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Section 18
Children & Loss: Tips for Parents Faced with Trauma

Question 18 | Test | Table of Contents

Family and friends, neighbors and acquaintances shuffled into position around the freshly dug grave. The young daughter stood closest--only inches from the open earth. Her father stood behind her, hands on her shoulders. After the short ceremony, the 5-year-old girl turned to her father and whispered, "Now what do I do?"

What will she do? What will she do when she seeks the comfort of a mother? When a new friend asks what her mother does? What will she do on each Mother's Day? At her prom? Her wedding? At the birth of her child? Her major emotional connection is gone. She must heal the severed emotional tie to her mother, strengthen some existing bonds (father, grandparents) and, over time, create new relationships and make new connections. In this way, she will reshape her emotional landscape, slowly smoothing the jagged fault lines left by her mother's death.

Loss from death or divorce
Death is the most permanent loss we face. Yet there are forms of loss that can alter, break, or erode our emotional anchors. The most common for children are moving and divorce. In this modern world, we adults control the context and the shape of our children's relationships. When we decide to move or separate, often after we have time to gradually adjust to these transitions, we force our choices onto our children. They have less time and fewer skills to rely on. Death, divorce, and moving all cause pain for children.

The pain of loss is related to the nature of the transition. The sudden death, the precipitous move, and the unanticipated separation all shatter existing emotional connections and cause fear and intense emotional pain. When loss is sudden and unexpected, there is much less time for the child to begin adjusting. The anticipated death, separation, or move is easier because there has been time to think, review, mourn, and slowly reshape relationships. Gradual, predictable transitions, though painful, make loss easier to deal with.

The pain from loss is also related to the nature of the relationship. If a child is close to and dependent upon the lost loved one, he will experience the most distress. If the move or the separation takes the child away from the loved one, he may experience the same intensity of pain as if this were a death. In other cases, such as with separation, the parents are able to preserve the time, context, and essential nature of the parent-child relationship so the loss is not as devastating.

Children may not understand the finality of death or what divorce means. They will seek explanation, guidance, and comfort from adults. Yet parents may feel overwhelmed by the loss, as well, and helpless when faced with the challenge of supporting the grieving child. Caregivers need not feel helpless. There are some simple yet powerful things they can do to help children cope with loss.

Grief: Reshaping the child's emotional world
Grief is a process that reshapes our inner world following loss. It involves a set of emotional, cognitive, behavioral, and physical reactions that can vary depending upon the individual and the nature of the loss. During the grieving process, there are two central challenges for the child: (1) processing the actual event ("What is cancer, Daddy? Can you catch it too?" " Will I ever see Mommy?") and (2) coping with the loss of the loved one ("I want Daddy to live with us again"). In the weeks immediately following the loss, the child often experiences disturbing thoughts. The primary emotion during this time is fear. Over time, the child's thoughts will be dominated by loss with the primary emotion being sadness.

There is no "best" way to grieve, and there are no cookbook approaches to taking the pain away from children. Children of different ages have different styles of adapting and different abilities to understand abstract concepts such as death, love, and marriage. The 4-year-old may have little appreciation of the finality of death or why divorced couples do not take vacations together. It is not unusual for a 3-year-old child to ask, "When is Mommy coming home?" despite having her mother's death explained several times. In addition, each child has an individual style of coping. While children will not talk much, others will even talk about their loss to strangers. A 5-year-old may announce to her new kindergarten teacher, "My mother is dead," but another child may refrain from talking to any adults about his parents getting divorced.

Grief is normal, but if emotional or behavioral problems seem extreme, if they persist beyond six months, or if they interfere with any aspect of functioning, consider contacting a professional. As your child slowly reshapes her emotional landscape, you can help by listening and talking.

The father knelt, held his daughter close, and rocked slowly. Then he rose, took her hand, and said, "Let's go home." As they moved away, the contours of their emotional landscape shifted under the weight of their grief.

