What the Death of a Child Does to Parents,

Psychologically and Biologically

Though parents mourning the death of a child experience classic psychological, biological, and social grief responses, there are unique challenges.

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The death of a child may be considered the worst trauma that any human can experience. Though it’s not a terribly common experience in the United States—about 10,000 children between the ages of 1 and 14 died in 2016—the horrific potential for childhood mortality looms large. While reassuring, the numbers also make plain why this one specific type of loss is so feared, so painful, and so stigmatized. 

“The death of a child is considered the single worst stressor a person can go through,” says Deborah Carr, chair of the sociology department at Boston University. “Parents and fathers specifically feel responsible for the child’s wellbeing. And they’re not just losing a person they loved. They’re also losing the years of promise they had looked forward to.”

Although parents mourning the death of a child are, in many ways, experiencing classic grief responses— usual battery of psychological, biological, and social repercussions—there are many unique challenges. The trauma is often more intense, the memories and hopes harder to let go of. As such, the mourning process is longer and the potential for recurring or near constant trauma is far greater. “The death of a child brings with it a range of different and ongoing challenges for the individual and the family. Everyday questions such as ‘How many kids do you have?’ can trigger intense distress.” explains Fiona MacCullum, a professor at the University of Queensland. “Some people do find ways of living with the loss. Others struggle to find meaning in life.”

Psychological Impacts: How The Trauma Of Child Loss Harms The Psyche

Interestingly, very few studies have delved into the nightmare of the death of a child. Most of the research on the psychological response to death focuses on the loss of a spouse or a parent. Presumably this is in part because of the difficulty of finding subjects for study and also in the potential difficulty of recruiting participants in anything longitudinal.

“While there have been significant advances in our scientific understanding of grief, we have a long way to go,”  MacCullum says. 

That’s not to say we are without literature. One 2015 study of 2,512 bereaved adults (many of whom were mourning the loss of a child) found little or no evidence of depression in 68 percent of those surveyed shortly after the tragedy. About 11 percent initially suffered from depression but improved; roughly 7 percent had symptoms of depression before the loss, which continued unabated. For 13 percent of the bereaved, chronic grief and clinical depression kicked in only after their lives were turned upside down. (If those numbers seem low, it’s worth remembering that it is entirely possible to be deeply sad without being depressed.)

Unfortunately, the research suggests that psychological damage done by a child’s death often does not heal over time. One 2008 study found that even 18 years after the death of a child, bereaved parents reported “more depressive symptoms, poorer well-being, and more health problems and were more likely to have experienced a depressive episode and marital disruption.” While some parents did improve, “recovery from grief…was unrelated to the amount of time since the death.”

“The first year after losing a younger child, a parent is at an increased risk for suicide and everything from major depression to complicated grief,” Dr. Gail Saltz, a psychiatrist at the NY Presbyterian Hospital Weill-Cornell School of Medicine, told Fatherly. Complicated grief differs from expected, normal grief, in that “there are more intense symptoms, alternating with seemingly no symptoms—a numbness—which potentially impairs their ability to function.”

“A parent who grieves without any type of serious complications, such as suicidal thoughts or self-harm behaviors, would be the best-case scenario,” says Dr. Kirsten Fuller, a physician and clinical writer for the Center of Discovery treatment centers. “Worst-case scenarios would be experiencing suicidal tendencies, psychosis or developing a mental health disorder or an eating disorder.”

Biological Impacts: How The Death Of A Child Changes A Parent’s Body

The impacts of this tragedy are not solely psychological. In 2018, Frank Infurna and colleagues looked the general health and physical functioning of 461 parents who had lost children over the course of 13 years. “We did see some decline, followed by a general bounceback, or recovery, over time,” Infurna, who studies resilience to major stressors at Arizona State University, told Fatherly. Physical functioning was focused on one’s ability to complete various everyday tasks, and “we didn’t see much change in this,” Infurna recalls. But when he reviewed bereaved parents’ self-reports—whether they felt they got sick often, or whether they expected their health to improve or decline— he found poorer perceptions of health.

As with all major grief responses, the mental health trauma of losing a child can kick off physical symptoms, including stomach pains, muscle cramps, headaches, and even irritable bowel syndrome. A handful of studies have found more tenuous links between unresolved grief and immune disorders, cancer, and long-term genetic changes at the cellular level.

One surprising impact, often seen among parents mourning the loss of a child, is known as broken heart syndrome—a condition that presents oddly like a textbook heart attack. Symptoms include “crushing chest, pain, ST-segment elevation on electrocardiography, and elevated cardiac enzyme markers on lab results,” Fuller says, citing her previously written work on the subject. “As a reaction to emotional or physical stress, the body’s natural response is to release catecholamines, also known as stress hormones, that temporarily stun the heart muscle.”

