For most people, spending an hour in a century-old cemetery chapel talking about death with a circle of strangers isn’t the ideal Tuesday evening. But recently, I decided to do just that and attend a local death café, a free-form discussion group that centers around the topic of—you guessed it—death.

“You get together with a bunch of people, eat cake, and talk about death,” a colleague had told me earlier about his own experience. He didn’t say much else, but I was intrigued. I’d never heard of a death café. It sounded a little like group therapy, only more . . . morbid.

How do therapists feel about death cafés? I wondered. Do they think the subject of death is best left to trained mental health professionals? Does a death café seem like a dangerous undertaking for someone with death anxiety, or a useful adjunct to therapy? Would a therapist ever refer a client to a death café?

I decided to find out—a quest that brought me to deathcafe.com, the bare-bones online headquarters for the death café community. Loopy black font covered the homepage, along with pictures of skull-covered teacups and cakes decorated with little gravestones made of frosting. A bold move, I thought.

“Our objective,” the site read, “is to increase awareness of death with a view to helping people make the most of their (finite) lives. A death café is a group-directed discussion of death with no agenda, objectives, or themes. It’s a discussion group rather than a grief support or counseling session.”

Apparently, there aren’t many official requirements for hosting a death café. Moderators don’t need formal qualifications, just good listening, group-facilitation, and problem-solving skills—and “enthusiasm for talking about death and dying.”

I clicked another tab: “Find a Death Café.” Sure enough, a handful were scheduled in my area—including one at Washington, DC’s historic Congressional Cemetery. Would I? Could I? I spent a few minutes pondering. Then, resolutely, I opened the Calendar app on my phone and consigned myself to an evening of death.

Unexpected Connections

Of course, I wasn’t about to rush headlong into a death café without first talking to a few death experts to prepare myself. Death café moderators, I’d learned, often refer to themselves as death doulas. It’s a title that conjures up motherly skill and gentle guidance—exactly what I’d imagine it takes to direct conversations about death. Digging a little deeper, I came across Lizzy Miles, the first death doula to hold a death café stateside. So I was particularly excited when she agreed to speak with me.

While most death doulas don’t have a mental health background, Miles does. She’s a hospice social worker of 13 years based in Columbus, Ohio—and “really gung-ho about end-of-life issues,” as she puts it. In contrast, she says, “Most of my patients, and most other people I meet, for that matter, have never given death much thought. They’re often in shock about the fact that they’re going to die, as are their families. They’ve never talked about it.”

Miles always knew she wanted to create a space for people to air their death-related questions, concerns, and curiosities. So in 2012, after coming across a blog post about a death café in England, she decided to hold her own, renting out the back room of a local Panera Bread shop and creating a Kickstarter campaign to spread the word.

“Even though only 13 people showed up, they brought up things I never would’ve imagined,” she says. “We talked about whether it’s worse to lose a loved one to a long-term illness or an unexpected accident. Elderly parents talked about getting their affairs in order to spare their kids the hassle. An older participant turned to a 20-something attendee and said, pointedly, ‘What do you know about death?’ ‘Well, I was in a car accident,’ he replied, ‘and I almost died.’ There were unexpected moments of deep connection. It was beautiful.”

Miles and the attendees chatted for almost two hours, until it grew dark and Panera’s staff ushered them out so they could close up. From there, word of Miles’s death café spread, and soon she was being invited to host death cafés all over Columbus: in homes, libraries, museums, restaurants, and senior centers. Sometimes conversations were light, other times heavy, like at a death café she cohosted with staff at her local Stonewall Community Center, where every LGBTQ+ person in attendance had either witnessed or contemplated suicide. For Miles, one thing was clear: people were hungry—hurting, even—to have an honest conversation about death.

Miles stopped hosting death cafés in 2020 to pursue other projects, but she estimates she’s spent over a thousand hours training people around the country on how to host their own death cafés. To date, more than 16,000 death cafés have been held in more than 80 countries, each one seeming to inspire more.

Nicole Heidbreder, a hospice and emergency room nurse, started holding monthly death cafés in 2017 at The Potter’s House, a social-justice café and bookstore in downtown Washington, DC, after hearing about them from a colleague. She knew immediately it was the community service she wanted to provide. Like Miles, Heidbreder says most of her patients facing terminal illness had never talked about death—not even with the professionals responsible for their care.

