A Catholic Approach to Bereavement

http://www.saintjoe.com/prodinfo.asp?number=DNL1 


Dr. Nicholas was interviewed on Feb 17, 2012 at Saint Joseph Communication's Station in Covina, CA. This is an excellent interview in regarding Bereavement state. 


Please order this wonderful CD to assist and ease your family thoughts during the pre-anticipatory grief, death and dying process, and the process of bereavement.  


Dr. Nicholas will be speaking more on this topic locally and by request for audiences at your Parishes, Organizations, and Schools, Colleges, and Universities. 


Contact the scheduler at 877 867 8556 to be placed on Dr. Nicholas speaking schedule. 

Children and Grief

n the past, children were thought to be miniature adults and were expected to behave as adults. It is now understood that there are differences in the ways in which children and adults mourn. Unlike adults, bereaved children do not experience continual and intense emotional and behavioral grief reactions. Children may seem to show grief only occasionally and briefly, but in reality a child's grief usually lasts longer than that of an adult. This may be explained by the fact that a child's ability to experience intense emotions is limited. Mourning in children may need to be addressed again and again as the child gets older. Since bereavement is a process that continues over time, children will think about the loss repeatedly, especially during important times in their life, such as going to camp, graduating from school, getting married, or giving birth to their own children. A child's grief may be influenced by his or her age, personality, stage of development, earlier experiences with death, and his or her relationship with the deceased. The surroundings, cause of death, family members' ability to communicate with one another and to continue as a family after the death can also affect grief. The child's ongoing need for care, the child's opportunity to share his or her feelings and memories, the parent's ability to cope with stress, and the child's steady relationships with other adults are also other factors that may influence grief. Children do not react to loss in the same ways as adults. Grieving children may not show their feelings as openly as adults. Grieving children may not withdraw and dwell on the person who died, but instead may throw themselves into activities (for example, they may be sad one minute and playful the next). Often families think the child doesn't really understand or has gotten over the death. Neither is true; children's minds protect them from what is too powerful for them to handle. Children's grieving periods are shortened because they cannot think through their thoughts and feelings like adults. Also, children have trouble putting their feelings about grief into words. Instead, his or her behavior speaks for the child. Strong feelings of anger and fears of abandonment or death may show up in the behavior of grieving children. Children often play death games as a way of working out their feelings and anxieties. These games are familiar to the children and provide safe opportunities to express their feelings. Children's Grief and Developmental Stages Children at different stages of development have different understandings of death and the events near death. Infants Infants do not recognize death, but feelings of loss and separation are part of developing an awareness of death. Children who have been separated from their mother may be sluggish, quiet, unresponsive to a smile or a coo, undergo physical changes (for example, weight loss), be less active, and sleep less.

Age 2-3 years

Children at this age often confuse death with sleep and may experience anxiety as early as age 3. They may stop talking and appear to feel overall distress.

Age 3-6 years

At this age children see death as a kind of sleep; the person is alive, but only in a limited way. The child cannot fully separate death from life. Children may think that the person is still living, even though he or she might have been buried, and ask questions about the deceased (for example, how does the deceased eat, go to the toilet, breathe, or play?). Young children know that death occurs physically, but think it is temporary, reversible, and not final. The child's concept of death may involve magical thinking. For example, the child may think that his or her thoughts can cause another person to become sick or die. Grieving children under 5 may have trouble eating, sleeping, and controlling bladder and bowel functions.

Age 6-9 years

Children at this age are commonly very curious about death, and may ask questions about what happens to one's body when it dies. Death is thought of as a person or spirit separate from the person who was alive, such as a skeleton, ghost, angel of death, or bogeyman. They may see death as final and frightening but as something that happens mostly to old people (and not to themselves). Grieving children can become afraid of school, have learning problems, develop antisocialor aggressive behaviors, become overly concerned about their own health (for example, developing symptoms of imaginary illness), or withdraw from others. Or, children this age can become too attached and clinging. Boys usually become more aggressive and destructive (for example, acting out in school), instead of openly showing their sadness. When a parent dies children may feel abandoned by both their deceased parent and their surviving parent because the surviving parent is grieving and is unable to emotionally support the child.

Ages 9 and older

By the time a child is 9 years old, death is known to be unavoidable and is not seen as a punishment. By the time a child is 12 years old, death is seen as final and something that happens to everyone.