Chronic stress can even impact how the brain functions, as long-term exposure to the stress hormone cortisol has been linked to the death of brain cells. And in a cruel twist of neurobiology, the regions of the brain responsible for grief processing, such as the posterior cingulate cortex, frontal cortex, and cerebellum, are also involved in regulating appetite and sleep. This may explain why grieving parents develop eating and sleeping disorders in the aftermath of the loss.

“There are many many studies that have looked at the ongoing health effects of high levels of chronic stress,” Saltz says. “And when you look at lists of stressful life events, this is at the top.”

Social Impacts: How Child Loss Strengthens (Or Ruins) Families

Major life stressors naturally take a toll on marriages. But divorce in the aftermath of a child’s death is not inevitable. “It’s really important to underscore that the death of a child is not going to ruin a marriage,” Carr says. “It generally makes a troubled marriage worse, and a strong marriage better.” When dealing with illness or addiction, spouses who disagreed over the best course of treatment are at particularly high risk. “If one spouse blames the other, or feels the other did something to hasten the death, that’s almost something that cannot be recovered from.”

There are also factors, beyond the couple’s control, which may sour or save the marriage. “Grief, trauma, and depression impact one’s ability to participate in all meaningful relationships,” Saltz says. “But I have seen couples where the opposite is the case. They become closer, they support each other. This is the only person who can really understand how you feel.”

Mothers and father who lose a child often must also contend with surviving siblings. Figuring out how to parent after losing a child is a unique challenge and here, too, experts agree that the outcomes for both the surviving children and parents largely depend on the state of the relationship before the trauma. The death can both bring a family together or tear it apart.

When dealing with terminally ill children, one particular risk is that other siblings may feel neglected, or find too many responsibilities foisted upon them while the parents shift their focus solely to the suffering child. A sick kid “is going to consistently get more attention, because they have to,” Carr says. “Sometimes the other children’s needs aren’t met, or they are treated like little adults, given more chores to do, or expected to provide emotional support to the parents.”

“That can be really troubling for them. Or it can be empowering, but difficult.”

Predictors: How Age Of The Child And Other Factors Impact The Trauma

A handful of studies have tried to pinpoint key factors that influence how well parents adjust in the aftermath of losing a child. One 2005 study found that the child’s age, the cause of death, and the number of remaining children was strongly linked to the levels of grief displayed by parents, while depression was linked to gender, religious affiliation, and whether the bereaved sought professional help. Subsequent studies have uncovered other predictors of lower grief responses: a strong sense of purpose in life and having had the opportunity to say goodbye.

“It depends on the psychological makeup of the parent, whether they have a history of mental illness, what coping skills and what social supports they have,” Saltz says. Outside factors can play a role, too. Suicide is often more difficult but a terminal disease can present recurring traumas over a long period of time. Saltz also suspects that gender may be part of the puzzle. “This will undoubtedly shift, but historically mothers have been the primary caretakers and more likely to have their identities wrapped up in being mothers,” he explains, adding that this may result in stronger responses among women who lose their children

One of the most salient predictors of trauma is the age of the child. Miscarriages and stillbirths are devastating, and made worse by the fact that the loss is often diminished by public perception that a fetus is not a fully-formed child. But “is it as devastating as the death of a child who has been alive for many years? Not to diminish this experience, but I think not,” Carr says.

Once a child is born, however, the script flips. Older adults who outlive their children generally have an easier time coping than parents who lose very young children. “The age of the child is really important, because it speaks to promise,” Carr says. When a young child dies, that promise dies with them: “the graduation, the grandbabies, the marriages—that’s lost, too.”

Nonetheless, even older adults may suffer intensely after the death of an adult son or daughter. “You can meet someone who is 75 who loses a 50-year-old child, and it’s still devastating,” Carr says. “There’s this belief in the natural order. A parent should die first. So even though age matters, older parents still are quite bereft. They’re just losing less of that long-term promise.”

Coping: How to Provide and Seek Comfort

After a child dies, those who are left behind may experience depression, biological and neurological changes, and a destabilization of the family and marriage. “If you’re in this situation, and it is impairing your ability to function, you need to seek treatment,” Saltz stresses. “Parents who fall into major depression will be unable to parent other children, or be in a marriage. Psychotherapy can be helpful and medication can too, at least in the short run.”

The best thing that friends and loved ones of bereaved parents can do is be present, available, and supportive. If the bereaved speaks of suicide, take them to an emergency room; if the situation is less dire, but the grief does not seem to abate over time, help them make an appointment to speak with a professional or attend a self-help group with other bereaved parents. Because even the most sensitive souls are seldom equipped to help parents cope with a loss of this magnitude—and no matter how hard you try, you’re unlikely to really understand.

That’s where a self-help group’s value really shines through. “The one thing that people who have lost a child hate hearing from others is ‘I know what you’re going through,’” Carr says. “They cannot possibly know.”

