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Section 1
Aspects of Denial in Children

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In this section, we will discuss denial. Three important aspects of denial regarding children are: how imagination leads to denial in children, death is overwhelming, and natural vs. non-productive denial.  We will also discuss techniques for coping with denial.  As you listen to this section, consider playing it for the parents of grieving clients you are treating. 

Three Aspects of Denial

♦ Aspect #1 - How Imagination Leads to Denial in Children
First, let’s discuss how imagination leads to denial in children. Faced with more than she could handle, 8 year old Miranda often used her imagination to step out of the real world into one she found more acceptable. Miranda’s father, Jay, age 41 had been killed in a traumatic automobile accident. Miranda, like other children her age, had great control over her imagination. 

Therefore, blocking out the unpleasant circumstances surrounding her father’s death became a natural way for Miranda to cope with her father’s death.  Have you found that children may be able to focus on a particular object so well that they block out what is going on around them?  For example, Miranda couldn’t remember much regarding her father’s funeral, however she was able to draw the casket in minute detail. 

Would you agree that children who deny their grief by blocking out painful images are prolonging their grief?  I have found that a productive way to bring such children back to reality is by gently providing them with factual information.  Later, we will discuss coping techniques which were productive in helping Miranda face the pain of her grief.

♦ Aspect #2 - Death is Overwhelming
The second factor relating to denial is death is overwhelming.  Miranda’s mother, Beth, sought therapy for Miranda after a prolonged period in which Miranda displayed an inability to express the pain of her grief.  Miranda was in denial and blocked the memory of her deceased father with her imagination. 

When Beth explained Miranda’s denial, she stated, "Miranda doesn’t seem like she is willing to accept that her father is dead.  She often tells people that even though her father is gone, he’ll be back soon."  I stated to Beth, "The finality of death is overwhelming.  The idea that her father is ‘never coming back’ may be difficult for Miranda to grasp." 

Are you treating a grieving client like Miranda who is in denial regarding the death of a loved one?  If so, the following techniques for coping with denial may be useful to help your grieving client.

♦ Technique: Coping with Denial
To help Miranda cope with denial and accept the death of her father, I shared with Beth the following techniques for coping with denial.  I explained three techniques for coping with denial. 

--Step #1 - The first technique is talking to the child. I stated to Beth, "You may find that talking is the best tool to use when working with Miranda.  Remember to use precise vocabulary.  For example, dead is dead, not ‘gone on a trip’.  Also, be honest when answering Miranda’s questions, even if that honesty is painful.  Asking Miranda questions will help you to uncover her feelings and share your own feelings." 

-- Step #2 - The second technique I use for coping with denial is education.  In order to educate Miranda, Beth took her to Jay’s grave.  This cemetery visit gave Miranda the opportunity to mourn and accept the death of her father.  Beth also checked out some children’s books about death from the library to read with Miranda. Finally, Beth took Miranda on a nature walk.  During their nature walk, Beth and Miranda happened on a dead field mouse.  Beth used this opportunity to educate Miranda on the differences between being alive and dead. 

-- Step #3 - In addition to talking to the child and education, the third technique for coping with denial is play acting.  I stated to Beth, "Observing Miranda at play can provide insight into what she is thinking. Children often play out life situations. If you see Miranda planning a doll funeral, you know she is starting to accept the finality of death. On the other hand, if Miranda is playing out the return of her father from the dead, more work may need to be done to help her accept the finality of death."

Think of your Miranda.  Is her denial a natural response to death or a prolonged, non-productive effect of negative grief?  What other techniques have you seen parents implement to educate children about death? 

♦ Aspect #3 - Natural vs. Non-Productive Denial
A colleague of mine, Evelyn, has extensively studied denial as it relates to the grief process.  Evelyn found that though it is natural for the grieving client to be in a state of denial for a period of time,  it is difficult to know when the normal period of denial is leading into a non-productive period of denial. 

As you know, natural denial is generally displayed as a state of shock that someone is really gone. Evelyn states that this state of shock varies from two days to several weeks depending on a number of factors. Some of these factors include suddenness of death, the cause of death, interpersonal communications and changes in routine. In grieving children, the onset of fictitious or imaginary friends may indicate non-productive denial. 

Also, children who leave the room whenever the deceased person’s name is mentioned, may be experiencing a non-productive form of denial. I encourage parents of children in denial to talk privately to their children and ask them questions regarding why they left the room, what they missed about the person who died, and painful emotions. 

I also encourage parents of grieving children in denial to present caring displays of reassurance.  Of course, you already know how important it is to children to feel needed and secure. Think of your grieving client. Is he or she experiencing denial as a prolonged and non-productive effect of negative grief?  Could the implementation of the techniques in this section benefit the child?  Would it help to play this section in an individual or group setting with the parents of a grieving child?

In this section, we have discussed denial.  Three important aspects of denial in children are how imagination leads to denial in children, death is overwhelming, and natural vs. non-productive denial.

- Dowdney, L. (2000). Annotation: Childhood Bereavement Following Parental Death. Journal of Child Psychology and Psychiatry, 41(7), 819-830. doi:10.1111/1469-7610.00670 

In the next section, we will discuss anger.  Three important aspects of anger are anger as a manifestation of grief, anger history, and identifying triggers.  We will also discuss two techniques for coping with anger. 
Reviewed 2023

Peer-Reviewed Journal Article References:
Austin, K., Theakston, A., Lieven, E., & Tomasello, M. (2014). Young children’s understanding of denial. Developmental Psychology, 50(8), 2061–2070. 

Boerner, M., Joseph, S., & Murphy, D. (2020). Is the association between posttraumatic stress and posttraumatic growth moderated by defense styles? Traumatology. Advance online publication. 

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.

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

Kim, J. L., Shatz, M., & Akiyama, M. M. (1990). Effects of language and task on children's patterns of sentence verification and denial. Developmental Psychology, 26(5), 821–829.

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. 

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