Ch. 3: The Concept of Death in Children

Question 1

The study of the child

Answer 1

The study of the child provides an unparalleled opportunity to study the human’s grapple with death.
Fear of death doesn’t appear de novo in adulthood, it results from a lifetime of occupation with security and survival

Question 2

Discrepancy between importance of death to the child and how it has been studied

Answer 2

Seems perfunctory (without real interest) compared to other child-development issues.

Empirical studies are rare and psychoanalysts have tried, but with severe bias

Question 3

Yalom’s conclusions about study of death in children (4)

Answer 3

1. When behavioral scientists choose to study death in children they discover that children are extraordinarily preoccupied with it.
   - One of the major developmental tasks is to deal with fears of helplessness and obliteration while sexual matters are secondary and derivative
2. These concerns start earlier than generally thought
3. Kids go through an orderly progression of stages in awareness of death and in their methods to deal with it
4. Coping strategies are invariably denial-based: it seems that we do not - perhaps cannot - grow up tolerating the straight facts about life and death

Question 4

Whence? Whither?

Answer 4

Freud believed that a silent sexual research is what distinguishes children from adults (the question whence?); Yalom says that there is however also ample evidence that death is often on the mind of the kid (the question whither?)

Question 5

Few parents have not been surprised by their kids’ death questions.

Answer 5

Yalom’s 5-year-old: “Both of my grandparents died before I ever met them, you know.” When Yalom asked how often he thinks about it, the kid said: “I never stop thinking about it.”

When the kid’s older brother left for college, the kid said: “It’s just three of us here now. I wonder who will die first?”

A 4-year-old to her parent: “I wish I will never grow old for then I’d never die.”

A 3-year-old asked for a stone to be put on her head so she could stop growing and wouldn’t grow old and die.

A 4-year-old wept for 24 hours when she found out that all living things die.
- The mom couldn’t calm her down in any other way than to tell her that she will not die.

A kid whose grandma had died a few days earlier and had not reacted to the death too strongly saw a dead goose on the table and asked: “Is that what you call dead?”

4-year-old who had convulsions after seeing his grandma’s coffin, after finding a dead rat and after accidentally crushing a butterfly in his hand.

Question 6

Kids ask these questions so directly

Answer 6

When are you going to die?
How old are you?
How old are people when they die?
“I want to live until I’m a thousand years old. I want to be the oldest person alive.”
Innocence + fear of death?

Question 7

Anthony administered a story-completion test

Answer 7

Anthony administered a story-completion test to 98 children, objective measure of children’s death concern.
Open-ended and without death mentioned
“When the boy went to bed at night, what did he think about?”
“A boy went to school, and when playtime came he stood alone in the corner without playing with others. Why?”
~50% of kids referred in their story completions to death, funerals, killings or ghosts, with slightly inferential answers (“He got run over”) it rose to 60%.
35% of the children expressed in their story completions a preference for staying young

Question 8

IMPEDIMENTS TO KNOWING WHAT THE CHILD KNOWS ABOUT DEATH:

1. Lack of language

Answer 8

• Child can’t always express themselves, so a lot of, likely biased, assumptions about what the child knows and thinks
• Jean Piaget has demonstrated that children lack abstract thought - even at the age of 10 it’s hard to grasp “possible” and “potential”. Many have concluded that children thus don’t have an understanding of the concept of death (or finality, consciousness, being/nonbeing, eternity, future)

Question 9

IMPEDIMENTS TO KNOWING WHAT THE CHILD KNOWS ABOUT DEATH:

2. Freud’s stand

Answer 9

2. Freud’s stand
   - Was convinced that child doesn’t grasp death, and because childhood was so important for Freud’s theories he considered death unimportant in psychic development
   - “The fear of death has no meaning to a child, and because of it they play with the word lightly: ‘If you do that again you will die like Franz!’”
   - “To children, being dead means as much as being ‘gone’
   - He was also highly influential which resulted in the issue of death being prematurely sealed off for a generation
   - A methodological problem: Freud never worked directly with children

Question 10

IMPEDIMENTS TO KNOWING WHAT THE CHILD KNOWS ABOUT DEATH:

3. Adult bias

Answer 10

• Whether the study is observational, psychometric or objective, an adult must collect and interpret the data and that adult’s fear and denial often contaminate the results
• Adults are reluctant to speak to children about death, they avoid the topic, they accept surface data too fast because they are unwilling to probe the child further, they systematically misperceive a child’s experience, and they always tend to think that a child has less awareness of death, and less anguish therefrom.

