Pathological fear of death, panic attacks, and hypochondriasis

The article has presented a concept of the pathological fear of death as a categorically defined phenomenon and outlined its distinguishing features. In an attempt to account for the origin of the pathological fear of death, most weight has been given to developmental and structural abnormalities in the regulation and control of the primary and disruptive forms of anxiety. The additional contributing factors have also been taken into consideration: a defect in the defensive and symbolic representation of death, and a general collapse of defensive functioning, with regression to a state of infantile helplessness and revival of the infantile death cognitions. A role of the cognitive abnormalities in the genesis of the pathological fear of death has been examined in the panic attacks and hypochondriasis, while a developmentally determined, pervasive mistrust in the bodily functioning and bodily worth has been stressed as a factor that crucially predisposes to the pathological fear of death in hypochondriasis, and to the respective type of hypochondriasis as well. A relationship between panic disorder and hypochondriasis has been examined in the light of the pathological fear of death that they often share. Finally, the article has briefly dealt with the relevance of the pathological fear of death for diagnostic assessment and psychotherapy of patients with panic disorder and hypochondriasis. The concept of the pathological fear of death requires further study and refinement in the area of its descriptive demarcation, psychogenesis, and clinical application.