BFO Toronto - Articles - Liana Lowenstein

Children experience many different thoughts and feelings when they are dealing with the death of a parent or sibling. Following is a brief summary of children's experiences of grief, and some suggestions of how adults can best respond to the needs of bereaved children.

Shock and Denial

Shock is one of the first feelings children experience when a parent or sibling has died. They may think the person is not really dead, or is coming back. They may feel little or no emotion. They may behave as if everything is fine. Adults sometimes have difficulty understanding how children can be laughing and playing, when someone they love has just died. However, this stage of shock and denial allows children to block their emotional pain, so they can face their grief at a slower pace, when they are ready. While it is important to allow children this initial period of denial, it is not helpful to reinforce their beliefs by saying something like, "Daddy will be home soon." It is helpful to talk to children about the death openly and directly, and in a way they will understand.

The book, Explaining Death to Children by Earl Grollman, is a useful guide. Reading children storybooks about death can also be helpful (a good selection of books can be found at Parentbooks: 416-537-8334). Saying things like, "Be strong," or "Big boys don't cry" is not helpful as this encourages children to hide their emotions. It is helpful to accept children's apparent lack of feelings as a normal response, while at the same time giving them permission to openly express their emotions. For example, it is helpful to say, "You may feel nothing at all right now, or you may feel very upset and feel like crying--whatever you feel is okay, and you can talk to me about anything." Children will more readily confront the reality of the death and express their emotions when they feel comfortable and safe.

Disorganization and Panic

Bereaved children often experience a heightened sense of disorganization or panic. They may think, "Who will take care of me now?" or "Will I or someone else I love die too?" They may feel scared, insecure, confused, or overwhelmed. They may behave by appearing irritable, hyperactive, or unfocussed. They may complain of frequent headaches or stomachaches, or have trouble sleeping or eating. They may become regressed or clingy in an effort to get comfort, or they may act older than their years as a way of trying to feel in control. It is not helpful to reprimand the child. It is helpful to reassure the child by saying things like, "Even though I feel sad, I am going to be okay and I am here to take care of you," "Even though the doctors could not make your sister better, most people live a long and healthy life," "You and I both went to the doctor for a check-up and we are healthy," "Your job is not to take care of me or your younger brother, your job is to be a kid." Providing children with comfort and reassurance will support them through this difficult time.

Explosive Emotions

Sometimes bereaved children exhibit explosive emotions, such as rage, blame, terror, and jealousy. They may think their life is out of control. They may feel overwhelmed. They may behave by acting out. It is important to allow children to express their strong emotions, so they do not turn their anger inward. It is not helpful to discourage the expression of feelings, or to be punitive. Rather, it is helpful to encourage the healthy expression of emotions, while setting appropriate limits. A three-step process can be used: 1. Label the child's feelings (e.g., "You are angry because dad is not here to play baseball with you.") 2. Set a limit (e.g., "It's okay to be angry but it's not okay to let out your anger by punching your sister.") 3. Provide an appropriate alternative (e.g., "You can let out your anger by punching a pillow.") It is helpful to understand the needs that underlie children's acting-out behavior. For example, children may be communicating a need to be comforted, reassured, or empowered. Talking to children about their feelings, and validating their anger, will help them express their emotions, rather than repress their grief.

Guilt

Many children blame themselves when someone they love dies. Young children, in particular, may blame themselves because they believe that by thinking about something, they can make it happen. This is called magical thinking. For example, in anger a child may say, "I hate you, I wish you were dead!" and then when that person dies, they believe their angry thoughts caused the death. Children may also believe their misbehavior caused the death. They may think "It's all my fault." They may feel like they are bad, or worthless. They may behave by directly or indirectly seeking punishment, or by acting good in order to bring the person back to life.

