Children Worried About Death

Q: My 9-year-old is terrified of dying. She doesn’t know anyone who has died, but in the last few months she seems to think about death more and more. Even though she is normally a bright and “spirited” child, about twice a week she breaks into tears saying that she is worried that someone in the family will die. What can I do to help her?

A: It is not unusual for 9-year-olds to suddenly be worried about death. A child’s understanding of death changes as she grows. Young children typically think of death as a long trip from which you can return, but between 8 and 12 children begin to get a sense of the permanency of death, a terrible and sometimes overwhelming thought. Many children go through periods when they worry about death, and, like your child, they get upset on a regular basis. The mind can work in mysterious ways, and just because you don’t see any triggers for her worries, this doesn’t mean that they don’t exist. Perhaps it is the news reports of the war in Iraq, or a book she is reading, or a television show or movie that she has watched. Maybe she has a friend who has experienced a death in her life. Often these kinds of anxieties are “contagious.”Whatever is triggering her fears, you must ask yourself if her worry about death is a symptom of a more serious anxiety disorder. There are several tests which can help you distinguish normal anxiety from clinical anxiety, including the Multidimensional Anxiety Scale for Children (MHS, Inc. 1997), and the Revised Children’s Manifest Anxiety Scale (Western Psychological Services1985). A school psychologist should have access to these or similar standardized ways to measure anxiety. Obviously if an anxiety disorder is discovered, treatment should follow as soon as possible.The most important part of your question is what should you do to help alleviate your child’s worries. Whenever I encounter a psychological or developmental problem in children, I ask myself: “What does this child need to solve the problem herself.” The answer to this question is always a specific emotional intelligence skill.In the case of your daughter, I would say that the two most important skills she needs are to “self-calm” and to be able to communicate her feelings to people who can give her a sense of support and belonging. Every emotional intelligence skill is related to a specific part of the brain’s emotional chemistry. Learning to self-calm (through deep breathing, meditation, guided imagery, and so on) reduces stress biochemicals, including cortisol, adrenaline, and norepinephrine. Practicing using self-calming techniques will train your child’s brain to be able to deal with all kinds of stress and worry. Talking about her feelings to others produces serotonin in the brain, a biochemical that is a mood modulator. These feelings may be about her anxiety, but talking about any concern at all will help her feel a sense of belonging and being cared about. When people say that they “feel better” after talking to a counselor, a family member, or a friend, this feeling actually comes from the increased serotonin in the brain.Although I don’t really think that talking about death will help your daughter, and may temporarily increase her anxiety, there are several books available to help parents open a discussion about this difficult subject. One of my favorite books for children is When Dinosaurs Die by Laurie Krasny Brown and Marc Brown. This illustrated book has a comic book feel, and seems to intrigue children without talking down to them. You may want to read this book yourself to get a better feeling of how a child your daughter’s age thinks about death and what might be appropriate answers to her questions and concerns. Then show the book to your child and suggest that she may want to look at it herself. Let her choose whether this is something she wants to do.