"Before I die I want to …": An experience of death education among university students of social service and psychology

Interest and Confidence in Death Education and Palliative Psychology in Italian and Indian University Students of Psychology: Similarities and Differences

Teaching death education and palliative psychology in universities has proven to be of great importance, especially in the health professions. The present study aims to evaluate the similarities and differences in interest and confidence in death education and palliative psychology between university psychology students from two culturally different countries: Italy and India. For this study, 63 Italian and 35 Indian psychology students were recruited to take part in a course on death education and palliative psychology. The results showed the positive impact of a death education and palliative psychology course on the training of professionals. In particular, this course was useful in helping students become familiar with and learn how to manage future professional situations related to death and dying. Specific differences between the two countries also emerged, particularly with regard to their approach to the end-of-life field, due to different cultural contexts. There is still much to be done by institutions to improve the dissemination and academic teaching of this area, which in turn can promote job opportunities for young people and encourage them to work in this field.

Death Education for Palliative Psychology: The Impact of a Death Education Course for Italian University Students

The present study investigated the effects of a hybrid online course on a group of Italian Master's degree students involved in a European Erasmus+ project. The course was composed of nine modules about death education, palliative psychology and the use of creative arts therapies-such as psychodrama, intermodal psychodrama and photovoice-in the end-of-life-field. The project involved 64 students in the experimental group (who attended the course) and 56 students as the control group. Both groups completed an online questionnaire before and after the delivery of the course and 10 students from the experimental group participated in a focus group at the end of the course. The quantitative analysis revealed that the experimental group students showed lesser levels of perception of death as annihilation, fear of the death and death avoidance, while they increased their levels of death acceptance, creative self-efficacy and attitude toward the care of the dying. Qualitative analysis identified three main themes: the positive impact of the course on death education and end-of-life care; the role of art therapies on death and end-of-life care; and the unhelpful facets of the course. Overall, this intervention changed the perception and the feelings of the students regarding the themes of death and palliative psychology and increased their creative self-efficacy and their interest in working in an end-of-life field.

The Central Role of Schools in Promoting Death Education Interventions

Avoidance of discussion about death is common in contemporary Western societies. Plenty of literature substantiates that (at the beginning of the sentence), the actual tendency toward death denial can produce many negative effects such as the suppression of death-related thoughts and emotions. Death Education aims to strengthen the psychological anchors that allow us to recognize the profiles of anguish, prevent the decompensating factors of pathological mourning and process the experiences of loss at all ages. The article aims to support the usefulness and use of Death Education interventions in schools and their central role in promoting these interventions.

Construction of life-and-death education contents for the elderly: a Delphi study

BACKGROUND

Life-and-death education is intimately related to palliative-and-hospice care. It should be implemented among groups of all ages, especially for the elderly. This study aims to establish expert consensus on a set of scientific and systematic life-and-death education contents for the elderly and provide reference for the practice on the elderly.

METHODS

This study designed three rounds of expert consultation by using a Delphi method. A panel of 22 experts from the fields of palliative-and-hospice care, life-and-death education, geriatric nursing, humanities and ethics, and geriatric psychology participated in the study.

RESULTS

This study finally reached expert consensus on the contents of life-and-death education for the elderly, containing 4 first-level items, Life-and-death literacy promotion in the elderly; Life-and-death concept establishment of the elderly; Life-and-death planning of the elderly; Life-and-death thoughts of the elderly with affiliated 9 second-level items, and corresponding 23 detailed third-level items.

CONCLUSIONS

The life-and-death education contents for the elderly offer a basis for publicity for health professionals, promote dialogues on death, preparation, and planning for death and dying. The life-and-death education contents system was clear in coherence containing definite and comprehensive contents, which enriched life-and-death education resources globally. The results could assist in the planning of palliative-and-hospice care services to improve quality of death of the elderly.

Anticipatory Mourning and Narrative Meaning-Making in the Younger Breast Cancer Experience: An Application of the Meaning of Loss Codebook

Breast cancer (BC) in women under 50 is a potentially traumatic experience that can upset a woman’s life during a crucial phase of her lifespan. Anticipatory mourning linked to the diagnosis of BC can produce a series of inevitable losses similar to those of the bereaved. Narration can be one tool to construct meaning, to grow through the experience, and reconfigure time perspectives during and after the illness. The aim of this study was to apply the Meaning of Loss Codebook (MLC) to the narrative context of young women with BC. An ad hoc narrative interview was administered to 17 women at four times during the first year of treatment. A thematic analysis was performed using the MLC, adopting a bottom-up and top-down methodology. The results highlight the MLC’s usefulness in capturing the experiences of the women, allowing for a greater appreciation of the nuances of the meanings embodied in their narratives. The thematic categories grounded in the MLC cover the whole experience of BC during the first year of treatment, attesting to the possibility of extending the use of the MLC to observe the longitudinal elaboration of the psychic experience of BC in addition to its established validity in the context of bereavement and loss.

