Death and Loss: Helping Children Manage Their Grief
"When is my mommy coming home from heaven? I've been waiting and waiting."
—Question asked by 5-year-old whose mother has just died.
The loss of a loved one is like an earthquake that fractures our emotional landscape. Although death is the most permanent loss we face, there are other forms of loss that can be devastating as well. The most common for children are moving and divorce. When adults decide to move or separate, usually after anticipating and gradually adjusting to the transition, children have no choice but to accept their decision. Since children have less time and fewer skills to help them adjust to these situations, they are more vulnerable to loss than adults.
Pain and Loss
The pain of loss is related to the nature of the transition. 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, anticipate, 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. A child experiences the most distress when he is close to and dependent upon the one he is separated from. 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.
Sometimes the teacher is the adult most aware of the child's pain. She sees the sadness, the lethargy, and the learning difficulties. Loss affects a child's capacity to thrive in learning and social settings. Parents, often coping with the same loss, may underestimate the impact of the separation, move, or death on the child, thinking, "children are resilient." Underestimating the vulnerability of the grieving child actually prolongs the child's pain and increases the probability that the effects of the loss will persist.
The Grieving Process
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?" "Can you catch it too?") and (2) coping with the loss of the loved one ("I want Daddy to take me to school"). In the weeks immediately following the loss, the child often experiences disturbing thoughts. The primary emotion during this time is fear — fear of the unknown, fear of the future. Over time, the child's thoughts will be dominated by loss and feelings of 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. In addition, each child has an individual style of coping. Some children will not talk much, and some will talk about it to strangers. Sally may announce to a substitute teacher, "My mother is dead." Other children in Sally's class may become extremely fearful about losing their own parents.
Grief is normal, but if emotional or behavioral problems are extreme, persist beyond six months, or compromise the child's capacity to learn, professional help is advised.
Tips for Teaching: Talking About Loss With Children
- Don't be afraid to talk about death or loss. Children do not benefit from "not thinking about it" or "putting it out of their minds." Share important facts about the event and try to get a sense of what the children think about it and about death in general.
- Share some of your own feelings and thoughts. Sometimes children act as if they have not heard anything you have said, but they have. Remember that in the midst of distressing experiences, children are not very capable of processing complex or abstract information. Be prepared to repeat the same information again and again.
- Invite children to talk about feelings they have regarding the event or death. Then you can let them take the lead as to when, how long, and how much this is discussed. If you sense that one or more of the children are becoming over-focused on these issues, redirect the discussion in a way that will not disrupt the class or impact the affected child.
- During these initial conversations, try to understand what the children think about divorce or death. Do they have a view of afterlife? Do they place blame for divorce on one party or another? The more you understand about how the children think about death or divorce, the easier it will be for you to talk about it in a meaningful way.
- If children sense that you are upset by the loss, they may not bring the topic up even when they want to. Be a good role model, showing children how to express emotions in a healthy and nondisruptive fashion. It can be very helpful for children to know that you have been affected by the event and that you are willing to talk about how you feel.
- Help the children understand how devastated their classmate feels. Explain that this child may be more tired than usual, more irritable, and less interested in playing. Advise them that their classmate may want to talk about the loss and encourage them to listen
- Tell the children that this is a completely out-of-bounds topic for teasing. You can teach the children to respect the grieving process and avoid the emotional tender spots for a child. Also help children understand that this will be a long process and a major challenge for their classmate.
The normal grief process may include:
- emotional numbing
- anger, irritability, and episodic rage
- fear and characteristic rushes of anxiety (pangs)
- difficulty sleeping
- regressive behaviors
- physical complaints such as "stomachaches" or headaches
- changes in appetite (overeating or lack of interest in food)
- transient visual or auditory misperceptions of the loved one's image or voice
This article originally appeared in Early Childhood Today magazine.
Dr. Bruce D. Perry, M.D., Ph.D., is an internationally recognized authority on brain development and children in crisis. Dr. Perry leads the ChildTrauma Academy, a pioneering center providing service, research and training in the area of child maltreatment (http://www.childtrauma.org/). In addition he is the Medical Director for Provincial Programs in Children's Mental Health for Alberta, Canada. Dr. Perry served as consultant on many high-profile incidents involving traumatized children, including the Columbine High School shootings in Littleton, Colorado; the Oklahoma City Bombing; and the Branch Davidian siege. His clinical research and practice focuses on traumatized children-examining the long-term effects of trauma in children, adolescents and adults. Dr. Perry's work has been instrumental in describing how traumatic events in childhood change the biology of the brain. The author of more than 200 journal articles, book chapters, and scientific proceedings and is the recipient of a variety of professional awards.
Bruce D. Perry, M.D., Ph.D., is the Thomas S. Trammell Research Professor of Child Psychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine; and Chief of Psychiatry, Texas Children's Hospital, Houston, Texas.