Dementia as an Existential Threat

Abstract

A diagnosis of dementia threatens not only many of the core aspects of what it is to be human, but leads, through a progressive deterioration, to death. Dementia thus represents an existential threat that creates profound emotional and psychological challenges for those who are directly affected by the illness. In this chapter, we argue that the psychological threat dementia represents needs to be viewed within the context of research from social psychology, and in particular Terror Management Theory (TMT). TMT proposes that humans experience a basic psychological conflict that results from having a self-preservation instinct on the one hand while on the other hand also knowing that death is inevitable. As a way of managing the distress that would otherwise arise from this knowledge, a series of defences operate to build psychological resilience and to reduce or to eliminate awareness of death. These defence strategies include the person investing themselves in religious and cultural belief systems which hold the possibility of spiritual immortality, as well as internal psychological processes such as repression and avoidance. We explore how the TMT framework might help us to make sense out of the experiences of people living with dementia.