• Linda Emanuel, Sheldon Solomon, George Fitchett, Harvey Chochinov, George Handzo, Tasha Schoppee, and Diana Wilkie.
• Northwestern University, Chicago, Illinois, USA.
• J Palliat Med. 2021 Feb 1; 24 (2): 211217211-217.

AbstractBackground: The COVID-19 pandemic has created an environment in which existence is more fragile and existential fears or terror rises in people. Objective: Managing existential terror calls for being mature about mortality, something with which palliative care providers are familiar and in need of greater understanding. Methods: Using a case to illustrate, we describe existential terror, terror management, and existential maturity and go on to outline how existential maturity is important for not only the dying and the grieving but for also those facing risk of acquiring COVID-19. Results: Next, we describe how essential components in attaining existential maturity come together. (1) Because people experience absent attachment to important people as very similar to dying, attending to those experiences of relationship is essential. (2) That entails an internal working through of important relationships, knowing their incompleteness, until able to "hold them inside," and invest in these and other connections. (3) And what allows that is making a meaningful connection with someone around the experience of absence or death. (4) We also describe the crucial nature of a holding environment in which all of these can wobble into place. Discussion: Finally, we consider how fostering existential maturity would help populations face up to the diverse challenges that the pandemic brings up for people everywhere.

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