Death education and photovoice at school: A workshop with Italian high school students

The study shows the effects of a death education workshop with Italian high school students. Students (N = 416) from 10 high schools throughout Italy participated: 212 in the experimental group and 204 in the control group. Four weekly, two-hour workshops about the themes of death, with theoretical lessons and an experiential artistic activity of photovoice. Results show that the students in the experimental group showed significantly increased self-efficacy levels and existential anxiety levels did not increase after death education intervention. Educating youth about death could give them the skills to improve the management of death-related events and cope with negative emotions.

Reconstructing Social Relationships in a Post-Lockdown Suburban Area of Southern Italy Using Pastoral Counselling

The growing interest in spirituality has enabled numerous avenues of pastoral counselling support, which can be a useful resource for improving quality of life in the context of significant social deprivation. The aim of this research was to investigate the role of the spiritual dimension of pastoral support interventions created to help the inhabitants of a strongly deprived territory in Southern Italy during the COVID-19 pandemic. Eight people between the ages of 28 and 67 took part in the study. A qualitative research design was applied via online interviews with the participants, who were operators of a pastoral counselling service located on the outskirts of a suburban town. The main emergent themes were the importance of religiosity and spirituality in the lives of the participants, the role that these two aspects play in the lives of those who carry out activities devoted to helping others, and the ways in which these dimensions are used within support programmes responding to the needs of an area characterized by socioeconomic and psychosocial problems. The interviews revealed how pastoral counselling can be useful in situations of stress in highly deprived areas.

A Death and Dying Class Benefits Life and Living: Evidence From a Nonrandomized Controlled Study

Humanistic theorists have long emphasized the importance and benefits of death awareness (Yalom, 1980) yet the literature on death education has focused on fear and anxiety. In the present study, 150 undergraduate students taking either a class on death and dying or a comparison class completed a pre and post-questionnaire on attitudes (negative and positive), values (intrinsic and extrinsic) and eudaimonic wellbeing (meaning in life and vitality). Results revealed that compared to their peers in another class, students studying death and dying significantly increased in death acceptance, intrinsic values, meaning in life, and vitality. Furthermore, increases in intrinsic values mediated the relationship between participation in death and dying education and meaning in life. Results are discussed in light of experiential learning, posttraumatic growth, and terror management.

Spirituality for Coping with the Trauma of a Loved One's Death During the COVID-19 Pandemic: An Italian Qualitative Study

Spirituality may be a key factor in reducing the negative psychological effects of traumatic events and a means by which the experience of grief can be processed. The objective of the present research is to assess whether and how spirituality provided concrete support in those who lost a loved one during the COVID-19 pandemic. The participants are 8 people from the most affected cities in northern Italy. They were interviewed in depth, the interviews were transcribed and the texts were analyzed through Interpretive Phenomenological Analysis. The results show that spirituality has been found to be a protective factor with regard to the processing of grief in crisis situations such as the COVID-19 pandemic, in particular with regard to the belief that the deceased loved one is now in an otherworldly dimension. In addition, the celebration of a funeral rite offers support to the grieving person in the early stages of mourning thus laying the foundation for a healthy grieving process. It is therefore important to support individual spirituality, which can be a useful tool for processing the traumatic experience, especially in difficult times such as the COVID-19 pandemic.

