What is the pathology behind an intense fear of death as a child?
As cognitive capacities develop and evolve, children come to understand the permanency of death. Experiencing a loss through death, such as the loss of a grandparent, may not be understood as permanent by a young child. Instead, the child may think “Grandpa is in heaven” as if this is an alternative living place to home.
As the child matures exposure to death will take many different forms: through television or movies, in books (e.g., Bambi’s mother dies), and first hand experience with the passing of living things (e.g., pets, relatives). The life cycle and process of death is addressed directly as the child progresses through the school years in certain classes, such that by later childhood the youth has a clear understanding of the process and permanence of dying and death. Religious beliefs and family approaches to death and dying will influence the child throughout his or her development.
A child is considered “intensely fearful” of death if the fear is intractable despite reassurance and causes interference in the child’s functioning. Excessive fear can arise in several different ways. Excessive fear (of anything) more easily occurs in children who tend to be anxious in general. The young child with an anxious temperament may “take” more readily to being fearful. A family history of anxiety may also predispose a child be being excessively fearful.
Environmental experiences such as the sudden death or traumatic loss of a loved one, an accident, near death experience, or a serious medical illness that is experienced by the individual or someone he or she knows can also lead to excessive fear of death. In general, the response of the child’s primary caretakers will also impact how the child manages his or her fear of death.
Hence, biological risk factors such as temperament or family history can combine with life experiences to render a given child more vulnerable to fearing death.