Complete Article HERE!

Schools fall short when it comes to helping students in grief

– here’s how they can improve

Many children experience the death of a loved one. How teachers respond matters.

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An adolescent experiences the death of his mother after a lengthy illness.

When I ask what services he would like to receive from the school, he initially says he didn’t expect special treatment, would be embarrassed by counseling from the school mental health staff and wouldn’t feel comfortable if many of his teachers asked to talk to him about his grief.

At the same time, the student felt as though the school should somehow take his situation into account.

“I don’t know what the school should do,” the student told me. “But I just lost the person I love most in my life and they act as if nothing happened.”

In my many years as a developmental-behavioral pediatrician who specializes in school crisis and child bereavement, I believe this dilemma – that is, the need to do enough but not to overwhelm the grieving student or the adults who are trying to help – represents a major challenge for America’s schools.

The need for recognition by trusted adults of their loss, a genuine expression of sympathy and an offer of assistance is often what students seek after a major loss – but too often don’t receive.

A common experience

Loss is very common in childhood – 9 out of 10 children experience the death of a close family member or friend and 1 in 20 children experience the death of a parent.

In contrast, teacher preparation to support grieving students is uncommon. In a recent survey conducted by the American Federation of Teachers and the New York Life Foundation, 93 percent of teachers reported that they never received any training on how to support grieving students. They identified this lack of training as the primary barrier that prevented them from reaching out to grieving students in their class and offering the support they knew they needed. Worried that they would do or say the wrong thing and only make matters worse, some educators chose instead to say and do nothing.

In recognition of this problem, I offer a series of insights and recommendations that teachers can adopt to make the school experience less stressful for students who have recently lost a loved one. Although the advice is aimed at educators, surviving parents or caretakers or anyone who cares about how to help bereaved students can use this advice to advocate on their behalf.

The consequences of inaction

Saying nothing says a lot to grieving children. It communicates that adults are either unaware, uninterested or unwilling to help. It leaves children confused about what has happened and how to react. It leaves children unsupported and forces them to grieve alone. Adults should reach out to grieving children and let them know that they are aware and concerned and are available to provide support and assistance.

What not to say

Anything that starts with “at least” should probably be reconsidered – “at least she’s not in pain anymore” or “at least you still have your father” are generally not helpful comments. It suggests that the adult is uncomfortable with the child’s expression of grief and is trying to “cheer up” the grieving child in order to limit the adult’s own discomfort. Don’t encourage children to hide their feelings or reactions, and don’t feel that you have to hide your own emotions. Be genuine and authentic. Tell grieving children that you are sorry about their loss and ask them what they are feeling and how they are doing.

There isn’t anything you can say that is going to make everything right again for a grieving child. So, listen more than you talk. Other guidelines of what not to say – and what to say instead – to grieving children can be found in “The Grieving Student: A Teacher’s Guide.”

Engage peers

Peers want to – and can – be an important source of support to grieving children, but often are unsure what to say or do. Provide them advice on what to say and practical suggestions on how to be helpful. This will help grieving children obtain critical peer support and decrease their sense of isolation. It will also reduce the likelihood that peers will instead ask repetitive and intrusive questions or tease grieving children.

Offer academic accommodations

Grieving children often experience a temporary decrease in learning ability. They may be tired from not being able to sleep, have difficulty concentrating and learning new material, or may be experiencing significant disruptions in their home environment that make it difficult to study or complete homework.

Grieving children should view school as a place of comfort and support, especially at a time of loss. If they are worried about failing, school becomes instead a source of additional distress. Teachers should offer educational support before children demonstrate academic failure. Check in more frequently to make sure that they are learning new material and are able to keep up with the workload.

Talk to other teachers, instructors and coaches and try to help grieving students balance all of their responsibilities. If the student needs to prepare for an important concert, then maybe academic teachers can lessen some of their assignments. Grieving students may need to have their workload decreased or modified temporarily. If a major report seems overwhelming, substitute with shorter and more manageable assignments. If it’s hard for them to stay on task to complete an individual project, consider a group project that might promote peer support.

Be more sensitive

Teachers can also introduce activities with more sensitivity. For example, if you are going to do a project for Mother’s Day, introduce the activity by telling students that you realize some children may not have a mother who is alive or living with them. They can still complete the activity remembering their mother, or can choose to focus on another important female family member. This will also help students whose mothers may be deployed in the military or incarcerated, or away for other reasons.

Help children manage grief triggers

Many things may remind grieving children about the person who died and cause them to temporarily feel a resurgence of their grief. It may be a comment made by a teacher or a peer, such as “I went shopping with my mother this weekend,” or a portion of a classroom lesson, such as a health education lesson that references a similar cause of death.

