Q. My 11-year-old daughter (who is an only child) gets very upset at night when she is going to bed. She thinks both her father and I are going to be killed and she will be left alone. It doesn’t matter how often we comfort and console her, we get this at least three nights out of the seven. She says she cannot imagine not being able to talk to us every day and never wants to leave us. Then, in the morning, she is fine again. The only way she falls asleep is by holding onto one of us in her bed. Both her father and I are older parents and she has often commented that we are older than her friends’ parents. I think this all started after I travelled down the country over the summer to attend several funerals. We feel this is when the upset began but don’t know for sure.
A. When children express a fear of death, this raises troubling questions for parents. Generally, most people tend to avoid thinking about their own death or of those close to them and, as a result, live in largely a state of denial about these facts. This denial is, of course, punctured by life events that remind us of death such as funerals or other losses or indeed the fears expressed by our own children.
In the normal course of development, children tend to become aware of death at the age of three or four, when they might become acutely aware that their parents may not live forever. These fears can be less prominent in the middle years, but can peak again at the onset of adolescence (as in the case of your daughter) when children are able to think more abstractly and ask probing questions about the nature of life and death.
Particular events such as funerals or even coverage of death in the media can precipitate a child to start worrying and questioning. For some children, these worries can become overwhelming. Indeed, worries about death is one of the more common anxiety problems.
Unlike other worries, however, it can be particularly hard to deal with our children’s fear about death. Such fears can invoke our own fears about dying as parents and about the impact of this on our children. As a result we can easily avoid talking about the subject or indeed over-reassure children that things will be okay.
Particular family circumstances can make these fears more pronounced such as being older parents (“my parents are more likely to die than my friends’”) and being an only child (“who will be there for me when my parents die?”). This can make these conversations harder for parents who like their children may also worry about these issues.
In helping your daughter, the first step is to make sure you are available to have a frank conversation with her about her fears and worries. The more you have come to terms with death and the more you have thought through the specific issues that she might be concerned about, the better you will be able to help her.
When she expresses a fear, the key is to both listen to the underlying worries and feelings, while also being reassuring and hopeful. For example, you might say, “It is hard and sad to think of someone close to you dying, but we hope to be around for a long time to come.”
Addressing issues directly might be helpful, for example, “I know we are older parents, but lots of people our age live for much longer – such as your Auntie N or Uncle Y.” Sharing spiritual beliefs that make sense to you may also offer your daughter comfort, “It is hard to think of someone close dying, but that is what makes life precious. That is the reason we have to enjoy each day with each other.”
As well as being prepared to talk with her about her fears, it is also useful to teach her strategies to manage her anxieties so they don’t become overwhelming. This can include techniques such as learning to relax or to distract her mind and focus on happy events.
In addition, to help her contain her worries you might agree a rule that you will have a specific “worry time” each day, when you will happily listen to her fears, but that at other times of the day you will concentrate on distracting her and talking about happy things and getting on with life. You might agree not to have the worry time in her bedroom or just before she sleeps.
You can also focus on helping her gradually regain her ability to sleep alone in the following way. First of all, sit down with her and get her agreement that she wants to make her fears more manageable and establish the goal of returning to her falling asleep alone.
Second, agree with her a relaxing bedtime routine which includes spending some enjoyable time with her before she sleeps, such as reading together or just chatting about the day.
Then make a plan with her to gradually reduce the support you provide to get to sleep, so she can begin to use her own resources and strategies. You might start by sitting with her holding her hand and then the next night sit outside the room, checking in on her every five minutes, and then over time increasing the distance between check-in times before eventually going downstairs.
The key is to go at her pace and to give her the option of some step backs. For example, if she is finding her anxiety rising, she can call you back in for a moment to help her calm before you return outside again.
The key to making this gradual withdrawal process work is to make sure she is on board with it, to be really upbeat and positive and to praise any effort and progress. Talking about her worries as external to her can help. You want to reassure her that you are working together as a team to defeat the anxiety that is bothering her.
Dr. John Sharry, Irish Times Newspaper, October 2011. John writes in The Irish Newspaper Health+ every Tuesday.