Grief and Developmental Stages

Age	Understanding of Death	Expressions of Grief
Infancy to 2 years	Is not yet able to understand death.	Quietness, crankiness, decreased activity, poor sleep, and weight loss.
Separation from mother causes changes.
2-6 years	Death is like sleeping.	Asks many questions (How does she go to the bathroom? How does she eat?).
Problems in eating, sleeping, and bladder and bowel control.
Fear of abandonment.
Tantrums.
Dead person continues to live and function in some ways.	Magical thinking (Did I think something or do something that caused the death? Like when I said I hate you and I wish you would die?).
Death is temporary, not final.
Dead person can come back to life.
6-9 years	Death is thought of as a person or spirit (skeleton, ghost, bogeyman).	Curious about death.
Asks specific questions.
May have exaggerated fears about school.
Death is final and frightening.	May have aggressive behaviors (especially boys).
Some concerns about imaginary illnesses.
Death happens to others, it won't happen to ME.	May feel abandoned.
9 and older	Everyone will die.	Heightened emotions, guilt, anger, shame.
Increased anxiety over own death.
Mood swings.
Death is final and cannot be changed.	Fear of rejection; not wanting to be different from peers.
Even I will die.	Changes in eating habits.
Sleeping problems.
Regressive behaviors (loss of interest in outside activities).
Impulsive behaviors.
Feels guilty about being alive (especially related to death of a brother, sister, or peer). In American society, many grieving adults withdraw and do not talk to others. Children, however, often talk to the people around them (even strangers) to see the reactions of others and to get clues for their own responses. Children may ask confusing questions. For example, a child may ask, "I know grandpa died, but when will he come home?" This is a way of testing reality and making sure the story of the death has not changed. Other Issues for Grieving Children Children's grief expresses 3 issues: Did I cause the death to happen? Is it going to happen to me? Who is going to take care of me? Did I cause the death to happen? Children often think that they have magical powers. If a mother says in irritation, "You'll be the death of me" and later dies, her child may wonder if he or she actually caused the mother's death. Also, when children argue, one may say (or think), "I wish you were dead." Should that child die, the surviving child may think that his or her thoughts actually caused the death. Is it going to happen to me? The death of another child may be especially hard for a child. If the child thinks that the death may have been prevented (by either a parent or a doctor) the child may think that he or she could also die. Who is going to take care of me? Since children depend on parents and other adults to take care of them, a grieving child may wonder who will care for him or her after the death of an important person. Grieving Children: Treatment A child's grieving process may be made easier by being open and honest with the child about death, using direct language, and incorporating the child into memorial ceremonies for the person who died. Explanation of death Not talking about death (which indicates that the subject is off-limits) does not help children learn to cope with loss. When discussing death with children, explanations should be simple and direct. Each child should be told the truth using as much detail as he or she is able to understand. The child's questions should be answered honestly and directly. Children need to be reassured about their own security (they often worry that they will also die, or that their surviving parent will go away). Children's questions should be answered, making sure that the child understands the answers. Correct language A discussion about death should include the proper words, such as cancer, died, and death. Substitute words or phrases (for example, "he passed away," "he is sleeping," or "we lost him") should never be used because they can confuse children and lead to misunderstandings. Planning memorial ceremonies When a death occurs, children can and should be included in the planning of and participation in memorial ceremonies. These events help children (and adults) remember loved ones. Children should not be forced to be involved in these ceremonies, but they should be encouraged to take part in those portions of the events with which they feel most comfortable. If the child wants to attend the funeral, wake, or memorial service, he or she should be given in advance a full explanation of what to expect. The surviving parent may be too involved in his or her own grief to give their child full attention, therefore, it may be helpful to have a familiar adult or family member care for the grieving child. References and resources for grieving children There are many helpful books and videos that can be shared with grieving children: Worden JW: Children and Grief: When a Parent Dies. New York: The Guilford Press, 1996. Doka KJ, Ed.: Children Mourning, Mourning Children. Washington, DC: Hospice Foundation of America, 1995. Wass H, Corr CA: Childhood and Death. Washington, DC: Hemisphere Publishing Corporation, 1984. Corr CA, McNeil JN: Adolescence and Death. New York: Springer Publishing Company, 1986. Corr, CA, Nabe CM, Corr DM: Death and Dying, Life and Living. 2nd ed., Pacific Grove: Brooks/Cole Publishing Company, 1997. Grollman EA: Talking About Death: A Dialogue Between Parent and Child. 3rd ed., Boston: Beacon Press, 1990. Schaefer D, Lyons C: How Do We Tell The Children?: Helping Children Understand And Cope When Someone Dies. New York: Newmarket Press, 1988. Wolfelt A: Helping Children Cope with Grief. Muncie: Accelerated Development, 1983. Walker A: To Hell with Dying. San Diego: Harcourt Brace Jovanovich, 1988. Williams M: Velveteen Rabbit. Garden City: Doubleday, 1922. Viost J: The Tenth Good Thing About Barney. New York: Atheneum, 1971. Tiffault BW: A Quilt for Elizabeth. Omaha: Centering Corporation, 1992. Levine J: Forever in My Heart: A Story to Help Children Participate in Life as a Parent Dies. Burnsville, NC: Rainbow Connection, 1992. Knoderer K: Memory Book: A Special Way to Remember Someone You Love. Warminster: Mar-Co Products, 1995. de Paola T: Nana Upstairs and Nana Downstairs. New York, NY: GP Putnam's Sons, 1973.