Holidays such as Thanksgiving or the winter holidays tend to involve spending time with loved ones and may accentuate the sense of loss. Let students know that these triggers may occur and set up a safety plan. Students may be given permission to step out of the classroom briefly if they are feeling upset and worried that they will not be able to contain their emotions. Work out a signal to communicate when this occurs that doesn’t draw attention to the student. Make a plan for where the student will go and who they can talk with. If students know that they will be able to leave, they often feel less overwhelmed and will be more likely to remain in class and stay engaged in the lesson.

For more information

The Coalition to Support Grieving Students offers free learning modules on a wide range of issues related to grieving students, including videos and written summaries. Schools can also learn more about how to help grieving students through the Grief-Sensitive Schools Initiative.

Complete Article HERE!

My sons’ grief at a friend’s death has forced me to see I can’t shelter them forever

One thing never ceases to strike fear into the heart of parents: the idea of our kids dying before us

The idea that someone could be in your life one day and gone the next was incomprehensible to Jo Davies’ sons.

By Jo Davies

I was at the grocery store the other night when my younger sons and I ran into my next-door neighbour toting his six-week-old son.

After cooing over Junior’s beautiful blue eyes and his adorable expressions for a bit, one of my boys asked to touch the little one’s cheek. My neighbor hesitated for a moment and then declined, saying the baby hadn’t yet had his second round of vaccinations.

I was shocked for a moment, then smiled, reminding myself we were dealing with that most nervous of Nellies: the first-time parent.

Whether you have kids or not, you’ve likely heard the stereotype of the hyper-responsible first-time mom or dad jumping to boil the baby’s pacifier the second it touches the floor or rushing to the ER for every uptick in temperature.

Undoubtedly, this initial hyper-vigilance serves a purpose: it’s Mother Nature’s way of ensuring the survival of the species. All parents go through it, and most get over it.

There’s one thing, however, that never ceases to strike fear into the heart of parents: the idea of our kids dying before us.

A few weeks ago, my sons’ classmate died at the age of 15.

He was a nice boy — quiet and respectful and kind. His death was unexpected, shocking and a heartbreaking introduction into the ways of grief not only for my two sons, but their school community as well.

At this point in their young lives, my sons haven’t experienced the death of anyone close to them except for their grandparents. That was obviously upsetting for them, but their father and I were able to help them to rationalize it, because their grandparents were much older than them; they’d lived a good life and left a legacy for which their many friends and family would remember them fondly.

When their friend died, however, it was virtually impossible to come to terms with it.

Despite the best efforts of their teachers and school counsellors, my boys were at a loss. The idea that someone could be in your life one day and gone the next was incomprehensible to them.

I asked myself: knowing what I know about death (my father died suddenly when I was 24), how can I make the death of their friend make sense to them? I came to the conclusion that I can’t.

There is no way to make sense of such a tragic circumstance, to find a silver lining. All I can do is try to help them cope with what’s happened.

To that end, I’ve done my best to read up on teenage grief, so I can be useful to my sons.

I’ve learned that, as with adults, teenage grief is as unique as each individual who experiences it. It can’t be dictated or forced to fit someone else’s conception of what’s appropriate.

I’ve also realized that for teenagers, grieving is just one more complication in an already turbulent period of life. The death of a close friend can cause them to question their own, newly formed identities as young adults; to ask questions they might never have considered before about life and mortality.

What’s been hardest for me in this process is watching my sons come to the realization that life, at its core, is uncertain. There are no guarantees of happy, long lives for the ones you love, even if you wish there were.

Up until now, their teenage brains (with their still-developing sense of consequences) have helped to make them feel invincible, or if not invincible, at least unconcerned with thoughts of dying — which seemed to me to be as it should be. Kids should be able to live their lives without constantly thinking about death and dying.

 

Now they know words like “hearse” and “pallbearer” and “condolences.” They have witnessed the depths of a parent’s grief as they listened to their friend’s mother describe all the ways she will miss him.

They’ve also been surprised by kindness from unexpected quarters; friends they didn’t know cared who gave them a hug or a tissue.

They have learned a lot of things over the past few weeks, as have I.

Mainly, I’ve learned that there was still a part of me that thought I could keep them safe from the harsh realities of life. I can’t, and that hurts.

However, just as I taught all three of my sons to use a spoon, to tie their shoelaces and to say “please” and “thank you,” I can teach them other things that are even more useful.

I can teach them to value each day they have on this earth, to be grateful that they knew their friend, and to be happy they were good friends to him during his short time here.

I’m pretty sure those are lessons worth learning.

Complete Article HERE!

Disney Movies Can Help Kids Understand the Concept of Death

So says a new study.

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Whether it was Bambi’s mother, Mufasa, or Syndrome, everyone remembers that one Disney death that really made an impact. Likely, it was your first encounter with a character meeting an untimely demise. Well, according to a new study from the University of Buffalo, Disney films can actually play a huge part in helping kids understand and accept death.

