, is a potent motivator of human behavior, whether or not such contemplation is made consciously," and since every one of us would choose 'equanimity & peace' over 'anguish,' what intelligent effective approaches to existential terror do we have in place, personally and as a profession, to ensure our best possible quality of life AND death?

       Niemiec CP, Brown KW, Kashdan TB et al. Being present in the face of existential threat: The role of trait mindfulness in reducing defensive responses to mortality salience. Journal of Personality and Social Psychology 2010; 99(2): 344-365.

Martha doing morning yoga - 'downward cat' pose