Children's Voice Nov/Dec 2007

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Helping Children Grieve

Coping with the loss of a family member or friend is hard enough for adults, let alone children.

By Greg Galanos

We know what grieving adults look like: A widow dressed in black, soldiers lowering a flag to halfmast, relatives gently laying flowers on a family member's grave. But what do grieving children do?
A cruel truth of grieving is the pain lasts far longer then people realize. Adults can privately suffer, weep, and mourn for months or years after the death of a loved one. How do we help children grieve in a world that often ignores the length and depth of grief in adults?

Over the many years I worked as a child and family therapist, grief often was a major unidentified issue in my patients. The children I worked with didn't even know they were grieving. Their issues were misbehavior, depression, or poor school performance. They had pain they couldn't even name that overwhelmed their ability to express or understand. So I learned how to help. It was never easy, but the basics were not as hard as I thought.

Theories about stages of grief often help counselors as much as the grieving. They let us feel that the blazing agony of grief has an order that those in mourning can't see. The late, world-renown psychiatrist Elisabeth Kubler-Ross listed five revolving issues the grieving will face.

The first is denial--this terrible event cannot be happening to me. Anger at being hurt is next. The third is bargaining--begging the world for some deal to relieve the pain. The heavy, unbearable sadness of depression is fourth. Last is acceptance, where those who grieve learn to live with loss.

Growth and Grief

An obvious challenge with grieving children is that they are still maturing. Kids younger than 2 will miss a loved one, but they don't have the memory to fully experience grief. Susan Smith, in The Forgotten Mourners, writes, "Intellectually the child will not be able to understand the permanence of the loss and will expect the person to return."

They will need help as they age, however, to understand their loss. As children grow, they will see their grief and how it has affected them in different ways. They may come to a good acceptance for their age, but they will need to relearn it as they grow.

Toddlers and young children age 2-5 will present more challenges when stricken with loss. They have an improved memory and closer attachments to people. They feel their loss more acutely. Starting at this age, regression becomes an issue.

Regression is a natural physical result of grieving, where children temporarily lose skills and abilities they have learned. Toddlers will often start to act like babies again--but don't worry, this is natural. Intense grief is a form of depression that leads to temporary cognitive problems. Children will often have memory problems, trouble concentrating, or nightmares. Normally happy, easygoing children may become cranky and not know why they are upset. They need comfort and reassurance they will be fine and that this is typical.

Perhaps the hardest single thing to do for adults is to talk about death. Helen Fitzgerald, in The Grieving Child, suggests, "Don't use euphemisms like, 'We have lost him' or 'He is walking in the valley of shadows,' because they can lead to misinterpretation. Try to imagine how your child could interpret those phrasesOeYou may want to ask your child if she is hearing any words she doesn't understand." Often children don't understand words like widow, funeral, or grieving. But they're not as afraid of the word dead as many adults are. They can handle simple language. In fact, it's less confusing for them. Grief is hard enough; don't confuse them with adult language.

Since children have a shallow understanding of death at best, many people will start with the concept of death in their religion. Others will use the loss of pets or animals as a starting point. Both are good starts. Children will tell you what they need to know. Young children often have simple concrete questions. Help the grieving child by answering his questions simply: Where is my mom? She is in a casket, in a grave. Does she feel pain? No. Is she sad? No.

Toddlers and grade-school-age children have an advantage over the rest of us. They are so in the moment that their grief can slide away for a time. Their hearts will temporarily lift and they can play and dream as freely as if they had never suffered a loss. Grief, for them, will be episodic.

Children ages 6-10 will present some new challenges. They are starting to understand the concept of forever, so their loss will take on a new meaning. As children age, they define themselves by their peers. Even if their loss happened as an infant, they will have to incorporate that into their self-image. They will often see themselves as different and know they are missing things other kids have.

Grade-school-age children may feel a stigma due to their loss. Adults who are uncomfortable with death can inadvertently cause this. Children often sense adults' feelings, but mistakenly see themselves as the cause. Starting with toddlers, but getting more acute at this age, children may feel they were to blame in some way for the death of their loved one. If a child had stopped her father from smoking, maybe he wouldn't have died; or if the child had been nicer to his siblings, they wouldn't have been in a car accident. Again, simple, concrete answers are best. Show children that death is acceptable to talk about by asking about their feelings and sharing your own.

