The word 活活 is formed through the process of reduplication, where the single-character adjective 活 (huó), meaning "alive" or "living", is repeated to create an intensified adverbial form. This reduplication transforms the base meaning into a vivid descriptor for verbs, most commonly conveying a sense of something happening in a vivid, direct, and often distressingly palpable manner, such as "before one's eyes" or "in a state of full vitality", frequently used in negative contexts like 活活打死 (beaten to death) or 活活气死 (angered to death). The repetition adds emphasis and a graphic, sometimes brutal, quality to the action it modifies.