“I’ve been hosting death cafés virtually ever since the pandemic, and they’ve been amazing,” she says. “Although each one is different, there’s a collective consciousness that emerges about how we define a good death, or how we deal with family dynamics around death. People from all walks of life show up, and it always leads to really beautiful conversations.”

It’s clear after talking to Miles and Heidbreder that most people who attend a death café find the experience therapeutic. But to call it therapy would be a vast overstatement. So why, then, does it feel so healing?

Heidbreder says that death cafés can be thought of as “little-T therapy,” in that they normalize people’s anxiety and depression around death. “Acknowledging the reality that everyone we love is going to die someday and hearing other people explore that,” she says, “has a therapeutic effect.”

“Have a Great Death Café!”

David Kessler is a world-renowned therapist and grief specialist who’s spent over a decade working in hospice and palliative care. He’s familiar with death cafés, and right away, I can tell he’s on board with them.

“Back when I worked in the hospital system,” he tells me, “I’d ask medical personnel, ‘When should we bring up death and dying?’ And they’d say, ‘When the patient does,’ even though they knew how important it is to talk about end-of-life care and advanced directives. Then I began to wonder, Is it true that people don’t want to talk about death, or have we just made it hard for them to do it? When I learned about death cafés, I realized that people had decided to have these conversations without us. And they were having them fearlessly, without the need for professionals. I thought it was remarkable.”

In the rare instance where a death café attendee says something alarming—for instance, that they want to die—Kessler advises that moderators ask them to reach out to 988 or their local help line immediately, since these groups aren’t designed to handle suicide prevention. But overall, most death cafés seem to be positive experiences that go off without a hitch.

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Kessler is so impressed by death cafés that he’s suggested them to clients who want to talk about death but whose friends and families are reluctant to do so. “Afterward, the client can come back to therapy and share what they learned,” he says. “Therapists can really help with the integration part of the experience—if they do their own work first.

“We have to ask ourselves the same questions we ask our clients: What were you taught about death? How were conversations around death and grief modeled for you? Can we hold space and contain ourselves in the midst of these conversations? We have to be okay getting support if they make us uncomfortable.”

Kessler wants to normalize talking about death. But for Jane Prelinger, founder and director of the Center for Existential Studies and Psychotherapy, death informs nearly every aspect of her therapy work.

“Existential therapists study the process of existence in the therapy room, where death is both a real thing and a metaphor,” she says. “It stands for finitude, limits. It enriches our thinking about meaning and purpose, about how we use our time. It rockets you out of whatever problem you’re having today into thinking, What do I want this whole life thing to be about? Once you start listening for death—not just ‘I’m scared of death,’ but the potential for regret—you can help your clients get down to the business of living.”

Prelinger speaks slowly, with the kind of soft, singsongy tone that immediately puts you at ease—which is great, considering the subject we’re talking about. “When I was very young, I understood on a visceral level that I was going to die someday,” she recalls. “For me, it was a mind-blowing realization, one that naturally brought me to how the existential perspective informs the practice of psychotherapy. Over my professional lifetime, I’ve looked for ways to work with that realization.”

One of those ways turned out to be hosting a death café. In 2018, Prelinger decided to arrange one for her staff at a Le Pain Quotidien bakery—a space, she says, “where we could just be people, together, and not just therapists.

“We spoke as human beings, and got to know each other in ways we wouldn’t have otherwise,” she says. “We talked about terminal illness, our fears about it, and people we knew who’d been terminally diagnosed. I shared that I’d recently lost my father, and learned that one of my colleagues had too. It was emotional, but we also had a lot of laughs, because the human condition can be sort of hilarious. I still had a lot of complex feelings and fears afterward, but I felt lighter, closer to my people.”

I tell Prelinger I’ll be heading to a death café in a few days, and she lights up.

“Here’s to a good experience!” she says as our conversation winds down. “Have a great death café!”

I hang up the phone and begin to wonder what my death café might hold. What kinds of conversations might bubble up? Will I find it cathartic? Will I find, like Prelinger, some shared affinity with the other attendees? Will I find my people? And will I be able to handle the hard feelings I know are going to come up for me?

“But I Don’t Want to Die”

On an evening in 2017, I’m out to dinner with my wife and parents, when our conversation takes a sudden turn.

“Oh my god,” my wife says, reaching for my hand. “Did you know?”

