I have a seven-year-old daughter who has become increasingly upset about the Madeleine McCann story. She is old enough to hear and understand the news headlines and she watches the news for children. At school, teachers are still saying prayers for Madeleine and her family. My daughter says that she is starting to have nightmares that involve her four-year-old sister being taken away. I don’t know whether she is aware of the type of speculation surrounding the McCann case (ie, paedophilia), or if her fear is simply of herself or her sister being taken away from home. I don’t want to encourage unnecessary alarm, neither do I want to play down the reality. How do I find a line between the two?

Michelle

The story of Madeleine McCann and her family is so tragic that I think we as adults are having a difficult time thinking about it – never mind our children. I find the daily agonies of Madeleine’s parents almost too difficult to contemplate – among the horrors of life, to lose one’s child and not know whether he or she are alive or dead must be the worst.

I have had many e-mails and letters about Madeleine, as my colleagues writing for this paper and others have. When faced with such a horror we need to ask questions, find answers – and try to discover something rational to hold on to when the facts tear at what we know and feel sure about.

Madeleine McCann: the key questions

Why are the "Tapas 9" key to solving the Madeleine mystery?

Related Internet Links

• The latest full coverage of Madeleine McCann

Background

• McCanns consider interview bids

• Madeleine McCann: the global reaction

• The forgotten victim in the McCann case

Multimedia

• Pictures: searching for Madeleine

• Video: McCann family start holiday

Related Links

• My toddler is a hormonal teenager

The truth is that there are no rational or easy answers. In fact the only comfort we onlookers can take is from the calm, dignified, determined way in which the McCanns are conducting themselves.

Your e-mail really struck me because it reminded me of the dilemma I faced when in 2001 my daughter, then aged 6, asked me why people would fly airplanes into buildings to explode and kill other people. I can remember at that time feeling that the events of 9/11 had to some degree shattered her innocent belief system and brought her face to face with the cold sharp realities of the cruelties of life. This realisation devastated me. I felt angry that my child was not sheltered from the harshness of life in the way that I remembered being as a child. Indeed, this week I found my children studying the bruised, battered and tortured face of Baha Mousa – the young Iraqi man who died in the custody of British Forces – on the front page of a national newspaper after it dropped through our front door.

Do our children know too much? Do they see and hear too much? Should we stem the liberal way we allow information to be reported? Should news reporting be given a watershed in the same way as TV programmes are?

At the risk of sounding old fashioned, out of touch, ridiculously conservative and unfashionable, I answer yes to all of the above. I am fervently in favour of the empowerment of children via the honest delivery of information, but I believe that we have gone too far. Why do children need to know about aspects of life that can, at their stage of psychological, emotional and cognitive development, only confuse, terrify and undermine all that they know as safe and good?

How do you discuss this with your seven-year-old? I suggest that you tell her that what happened to Madeleine McCann is very sad but also substantially and extremely rare, and that children can sleep safely in their beds without being snatched. I think you may need to spend a few nights sitting by her bed until she falls asleep and then gently move further away until she can fall asleep on her own. I also suggest that you think about restricting access to lurid newspaper headlines and pictures (as I have recently decided to) and, finally, I feel that we as adults should support our children with our honesty – limited to what they can cope with and really understand. Our children should not join us in the national outpouring of horror and sorrow for the plight of the McCanns, or any other family who has lost a child – because they are children themselves and so should be allowed the right to live their early years free of the anxiety and pain that we as adults know life can bring.

My ten-year-old daughter has started to pull out her eyelashes. She says that it makes her feel better and takes away her fears. She has been having a difficult time at school with girls being mean, and she has a huge fear of flying and even of going to bed at night.

Sue

What you describe is trichotillomania: an impulse control disorder, usually beginning in infancy, where a person (usually female) is compelled to pull out their body hair in a repetitive and uncontrolled way – from the head, the eyelashes, the eyebrows, the arm or the pubic area. Although Hippocrates noted that doctors should assess whether a patient “plucks his hair”, trichotillomania wasn’t labelled until 1987 despite an estimated 10 per cent of the world population pulling out hair in an uncontrollable fashion, leaving them with emotional and social difficulties, including significant and noticeable hair loss.

Hair-pullers describe how they feel tense and agitated before pulling, yet calm and focused afterwards. I have met people who describe the comfort derived from pulling and how they can become obsessed with tugging out the “perfect hair”, analysing its length, shape and root. Some people also eat their plucked hairs – trichophagia. Because of these experiences, trichotillomania has been likened to skin-picking and nail-biting, where anxiety and stress are managed in a body-focused manner. However, it is also worth noting that hair-pulling could be part of another clinical syndrome such as Tourette, autism or obsessive compulsive disorder.

It isn’t yet known what causes hair-pulling. For some it may be a learnt habit, for others related to stress at home or at school. Neurological research is now looking at structural differences in areas of the brain associated with motor actions. Genetics may also play a role, as is the case with obsessive-compulsive disorder and Tourette syndrome.

WORK OR FAMILY PROBLEMS?

E-mail drtanyabyron@thetimes.co.uk or write to her at: times2, 1 Pennington Street, London E98 1TT. Include your name, age, address and telephone number. Dr Byron cannot enter into personal correspondence