Catharsis Through Cinema: An Italian Qualitative Study on Watching Tragedies to Mitigate the Fear of COVID-19

Background: Among different ways of coping with the unsettling situation of the COVID-19 pandemic, a very peculiar one has been identified: a more frequent request, by the general population, of movies or TV series related to the very theme of viruses, contagions, and epidemics. Objectives: The aim of the present study was to explore this peculiar phenomenon, in order to identify people's emotions and cognitions during and after the process, and to better understand the possible psychological function cinema can have during moments of intense and generalized crisis like the present COVID-19 pandemic. Participants: Fifteen Italian adults took part in the study - eight women and seven men (average age = 30 years, SD = 10.54). Participants were recruited through social media via a specific announcement, and subsequently, through a "snowball sampling." Method: For the present study a qualitative approach was adopted, and more specifically, the principles of Interpretative Phenomenological Analysis (IPA) have been followed. Semi-structured interviews were conducted by telephone or through online meeting platforms (Zoom or Skype). The written texts obtained from the transcription of each interview were analyzed using thematic analysis with the support of the software Atlas.ti, in order to highlight their fundamental contents. Results: From the data analysis, four main areas of thematic prevalence emerged, which reflected the participants' condition during the pandemic that actually led them to watch epidemic-themed movies or TV series: the need to document themselves concerning the theme of epidemics, the need to exorcize contagion anxiety, the desire to find a character with which they could identify, and the casual condition of finding a peculiar movie related to the theme of pandemics and being interested in it because of the striking resemblance with real life. Conclusions: The findings suggest that cinema could indeed represent a powerful tool to help people face the intense uncertainty of the new COVID-19 epidemic, since it allows spectators to both obtain more insight into the current situation, and to project their fears and uncertainties into the movie or TV series, thus reaching a sort of cathartic liberation that offers them hope toward the future.

Psychology Students' Perceptions of COVID-19 in a Death Education Course

The systematic removal of death from social life in the West has exposed people living in areas affected by COVID-19 to the risk of being unable to adequately manage the anxiety caused by mortality salience. Death education is a type of intervention that helps people manage their fear of death by offering them effective strategies to deal with loss and anxiety. To that end, a path of death education has been carried out with University students of psychology. The main purpose of the research is to understand how students who participated in the death education course perceive the lockdown experience in light of course teachings. The research was carried out at a University in northern Italy in an area severely affected by COVID-19, during the first year of the pandemic. The group of participants included 38 students, 30 women and 8 men, with an average age of 25.45 years (SD = 7). At the end of the course, the students could respond on an optional basis to the request to comment on the training experience according to what they experienced during the pandemic. A thematic analysis was subsequently carried out on the texts, which made it possible to identify the most relevant thematic areas for the students. The qualitative analyses permitted recognition of three main forms of discovery: the removal of death in contemporary culture; the importance of community, ritual and funeral, and spirituality; and the significance of death education for future health professionals. The texts have highlighted how the removal of these issues exposes people to the risk of being unable to handle extremely painful events such as those related to dying. The results show the positivity of death education pathways conducted at the University level to help students reflect on these issues and manage the related anguish.

The hospice as a learning space: a death education intervention with a group of adolescents

Background

The denial of death in Western society deprives young people of the tools to derive meaning from experiences of death and dying. Literature shows that death education may allow them to become familiar with this topic without causing negative effects. This article describes the effects of a death education course with adolescents, wherein participants were given the opportunity to meet palliative doctors and palliative psychologists at school and in a hospice, where they were able to converse with the families of the dying.

Methods

This study used mixed methods and included an evaluation of a death education intervention with longitudinal follow-up of outcomes. The course involved 87 secondary school students (experimental group) aged between 16 and 20 years. We also recruited a control group of 76 similarly-aged students to observe differences. The variables we examined were: alexithymia, representation of death, value attributed to life and spirituality. These were measured with the following instruments: the Toronto Alexithymia Scale-20, the Testoni Death Representation Scale, the Personal Meaning Profile and the Spiritual Orientation Inventory, respectively. To better understand how the students perceived the experience, we asked the experimental group to answer some open-ended questions. Their answers were analysed through thematic analysis.

Results

The study showed that death education and the hospice experience did not produce negative effects, but rather allowed students to decrease alexithymia, improving their ability to recognise and express emotions. Thematic analysis revealed that all participants perceived the experience as very positive.

Conclusions

Our findings affirm that death education programs can be successfully implemented in high schools, and that they can usefully involve local hospices and palliative care professionals, especially physicians and psychologists.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12904-021-00747-w.