Why Disney movies specifically? Well, first and foremost, Disney (and Pixar) movies feature a lot of death. In fact, according to Business Insider, researchers Kelly Tenzek and Bonnie Nickels analyzed 57 Disney and Pixar films and found that, overall, there were a total of 71 character deaths. Researchers also noted that characters in kid’s movies are twice as likely to die than characters in movies aimed for adults.

In addition to all the death, the study, which was published in OMEGA Death and Dying, confirmed that the movies also feature themes that allow kids to handle death in a way that they would otherwise not be able. The movies use intentional patterns to teach kids lessons about life and death via “the character’s status in the film, the cause of death, whether the death was presented or implied, and also whether they were the good or the bad guy.”

An example of one of these themes in action is the fact that in several Disney movies, the main villain falls to their death instead of actually being killed by the protagonist. Think of Gaston in Beauty and the Beast or Captain Hook in Peter Pan. Why is this significant? According to the study, this frees the hero from responsibility and makes the death feel more justified in the eyes of young kids.

Disney movies also benefit from the fact that they are primarily animated. This allows kids to engage with the concept of death without it feeling too real. A child can know that a character such as Mufasa has died but also know that the character is ultimately fictional, which in turn allows them to grasp the concept of death without being overwhelmed.

So next time you’re watching The Lion King for the 100th time with your kid and you’re totally Timon and Pumbaa’d out, appreciate that, in addition to lodging the rhyme of “thin-skinned” and “downwind” in your head for the rest of the day, it  may just help your kid come to understand mortality a bit more.

Complete Article HERE!

When the family pet dies, children deserve the chance to grieve

If you think telling your child Fido, Fluffy or Feathers has “gone to live on a farm” is a good strategy when the family pet dies, think again.

Involving your children in your pet’s death helps them grieve.

By Kellie Scott

You’re likely missing an opportunity to help them grieve and learn about death, no matter their age, according to the experts.

But what you tell them and how involved they should be is dependent on developmental stage and personality.

Being prepared is an essential part of helping your child through the pet grieving process.

We spoke to a child psychologist, vet and mum-of-two who experienced the loss of a family pet for advice.

Why lying about a pet’s death won’t help

“Pet death is a very big opportunity to learn how to talk about death and how to cope with future death, like extended family, for example,” says Elizabeth Seeley-Wait, clinical psychologist and principal of a children’s psychology clinic.

Children who ask the most questions are usually worriers.

Dr Seeley-Wait says the modelling a parent shows around processing and coping with the death will go “a long way for their children”.

“Everyone is different in their coping style, but what parents at least want is to be honest about what is going on, and as open as they can be in the process of feeling sad and going through those emotions over time.”

After all, she says, children will often catch you in a lie.

“And if not, they will figure it out later and feel pretty uncomfortable with that.”

What to do when your pet dies

Whether your pet dies naturally, in an accident or is euthanased, kids will have questions.

How you answer those questions will depend on their developmental stage and personality, says Dr Seeley-Wait.

“The younger the child, the more simple terms you should use, and you probably want to be more general,” she says.

When children reach the pre-teen and teenage years, naturally they are going to want more information, warns Dr Seeley-Wait.

“Parents should use their best instincts on that, because they will have a sense of whether their child can handle details.”

She says the children that ask a lot of questions tend to be worriers.

“Kids ask a lot of questions, but they also ask questions they can’t handle the answers to.”

What should be consistent through all the ages, she says, is children being involved in some way to grieve properly.

When Kasey Drayton decided to put down her 16-year-old dog Max, her daughter and son, aged nine and 11 at the time, knew it was coming.

“He had been sick for some time, so we were hoping he would pass away naturally, but that didn’t happen,” she says.

“We explained he was possibly in pain, and it was the kindest thing to do.

“There was a bit of resistance in that they didn’t want to lose him, but once they understood it was better for him, they were fine.”

How to decide if your child should attend the pet’s euthanasia

The younger they are, the less they need to see, recommends Dr Seeley-Wait.

“To be honest, there would be some teenagers who don’t really need to see that.”

Sydney vet Sandra Nguyen says in her observations, including children in the euthanasia can help them process the death.

Being prepared is an essential part of helping your child through the pet grieving process.

“I feel it’s hard for a kid to understand that their pet has gone to the hospital and won’t come back,” she says.

“I’m relatively comfortable for kids to be there if we are putting the pet down — not all vets are the same.”

Kasey included her children in Max’s passing, something she says was a beautiful experience.

“On the day, we explained the vet will come here and it will be quite quick,” she says.

“We all took turns in holding him and saying goodbye. Tears were flowing.

When children are present for a euthanasia, Dr Nguyen keeps her language around the process as simple as possible.

She explains the euthanasia process as an injection that is an overdose of anaesthetic.

