Guidelines for Helping Grieving Children
A hundred years ago death was much more a natural part of a child’s experience. Grandparents often lived with families, so children witnessed them growing older and dying. Modern medicine has made strides in reducing infant and child mortality and has prolonged life expectancy for the elderly, so children witness fewer deaths. More and more elderly die in nursing homes and hospitals, outside the home environment. The exclusion of death from children’s lives requires us to teach them explicitly about death and grief.
In Mourning and Melancholia, Sigmund Freud outlined his belief that young children did not have the capacity to mourn. He believed that only as a child developed into an adolescent did he/she acquire the ego capacity to grieve. More contemporary research has concluded that children do in fact have the capacity to experience and express grief, but it is often more intermittent and drawn out over a longer period of time than with adult grief.[i]
The grieving process helps people heal from their pain. Pain is a natural reaction when we lose someone close, and children are capable of accepting painful reality directly and openly. When adults try to protect children from the pain of loss, it is usually themselves they are trying to protect. The most important thing to remember in helping children cope with the death of a loved one is to allow them to express their grief in their own way and in their own time. It is important not to pressure children to resume their normal activities if they are not ready.
Children tend to have “grief bursts” followed by play and normal activities. Children may not be able to succinctly verbalize what they are feeling and instead may demonstrate their feelings through their behavior and play. They may laugh or play at a time that feels inappropriate to an adult.
Children need to feel that it is okay to talk about death and grief. If a child does not want to talk about his/her grief, adults need to respect that. Adults should let the grieving child know that they are available to listen and help and that any feelings the child has--anger, sadness, fear or regret--are normal. Hugging and touching helps the grieving child feel secure in expressing emotions and also reassures the child that he or she is loved and will be cared for. Alan Wolfelt feels that if grieving children are ignored, they may suffer more from the sense of isolation that from the loss itself.[ii]
Messages relayed to a grieving child such as “Don’t cry. You need to be strong” or “You’re the man in the family now” or “Be a good girl. Your mommy needs your help now more than ever” suppress grief expression in children and set up unfair expectations of them. Adults should gently intervene if they observe a child taking on the roles and tasks of the bereaved. Grieving children should not be allowed to take on the role of the “confidante” or partner of one parent if the other has died.
It is important that adults not hide their own feelings of grief from a bereaved child. If they do, they teach the child that feelings are not OK--that they are something to be ashamed of, to be kept to oneself. It is also true that grieving adults should not grieve profusely and at length in front of a child since it might frighten and worry the child.
Religion is an important source of strength for many adults and children during the grief process. Children takes things literally, so explanations such as “It is God’s will” or “Bonnie is happy in heaven” could be frightening or confusing rather than comforting, particularly if religion has not played an important role in the child’s life. It’s important to inquire how the child perceives what is explained about the death. It is also important that children be allowed to express their religious and spiritual concerns.
Parents may be tempted to “send children away” when there is a loss--either to protect them from painful feelings or because it is difficult to care for them while grieving themselves. During the grieving period, children are often most comforted by familiar surroundings and routines, and separation may increase their fears about abandonment.
Grieving children who are sad or depressed require a lot of support and attention so that they can express their sad feelings and work through them. Helen Fitzgerald, a well-known children’s grief therapist, recommends several techniques for helping a depressed grieving child. She suggests having the child draw good and bad memories of the deceased and share them with others. The child could show photographs and describe keepsakes to others and develop a memory scrapbook. For a child who feels deep despair about the loss, it might be helpful to ask them to fantasize how their life might look differently if they were not so sad. Encouraging the child to engage in physical activity is another useful technique with a depressed child. [iii]
- Johnny was very withdrawn and depressed for several months after the death of his mother. Finally, his grief counselor suggested he make a “God box.” He could write down all his sad feelings and put them in the box and God would help him feel better. He wrote a new note almost every day and soon his father noticed that he seemed more cheerful.
It is sometimes easier for a child to feel mad than sad or guilty. Anger is not always rational and it can escalate by feeding upon itself. Anger does need to be expressed, however, and adults can be helpful in teaching grieving children how to express anger in constructive ways. Unexpressed anger can turn into depression or into anger that is out of control.