In addition to blaming themselves for the person's death, children may also blame themselves for the grief of those around them. For example, if they see a parent crying, they may believe it is their fault. Some children may feel guilty because they are relieved their loved one is dead, particularly if the person who died was ill for a long time or the child's relationship with the person who died was conflictual. Children may also feel guilty when they begin to re-experience joy or happiness, because they believe being happy in some ways betrays their relationship with their loved one who died. It is not helpful to avoid discussing the child's guilt, as this is likely to push the feelings underground. It is also not helpful to simply say, "It's not your fault" as this is telling the child how to feel, rather than exploring the child's feelings.

It is helpful to provide opportunities for the child to talk openly about his or her feelings, and to help the child understand that their thoughts or behavior did not cause the death. For example, it is helpful to open the dialogue by saying, "Sometimes kids think the death is all their fault. There are many reasons why kids feel guilty. Do you ever feel like you did something to cause the death?" After the child has expressed their feelings, it is important to reassure the child by saying something like, "It is very sad that mom died, but nothing you said or did caused her to die." For younger children who cannot articulate their feelings of guilt, it is helpful for adults to express warmth and acceptance both verbally and non-verbally. If a child is made to feel loved and valued, this will help alleviate feelings of guilt and shame.

Sadness

As children begin to acknowledge the reality and finality of the loss, their sadness begins to surface. They may think, "Mom is gone and is never coming back." They may feel depressed, empty, alone, or hopeless. They may behave by crying, or by being sullen and withdrawn. Often these feelings surface long after the death, when adults fail to make the connection to the death that occurred months or even years earlier. But it is important to understand that this is a time when children are particularly vulnerable, and are in need of support. It is not helpful to ignore or discount the child's feelings, or give the message that he or she should "be over it by now." It is helpful to encourage the child to openly express intense feelings of sadness. Children who have difficulty verbalizing their feelings may feel more comfortable drawing about their sadness.

Acceptance

People, both children and adults, do not "get over" grief, but feelings do lessen in intensity over time. At some point in the grief process, children come to accept the reality of the loss. It is at this point that children think, "Daddy is gone, I miss him, but I'm going to be okay." They feel a renewed sense of energy, hope, and confidence. They behave by being more joyful and by becoming re-involved in the activities of living. It is not helpful to rush the child along or to have expectations about how and when a child should grieve. It is helpful to be patient, and allow children to grieve in their own way and in their own time. It is also helpful to recognize that children re-visit grief at various points throughout their life. There will be times when they have "grief attacks" when strong feelings of loss come rushing back. "Grief attacks" can often be anticipated, as they are often triggered by special days such as the anniversary of the person's death, holidays, birthdays, graduations, etc.

It is helpful to talk about potential "grief attacks" ahead of time and ensure the child feels supported. For example, caregivers can say to a child, "Tomorrow is your birthday and you may have some mixed-up feelings. You may feel happy and excited, but you may also feel sad or angry because mom isn't here to celebrate this special day. Whatever you are feelings is normal and okay. Your mom would be very proud of you because you are such a terrific kid!"

Conclusion

Children do grieve, but how they grieve is different than adults. Whereas adults can more readily verbalize their feelings, children typically express their feelings through their behavior. Therefore, adults need to pay particular attention to how children behave, in order to gage their level of distress. Moreover, children will grieve in a healthier way if they feel safe and supported, and if those around them are grieving in healthy ways. Caregivers have a major impact on children, and play an important role in easing children through the difficult task of mourning. Participating in a support group at Bereaved Families of Ontario, and if needed, attending individual and/or family counseling, will also benefit bereaved children. There are many ways to help children cope with the death of a parent or sibling. Adults can help by acknowledging what children are thinking, validating what they are feeling, and responding sensitively to how they are behaving. It is also important to remember that children are amazingly resilient. Like the eensy weensy spider, children have remarkable survival skills, and can overcome adversity:

The eensy weensy spider climbed up the waterspout.
Down came the rain, and washed the spider out.
Out came the sun and dried up all the rain.
And the eensy weensy spider climbed up the spout again!