“I do tend to use pretty frank language, but I soften my voice,” she says.

“A friend of mine who is a childcare worker said not to say ‘put to sleep’ as kids can then associate sleep with dying.”

Dr Nguyen also prepares parents for how children might react.

“I’ve seen kids absolutely sobbing … but as they are leaving the pet hospital they will turn to Mum and Dad and ask for a new puppy,” she says.

“The parent can get quite upset that the child doesn’t seem to be mourning the loss.”

But ultimately, Dr Nguyen says having your child attend a euthanasia is a case-by-case situation.

“Some parents don’t want their kids’ last memories to be of the pet dying, and that is the same with adults — some people decide not to be there for the euthanasia themselves.”

How to deal with the aftermath of a pet dying

No-one grieves the same way, explains Dr Seeley.

In Kasey’s experience, her two children dealt with Max’s death differently.

“My daughter put a little shrine up in the bedroom and kept his collar and his old dog toy,” she says.

“She still refers to him and keeps his spirit alive, and that was her way of grieving.

“My son grieved quite differently. They both felt it acutely, but very different.”

Rituals like burying the pet or planting a tree are worth making time for, Dr Seeley-Wait says.

“Do something that commemorates the life of the pet,” she says.

Max has a headstone in the backyard of Kasey’s property.

“Those moments are pretty special and memorable. And at least really model to the child that you should take a moment out of your busy lives to commemorate the passing of someone important.

“Talk, remember their pet, share stories, and let them feel a part of the process of the ritual of letting a loved one go.”

In Kasey’s home, Max lives on.

His body was cremated, and his ashes are in an urn in the backyard with a plaque.

“We still very much talk about him. That sort of helps.”

Complete Article HERE!

Avoiding the No. 1 mistake in helping grieving children

By Amy Ford

The classroom was escalating quickly. With one, swift kick, the desk that perfectly fit a 9-year-old body crashed over, papers and colored pencils strewn about the floor. For being a thin, slight boy, Gabriel had a lot of strength.

It was a scene that happened every month or so. The teacher and the kids knew what to do: Stand back and give Gabe space until he calmed down enough for the principal to walk him to the office. His parent would be called, and he would go home.

What is wrong with Gabe?

Gabe’s parent is at wit’s end. Home life has been hard the past few years, ever since Gabe’s older brother was killed in a hunting accident. The parents have managed to stay together, and with two other young children, plus Gabe’s growing special needs, the parent is at a loss as to how to help Gabe. The principal is equally as frustrated. These classroom episodes can’t continue because they jeopardize everyone’s safety and learning environment.

Is Gabe oppositional defiant? Does he have ADHD, a developmental disability, or a learning disorder? Perhaps a battery of special education testing or an IEP(individualized education plan) is needed. That thought only increases the anxiety within Gabe’s parent. How will a diagnosis like this impact Gabe throughout his lifetime?

Grieving children

There are millions of grieving children in the United States. With increases in school violence, mass casualty events, and accidents, those numbers are expected to rise. Grief and loss are hard to talk about, and parents and concerned adults often are at a loss for resources.

It’s easy to assume that children who experience a loss like death, or a trauma like a community disaster, are grieving children. Indeed, they are. What about kids like Gabe? Gabe’s brother died years ago … surely Gabe is over that by now. Or is he?

The No.1 mistake

Adults make a big mistake when it comes to grieving children: Assuming that children process their grief verbally.

Have you ever heard a child younger than 14 say, “I’m going through my anger stage,” or “I’ve accepted my loss?” I haven’t, unless they were parroting an adult. Children’s brains are usually not developed enough to process information — traumatic or otherwise — in language. They respond to stressors (e.g., loss and trauma) through their behavior and emotions.

Adults typically recognize the Five Stages of Grief theory developed in 1969 by Swiss-American psychiatrist Elisabeth Kubler-Ross. This approach has been effective to heal grief. It requires the ability to process sophisticated emotions — shock, denial, anger, bargaining, acceptance — by talking about them. Children don’t yet have the brain capability to process their loss this way.

What works best with grieving children

Instead, we need to meet grieving children where they are at, using interventions that work for them. Gabe’s mother, school counselor, or teacher could try these strategies:

Address grief before considering any other diagnosis. This could be done through meeting with the school counselor, therapy outside of school, and/or parent-child interventions at home.

Don’t expect Gabe to verbalize feelings about his loss. Instead, expect a wide range of behavior — anything from behavioral acting out, high anxiety, perfectionism or withdrawal.

Be aware that high-intensity activity might trigger high-intensity emotions. Plan ahead, and have a “Plan B” (an alternate activity) ready if Gabe needs it.

Respond to the feeling behind misbehavior (loss) whenever possible.

Provide materials for Gabe to express feelings about his loss in non-verbal ways. Art supplies, toys, books and sensory objects (e.g., sand and bean trays) are great tools.