Children generally tend to express their anger physiologically. Instead of asking an angry child to “calm down,” it may be more useful to allow him/her to dissipate the anger in other ways, such as running, exercising, scribbling on paper, ripping paper, singing or sculpting play dough.
Don't try to deal with the cause of anger until the intensity has decreased. Adults can ask children questions about their anger at a time when they are not angry. It might be helpful to ask questions like, “What usually leads to your feeling angry?” “How does your body tell you that you are becoming angry?” Examining these precipitating factors usually diminishes the intensity if the anger and gives the child a sense of control by learning what triggers an angry response.
It is helpful to ask the child what he/she thinks are more appropriate ways of responding to angry feelings. It is also appropriate for an adult to set a limit with an angry bereaved child who is acting out. “It’s not OK to hit me but you can hit this pillow.” Maintaining household rules and chores actually increases the sense of normalcy and security for a grieving child.
- Stephen had been very close to his grandfather. When his grandfather died, Stephen's parents noticed he began bullying his younger siblings and picking fights at school. They called his football coach who suggested that Stephen might “work out” some of his aggression by staying after practice and “ramming” the dummy players. After two weeks of “extra” practices, Stephen was much less aggressive with other children.
Guilt and Regrets
Some children have regrets about negative aspects of the relationship with the deceased or regrets about things that did not happen or were not said prior to the death. Examples might be: “I never told my mother I loved her,” “I lied to my father and never told him the truth,” “I was mad at my mom the day she died,” “I didn’t have a chance to say goodbye.”
Helen Fitzgerald describes some techniques that are useful in helping children work through feelings of guilt and regret. One suggestion is to write a letter to or draw a picture for the deceased describing their “unfinished business.” Another suggestion is to have the child write a note about what e/she feels guilty about, tie the note to a helium balloon and then release the balloon into the sky. For younger children, she suggests making two puppets and drawing one puppet face as the child and the other as the deceased person. The child puppet could tell the other puppet what he/she feels guilty about or what he/she regrets about the relationship. [iv]
- After her mother’s death, Emily’s father noticed that she seemed very preoccupied and unable to focus on her schoolwork. After several months, he referred her to the school counselor who had experience in working with bereaved children. When she suggested Emily write letters to her mother, Emily seemed relieved to be able to communicate with her mother in this way. Emily then asked the counselor to read the letters. They were full of ways that Emily believed she could have prevented her mother’s death. After the counselor read several of these letters and educated Emily on the nature of her mother’s serious illness, Emily began to relax and was able to focus on her school work again.
It is important to help a fearful child identify what they are afraid of specifically, and then to address each fear individually. Children who are fearful generally need repetitive reassurance that they will be OK. It is also important that a parent or other significant adult spend alone and focused time with the grieving child, reassuring them that they are special and loved.
- Both of Anwar’s siblings had been killed in an automobile accident. Anwar was terrified of riding in a car for months after their death, and was also afraid that someone else close to him would die. His parents and family provided a great deal of love and support during this time. His father decided to help him confront his fear of riding in the car by taking incremental steps. First they sat in the car for a long time as Anwar expressed sorrow about his loss and his anger at the driver that hit the car. Later, his father backed out of the driveway reassuring Anwar that he was safe. The next day he drove down the street assuring Anwar about how accomplished a driver he was. Soon Anwar was able to ride in a car again without fear.
When a grieving child routinely has physical complaints like headaches and stomachaches, it is sometimes helpful to ask what other feelings he/she may be having. They may not disclose their emotions right away, but they may begin to make their own connection between their physical and emotional concerns.
If the physical complaints mirror those of the deceased, it is helpful to remind the child why the death happened. A visit to the pediatrician may also be advised, so the child can hear reassurance from the doctor that nothing is wrong.
- Jose complained of headaches for weeks after his father’s death. He was the oldest son and felt he had to be “strong” for his other siblings and for his mother, so he expressed very little emotion. Two months after his father’s death, his uncle asked Jose if he wanted to visit the cemetery. When they approached the grave Jose began to cry when they came to the grave. He and his uncle spent several hours while Jose talked to his father and reminisced with his uncle. After that, Jose no longer complained of headaches.