Question 11

Study by Lapouse & Monk

Who was interviewed?

Answer 11

First interviewed mothers about the fears of children

But also a subsample of 192 participants who they interviewed directly as well, and results indicated that the mothers had underestimated children’s fears

Question 12

Piaget was a strong believer of the “clinical interview”

Answer 12

Yalom: “I have serious doubts whether a research project whose design included explicit questioning of young children about death would even obtain clearance from a human subjects research committee”

Question 13

Maria Nagy (“Auntie Death”) and Sylvia Anthony

Answer 13

Maria Nagy (“Auntie Death”) and Sylvia Anthony asked children to draw death and write compositions about death and to discuss death verbally

The authors made concessions to the sensitivity of the children by accepting and reporting the reactions at face value

Question 14

IMPEDIMENTS TO KNOWING WHAT THE CHILD KNOWS ABOUT DEATH:

4. What the child is taught

Answer 14

A child’s state of knowing about death rarely exists in nascent form: adults rush in to spare the child from grappling with the idea of death

Even parents who want to be honest waver in the face of a child’s distress

What an investigator often discovers then is not a child’s natural inclination but a complex amalgam consisting of a child’s awareness, anxiety, and denial intermingled with an adult’s anxiety and denial defenses

Question 15

Emma Furman: what is helpful to children to know about death?

Answer 15

Erma Furman, who closely studied young children who had lost a parent, concluded that “concrete information about death was helpful to them at certain points and that the child’s task was made more difficult when adults wittingly or unwittingly obscured the objective facts”

Question 16

Death and the development of language.

Anthony

Sully & movements

Piage and stages of animism (4)

Answer 16

Anthony attempted to answer the question by asking 83 children to define the word death amongst other words in a vocabulary list
- 100% kids 7 or older and 66% of 6-year-olds gave a comprehensive meaning for the word

Sully, 1895 noted that young children seem to consider all spontaneous movements as a sign of life, also smoke or fire

Piaget considered the animism of children falls into fours stages:

1. Inanimate objects are considered to have life and will
2. 7 year old attributes life only to things that move
3. 8-12 year old child attributes life to things that move by themselves
4. 12+ the child’s view becomes increasingly adult-like

In one study 33% believed that a watch or a river lives, 75% believed that the moon lives, 12% felt that a tree does not live

Confusion probably arises because kids are not educated precisely about the matter, dolls and machines simulating life add to further confusion

Question 17

Observations of Children

Answer 17

Perhaps researchers are making unnecessarily stringent evidential demands

• Does a child have to be able to define “life” or “death” to know that he, and everything else, will one day cease to be?
• Kastenbaum and Aisenberg: “between the extremes of ‘no understanding’ and explicit, integrated abstract thought there are many ways by which the young mind can enter into a relationship with death” - the young mind is fearful of it, curious of it, registers death-related perceptions, and erects magic-based defenses against death

David, 18 months old, who discovered dead bird: “his face was set in a frozen expression resembling the Greek dramatic mask for tragedy”
- He asked another dead bird a month later to be put back on a tree

Szandor Brant’s 2-year-old son began waking up hysterically during nights after the parents stopped giving him the bottle. He would say he has to have the bottle or “I won’t make contact”, “I’ll run out of gas”, “My motor won’t run and I’ll die.”
- His father says that a couple of days earlier the kid had been around when the car “died”

Anna Freud: “It can be safely said that all the children over 2 in the London blitz realized the house will fall down when bombed and that people are often killed or get hurt in falling houses.”

Question 18

Maurer speculated about the infant’s early awareness of death

Answer 18

As the baby wawers back and forth between consciousness and unconsciousness they develop a sense of these states
What is the infant’s experience during a night terror? The baby might be panicked by a half-here, disembodied sensation
Maurer also suggests that infants throw toys because they are fascinated by disappearance and reappearance, i.e. being and nonbeing

Question 19

“All gone”

Destructiveness

Answer 19

“All gone” is one of the first phrases children learn - food disappearing, bath water all gone, or feces flushed away
- Rare is the child who wouldn’t fear being flushed away

When child realizes that vanished objects don’t come back they develop strategies to protect themselves from nonbeing - they become master’s of “all gone” rather than victims