The older Gabe gets, the more capable he will be of working through his feelings through reason and language. In the meantime, it’s important that we adults don’t miss the fact that he is grieving. Let’s not call it a behavioral problem, or otherwise mislabel it, until he has been able to process his grief in the way his 9-year-old brain is able to.

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How To Talk To Your Kids About Death And Grief

Loss is a natural, but complex part of life.

By Caroline Bologna

Death and grief are natural parts of the human experience, but mourning a loss is also an incredibly complex process.

When a young child loses a loved one, parents often grapple with the challenge of explaining the concept of death and helping their little one through the grieving process (all while grieving themselves).

To help inform these difficult conversations, HuffPost spoke to a number of child mental health experts. Of course, a family’s cultural and religious background may steer the discussion, but there are certain guiding principles that are helpful for everyone to keep in mind.

Here are some expert suggestions for parents and caregivers when they prepare to talk about death and grief with children.

Be Honest And Straightforward

“Tell them the ‘facts’ about the death,” clinical psychologist John Mayer told HuffPost. “Don’t sugarcoat what death is or use ‘baby talk’ with a child. Do not use phrases like, ‘Grammy is sleeping.’ This is an opportune time to teach them about death. Don’t shy away from it.”

Board certified licensed professional counselor Tammy Lewis Wilborn echoed this sentiment, noting that using “cutesy language” and euphemisms in an attempt to protect kids from the realities of death and loss can actually do more harm than good.

“Children tend to think concretely, not abstractly, so when you use language that’s euphemistic, it can actually be more confusing or frustrating,” she explained. When people say things like “Dad is in the clouds” or “Your dad is taking a really long nap,” a young child may not understand the permanence of the fact that their father died and might even look for him in the clouds or expect him to wake up at some point.

Words like “death,” “died” or “dying” may sound harsh, but this is still developmentally appropriate language, Wilborn noted, and it’s important for children to have the language to understand the permanence of death.

Ask And Answer Questions

The kind of conversation a parent has with a child following the death of a loved one depends on the child’s relationship with the person who died. It should also vary based on the child’s developmental age and their understanding of what happens when someone dies. To that end, it’s useful to ask kids questions or offer to answer any questions they might have.

“Starting with questions can be a way in,” said Wilborn. “And you don’t necessarily need to give the specific details of how the person died, particularly if we’re dealing with traumatic grief. They don’t need all of the information, but they need enough age-appropriate details to understand that a person has died and isn’t coming back.”

Sometimes children may have witnessed something related to the loved one’s death, like being present at the scene of an accident or visiting the person in the hospital. In these cases, they need help understanding what they saw, said Chandra Ghosh Ippen, an expert in early childhood trauma and the associate director of the Child Trauma Research Program at the University of California, San Francisco.

Parents should try to shrink themselves down to the size of their child and walk through what they’ve experienced. Seeing someone in a hospital with tubes coming out of them or watching paramedics perform lifesaving procedures may be frightening for a small child, so it’s necessary for adults to appreciate how scary things might look to them.

“Create space for them to share how it might’ve affected them, and try to help them understand that doctors and paramedics were trying to help their loved one,” Ghosh Ippen explained.

It’s an ongoing conversation. “Young children will often come back to you after your very excellent explanation of death and still ask, ‘Am I going to see so-and-so?’” Ghosh Ippen said. “It’s not that they didn’t understand you, but little kids tend to repeat their questions. It’s sort of their way of mulling it over and making meaning. This can be painful for caregivers, but appreciate that the child did hear you and is just having a difficult time wrapping their head around the concept of death.”

Know That Their Emotions Are Complicated

“Grief is a complex process, so it comes with a range of thoughts, emotions and behaviors,” Wilborn explained. While parents may expect their child to feel sad, angry, confused or even guilty about a loss, there are other behavioral changes that can be harder to understand, like changes in sleeping and eating patterns or school performance issues.

Sometimes parents may feel confused about a perceived lack of sadness in their kids. “Young children have a short sadness span,” said Ghosh Ippen. “A child can suffer a devastating loss and feel really sad, and then they can go play. You may be thinking, ‘Were they really affected by what happened?’”

While adults tend to immobilize and sink into sadness, kids often discharge it by running around or trying to do something else. “They kind of go in and out of sadness, and that can put us at odds with them if we’re thinking, ‘Oh, my God, do they not care?’” she continued. “But recognize that they did care.”

Be Patient

Wilborn noted that grief is a long process, so parents should reject the tendency to want to rush past it and wonder when their kids are going to be over it.

“Grief is a process that you cannot go around. You have to go through it. So you need to be OK with the pace of the process,” she said. “It can take some time for a child to return to his or her normal.”

