veryone takes an emotional hit after a death in the family. It is one of the most dreaded realities of life. But for children, the loss of a loved one can be enormously complex. Children are vulnerable to many fears that adults have grown out of, and their grasp on the meaning of death is very different from that of adults.
Below, two experts in bereavement and emotional healing discuss how you can help a child through this difficult process.
I the past, it seems that the standard procedure, when dealing with children and death, involved hiding children from grief. Is that right?
PATTY DONOVAN-DUFF, RN: That's right. Parents wanted to protect children from any pain. They thought by not including children in the dying process of the family member, the funeral, or their own expressions of grief, that the children would be protected. But in fact it probably made the experience more lonely and confusing for them. I think in the last ten to fifteen years we certainly have come a long way in recognizing that children also grieve, very much so.
What are some of the differences between childhood grief and adult grief?
PATTY DONOVAN-DUFF, RN: Children feel a lot of the same things that adults feel, but they do it differently. They show it differently. One of the big differences is, they grieve developmentally. A child who is four certainly doesn't understand death the way a child who is even six or eight. As they grow, they understand the permanence of death, the fact that it can happen to them, that it can happen to someone else in their family. As they get older they understand it differently.
They also have a very short sadness span. They have a natural anesthesia to pain. They can't be with it for very long. That's confusing to parents, sometimes, because it looks like they're fine. An eleven-year-old boy whose father just died in his home after a long illness might go out five minutes after the death and shoot baskets because he can't be with that pain like we can as adults. So they have a very short sadness span. They come in and out of it. But, that doesn't mean that they don't come into it.
When a young child loses a parent, it seems that the fear of losing the other parent would be acute. Is this true?
PATTY DONOVAN-DUFF, RN: Oh, yes. That fear is universally expressed in the children we work with. And it's also a fear in the parents. Children are very self-centered by nature, and certainly in their grieving they are really mostly concerned with their own fate. "What would happen to me if my parent died?" So we encourage the parents to approach that subject with the children, maybe saying, "Mommy's probably going to live for a long, long time, but just in case you wanted to know, you would probably go with Aunt Sarah if something happened." That's all they want to hear, and they want to be able to say, "Not Aunt Sarah, Aunt Beth." They want to know what's going to happen to them.
Are children to accept the permanence of death, that that person isn't coming back?
R. BENYAMIN CIRLIN, CSW: For the most part, I think it's not until a child is nine or ten that they have the cognitive capabilities to understand the permanence of death. Children who are between two and four think that death is not permanent, that the person is going to come back. It's really into the latency years, or the elementary school years, when kids begin to see that this really is forever.
How do children express anxiety about what has happened?
R. BENYAMIN CIRLIN, CSW: You'll have kids engaging in regressive behaviors. Some children who have been potty-trained will start bedwetting. Kids become much more clingy. Anger gets expressed at school in biting and fighting and all kinds of irritability. You have a lot of fears at nighttime around sleeping.
And how do you address these issues in your program?
PATTY DONOVAN-DUFF, RN: Our program is a bereavement support program for children between the ages of four and eighteen. We use play for children all the way up to the teens. We use a lot of arts and crafts and games.
Probably the most wonderful thing about the groups is that they're with other kids who have had the same loss. That in itself helps children so much, because they really feel very different after a loss. Kids have told us when they go back to school after their parent dies that they feel like they're walking around school with a big sign on their backs that says, "My dad died. You must see this in me. I'm wounded."
We like to talk to teachers and guidance departments about what the experience is like for the child coming back to school after a loss.
When I work with volunteers I am constantly saying to them, the children are teaching us what it's like. Most of us did not lose a parent as a child. We need to ask them. Children will tell you, and they want to tell you. But when they go back to school-that's where they spend most of their day-they need a safe place within the school environment. We very often will say, find a safe place in the school, in the nurse's office the principal's office, the coach's office, where you can go when that wave of grief might come over and you just can't be in a classroom.
R. BENYAMIN CIRLIN, CSW: All children have to learn how to deal with loss. So parents really need to create opportunities to talk about loss even when there's not a death-when it's fall and the leaves are falling, when a hamster dies, when you lose something, a favorite watch or something. Death is only the most serious loss. The whole life cycle is full of ongoing losses. Graduating from sixth grade and going to a new school, that's a loss.
If, as an adult, you notice that a surviving parent is too overwhelmed to really address a child's grief, is it appropriate to step in and help?
PATTY DONOVAN-DUFF, RN: They say that there are two things for good grieving for children. One is a safe environment-physical, emotional, psychological. The second is the presence of a caring adult other than the real immediate family-an aunt or an uncle, a coach, a teacher-and the presence of that person in their life when they need to talk is very important for children. In our work with children, we will very often say, at the end of the eight weeks of the group, "Who's out there that you can talk to? Ask that person to be that special person." Sometimes we say to the kids, "Maybe you should go and pick a person and ask that person to be the person that you'll call when you're having a tough time, or you want to remember your mom or your dad or your grandmother." I think it's very important. I think the presence of adults in children's lives when they're grieving is very important.
How can you help a child prepare for the well-intentioned but perhaps insensitive comments like, "You're the man of the family now," or "Life goes on."
R. BENYAMIN CIRLIN, CSW: Not only are these comments not helpful, they're destructive. And the children need "griever's assertiveness." You need to prepare the kid for these comments, and help them to say, "I'm not the man of the family. I'm still a child."
PATTY DONOVAN-DUFF, RN: I think we have so many teachable moments with children, to be able to teach them about loss of all kinds, and I think we really have to take advantage of those times with our kids to say to them that sometimes adults don't know what to say. We're not good at this either.
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