Coping with Death, Grief, and Loss

Counseling 448: Empowering Interventions

Children Suffer Physically, Emotionally and Spiritually in Response to Losses Such as the Following:

Loss of childhood dreams

Loss of health

Family moves

Changing schools

Loss of personal belongings

Failure

Loss of security

Children Suffer Physically, Emotionally, and Spiritually in Response to Losses Such as the Following:

Loss of safety

Loss of self-esteem

Loss of a pet, and/or

Parent separation and divorce

Loss of relationships

Death of a significant other

How children are affected by loss and cope with it will shape how they respond to future losses in their lives

“Attempts to shield children from the reality of death reinforces in the perception that death is either not real, too frightening to examine or that the ending of life is not worth noting with respect and reverence...These unintended lessons are unhealthy...for a sound appreciation of the meaning of death, parents and teachers must face the topic realistically and naturally for themselves and for the children they teach.”

Children’s Perceptions of Loss

Ages Three through Five:

Death is viewed as a temporary state

Appear to shoe little or no reaction to the loss

Unable to distinguish between reality and fantasy

May blame themselves for the death

Children’s Perceptions of Loss

Ages Six through Eight:

Beginning to understand that death is final

Interested in the biological facts and physical details about death

Questions regarding funeral homes, burial, cremation, coffins, tombstones, and various

rituals at the time of death

Children’s Perceptions of Loss

Ages Nine and Over:

Beginning to accept an adult perspective of death

By age ten, children understand that death is final, inevitable, and personal

They are limited in their actual experiences with death and coping with their emotions in response to loss

Clarification of Terms

Grief =Emotional suffering caused by a death

Mourning= Grief gone public; actions we take following death, i.e., societal rites such as funerals

Grief work activities that are involved in working through a loss

The Grieving Process

The stage theory of grief helps explain the grieving process but should not be used as diagnostic or predictive instrument force fitting children into a static description of a fluid process.

Children proceed at varying rates, skipping some and

experiencing others out of sequence.

The Grieving Process

Shock, Denial, Disbelief, and Numbness:

Disbelief and emotional shock

Unable to comprehend the magnitude of their loss

Deny their loss to protect themselves

What is happening to them is a dream

The Grieving Process

Lack of Feelings:

May appear to lack emotions as we attempt to protect themselves in an environment that is no longer predictable and safe

The Grieving Process

Physiological Changes - As children begin to process mentally their bodies respond accordingly.

Common Somatic Changes:

tiredness and lack of energy

difficulty sleeping

lack of appetite

tightness in the throat

shortness of breath

general nervousness

head and stomach pain

skin rashes

The Grieving Process

Regression to an earlier developmental level:

Overdependence of the parent

A need to be held/rocked

A need to sleep with parent

Separation anxiety

Attention seeking behavior at school

Acting sick to stay home from school

Regression to “baby talk”

Breakdown in peer relationships

The Grieving Process

“Big Man” or “Big Women: Attempt to become the man or woman of the house in an effort to replace the deceased parent

Disorganization and Panic: Overwhelming thoughts, feelings, panic, and disorganization

Who will take care of them

Scary dreams and memories of the deceased

Try to connect to deceased by remembering their voice, bodily features, and pleasant events

The Grieving Process

Explosive Emotions: Expression of auger, hatred, and terror in response to a perceived sense of abandonment

Acting Out Behavior: Temper tantrums, fighting, defiance against authority are typical physical responses to grief

Fear: Fear of being alone, losing surviving parent, and their own death.

The Grieving Process

Guilt and Self-blame:

Blame themselves for the death

Experience the guilt associated with self-blame

“If only I would have...”

“I wish I could have...”

“Why didn’t I“

Bargain with God for the deceased person to return

The Grieving Process

Loss, Emptiness and Sadness 6 to 10 months after the death

lack of interest in self and others

change of appetite and sleeping patterns

prolonged withdrawal

nervousness

inability to experience pleasure, and

low self-esteem

Six Elements that Caregivers Must Consider in Helping Children Face Significant Losses in Their Lives

The child’s relationship with the person who has died

The nature of the death

The child’s personality and previous experience with death

The child’s chronological and developmental age

The availability of family/social/community support

The behavior, attitudes and responsiveness of significant adults

Types of Loss

Lost Toy

Moving Away

Divorce

Step families

Death of a pet

Strengths Children Need to Learn

INFORMATION

There are many types of loss

Significant loss makes us grieve

Grief is a normal process that takes time

There is no timetable for resolving loss

Grieving is personal

Working through grief is difficult

Anger, sadness, loneliness, guilt, frustration and numbness are normal feelings

Strengths Children Need to Learn

INFORMATION

You can express grief through pictures, talking to others, writing a poem

You will experience highs and lows

Take breaks from grieving by spending time with friends, listening to music, and

doing healthy things

Strengths Children Need to Learn

SHARING FEELINGS

Share feelings in discussion and in pictures

Ask for help

Share your grief

Painful feelings do not last forever

Strengths Children Need to Learn

SHARING BELIEFS

Sharing beliefs about loss and death to help children recognize the power that their thoughts play in affecting feelings and action

Challenge irrational beliefs and replace them with rational thought and more responsible action,

Strengths Children Need to Learn

TAKING ACTION

Teach that taking action reduces stress

Include children in cooking a meal, delivering food, planning part of the service, selecting flowers, sending cards

Emphasize the importance of connecting with the deceased through pictures, mementos, and memories

Helping Bereaved Children Explanations that Don’t Help

Children are very literal in their thinking. If an adult says:

“Grandpa died because he was too old and tired,”

“The child may wonder when he too will be too old?;” and

When he is tired, what is tired enough to die?’

Helping Bereaved Children: Explanations that Don’t Help

“Daddy went on a long trip and won’t be back for a long time”

The child may wonder why he didn’t say goodbye; or did he do something to cause Daddy to leave?

The child may wonder why he didn’t say goodbye; or did be do something to cause Daddy to leave?

“Uncle John was sick and went to the hospital where he died”

The child may be fearful to go to the hospital. Also explain little illness vs big illness.

Helping Bereaved Children: Explanations that Don’t Help

“Grandma will sleep in peace forever.

The child may be fearful of going to bed or to sleep.

“It is God’s will. God took him because he was so good.”

The child may decide to be bad so that God won’t take him.

Characteristics that Require More Individualized Assistance

Bizarre behavior such as self-destruction, hurting animals, giving away possessions, playing with knives

Frequent panic attacks in a state of shock over the loss

Socially inappropriate delinquent behaviors, stealing, or vandalism

Refuses to socialize with other children

Is assessed as suicidal