• Children start blowing out candles, pulling the bath plug, flushing objects down the toilet etc
• Horney: “destructiveness of a child are proportional to the extent to which the child perceives their survival to be endangered”

Question 20

The known does not remain known

Answer 20

Mcintire, Angle, Stuempler (all women by the way) did study with 598 children:
Asked whether a dead pet knows that its owner misses it
7-year-olds were more inclined to accept death’s finality than 11 and 12-year-olds

Alexander and Adlerstein checked GSR (galvanic skin response) do death words in list with neutral words
9-12 year olds had less reaction than 5-8 year olds or 13-16 year olds
“9-12 (latency) is the golden age of childhood where children seem to be too much involved in routine and attendant pleasures to be concerned with the concept of death”

Question 21

“there’s a less pollyannaish explanation I believe”

Answer 21

Basically Yalom says that kids are confronted with death between 5-8 and they have to cope with it somehow - denial, scoff at it, personify it, repress it, displace it

• By 9-12 they have learned (or been taught) efficient forms of denial - the golden age doesn’t diminish death anxiety, but results from it
• 13-16 in adolescence the now childish denial forms are no longer effective. The introspective tendencies and generally greater available resources permit the adolescent to once again face the inevitability of death and to search for an alternate mode of coping

Question 22

STAGES OF KNOWING (8)

Answer 22

1. Denial: Death is temporary, diminution, suspended animation, or sleep
2. Denial: The two basic bulwarks against death
   - Specialness
   - The ultimate rescuer
3. Denial: The belief that children do not die
4. Denial: The personification of death
5. Denial: Taunting of death
6. Denial of death awareness in child psychiatric literature

Question 23

Yalom on empirical research

Answer 23

Bowlby, on his monumental work on attachment and separation, demonstrated that children from 6-30 months old fear separation.
- Bowlby concludes that separation anxiety is the fundamental anxiety, and other fears, including death, are acquired via emotional equations with separation anxiety.
- Bowlby references Jersild, who asked ~400 kids about their fears, and both Bowlby and Jersild concluded based on the kids’ fears about animals, darkness, heights, or being attacked by ghosts or kidnappers, that kids don’t have fear of death before age 9
Yalom: “But what is the meaning of these fears (animals, darkness, heights)? Is it not fear of death?

Empirical research demonstrates that the child is fearful when separated but in no way demonstrates that separation anxiety is the primal anxiety from which death anxiety is derived

Developmentalists avoid the idea that a young child before 30 months could experience death anxiety because it has little concept of a self that is separate from its surroundings - yet the same could be said about separation anxiety: without a conception of self, the child cannot conceive of separation

Question 24

Why is death omitted from dynamic theory?

Answer 24

The omission of dynamic theory is obviously not oversight nor is there enough reason to justify translating this fear into other concepts

“I believe, there’s an active repressive process at work - a process that stems from the universal tendency of mankind to deny death - both personally and in life work”

Anthony: “The patent insensibility to man’s fear of death can be attributed only to conventional (i.e. culturally induced) repression of this fear by the writers themselves and those whose researches they report.”

Charles Wahl: “Could this suggest that psychiatrists, no less than other mortal men, have a reluctance to consider or study a problem which is so closely and personally indicative of the contingency of the human state? … Perhaps they would seem to confirm de La Rochefoucauld’s observation - “One cannot look directly at either the sun or death.”

Question 25

Why do some develop crippling disorders and others reach adulthood in a relatively well-integrated fashion?

Answer 25

No empirical research to help this question, so I can only suggest possibilities. Certainly a number of factors interact in a complex fashion.

Question 26

“ideal” timing

Answer 26

There must be some “ideal” timing or sequence of developmental events: the child must deal with the issues at a pace compatible with his or her inner resources.

• A child harshly confronted with death before having developed appropriate defenses may be severely distressed
• Freud cited a biology experiment which demonstrated the catastrophic effects on an adult organism caused by the tiny prick of a needle into the embryo at the very beginning of its development

Question 27

What type of trauma may be involved?