“Know what?” I say flatly, nudging the scraps of steak and potato on my plate.

“That you almost died.”

I did know. It’s a story my parents have told several times. I didn’t, however, expect they’d be telling it tonight, in a restaurant full of people, on what was, until now, a perfectly nice, uneventful evening.

“It’s true,” my mom says matter-of-factly. “You got stuck in the birth canal. You’d stopped breathing. The obstetrician had to call in two other doctors for help, and they had to pull you out with forceps. Dad started crying.” I look over at my dad. He looks uneasy, but says nothing.

This is a conversation I’d rather not have. I don’t like talking about death, let alone my own almost-death. I don’t like thinking about the frantic prayers my parents recited in that moment, or my dad crying, or the silent bargaining he must have done with some invisible higher power to keep me alive. I don’t like thinking that how and when we die is left to some cosmic role of the dice. And I don’t like thinking about how, over the years, my parents’ anxieties and traumas around death have likely trickled down to me.

Even now, I can still vividly remember being four years old and riding in the backseat of my parents’ clunky Toyota Corolla when my mom told me, almost nonchalantly, “Everybody dies.”

I don’t remember why she said it, but I can still feel the way my stomach dropped. A blood-orange sunset hovered on the horizon ahead. Even at four, I felt a deep sense of injustice. Death was unfair.

“But I don’t want to die,” I mustered weakly.

“I know, sweetheart.”

Here I am, 32 years later, and death still feels unfair. I can’t count the number of nights I’ve climbed into bed, only to start spiraling the moment the lights go off and my head thumps the pillow. My back aches, I think to myself. That knee is acting up again. God, I’m falling apart. Getting old sucks. Soon comes the crescendo: Time moves so fast. Nothing lasts forever. Death is coming for me—and everyone I know and love. What if I don’t wake up tomorrow? Where will I go? Why am I here?

The fear dive-bombs my cortisol-soaked brain like a vulture zeroing in on a wounded rabbit. Before long, I’m ping-ponging between panic and dread, gritting my teeth, cursing under my breath, and twisting the comforter in my fists. I resist the urge to wake my wife, inches away and slumbering peacefully, blissfully unaware of my midnight existential crisis.

I’d shared a little of this distress with Kessler and Heidbreder, hoping that, as therapists, they’d be able to help me steel myself for my upcoming death café, which I had no doubt would be triggering.

“Someone might say something there that’ll calm you down,” Kessler told me. “Note what it is, and later, look at why it calmed you down. Or maybe someone will say something that makes you anxious. Make note of that too, and ask yourself what it is about that statement that made you anxious. What story is your mind making up? Notice your mind’s reactions, because that’s going to be the real key about what’s going on with you.”

“Chris, I love hearing this,” Heidbreder exclaimed when I told her I was anxious. “You have a real sensitivity to the subject. I think that for someone who’s trying to make sense of things, a death café can be very helpful. You sound right for the experience.”

What Doesn’t Kill You

A few days later, I push open the tall, black wrought-iron gates at the cemetery entrance and begin to walk down a stone path, where a chalkboard sign reads, Death café at the chapel, straight ahead. It’s a perfect summer evening. Golden sunlight dapples the ground, and a gentle breeze rustles the leaves overhead. Spandex-clad locals have brought their dogs here for a post-work romp, and golden retrievers and poodles bob and weave between the headstones. It’s damn-near idyllic—if you don’t think about the hundreds of dead people under your feet.

On a shaded hill up ahead, the chapel soon comes into focus, flanked by rosebushes and cherry trees. It’s quaint and unassuming, like a dollhouse plucked straight out of a Christmas storybook. After nearly tripping over a wide-eyed beagle at the chapel’s wooden double doors, I pick an empty seat in the circle and assess my surroundings. There are about two dozen other participants, mostly middle-aged and senior, but a few Millennials and Gen Zers too. An anemic-looking snack table with a three-tiered cookie stand and a handful of canned seltzers sits nearby, largely untouched, making it clear that the café aspect of the death café isn’t the reason everyone’s gathered here.

Our group moderator, Leah, drapes a tattooed arm over the wooden pew facing the circle of chairs. With her orange sundress, earth-toned clogs, and salt-and-pepper hair cut in a stylish bob, she looks more like someone’s cool aunt than a death doula.

