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Section 13
Complicated Grief in Children

Question 13 | Test | Table of Contents

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In the last section, we discussed displacement reactions.  Two topics regarding displacement reactions that we discussed are why displacement reactions occur and identifying patterns and triggers of displacement reaction. We also discussed the I Think, I Feel, I Want technique.

In this section, we will discuss delayed grief work. We will discuss how grief gets delayed and techniques for delayed grief work. Three techniques we will discuss are talking, cemetery visits, and drawing. As you listen to this section, you might consider playing it for the parent of a grieving child you are treating.

♦ How Grief Gets Delayed
First, let’s discuss how grief gets delayed.  Do you have experience treating grieving children whose parents didn’t realize at the time of a death or other loss that their children needed help in grieving their loss? A colleague of mine, Evelyn, treated three children whose mother had committed suicide. The children’s father, George, age 36, struggled to show his children love and affection after the loss of their mother.

George involved the children in the funeral and explained to the children what had happened when they had found their mother slumped over the steering wheel of her car in the garage. The only thing George had omitted was that the death was a suicide. George had explained their mother’s death to the children as an accident. 

As George tried to restore a normal life to his children over the next year, he found them irritable and prone to arguments, leading to frequent family fights. When George finally sought therapy, he told Evelyn, my colleague, that he had never mentioned suicide. Because the suicide remained a secret, Evelyn felt that the unspoken truth of suicide may have been causing some of the children’s problems.  Evelyn asked me to sit in on one of the family’s sessions. 

In that session, Evelyn asked the children, "What is it called when somebody purposely kills herself?"  The 10 year old daughter, Tessa, instantly replied "Suicide."  Would you agree that Tessa’s instant reply revealed an awareness of suicide, and possibly a realization that it was acceptable for her to use that word?  In the ensuing discussion, George was able to explain to his children that their mother had committed suicide.  George also explained why he had told the children that their mother’s death was an accident.  George stated, "I thought it would be easier for you kids if you didn’t know the real cause of your mother’s death." 

Other ways I have found that grief gets delayed include additional life changes, such as relocation or parents who remarry.  Also, if the parents of the grieving child are having difficulty working through their own grief, they may overlook the importance of the child’s grief.  Have you treated a grieving client whose grief work was delayed by misinformation, life changes, or a parent’s grief?  If so, here are some techniques for delayed grief work.

♦ Techniques:  Delayed Grief Work
In order to help George’s children work through their postponed grief, Evelyn implemented several techniques for both George and the children. 

Step 1 - First, Evelyn encouraged George to talk to his children. George worked to find out how much his children knew about their mother’s suicide and tried to fill in the gaps of information. George talked with his children about the funeral and the burial. George invited his children to ask any questions they might have. 

Next, George talked to his children about their feelings. By asking how they felt when they found their mother, how they felt at the funeral, and how they feel now, George realized that for some time his oldest two children suspected suicide. 

Step 2 - Second, a trip to the deceased’s grave can serve two purposes in delayed grief work.  A trip to the cemetery can help open communications between a child and parent. Also, a trip to the cemetery can help children feel that the deceased is still part of their lives. 

Step 3 - In addition to talking and cemetery trips, the third delayed grief work technique is drawing.  Because George’s youngest child, Justin, age 6, lacked the communication skills to talk about his feelings in depth, Evelyn suggested he draw his feelings. Justin drew his things that he remembered about his mother, including her car and her grave.

Justin’s drawings contained question marks, revealing his questions about what happened and why. This insight into Justin’s concerns gave George and Evelyn a starting point for Justin’s delayed grief work. 

In this section, we have discussed delayed grief work.  We discussed how grief gets delayed and techniques for delayed grief work.  Three techniques we discussed are talking, cemetery visits, and drawing. 

In the next section, we will discuss resolving childhood grief as an adult.  The two main topics regarding resolving childhood grief as an adult in the next section are latent signs of childhood grief and why childhood grief spills into adulthood.

- Moody, R., M.D., & Arcangel, D. (2001). Life After Loss: Conquering Grief and Finding Hope. New York, NY: Harper Collins.
Reviewed 2023

Peer-Reviewed Journal Article References:
Bellet, B. W., LeBlanc, N. J., Nizzi, M.-C., Carter, M. L., van der Does, F. H. S., Peters, J., Robinaugh, D. J., & McNally, R. J. (2020). Identity confusion in complicated grief: A closer look. Journal of Abnormal Psychology, 129(4), 397–407.

Colasante, T., Zuffianò, A., Haley, D. W., & Malti, T. (2018). Children’s autonomic nervous system activity while transgressing: Relations to guilt feelings and aggression. Developmental Psychology, 54(9), 1621–1633.

Diminich, E. D., & Bonanno, G. A. (2014). Faces, feelings, words: Divergence across channels of emotional responding in complicated grief. Journal of Abnormal Psychology, 123(2), 350–361. 

Donohue, M. R., & Tully, E. C. (2019). Reparative prosocial behaviors alleviate children’s guilt. Developmental Psychology, 55(10), 2102–2113.

Stutey, D. M., Helm, H. M., LoSasso, H., & Kreider, H. D. (2016). Play therapy and photo-elicitation: A narrative examination of children’s grief. International Journal of Play Therapy, 25(3), 154–165. 

 QUESTION 13
What are three techniques for delayed grief work? To select and enter your answer go to Test.

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