Mayer emphasized the power of this experience and of talking to kids about death as a way to build major developmental coping skills. “This is a positive and helps them cope with loss in their life in the future and even transitions in their life, such as leaving one school to another, advancing to high school or college, and losing relationships.”

Encourage Expression

“Children need to see that their parents are a resource; home is a resource where grief is welcome,” Wilborn said, noting that parents should encourage age-appropriate expressions of grief.

“For example with a school-aged, play is their language, so you want to lean into ways that children play to promote communication ― things like drawing pictures, playing games, dolls, puppet shows at home,” she added. “With older kids, you might encourage them to journal, draw, write songs, create poems.”

Mayer noted that being a resource for your child creates a sense of safety and security that will serve them in later life events. “They know they can depend on you, and it is wonderful modeling for them.”

Create Rituals

Creating rituals around remembering and honoring a loved one who died is another significant form of expression. “Explain that this person may not be here with us, but we can still remember him or her and celebrate their life as a family,” said Wilborn.

“When the death is really traumatic, sometimes caregivers stop talking about the person who died,” Ghosh Ippen explained. “And what’s hard in those cases is that children lose their ‘angel memories’ ― times when they really felt loved and cared for with that person. It’s normal for grown-ups in mourning to find it hard to talk about the person who died, but it’s important to memorialize them.”

The death of a loved one offers an opportunity to talk to your child about your cultural and religious beliefs.

Many cultures and religions promote rituals around saying goodbye and making meaning of death. Mayer noted that losing a loved one presents an opportunity for parents who have religious belief systems to explain these tenets to their children.

“Religious or not, it is also very helpful to teach your children that all the experiences and memories you have had with this loved one do not get erased with their death. People always live in our hearts and our minds forever, and no one or nothing can take that away,” he explained. “Say something like, ‘Where’s Aunt Susie right now? She’s not in this room with us right now, correct? That doesn’t mean she doesn’t exist.’ Aunt Susie is here (point to your head) and here (point to your heart). We have to keep our memories and good times with Aunt Susie alive.”

Make Sure They Know It’s Not Their Fault

“Sometimes children have this really uncanny way of assigning blame to themselves for things that have nothing to do with them,” said Wilborn.

With that in mind, caregivers need to help kids understand that the death is in no way their fault, and it’s not their responsibility to put on a strong face or hide their feelings.

Use Books And Other Resources

There are many great resources for parents navigating this difficult topic with their children. Ghosh Ippen and Wilborn both recommend Sesame Street’s online grief toolkit, which provides talking points, videos, activities, storybooks and more. Ghosh Ippen and Wilborn also pointed to the National Child Traumatic Stress Network as another great source of online resources.

Ghosh Ippen maintains Pinterest boards with book recommendations, including one on loss, grief and traumatic bereavement. Some of her favorite children’s books that tackle these topics include Chester Raccoon and the Acorn Full of Memories, The Dragonfly Door, When Dinosaurs Die: A Guide to Understanding Death, Rosie Remembers Mommy: Forever in Her Heart, Sad Isn’t Bad: A Good-Grief Guidebook for Kids Dealing With Loss and Samantha Jane’s Missing Smile: A Story About Coping With the Loss of a Parent.

As far as books for parents, Mayer recommended the writings of psychiatrist Elisabeth Kübler-Ross, as well as How Do We Tell the Children? Fourth Edition: A Step-by-Step Guide for Helping Children and Teens Cope When Someone Dies and Understanding and Supporting Bereaved Children: A Practical Guide for Professionals.

There are many children’s books that cover the experience of loss.

Beyond books and online resources, Wilborn emphasized the value of community resources, such as school counseling, support groups, play therapy and peer counseling.

Let Them See You Grieve

The way a child’s parents or caregivers respond to a loss is instrumental in helping them cope. “They need to see you grieve,” said Wilborn. “But they also need to see you taking care of yourself and engaging in self-care, which may or may not include professional help. If you don’t, they may feel like they have to take care of you because you’re not managing grief in a way that’s healthy.”

It’s OK to cry in front of your children and show the value of expressing emotions and having shared emotions among family members. It’s OK to say things like “I’m feeling really sad because my dad died” or “Daddy is sad because he misses his mom.”

“Within our culture, we often have a sense that we have to be tough, so many parents are trying to help their kids by putting on a brave or overly cheery face,” said Ghosh Ippen. “But that can seem really odd and confusing. The child is feeling sad because it’s devastating that this person is gone, but then the parent is cheery ― which can feel eerie and weird.”

Ultimately, it’s about conveying the idea that “Mom is sad, and Mom is also strong,” she continued. If the feelings of grief become overwhelming, parents should seek help from other sources because it’s not their child’s role to help them.

“It’s important for little kids to believe that grown-ups are bigger, wiser and stronger,” said Ghosh Ippen. “We are not going to fall apart, and if we are going to fall apart, other grown-ups are going to help us.”

Complete Article HERE!