Special Consideration--Death of a Parent or Significant Adult
Parents naturally love their children and children depend upon parents for survival and stability. Silverman believes that what a child experiences as lost along with the death, how they talk about their deceased parent or significant adult, and how they understand his or her place in their lives can be even more critical than age-specific understanding of death.[v] The death of a parent or significant adult seems to be more difficult if the death was sudden OR if the child lacks a solid replacement figure. [vi]
Some children fantasize that their parent will return; others wish to die so they can be reunited with their deceased parent. Usually this is a fleeting desire rather than true suicidal ideation. The child should, however, be questioned more deeply, and an investigation made as to whether they do have a specific plan and means available to carry out their wishes.
Silverman describes the accommodation and adaptation to the loss of a parent or significant adult that a bereaved child experiences throughout his or her life. These children tend to revisit the meaning of their parent’s death over and over again at different developmental stages. They also re-experience the loss at events such as graduation, marriage and the birth of a child.
Some bereaved children idealize the parent or significant adult as a way to keep pleasant, comforting memories alive. This can be adaptive unless it gets in the way of the child expressing angry feelings toward the parent for leaving him/her or for any “unfinished business” in the relationship. It is important that the surviving parent allow the idealization of the deceased parent, but also reassure the child how much the surviving parent loves, cares and supports him/her.
[i] Charles A. Corr; “What Do We Know About Grieving Children and Adolescents?”, in Kenneth J. Doka, editor, Children, Adolescents and Loss: Living With Grief (Washington: Hospice Foundation of America, 2000), p.28.
[ii] Alan D. Wolfelt, PhD. A Child’s View of Grief (Service Corporation International, 1990) page 17.
[iii] Helen Fitzgerald, The Grieving Child (New York: Simon & Schuster, 1992), p.
[iv] Helen Fitzgerald, The Grieving Child (New York: Simon & Schuster, 1992), p.122-126.
[v] Phyllis SR. Silverman, “When Parents Die,” in Kenneth J.Doka, editor, Children, Adolescents and Loss: Living with Grief (Washington: Hospice Foundation of America, 2000), p. 221.
[vi] Atle Dyregrov, Grief in Children: A Handbook for Adults (London: Jessica Kingsley Publishers, 1990), p.31.
Bolby, John (1980). Attachment and Loss: Loss-Sadness and Depression-Volume III. New York: Basic Books.
Cline, Karen D. et.al. (1988). A Family Guide to Helping Children Cope. California: American Cancer Society.
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Doka, Kenneth J., editor. (1995). Children Mourning, Mourning Children. Washington: Hospice Foundation of America.
Dyregrov, Atle. (1990). Grief in Children: A Handbook for Adults. London: Jessica Kingsley Publishers.
Fitzgerald, Helen. (1992). The Grieving Child. New York: Simon & Schuster.
Grollman, Earl. (1985). Bereaved Children and Teens: A Support Guide for Parents and Professionals. Boston: Beacon Press.
Huntley, Theresa. (1991). Helping Children Grieve. Augsburg: Augsburg Fortress.
Kroen, William C. (1996). Helping Children Cope with the Loss of a Loved One. Minneapolis: Free Spirit Publishing, Inc.
Osterweis, Marian; Solomon, Frederic; & Green, Morris, editors. (1984). Bereavement: Reactions, Consequences and Cure. Washington: National Academy Press.
Pennells, Sr. Margaret & Smith, Susan C. (1995). The Forgotten Mourners: Guidelines for Working with Bereaved Children. London: Jessica Kingsley Publishers.
Wolfelt, Alan. (1983). Helping Children Cope with Grief. Bristol: Accelerated Development.
Wolfelt, Alan. (1990). A Child’s View of Grief: A Guide for Caring Adults. Service Corporation International.
Worden, J. William. (2001). Children and Grief: When a Parent Dies. New York: Guilford Publications.
Resources for Grieving Children
- Buscaliglia, Leo. (1982). The Fall of Freddie the Leaf. Holt, Rinehart and Winston.
- Fassler, Joan. (1971). My Grandpa Died Today. New York: Behavioral Publications Co.
- Krementz, J. (1991). How it Feels when a Parent Dies. Knopf.
- Viorst, Judith. (1972). The Tenth Good Thing About Barney. New York: Atheneum