Posted in Psychology & Medicine

Voodoo Death

We inherently fear death. Much of what we do biologically is struggling against death. We eat and drink to sustain ourselves. We feel pain to avoid things that may eventually kill us. Even moments before our death, our brain will flash our life before our eyes to grasp at any past experiences that may help us survive.

Because of this, we are also inherently neurotic. Some fear flying in a plane because they can imagine the plane crashing and burning, even knowing that flying is safer than a car ride. Childhood traumas where we thought we might die cause long-lasting damage to how we behave and think as an adult.

The most interesting example of how the fear of death can affect us is the phenomenon of voodoo death.

American physiologist Walter Cannon published a paper in 1942 studying cases of “voodoo death” – where healthy people (usually from tribal societies) suddenly passed away after being cursed. Voodoo death starts when a person is cursed or condemned to die by a medical person, such as a witch doctor or shaman. The victim and those around them must believe that the curse will actuall kill them (due to the culture or tradition). The victim’s family may even prepare a funeral. The victim loses all hope that they can survive the curse. They then die, even though their body shows no signs of physical ailment.

For example, the Australian Aborigines are known to have practised “boning”, where a witch doctor would point a vexed bone at an enemy, causing the victim to immediately convulse and die. A Nairobi woman passed away within 24 hours of finding out that the fruit she ate was sacred and she committed a great sin. A Maori man, who was told he should never eat wild game meat, died a day after finding out that he had accidentally eaten wild game meat – even though he had eaten it 2 years ago.

Voodoo death is not only limited to pre-modern societies. In the 1990’s, there was a documented case where a patient was diagnosed with terminal metastatic oesophageal cancer. After saying his goodbyes to his family as were his last wishes, he swiftly passed away. On autopsy, they discovered that the cancer had not actually spread that much and was not the cause of death.

There are many theories as to what may cause voodoo death. The traditional thought was that intense fear and stress stimulates the release of catecholamines such as adrenaline, inducing a massive fight-or-flight response, as seen in broken heart syndrome. The surge of adrenaline causes the heart to beat too fast and too strongly, until it gives out and causes cardiac arrest.

However, more recent studies showed that animals that die from stress exhibit signs of the opposite happening – that is, the parasympathetic nervous system (responsible for the common type of fainting spells called vasovagal syncope) is overactive. Because the parasympathetic nervous system has the opposite effect to the sympathetic (fight-or-flight), it can cause the heart to slow to the point of stopping.

This parasympathetic overactivity may be triggered by a sense of absolute hopelessness, essentially causing the body to “give up” on life. On a related note, the hopeless victim will likely not be eating or drinking much while under extreme emotional duress, so dehydration and catatonia may play a role as well.

Voodoo death is an excellent example of how much power the mind has over the body. Ironically, the fear of death itself can cause death.

Posted in Psychology & Medicine

Five Stages Of Grief

Dr. Elisabeth Kübler-Ross was a psychiatrist who was greatly interested in the field of death and dying. She believed that medical students and doctors should be aware of how important the topic was. One of her major contributions to the field of medicine was a theory inspired by her work with terminally ill patients. Dr. Kübler-Ross discovered that patients who were given bad news often reacted in a rather predictable pattern of five “stages”. She also found that these theoretical stages of coping with dying also applied to other grieving processes, such as a child going through a divorce or grieving a break-up. It is important to note that these stages are not absolutely complete or chronological, but only a general theory of how people react to grief.

  1. Denial: A person’s initial response to any bad news or trauma is usually denial. Denial is a hardwired defence mechanism of the brain to protect the mind from trauma. However, it may hinder the process of coping, with some people being perpetually stuck in this stage while never fully coping with their grief. An example thought during this stage is “This can’t be happening to me”.
  2. Anger: Once the person overcomes their denial and recognises reality, they respond with anger. This is an externalisation response where the mind tries to deal with the bad news by lashing out. It can be seen as the mind’s response to the confusion that arises from receiving the bad news, which may be caused by cognitive dissonance arising from the conflict between denial and reality. Because people at this stage often lash out with rage and verbal abuse (sometimes even physical), they may be difficult to deal with. Thus, it is important to recognise that this is a natural response to grief and try to support them even though they are acting abusive. An example thought during this stage is “It’s unfair that this is happening to me”.
  3. Bargaining: When the anger settles down, a person attempts to deal with the grief with logic instead of emotions. They will try to negotiate with a higher power to delay their death, such as through praying. This stage shows how desperate and vulnerable the person is while trying to deal with the bad news. They will try to do anything to make the grief go away, or at least reduce it. However, this stage rarely produces any viable solutions. An example thought during this stage is “If I can have a few more years, I will do anything”.
  4. Depression: With both emotions and logic failing to protect them from the grief, the person will fall into a state of depression. Hope is lost and the person understands that resistance is futile (an example of learned helplessness). By this stage, the person has become quiet and withdrawn, often detaching themselves from family and friends. Ironically, trying to cheer a person up during this stage is ill-advised. It is more beneficial if the person can pull through the depression and process it to make it to the last stage of grief. An example thought during this stage is “Why bother, I’m going to die anyway”.
  5. Acceptance: The last stage of grief is not only accepting that death is unavoidable, but also recognising that there is still time before that. The person reaches a state of clarity and comes to term with the grief, achieving some inner peace. The time taken to reach this state varies and some people may never reach it at all. It is also important to note that just because the person receiving the bad news has accepted it, others around them may not have processed the grief. An example thought during this stage is “Everything is going to be okay”.