Tips For Coping With Loss
Be honest, open, and clear. Give children the facts regarding the loss. There is no need to describe gruesome aspects, but give key details; otherwise, a child's imagination will "fill" them in.

Do not avoid the topic when the child brings it up. Be available when the child wants to talk, but avoid probing. This may mean struggling with a very difficult question. "Did it hurt when Morn had cancer?" "Did you love Daddy when I was a baby?" "Why do people fall out of love?" Don't be surprised if in the middle of your struggle for the "right" answer, the child returns to play and acts uninterested.

Be prepared to discuss the same details again and again. Expect the child not to hear things the first time. Patiently, repeat facts for her. The child has, in some sense, a lifelong task of working and re-working, experiencing and re-experiencing the loss. The missing family member shadows each holiday, each "family" event. Always try to bring positive memories, images, and recollections into the conversation.

Take care yourself. Children look to adults to understand and interpret their own inner states. Younger children will even mirror the nature and intensity of an adult's emotions. If you feel you will be unable to control your emotions when you are trying to help the child, take a few moments, collect yourself, and then try to help. it is only human to lose control and be very emotional at these times.

TALKING About Loss

• Don't be afraid to talk about the death, the divorce, or the loved one. Children do not benefit from "not thinking about it" or "putting it out of their minds." In the first few days following the initial trauma, parents should sit down with their child and talk. Tell them how it is normal for thoughts about death and the loved one to keep coming back.
• Share feelings and thoughts. It's normal for a child to remain very quite. Sometimes children act as if they have not heard anything you have said, but they have. Remember that immediately following the death or separation, a child will not be capable of processing complex or abstract information. It will take many moments of sad clarity for the painful reality to sink in.
• Invite the child to talk about feelings any time she wants. And from then on, let her take the lead as to when, how long, and how an adult talks with her.
• Try to understand a child's thoughts about divorce or death. Does she have a view of afterlife? Does she think she had anything to do with the divorce? The more you understand about a child's concept of death or divorce, the easier it will be for you to communicate in a meaningful fashion.
• If a child senses that you are upset, she may not bring the topic up even if she wants to. It can be very helpful for a child to know that you feel sad too and that you are willing to talk about how you feel. Children model their emotional expressions and behaviors after their caregivers.

Help children keep part of the loved one with them in rituals, habits, special memories or traditions. The formal mourning rituals and beliefs of your culture or religion are very important for children.
- Perry, Bruce; Children and loss; Scholastic Parent & Child; Oct/Nov 2000; Vol. 8; Issue 2.

Personal Reflection Exercise #4
The preceding section contained information about tips for parents about children and loss. Write three case study examples regarding how you might use the content of this section in your practice.

Update
Comparing Asphyxia and Unexplained
Causes of Death: A Retrospective
Cohort Analysis of Sleep-Related
Infant Death Cases from A State
Child Fatality Review Programme

- Macdonald, M., Thompson, D., Perry, R., & Brooks, R. (2022). Comparing asphyxia and unexplained causes of death: a retrospective cohort analysis of sleep-related infant death cases from a state child fatality review programme. BMJ open, 12(9), e059745.

Peer-Reviewed Journal Article References:
Howard Sharp, K. M., Russell, C., Keim, M., Barrera, M., Gilmer, M. J., Foster Akard, T., Compas, B. E., Fairclough, D. L., Davies, B., Hogan, N., Young-Saleme, T., Vannatta, K., & Gerhardt, C. A. (2018). Grief and growth in bereaved siblings: Interactions between different sources of social support. School Psychology Quarterly, 33(3), 363–371.

Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnout. Psychological Services. Advance online publication.

Salinas, C. L. (2021). Playing to heal: The impact of bereavement camp for children with grief. International Journal of Play Therapy, 30(1), 40–49.

QUESTION 18
Under what circumstances might a parent consider seeking a professional for their grieving child? To select and enter your answer go to Test.

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