With the start of puberty, grief will take on new meaning. The mood swings that are part of adolescence will make the grief at this age even more excruciating. Finding their place in the world, and all the redefinitions of themselves that happen at this age, will mix with their pain. A swirl of feelings already common in adolescents--rebellion, self-pity, and aloneness--will surge. They will now truly understand what has been lost: Her mother won't get to see her graduate, his brother won't be able to give him advice on dating, or her sister won't be at her wedding.

To Help, Start by Looking at Yourself

To help a grieving child, start by looking in the mirror. How comfortable are you with talking about death? If you are awkward and struggle with the subject, children will pick that up. They will feel uncomfortable and learn that death is a taboo subject.

Depending on your own history of loss, you may have more to offer than you know. One way to start talking to a child is to talk about your experience of grieving. That can be a bonding experience and a way to show the child there is hope. In almost every interaction with children, your own example is more important than your words.

When talking with grieving children, use open-ended questions. Lead the children to open up, but never push. Use toys or creative activities to let children express themselves. Children, especially young children, can't concentrate on emotional topics for long. They will ask a handful of questions, then process the answers. Let the child pick his own pace.

Involve children in building a scrapbook or keepsake box about the person they lost. Let them pick the items; a rock may have deep meaning to a child. If possible, children should have a place in a funeral. Often this can be done with a small ceremony before the main funeral. Only close family should be present, and the children should have a strong voice in the ceremony.

Holidays are often a source of torment for the grieving. In school, for example, many children make cards for Mothers and Fathers Day. The child who has just lost a parent may be suddenly socked in the gut when presented with this activity. Disruptive or avoidant behavior is sometimes the result.

The answer is as much preparation as possible. Teachers can call the child and her family the day before a painful activity. Let the child know if she can be excused, or offer a substitute. Instead of a Fathers Day card, let the child write a letter or a card for her father's grave.

Part of discussing grief and death is teaching kids how to speak about it. Most adults struggle about how to describe their own loss. What does a child say if his mother has died?

Start with what the child thinks he should say. Some children like to use euphemisms, like "passed away," but others will choose plain language, like "died." Just saying the words, "My mom passed away," will be bitter. Develop a short script. If he wants to use "passed on," that's fine, but figure out the words before he is confronted with saying them. What's important is for the child to know what he will say. Also, explain to him how it will be hard for his friends to talk to him about grief.

Although holidays can be painful, they are also a time for bonding. Many families visit graves on holidays. Sit with the child to help her make something for the grave or to put out at family dinnertime. Have her make a gift to her dead brother or sister, something the child liked to play with. Some families will add that gift to the keepsake box so the grieving child has a more tangible sense of giving it to her sibling. But always make the grieving child part of the plans, and have her contribute.

With Love and Attention, Children Heal Themselves

No discussion of grief in children is complete without addressing two topics--who died and how did it happen? Many changes occur when a child loses a parent or a sibling. Family dynamics and the economic security of the family can be threatened. Often, families have to move and completely restructure their lives. Many grieving children will not only grieve the person they lost, but also their lives before the loved one died.

The type of death that occurred also has implications. A long, drawn-out death through disease, while difficult, does have the advantage of allowing the child and family to prepare as much as possible. Sudden deaths create more feelings of insecurity and shock: Children learn in the harshest way possible the world is not always safe and adults can't protect them from everything.

Death through suicide or murder leads to many sticky problems, from how to explain what happened, to restoring a sense of safety to the child. Help is often necessary in these difficult situations. School counselors and hospices often know about grief support groups of all kinds.

When I picture all the grieving children I have worked with, I see Sam first. At 10, he was athletic and playful, yet he couldn't get along with his peers. He was grieving his father, who had been gone for two years, but his identified problem was poor school performance. He refused for months to talk about his feelings. Sam was struggling at school and with making friends.

In sessions with me, he liked to play catch with a ball with the lights turned down low. One afternoon, after months of sessions and in the middle of our game of catch, he said, "I miss my dad." For five minutes he talked about being sad and not getting along with his schoolmates. Then he stopped and never talked to me about his feelings again. But his progress quickened and within a few months he was no longer having problems in school. He took what he needed, when he could handle it.

More than any specific item, activity, or words, grieving children need love, patience, and attention. If you give those things, they will heal themselves.

Greg Galanos MA is child custody investigator with the Alaska Court System. He has worked for 15 years with children and teens, including five years as a child and family therapist.

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