Anticipatory Grief

Anticipatory grief is the normal mourning that occurs when a patient or family is expecting a death. Anticipatory grief has many of the same symptoms as those experienced after a death has occurred. It includes all of the thinking, feeling, cultural, and social reactions to an expected death that are felt by the patient and family. Anticipatory grief includes depression, extreme concern for the dying person, preparing for the death, and adjusting to changes caused by the death. Anticipatory grief gives the family more time to slowly get used to the reality of the loss. People are able to complete unfinished business with the dying person (for example, saying "good-bye," "I love you," or "I forgive you"). Recommended Related to Cancer General Approach to Care for Children with Brain and Spinal Cord Tumors Important concepts that should be understood by those treating and caring for a child who has a brain or spinal cord tumor include the following: The cause of most childhood brain tumors remains unknown.[1] Selection of an appropriate therapy can only occur if the correct diagnosis is made and the stage of the disease is accurately determined. Children with primary brain or spinal cord tumors represent a major therapy challenge that, for optimal results, requires the coordinated efforts... Read the General Approach to Care for Children with Brain and Spinal Cord Tumors article > > Anticipatory grief may not always occur. Anticipatory grief does not mean that before the death, a person feels the same kind of grief as the grief felt after a death. There is not a set amount of grief that a person will feel. The grief experienced before a death does not make the grief after the death last a shorter amount of time. Grief that follows an unplanned death is different from anticipatory grief. Unplanned loss may overwhelm the coping abilities of a person, making normal functioning impossible. Mourners may not be able to realize the total impact of their loss. Even though the person recognizes that the loss occurred, he or she may not be able to accept the loss mentally and emotionally. Following an unexpected death, the mourner may feel that the world no longer has order and does not make sense. Some people believe that anticipatory grief is rare. To accept a loved one's death while he or she is still alive may leave the mourner feeling that the dying patient has been abandoned. Expecting the loss often makes the attachment to the dying person stronger. Although anticipatory grief may help the family, the dying person may experience too much grief, causing the patient to become withdrawn.

Bereavement

Bereavement is defined as a state of sadness or loneliness. An individual is in a state of bereavement when that person experiences loss of another person. The loss could be due to relationship breakups, death, loss of pets, someone moving away forever, divorce for instance, loss of employment, etc. thus, the cause for bereavement might be different for each person. Bereavement behaviors are loneliness, anger, guilt, numbness, shock, agitation, etc. Bereavement grief means a package of emotions related with the loss of an individual. Researchers oftentimes pertain to bereavement behavior as grief cycle. After an extensive research of over four decades and still continuing, researchers have discovered some usual demeanors observed in persons in mourning. When an individual is undergoing through this grief, the person observes behaviors such as crying, insomnia, restlessness and withdrawal. But the most commonly observed behaviors are denial and shock. Bereavement grief is almost just a part of each person's life. This kind of grief has a large extent of effects, and the density in which an individual could be affected vary from one person to another. There are 2 kinds of bereavement grief. The first one is complicated and the other is a normal grief. When a person is suffering from a complicated grief he or she sometimes may attempt to kill him/herself. Most persons typically fall helpless prey to complicated bereavement grief due to a sudden shock. On the other hand, normal bereavement grief is commonly accepted for a person.Mourning has a despair and disorganization behavior, where someone is crying and grieving due to being away from a person or due to loss of a loved one. Bereavement behavior not just affects a person mentally, but it also causes risky and dangerous effects on one's healthy life and well being. Heavy symptoms of breathing problems and abdominal pain are observed even after six months of an event that has happened. Volatile reactions are always observed in individuals who feel that their social image or their identity is being affected. Changeable reactions may cause people to get easily frustrated, harbor jealousy and hatred with other persons. They have a natural tendency to feel they are helpless, and this hurts a lot; feeling furious is also commonly frequent in them. Reorganization is observed on this kind of behavior when a person or something is lost without their fault or without the individual being dead. Also, some bereaved people can't realize the reality because of the feeling of shock and denial, and a feeling of being unreal is very common. People aren't able to accept the facts, or reality which has happened in them. Oftentimes, they are afflicted with depersonalization and anaesthetizing of effect. Fortunately, you don't need to pay a large amount of money or go to any doctor for the remedy. You yourself are enough to come out of it of this condition. And, you are not able accomplish this alone you can certainly contact Hand of Passion at 877 867 8556 for immediate attention. 

