Understanding Fear and Acceptance: Expanded States of Consciousness and End-of-Life Anxiety

For many people, fear or anxiety around death emerges during moments of illness, aging, or major life change. It can even surface for people who otherwise feel healthy and successful. Questions about meaning, unfinished business, regret, and what lies ahead can feel overwhelming, even for those who have iced rich and purposeful lives. There has been interest in how expanded states of consciousness may influence how people relate to mortality and existential uncertainty.

According to a study by Johns Hopkinds, participants reported having less fear of death and dying after an experience involving expanded states of consciousness, with a lasting positive effect by providing personal meaning, spiritual significance, and psychological insight [1].

In addition, a study looking at patients with life-threatening cancer found that experiences involving expanded states of consciousness produced immediate, substantial, and sustained improvements in anxiety and depression, and led to decreases in cancer-related demoralization and hopelessness, improved spiritual wellbeing, improved attitudes towards death and increased quality of life [2].

What We’ll Explore

• How fear of death and existential anxiety show up across different stages of life and why it is so common
• What current research suggests about how expanded states of consciousness may affect fear, meaning, and emotional perspective near the end of life
• How people describe changes in their relationship to mortality following these experiences 
• Important limitations, risks, and misconceptions to understand before drawing conclusions
• Why these experiences are not about escaping death, but about changing one’s relationship to it

[1] Johns Hopkins Medicine. Psychedelics May Lessen Fear of Death and Dying, Similar to Feelings Reported by Those Who’ve Had Near Death Experiences. https://www.hopkinsmedicine.org/news/newsroom/news-releases/2022/08/psychedelics-may-lessen-fear-of-death-and-dying-similar-to-feelings-reported-by-those-whove-had-near-death-experiences

[2] Ross S, Bossis A, Guss J, et al. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. Journal of Psychopharmacology. 2016;30(12):1165-1180. doi:10.1177/0269881116675512