Stages of Grief In Children
By Dr. John Canine
As published in the Maximum Living Newsletter,
May/June 1996
Every child's grief is unique to his or her
circumstances and situation. However, some grief responses can be
considered "norms". As in adults, these normal responses can be
defined as stages. As Claudia Jewett (1982) says, "Though there may
be overlapping, skipping around, or returns to previous stages, each phase
has a number of components that follow in a somewhat predictable
order".
Shock
That child's first reaction to death is generally a
lack of sensation. It is like watching an event that is happening to
someone else. This numbness can lead to withdrawal. Observers of the child
may notice little physical activity, loneliness, sadness, and a
"flat" facial expression, lasting for a few hours to a few days.
As the reality of the loss begins to register, the child may alternate
between crying/sadness and anger/irritability. During this stage it is not
uncommon for the child to "protest" the loss. For example, the
child may say to the surviving parent "Daddy did not die," or
"Daddy is at work." Nevertheless, the painful experience of
grief has begun, and the child's ability to move through the process will
determine the outcome.
Alarm
Children look to adults for safety and security. When
someone close to them dies, their world becomes less safe. This feeling is
intensified after the death of a parent. However, feelings of
vulnerability, separation anxiety, depression, and immobilization are
characteristic of most childhood losses (Vida and Grizenko 1989).
Furthermore, many children experience shortness of breath, bowel and
bladder relaxation, and physical exhaustion when discussing the death.
Insomnia is common in the alarm stage (Koochler 1983). When your trust in
the world is shaken, it is difficult to let your defenses down and sleep.
John Bowlby, in his book Attachment and Loss (1980), reported that
following a loss many children experienced acute night terrors, and a
desire to sleep with a parent or sibling.
Disbelief
Have you ever seen a child in a threatening situation
close her eyes? Or, when a small child is greeted for the first time by a
very "large" adult, have you ever noticed he may put his hands
over his eyes and pretend the person is not there? Disbelief is a
conscious or unconscious defense the child uses to avoid, prevent, or
reduce anxiety. It is akin to denial. The child tries to
"forget," which enables an exclusion of feelings that rightfully
go with the loss. Also, some magical thinking goes with disbelief, such as
"Mommy did not die, she will come to my bedroom tonight and tuck me
in," or "This cannot really be happening". It should also
be noted that occasionally children will use disbelief at some time during
the grief process to allow for a reprieve from the pain and working of
mourning.
Yearning
It is normal for all children to yearn, wish, and
hope that the loss will "go away" and that the one who has
"left" will come back. The conflict between letting go of that
which has been lost and the wish to hold on to it can have a positive
effect on the child. It is the process of working through ambivalence that
enables the child to identify conflicting impulses, learn to live without
the one who has died, and eventually understand the reality of the
separation. Sometimes, however, a child will temporarily give up a skill
that was mastered earlier in the developmental process because of intense
yearning. This return to the behavior of an earlier age is called
regression. A younger child may begin again to wet the bed, suck a thumb,
or cry for a bottle. An older child may want to sit on Mother's lap or
cling to Daddy (Van Eedewegh 1982). The child's regressive behavior should
not be a cause for panic. It should be a signal to the adult that the
child needs some special attention in working through the grief process.
Searching
Searching for something that is lost seems reasonable
enough. The tongue explores the place where the tooth has been lost. And,
of course, one will go back to the same spot to look over and over again
for an item that has been lost. Searching for someone who has died seems
compulsive and irrational , yet we all do it, especially children.
Psychologist Claudia Jewett (1982) says the following are the three basic
elements to this stage: 1. Preoccupied and intense thought about the lost
person, involving a compulsion to speak to him, to review a lifetime of
memories about him, and to ignore anything not relevant to his presence.
2. A sense of waiting for something to happen and a direction of attention
to places where the person is likely to be found. 3. Restless, sometimes
aimless moving around with an inability to sit still, and constant
searching for something to do, a scanning of the environment. As in
adults, the searching stage for the child can last for months. The effort
to find the lost loved one and restore the bond may wane when the child is
not successful (Silverman, Nickman, and Worden 1992)
Disorganization
Grief Is hard work. To try and understand emotions
like sadness, guilt, shame and anger is extremely demanding on the child.
Grief takes energy. Sometimes the child cannot keep up. Hence , the child
becomes disorganized in social activities, domestic responsibilities, and
schoolwork. Observers of the child may see him or her walking around
aimlessly, withdrawn, daydreaming, unable to complete simple tasks or
follow directions, ignoring school assignments, and fighting with friends.
It is a matter of focus, and the child is focused on the enormous pain of
separation and loss. There is very little energy left for anything else.
Resolution
The quality of "being determined" or the
ability "to persevere" is resolution. This is the child at the
end of the grief process. A whole, healthy person emerges from grief ready
to live and enjoy life again. The child is no longer preoccupied with the
loss. There is decreased anger and irritability. There is a return to
stable eating and sleeping patterns. There is ability, once again, to
focus on schoolwork and other responsibilities. The child has greater
understanding of death and its finality. And most importantly, he or she
is able to freely love again.
These stages of grief are not given for the
purpose of defining a timetable with specific points of when a child
should be "better" or eventually "over" grief. They
are given to better assist the death care professional in understanding
the grief process a child goes through. They should be used by adults who
allow and encourage children to move toward their grief, not away from it,
keeping in mind, that our best gift to our children is ourselves, with the
assurance that life will go on.
Dr. John D. Canine is director of Maximum
Living Associates, in Birmingham Michigan. Dr. Canine and his staff have
counseled many individuals and families following a loss of a family
member. Maximum Living Associates works in partnership with funeral Homes
throughout Michigan, Ohio, Illinois, and Florida, and are expanding their
services to other areas as well.
If you would like further information on grief and
bereavement you are welcome to contact Dr. Canine and his staff at their
offices Suite 302, 640 N. Woodward, Birmingham, MI 48009. Tel. #
248-540-0047.
|