Strategies to Help a Girl Face Her Fear of Death

Q. Our happy-go-lucky 11-year-old functions normally at school and with friends, but she sometimes is seized with worry at home.

We can trace her problems back to last summer and fall when she faced a string of medical incidents: a foot that was broken in a bike accident; a bad reaction to tree nuts; and then the long illness and death of our beloved dog.

Our daughter began to obsess over this illness, thinking that she had caught it, too, and it's gone downhill from there. We took her to the pediatrician a couple of times to get an "all clear" but she's still afraid that every cold will turn into pneumonia and that every headache is caused by a brain tumor.

How can we help our child overcome these worries?

A.Small doses of fear and anxiety keep children from doing wild and foolish things, but your little girl had a dose that was much bigger than she could handle.

Although her fears are exaggerated, they're not unusual. Children between 7 and 12 often develop big and little worries when they hear about tornadoes and floods or when their ancient relatives -- or their old dogs -- die. Suddenly they realize they are mortal, and they're quite shocked by the whole idea.

It should help your daughter to know that life is a journey full of ups and downs for everyone, but it's an adventure nonetheless.

You'll also help her when you encourage her to talk about her fears and then listen to her attentively and sympathetically. Don't tell her that the possibility of getting pneumonia or a brain tumor is silly, however, and don't bother to ask the pediatrician to reassure her anymore. Your daughter is the only one who can make her fears go away, and she can only do it by proving to herself that she is in charge of her own body and her own mind.

She can do this best if you can teach her some well-established coping strategies. Ask her to rate her next worry on a scale of 1 to 10, and give her a diary so she can track her fears. When she looks back, she'll see that the bad cold didn't turn into pneumonia and that it took only an aspirin to make her headache -- and that pesky brain tumor -- disappear.

You might also ask her to put the dog's pictures into a special scrapbook, along with her written memories of him. This will help her grieve for her old friend, which is important. It can be quite hard for a child to lose a family pet, especially at 11 -- the age when children usually love animals with such intensity that many of them are sure they will be veterinarians when they grow up.

When your daughter's grief begins to fade, you might start talking about all the dogs that have been abandoned in your town and ask her if she'd like to go to the pound with you to give them some treats, if that's allowed. If she goes, she will probably want to rescue one of those pups, which could chase her worries away, but if it doesn't, you might ask her to meditate with you or let you massage her back at bedtime or brush her body with a soft brush -- the kind that's used to get rid of a baby's cradle cap. For some reason, this technique, which was developed to calm children with sensory integration problems, can soothe almost any child.

If none of this works, take your daughter to an acupuncturist, because this treatment can mellow the mind so well, or to a psychologist who uses cognitive behavioral therapy, because some research has shown that CBT usually helps this condition in about 12 weeks.

There are also some fine books about anxiety. "I Bet I Won't Fret" by Timothy A. Sisemore (Instant Help, $17) gives young readers some exercises and activities to overcome their anxiety and their fears. "What to Do When You Worry Too Much" by Dawn Huebner (Magination Press, $15) shows them how to withhold power from their worries, as if the worries were playground bullies at school. For parents, there's "Freeing Your Child From Anxiety" by Tamar E. Chansky (Broadway, $14), which is a sound book and, thank heavens, it's jargon-free.

Questions? Send them toadvice@margueritekelly.comor to Box 15310, Washington, D.C. 20003.