Answer 27

Several possibilities. Some types of exposure to death may result in inoculation, some may exceed the child’s capacity to shield themselves

• Every child is exposed to death in encounters with insects, flowers, pets, and other small animals - can evoke curiosity and discussions about death with parents
• Death of a human is possibly a greater trauma

Question 28

The death of another child

Answer 28

Especially frightening because it undermines the consoling belief that only very old people die
The death of a sibling is a major trauma. The child’s reactions may be very complex:
1. Guilt from sibling rivalry
2. Loss
3. Evocation of fear of one’s personal death

Literature mainly deals with the first, sometimes with the second, and almost never with the third

Question 29

Factors that influence reaction to parent’s death (5)

Answer 29

• Quality of parental relationship
• Circumstances of the death - natural or violent
• The parent’s attitude during their final illness
• Existence of a strong surviving parent (figure)
• Network of community and family resources

Question 30

Josephine Hilgard and Martha Newman studied psychiatric patients who had lost a parent

Answer 30

Significant correlation between a patient’s age at hospitalization and their parent’s age at death: when a patient’s mother died at the age of 30 the patient themselves is “at risk” at the age of 30

Another finding from them: the patient’s oldest child is likely to be the same age as the patient when the parent died: a patient who was 6 when her mother died is “at risk” when her oldest daughter is 6

Though the authors did not raise the issue of death anxiety, Yalom: “it would seem possible that the death of the original mother signaled that the child too must die”. The associated anxiety remained unconscious until triggered by the anniversary (attaining the age at which the parent died)

Question 31

Cultural differences regarding death

Answer 31

Children in many cultures participate in rituals surrounding the dead, e.g. roles in funerals

• In Foré culture in New Guinea the children participate in the ritual devouring of a dead relative
• Most likely this is not catastrophic because the adults participate in the activities without severe anxiety; it is part of a natural, un-selfconscious stream of life

As is often true in Western culture, if a parent experiences severe anxiety about the issue of death then the child is given the message that there is much to fear
- Breckenridge & Lee Vincent: “The children feel the anxiety of their parents that they may die, and hence tend to carry a vague uneasiness which healthy children do not experience.”

Question 32

Parents escalating reality

Answer 32

Many parents in our culture attempt gradually to escalate reality in regard to death education.

• Young children are shielded from death
• They are explicitly misinformed
• Denial is implanted early in life with tales of heaven or return from the dead or assurances that children don’t die
• Later, when the child is “ready to take it” a parent gradually increases the dose of reality

Question 33

Enlightened parents struggle

Answer 33

Occasionally, an (enlightened) parent takes a stand against self-deception and refuses to teach their children to negate reality.
However, they find it hard when a child gets frightened to refrain from offering solace through some reality-negating reassurance - either a flat denial or a “long journey” afterlife myth

Question 34

Elisabeth Kübler-Ross

Answer 34

Elisabeth Kübler-Ross disapproves of traditional religion’s practice of indoctrinating children with “fairy tales” of heaven, God, and angels

Yet in her descriptions with children who are afraid of death it is obvious that she too offers denial-based consolations: “At the moment of death one is transformed or liberated ‘like a butterfly’ to a comforting, beckoning future.”

She insists that this is not denial but instead a reality based on objective research on life-after-death-experiences. Yalom: “the empirical evidence remains unpublished. /…/ As far as I can judge, Kübler-Ross’s ‘objective data’ differ in no significant manner from traditional religion’s ‘knowing’ through faith.”

Question 35

Educational guidelines

Anthony vs Bruner

Answer 35

Clear educational guidelines for physical development, information acquisition, social skills, psychological development, but with death parents are on their own
Often the child is given information that is obscure, commingled with parental anxiety, likely to be contradicted by other sources of information

Anthony recommends that parents negate reality to the child: “negation of reality is a transition phase between ignoring and accepting reality”
- If the kid later accuses the parent of lying, the parent could say: “You could not take it, then.”

Jerome Bruner on the other hand: “any subject can be taught effectively in some intellectually honest form to any child at any stage of development” and attempt to assist the child’s gradual realistic understanding of the concept of death

Question 36

Kids deal with death in two ways

Answer 36

Altering the intolerable objective reality of death

• Denies the inevitability of and the permanence of death
• Immortality myths, made up or accepts ones from elders

Altering the inner subjective experience

• Believes both in his or her personal specialness, omnipotence, and invulnerability
• Or believes in the existence of some external force that will save them from the fate of everyone else

Question 37

Rochlin on children and adults

Answer 37

“what is remarkable is not that children arrive at adult views of the cessation of life, but rather how tenaciously throughout life adults hold to the child’s beliefs and how readily they revert to them.”