Monday, September 9, 2013

How Children are Involved in Grief and Loss

Children often are disenfranchised in their grief. Well-meaning adults try to protect them from the enormousness of loss by distracting them, telling them half-truths, even lying to them about the death of someone they loved. Some adults, perhaps to protect themselves from having to manage the full impact of a child’s grief, fool themselves into believing that children are “too young” to know what is going on. As noted children’s psychologist, Alan Wolfelt (1991), has said, “Anyone old enough to love is old enough to grieve.”

Children need avenues for safe expression of feelings that may include fear, sadness, guilt, and anger. Children’s play is their “work.” Provide a child-friendly environment where a child may choose the avenue best suited to his or her self-expression. For some children, it may be drawing or writing, for others, it may be puppetry, music, or physical activity. Keep in mind that a child’s reactions to grief will not appear the same as those seen in adults; as a result, children often are misunderstood. They may appear disinterested or respond as if they don’t understand the significance of what has happened.

For example, upon being told that her mother might soon die from metastatic cancer, a 10-year-old responded by asking, “When we go to dinner tonight, can I order extra pickles?” She was letting the adults know that she had heard enough for the moment. A four-year-old was told that his father died. He continued to ask, “When will he be back?” At this age, children don’t understand that death is permanent, final, and irreversible. Adults need to understand what is appropriate and expectable with children at different ages and stages of development and to recognize that children grieve in their own way and in their own time. Adults who tend to these children must focus on the children’s individual needs as well as their own.

When a child is denied the opportunity for grieving, there may be adverse consequences. At the D’Esopo Resource Center for Loss and Transition, located in Wethersfield, Conn., we regularly receive calls from parents who are worried about their children’s response to loss.
Recently, a mother called to say that she was very concerned about her three-year-old daughter. The child’s grandmother had died the previous month. The mother explained that she had consulted with the child’s pediatrician who told her that three-year-olds are too young to go to a funeral service because they do not understand death. The parents had therefore not included the child in any of the family’s commemorative rituals. Ever since, the little girl had been afraid to go to sleep and, when she did go to sleep, she experiencednightmares. During the day she was uncharacteristically anxious and clingy.

Fortunately this child, like most young children, is remarkably resilient. The problem was corrected by giving her a simple, direct, child-centered, age-appropriate explanation. She was told what happens to the body upon death (“It stops working”). And she was also given an explanation of the type of ritual that the family chose based on their religion and culture. She responded by sleeping well, having no more nightmares, and returning to her usual outgoing behavior.

While it is true that three-year-olds don’t understand that death is permanent, final, and irreversible, they do understand that something terribly sad has happened. They will miss the presence of people who have died, and they will worry about the sadness they feel around them. Lying to children or hiding the truth increases their anxiety. They are better observers of adults than most people recognize. You can’t fool them. They are remarkably perceptive.

When children of any age are not given proper explanations, their powerful imaginations will fill in the blanks in the information they have picked up from those around them. Unfortunately, their imaginations often come up with things that are far worse than the simple truth would have been. If, for example, they don’t understand the concept of “burial,” they may create images of dead loved ones being buried alive, gasping for air and trying to claw out of the ground. In the case of cremation, they may imagine their loved one being burned alive and suffering horribly.

It is far better to give them a clear idea about what is going on than to leave them to the mercy of their own imaginations. Children need to know not only what happens to the body upon death, they also need an explanation of what happens to the spirit or the soul, based on the family’s religious, spiritual, and cultural beliefs. It is essential to offer a detailed description of everything they likely will see and experience. At least one responsible adult should be present to support the child during the funeral and any other rituals.

One of the first workshops I attended regarding children and death began with the statement, “Anyone old enough to die is old enough to go to a funeral.” Participants gasped until the presenter went on to say, “as long as they are properly prepared and given the option — never forced — to attend.”

Children thrive when they are told what to expect and are allowed to participate in the commemoration of loved ones. When children and adults are encouraged to develop creative, personalized rituals, it helps everyone find comfort during the sad times. At the Resource Center, we ask children to draw or write a description of their favorite memory of the person who died. They love to share their memories and place the pictures, stories, and other items they have made into the casket to be buried or cremated along with their loved one. These kinds of activities can help the rituals around death become a meaningful family bonding experience rather than a continuing source of fear and pain.

Shakespeare said it best: “Give sorrow words. The grief that does not speak whispers the o’er fraught heart and bids it . . . break.” (Macbeth, Act IV, Scene 1)

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