What causes phobias? How fear of death can feed anxieties and fears.

In the week that I decided to write about how phobias are underpinned by a fear of death, I noticed I was developing pains in my right hand. Repetitive strain injury? Arthritis? I’m not sure. It was, of course, my writing hand, my mouse hand, my tea-drinking hand, my almost-everything-hand.

Two paragraphs in, and my right hand is creaking, as it dominantly bears the burden of typing. It’s an aching, utilitarian memento mori. Higher up the body, my elbow is also making its displeasure known. Death is winking at me, reminding me that my flesh and bones are mortal. You want death? Here’s the amuse-bouche, a little taste of arthritis. Just wait till the main course, he cackles, and the dessert is to die for.

I tell myself that the beginning of arthritis is a gift. (Allow me the smugness for now, we know it will be a curse, in due course.) A spot of arthritis is a reminder of the frailty of the human body and a clarion call to enjoy life now while I can.

I’m over a half-century old. According to the Bible, the days of our years are threescore years and ten. If I live that long, the days of my life will number 25,550. When I turned fifty I had already lived 18,250 of them. The turn of a decade is different to any other age. The zero gapes at you, a round, slack-jawed open mouth: you are how old now? Zero is the void and eternity, your ten-yearly reminder of oblivion. I’ve had five of them now. How many more of them will there be?

That sounds stark. But that lack of knowing is the truth.

Humans die all the time. Every day. Although death comes to us all, we’re not very good at confronting it. Since the dawn of time, death has fascinated, terrified, and baffled humanity in equal measure.

Since we are all going to die at some point, death anxiety is a normal part of the human experience. Evolution would be very remiss if we were not hard-wired to try and avoid it. Our genes sing for continuation, not obliteration. So, if you are frightened of death you are not alone — and you are perfectly normal.

The problem is that sometimes our fear of death contorts and disguises itself in other fears. Because facing death directly is overwhelming, our minds often translate that anxiety into more immediate and controllable threats — spiders, heights, planes, germs — each a symbolic stand-in for the ultimate unknown.

A straightforward phobia of death is known as thanatophobia, but research suggests that many of the phobias we live with are, at heart, expressions of this same fundamental anxiety. According to a meta-analysis titled “From Dread to Disorder: A Meta-analysis of the Impact of Death Anxiety on Mental Illness Symptoms”, fears of spiders, snakes, heights, blood, germs and even social situations may be more about death anxiety than the object of fear itself.

This perspective aligns with Terror Management Theory (TMT), a psychological framework that explores how humans cope with awareness of their own mortality. The theory suggests that when we become conscious of death, we develop both conscious and unconscious strategies to manage the resulting anxiety. Sometimes this manifests in seemingly irrational fears or behaviours — compulsive checking, avoidance, or social anxieties — all of which can be seen as attempts to shield ourselves from the knowledge of mortality.

Our unconscious mind displaces our deepest existential fears onto more manageable, everyday threats. A spider on the wall may be frightening, but it also becomes a symbolic focus for a much bigger, vaguer fear: the knowledge that our lives are finite. It comes up time and again in my hypnotherapy practice — simple phobias are often underwritten by a deeper fear of death.

Reassuringly, this does not mean phobias are “all in your head” in a dismissive sense; rather, it highlights the profound, existential nature of human fear. Understanding this can be a liberating first step toward reframing and reducing anxiety.

I’ve pondered how my own former arachnophobia may have evolved from a latent fear of death. When I worked with hypnotherapy to address it, I didn’t completely destroy the fear, but I was able to puncture it, take the edge off, and rationalise it. That reduced the fight-and-flight response, a paralysing reaction to an irrational fear, and restored my confidence and agency.

There is a positive flip side to our fear of mortality. As Ernest Becker famously wrote, “The idea of death… haunts the human animal like nothing else; it is the mainspring of human culture.” This explains why humans seek symbolic immortality through art, literature, science, and parenthood. We create, achieve, and strive to leave a mark — symbolic or literal — as a buffer against mortality.

Self-esteem plays a crucial role here: when we feel competent, valued, and connected to others, we are better able to manage existential anxiety. In other words, nurturing a sense of worth and purpose acts as a psychological shield against the fear that underpins phobias.

Hypnotherapy offers a unique pathway for engaging with these deeper layers. Unlike exposure therapy alone — which helps clients confront the immediate object of fear — hypnotherapy can access the unconscious where this existential anxiety resides. Through guided imagery, metaphor and desensitisation clients can explore their relationship with the fear object, reframing it in ways that reduce its grip. But hypnotherapy can also go deeper, drawing on the principles of Terror Management Theory, and explore the fear of death, provide a reassuring context and build confidence and self-esteem. The aim is not to erase the awareness of mortality — a futile and arguably undesirable task — but to release its disproportionate hold on daily life and diminish phobic reactions.

Other therapies, such as Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), group therapy, and psychodynamic therapy, also provide pathways for managing fear. CBT helps restructure the thoughts that feed phobias, ACT encourages acceptance of fear while pursuing meaningful action, and group or psychodynamic therapies explore relational and unconscious dimensions of anxiety. Hypnotherapy complements these approaches by accessing the deeper, existential layers that are often invisible to conscious thought — and we bury our fear of mortality very deep.

Fear has the power to motivate a life well-lived. Death anxiety becomes a problem when it leads to pathological thoughts and behaviours. Avoiding stairs, refusing to go near dogs, or compulsively checking doors might seem like discrete problems, but each can be a ripple from the same deep pool of fear. Awareness, gentle exposure, and reframing allow us to transform that fear from a controlling force into a guiding one, motivating mindful, intentional living.

In other words, a fear of death should not interfere with living your life well. As the Roman Emperor and philosopher Marcus Aurelius wrote, “It is not death that a man should fear, but he should fear never beginning to live.” Understanding the underlying fear of death is the first step, but seeking support is often the next.

So, if you find yourself avoiding, recoiling, or panicking, it may be worth asking: What am I truly afraid of? Often, the answer is as ancient and universal as life itself: mortality. And in acknowledging it and learning to live alongside it, we can reclaim not just freedom from phobia, but freedom to live well. Painful reminders — like a creaking hand — nudge us toward awareness: life is fragile and we only live once. I’d better get that hand seen to.

If you’d like to explore how hypnotherapy can help you resolve your fears, please get in touch.