Why is it so difficult to discuss end-of-life issues in American culture?

Modern Americans have a difficult time dealing with painful emotions, such as ones associated with death and sickness, and we often respond with denial (putting up walls and defenses, and using forms of distraction), harshness ("just be a man"), or confusion (converting pain into another emotion like anger without realizing it). In some cultures death is not thought upon negatively. Yes, of couse it is painful to lose a loved one; however, many cultures regard death in a celebratory way. Death is viewed as a transition - albeit a significant one - along the spiritual journey of life.

I lost my father to cancer when I was three. Our family did not discuss his death much, and immediately following, my mom took us cross-country to San Diego and Disneyland as an "escape." If our family had dealt with the pain of death head on, perhaps a trip would have been helpful - sometimes a change of scenery can be useful and refreshing during a stressful period. However, I think the combination of denying emotions and fleeing a situation was not the most beneficial, and perhaps conveyed to our deeper internal selves, or subconscious, the message of fear and powerlessness.

So, how does one deal with or manage difficult emotions such as ones associated with death effectively? According to dialectical behavior therapy (DBT) a mindfulness based approach, "No appropriate psychological technique can change a natural feeling into a different one. It would not be right to [try] to change the feeling of depression about losing a loved one into the feeling of indifference. This [is] an attempt to truncate your feelings, to deny them. So emotional regulation isn't about making one feeling into another. It's about changing our emotional state altogether," states Thomas Marra, Ph.D., president of the Center for Dialectical Behavior Therapy in Monterey, CA.

The keys, according to mindfulness based therapies, are acknowledgment, responsibility, and choice. If we acknowledge the pain we are not denying it; rather, we are embracing our humanness, admitting we are emotional beings, however, that does not mean succumbing to our emotions. It means also taking responsibility for our feelings, and recognizing we possess the ability to make choices in how we respond to situations.

In my view,one of the main reasons Americans have trouble dealing with death is because we tend to fear our emotional selves and emotional states and therefore also deny and disregard our internal self, and in a sense our innate humanness.

References
Marra, T. (2004). Depressed and Anxious: The Dialectical Behavior Therapy Workbook for Overcoming Depression and Anxiety. Oakland, CA: New Harbinger Publications, Inc.