My Future: Psychodrama and Meditation to Improve Well-Being Through the Elaboration of Traumatic Loss Among Italian High School Students

This study was designed as an action research aimed to help students to elaborate their feelings of traumatic grief, due to a car accident and a suicide of two of their classmates, in an Italian high school. A death education project was realized in order to prevent the Werther effect. The intervention was based on psychodramatic techniques and meditation with Tibetan bells to encourage reflection on the suffering of traumatic loss, the sense of life, and their future. A total of 89 students from four classes (46 in the experimental group: two classes, 43 in the control groups: two classes) participated in the study, among which 82 (45 in the experimental group, 37 in the control group) completed the pre- and post-test survey. The intervention consisted of eight 2-h meetings, during which the themes of death and loss were dealt with through theoretical discussions, dramatization, and meditation. Two other classes which participated in the assessment as a control group did not attend the activities. The following instruments were used: Death Attitude Profile-Revised, which measures individual attitudes toward death; Psychological Well-being Scale, which measures a person’s psychological well-being; Resilience Scale for Adolescents, which measures the construct of resilience in adolescents; Self-Transcendence Scale, which measures self-transcendence; and Testoni Death Representation Scale, which measures the ontological representations of death. The results demonstrated that in the experimental group, there was a reduction in the fear of death and its avoidance, and that the students normalized the representation of death as something natural, thus improving their well-being. It is consequently possible to say that well-being is not simply the absence of suffering and worries, but rather, is rooted in the possibility of thinking of creative solutions to the trauma.

"Imagine You Have ALS": Death Education to Prepare for Advance Treatment Directives

The study presents the results of qualitative research carried out within a death education project dedicated to advance treatment directives (ATDs) in which it was proposed to participants to empathize with people who had received a diagnosis of Amyotrophic Lateral Sclerosis (ALS). The study involved 104 people who discussed and reflected on issues related to the knowledge of having to die, palliative care and ATDs, investigating what choices they would have made if they had received such a diagnosis. Finally, they were asked to write a paper describing their impressions and hypothetical choices. Qualitative analysis has elucidated among fundamental themes. Four thematic areas emerged from the data analysis: (1) ATDs and the family; (2) the importance of reducing pain and suffering; (3) emotions and considerations regarding death, illness and spirituality; and (4) opinions on the DeEd course. It has emerged that some people are unfamiliar with palliative care or the right to self-determination and that addressing these issues helps manage the thought of the future with less terror. The experience of death education has therefore proven to be very positive in dealing with complex and often censored issues, allowing thinking about death in a less distressing way.

The COVID-19 Disappeared: From Traumatic to Ambiguous Loss and the Role of the Internet for the Bereaved in Italy

In Italy, in the very first phase of the COVID-19 pandemic there was a dramatic rise in mortality. However, families were forbidden because of lockdown regulations to be with their loved ones at their deathbeds or to hold funerals. This qualitative study examined bereavement experiences among family members, how they processed their grief, and how they used social networks in particular by uploading photographs during the working-through of bereavement. The sample was composed of 40 individuals aged 23-63 (80% women) from different Italian cities severely impacted by the virus, including a subgroup from the province of Bergamo, which was the city with the highest mortality rate during that time. All interviews were conducted by phone, Skype, or Zoom. Then, the transcriptions underwent a thematic analysis using Atlas.ti. The main themes that emerged were: abandonment anger and guilt, dehumanized disappeared, derealization and constant rumination, and social support and the importance of sharing photos on Facebook. Importantly, the use of social networks proved to be a valuable source of support and photographs were a powerful tool in facilitating the process of mourning by encouraging narration and sharing. Grief had a complex profile: on the one hand, it was traumatic and characterized by all the risk factors causing mourners to experience prolonged grief, but on the other, some features were similar to ambiguous loss (that occurs without closure and clear understanding) because of the impossibility to be with their relatives in their final moments. The possible relationships between ambiguous loss, the use of internet, and the risk of prolonged grief are discussed.

The Sense of Dignity at the End of Life: Reflections on Lifetime Values through the Family Photo Album

This study focuses on the dimensions of dignity, linking Chochinov's Dignity Therapy to Schwartz's Theory of Values. The use of family photo albums has enriched the application of dignity therapy. Seven terminal patients in home-based palliative care participated in the therapeutic intervention. To measure the effects of the intervention, we administered the Edmonton Symptom Assessment Scale and the Patient Dignity Inventory, then, at the end of the meetings, collected the opinions of participants, available nurses, and relatives who attended the sessions. The resulting generativity documents were then analyzed through thematic analysis, which revealed three main themes linked to both fundamental values and the dimensions of dignity: The relationship between continuity of self and myriad values in the context of family relationships; personal dignity as characterized by the values of personal success, hope, and wisdom; and hope and generativity. The fourth theme reflected the participants' final judgements on the intervention, which were highly positive and greatly encouraged further use of photographs in similar therapeutic interventions. The assessment protocol highlighted a significant decrease in tiredness amongst the participants and a trend towards a significant decrease in drowsiness after the intervention.