She introduces herself, then gives a brief history of death cafés (the first was held in Switzerland almost two decades ago before spreading globally) before laying out a few ground rules: respect your fellow attendees, don’t hog the space, and—since this is a discussion group, not therapy—try not to unload too much. It tends, she says, to create a dynamic that violates rule number two. After inviting us to close our eyes and take a few deep breaths to relax and get centered, she kicks things off. “So, would anyone like to share what brought them here?”

An uncomfortable silence lingers as participants’ eyes dart nervously from one person to the next. The fading sunlight shining through the chapel’s stained-glass windows throws a peach-colored smudge across the creamy marble floor where we’ve plopped our bags and seltzers. I wonder if I’m going to regret my decision to come here. I mean, does anyone really want to talk about death? Normally, most of us would be at home right now, probably cooking dinner or watching something mindless on TV. But that’s kind of the point: we live in a culture that doesn’t talk about death, and today, at least on a micro level, we’re breaking the mold.

After a moment, I lean forward in my chair, take a breath, and raise my hand. Leah gives me a nod.

“It feels like, lately, not a day’s gone by where I haven’t thought about death,” I say. “It usually happens at night, right before I go to sleep.” I glance up and see a few heads nodding. “There’s something else,” I continue. “My parents are getting older, and I’m realizing they won’t be here forever. I’m struggling with the role reversal, where I feel like I’ve got to start taking care of them. That’s been tough.”

“Mmmm,” Leah says, knowingly. “Anyone else?”

An older woman sitting across the circle raises her hand. “Yeah,” she says, locking eyes with me. “What you just said really resonated.” She’d lost her mother a few months ago, she tells us, and it’s been hard.

Another attendee, a 20-something woman, turns toward me. “My dad refuses to talk about getting older,” she says. “He keeps saying he’s fine, but I can tell he’s slowing down.” She apologizes as she begins to wipe away tears, and Leah slides a tissue box across the floor.

As the hour progresses, the conversation shifts. One 30-something attendee says she’s not so much afraid of death or being dead, but of dying, of losing her memory and bodily function. One of the senior attendees shares that she’s made peace with death at this late stage of life, but that planning for her death, like drawing up a will, is a struggle. We talk about what it means to have a “good” death. For most of the group, it’s dying peacefully at home, surrounded by loved ones.

These conversations flow naturally. Personal stories and moments of vulnerability give way to more stories and more vulnerabilities shared. Other than a word here and a nod there, Leah hardly interjects at all. She doesn’t have to. It’s clear that this has become a safe place, where we can gripe, and muse, and wonder, and be scared—not only without judgment, but with mutual acknowledgment and validation.

Soon enough, our time is up. Leah thanks everyone for coming, and we push back our chairs to leave. “Remember,” she says as people scoop up their bags. “Stepping into these conversations is an act of bravery.”

I feel a little jittery as I stand up, but good. That was okay, I think to myself. I’m okay. But I also wonder: What happens now? In just an hour, I made a deep connection with total strangers. I shared things I haven’t even told my best friends. We all did. Should I give someone a hug? But people are filing out quickly, and the opportunity has passed.

On the drive home, I sit in silence, marinating in the glow of whatever just happened. The traffic that clogged the city streets on the ride over has dissipated, and I have the road almost entirely to myself. I press the pedal down and hug the curves around the Tidal Basin, driving past the Lincoln and Jefferson memorials. I think about how they’ll still be standing hundreds, if not thousands, of years after I’m gone.

The sun has almost fully set now, and the last bits of daylight shimmer on the Potomac River. A small boat on its way into Georgetown slices the still water, leaving a trail that slowly melts away.

I went to a death café looking for answers that, if I’m being honest, I still don’t have. But I can live with what I did get: a little bit of peace. Death still terrifies me. But it’s nice to know at least I’m not alone. That, in itself, is deeply therapeutic. It’s a truth I’ll carry with me for the rest of my life.

One day death will come, I think to myself. But not today.

Chris Lyford

Chris Lyford is the Senior Editor at Psychotherapy Networker. Previously, he was Assistant Director and Editor of the The Atlantic Post, where he wrote and edited news pieces on the Middle East and Africa. He also formerly worked at The Washington Post, where he wrote local feature pieces for the Metro, Sports, and Style sections. Contact: clyford@psychnetworker.org.