Mourning A Loved One

It is not easy to cope after a loved one dies. You will mourn and grieve. Mourning is the natural process you go through to accept a major loss. Mourning may include religious traditions honoring the dead or gathering with friends and family to share your loss. Mourning is personal and may last months or years.

Grieving is the outward expression of your loss. Your grief is likely to be expressed physically, emotionally, and psychologically. For instance, crying is a physical expression, while depression is a psychological expression.

It is very important to allow yourself to express these feelings. Often, death is a subject that is avoided, ignored or denied. At first it may seem helpful to separate yourself from the pain, but you cannot avoid grieving forever. Someday those feelings will need to be resolved or they may cause physical or emotional illness.

Many people report physical symptoms that accompany grief. Stomach pain, loss of appetite, intestinal upsets, sleep disturbances and loss of energy are all common symptoms of acute grief. Of all life's stresses, mourning can seriously test your natural defense systems. Existing illnesses may worsen or new conditions may develop.

Profound emotional reactions may occur. These reactions include anxiety attacks, chronic fatigue, depression and thoughts of suicide. An obsession with the deceased is also a common reaction to death.

Dealing with Major Loss

Dealing with a Major Loss

The death of a loved one is always difficult. Your reactions are influenced by the circumstances of a death, particularly when it is sudden or accidental. Your reactions are also influenced by your relationship with the person who died.

A child's death arouses an overwhelming sense of injustice - for lost potential, unfulfilled dreams and senseless suffering. Parents may feel responsible for the child's death, no matter how irrational that may seem. Parents may also feel that they have lost a vital part of their own identity.

A spouse's death is very traumatic. In addition to the severe emotional shock, the death may cause a potential financial crisis if the spouse was the family's main income source. The death may necessitate major social adjustments requiring the surviving spouse to parent alone, adjust to single life and maybe even return to work.

Elderly people may be especially vulnerable when they lose a spouse because it means losing a lifetime of shared experiences. At this time, feelings of loneliness may be compounded by the death of close friends.

A loss due to suicide can be among the most difficult losses to bear. They may leave the survivors with a tremendous burden of guilt, anger and shame. Survivors may even feel responsible for the death. Dr. Losito is an expert with advance experience pre-suicidal tendencies can provide care and support 877 867 8556. 

Suicide of a Child.

The death of a child is devastating enough, but how do parents and loved ones cope when a child commits suicide?

Most of us can't even imagine what it would be like to lose a child in an accident, or assault or as a result of an illness. Can you imagine then how much more difficult, emotionally, it might be for a parent to lose a child as a result of suicide? Though suicides amongst children and teens are not very common, tragically they do happen.

Parental Guilt When A Child Commits Suicide

When a child suicides, it brings about not only the usual emotions found in thegrieving process, but, in addition, often brings about a great sense of guilt for parents, family members and close friends. "Could I have done more?" "Might I have prevented the suicide if only I had..."

There is often frustration between the two parents with regard to what could have or should have been done that might have prevented the depression or behavior that led to the suicide. Anger is a normal part of the grief reaction, and in the case of a suicide of a child, that anger can lead to fights between the parents or between parents and friends of the child about what "could have or should have" been done to prevent the suicide.

Impact of Child Suicide

When I was in training, I was taught that parents who lose a child, especially to suicide, were more likely to divorce than other couples. Fortunately, a review of the research literature shows that this is not the case. While it is certainly true that the death of a child (especially from suicide) can strain a marital relationship, there is no evidence that the suicide is more likely to result in separation or divorce than other causes of marital discord. In some cases, the loss and bereavement may, in fact, strengthen a relationship although it often takes years before the effects of the death of a child result in stabilization of a relationship.

Coping with the Suicide of a Child

Most of the experts agree that the best thing to do following the loss of a child, especially to suicide, is to find a support group that understands and can help the bereaved parents cope with the feelings that they may have and yet not understand very well. This may be accomplished through contacting Hand of Passion that Dr. Losito can provide formal individual and support group 877 867 8556, or a Parish Priest or Minister and getting counseling from a mental health professional.