A Challenge for Palliative Psychology: Freedom of Choice at the End of Life among the Attitudes of Physicians and Nurses

This article considers a particular aspect of palliative psychology that is inherent to the needs in the area of attitudes concerning Advance Healthcare Directives (AHDs) among Italian physicians and nurses after the promulgation of Law No. 219/2017 on AHDs and informed consent in 2018. The study utilized a mixed-method approach. The group of participants was composed of 102 healthcare professionals (63 females and 39 males). The quantitative part utilized the following scales: Attitudes toward Euthanasia, the Religious Orientation Scale, the Balanced Inventory of Desirable Responding, and the Testoni Death Representation Scale. The results were mostly in line with the current literature, especially concerning a positive correlation between religiosity and the participants’ rejection of the idea of euthanasia. However, the qualitative results showed both positive and negative attitudes towards AHDs, with four main thematic areas: “Positive aspects of the new law and of AHDs”, “Negative aspects of the new law and of AHDs”, “Changes that occurred in the professional context and critical incidents”, and “Attitudes towards euthanasia requests.” It emerged that there is not any polarization between Catholics or religious people and secularists: Their positions are substantially similar with respect to all aspects, including with regard to euthanasia. The general result is that the law is not sufficiently understood, and so a quarter of the participants associate AHDs with euthanasia. Discussions on the opportunity for palliative psychologists to help health professionals to better manage these issues through death education courses are presented.

The Hospice as a Learning Environment: A Follow-Up Study with a Palliative Care Team

In Western society, the topic of death has been removed from everyday life and replaced with medical language. Such censorship does not reduce individuals’ fear of death, but rather limits their ability to elaborate their experiences of death, thus generating negative effects. The objective of this follow-up qualitative study was to detect how and if death education can help to improve individuals’ relationship with death and enhance care environments like hospices. Semi-structured interviews were conducted with palliative care professionals and teachers who had taken part in a death education initiative three years earlier. The results confirmed the initiative’s positive effect on both palliative care professionals and teachers. The participants reported that the education initiative helped them to positively modify their perspective on death, end-of-life care, and their own relationship to life, as well as their perception of community attitudes towards the hospice, which seemed to become less discriminatory. This study confirmed that school education initiatives can usefully create continuity between hospices and local communities. This project provided an educational space wherein it was possible for participants to elaborate their experiences in relation to death and to re-evaluate and appreciate hospices.

Enhancing Existential Thinking through Death Education: A Qualitative Study among High School Students

The censorship of death-related issues is widespread in contemporary Western culture because the boundary between death and life is substantially managed in medical areas. In the context of Italian educational initiatives, to remove this limitation, 215 high school students in Southern Italy were educated on death through conventional and informal lessons. The students answered a questionnaire with open questions to survey their emotional and reflective experiences. Their answers were qualitatively, thematically analysed to explore how the representation of death can follow a death education course, and if this experience can be managed without harmful effects. The students’ answers narrated how the course reduced their anxiety linked to these themes, on the one hand improving communication between peers by making it more authentic and empathic and, on the other, providing alternative perspectives on life. Indeed, the project offered an opportunity to discuss something strongly heartfelt but rarely faced, and the survey confirmed that the research objectives were fully achieved.

The Value of Dignity in Prison: A Qualitative Study with Life Convicts

Background: This research is based on the perspective of dignity according to Chochinov; thus, the life imprisonment of detainees is assimilated to a severe disease. Methods: Ten male prisoners were interviewed trough Chochinov’s Dignity Therapy, and the results were analysed using thematic analysis. Results: Two areas of thematic prevalence emerged, namely, value of freedom, self-consciousness and education and their failure in jail, and life sentence as annihilation of life meaning and of the values of generativity and family. Conclusions: Life imprisonment has been described in its negativity by several respondents as a punishment worse than the death penalty. It has been compared to death itself, to a terminal illness, to torture and to a pain that grows over the years, with the awareness that despite the passing of time, you will not have the opportunity to return to your loved one and to a free life. In fact, prisoners live out their condition within a space in which any value that gives meaning to life risks being destroyed.

Can Desire and Wellbeing Be Promoted in Adolescents and Young Adults Affected by Cancer? PhotoTherapy as a Mirror That Increases Resilience

PhotoTherapy represents a recent psychotherapeutic intervention which, through the medium of photography, has the objective of helping a patient reach a higher self-knowledge and explore thoughts, desires, and intimate perceptions that would otherwise remain hidden. Because of this, it may help people overcome their cognitive and emotional boundaries and bring out their interiority, even when exploring some of the most distressing themes. The objective of the present research was to demonstrate that the elaboration and expression of inner desires, fears and needs of wellbeing among adolescents and young adults, who were either sick or had been cured of cancer, could be facilitated through the use of PhotoTherapy. Their responses were also compared with those of healthy young adults, in order to be able to explore the kind of impact such a pathology can have on those who are affected by it and highlight eventual differences in the kind of desires and needs expressed instead by those who never had a diagnosis of cancer. A qualitative research design was adopted. 45 people took part in the study, aged between 12 and 25 (mean age 19). The participants were divided into three groups: those currently being treated for cancer, those with a history of cancer and those who had no experience of cancer (third group). From the data analysis, different preferences and attitudes toward the presented pictures and themes emerged among the participants, depending on the specific group they belonged to. The article discusses these preferences and considers how PhotoTherapy can help treat psychological distress caused by cancer.

Lack of Truth-Telling in Palliative Care and Its Effects among Nurses and Nursing Students

Unclear communication of inauspicious prognoses may disorientate both patients and their relatives, drastically jeopardizing the planning of palliative care. This paper considers the issue of truth-telling in the communicative problems of nurses and students of nursing with terminally ill patients. The fundamental objective is the analysis of the difficulties related to the lack of truth-telling and how it might impact their professional and personal lives. A qualitative study was realized, involving 47 participants, both nurses (25) and nursing students (22), working in palliative care units or in associations of volunteers for the assistance of oncological patients. The exploration was focused on the way they relate to patients who are not aware of their real health conditions and their consequences. Particular attention was paid to their opinions concerning what could be done in order to manage such problematic situations in the near future.

Beyond the Wall: Death Education at Middle School as Suicide Prevention

This study investigates the psychological effects of participation in Death Education (DeEd) by middle school children in two towns in northeast Italy in which suicides occur to a greater extent than in the rest of the region. The aims of the project "Beyond the Wall" were inherent to the prevention of suicide, address existential issues and enhance the meaning of life through positive intentions for the future and reflection on mortality. It involved eight classes (150 students in four classes in the experimental group; 81 in four classes in the control group) engaging with films, workgroup activities, photovoice and psychodrama. The constructs of resilience, emotional competency and psychological well-being were monitored with the Resilience Scale for Adolescents, the Hopelessness Scale for Children, the Alexithymia Questionnaire for Children and the Stirling Children's Well-being Scale. The DeEd intervention was found to be significantly related to some of the variables investigated, improving the students' ability to recognise emotions and communicate them verbally while maintaining stable initial characteristics, such as psychological well-being and positive expectations for the future.

Death education from an Hegelian perspective

This paper discusses death education from an Hegelian perspective, with the aim to generate insights to complement existing literature on death education. Three Hegelian elements are identified. The first is the natural view, that is, death is a natural phenomenon. The second is the moral view, that is, death is significant in contributing to the ethical life and no individuals have the right to end their own life. The third is the ontological view, that is, the life-and-death struggles for recognition raises individuals' consciousness, and death transforms the divine into universal and enables the ultimate realization of the spirit to Absolute Knowing.

Let's Start With the End: Bibliodrama in an Italian Death Education Course on Managing Fear of Death, Fantasy-Proneness, and Alexithymia With a Mixed-Method Analysis

This article presents the results of an experience of death education (DE) course with bibliodrama in Italian high schools, which focused on emotions and existential themes. The research analyzed the inability to recognize or describe one's own emotions (alexithymia), fantasy-proneness, and attitudes toward death in two different groups of students: one who took a course on DE (with 113 students) and another who did not participate in it (with 114 students). The use of a mixed method allowed this study to explore the quantitative results that the students indicated in the questionnaire and the qualitative open answers to the final question about how they had profited from this DE course. The results showed that the course had a positive effect, as the DE group significantly decreased alexithymia and negative attitudes toward death, particularly in fear and avoidance of death, making their representation of death less traumatic.