Chapter 11: Talking about the bereavement of children and young people

Back to Reflections on Chapter 10

Children certainly grieve and they may be helped by sharing their distress with others, but there are some extra issues. It may be that you  should consider the following before offering your services as a companion to a child.

i)        Young children, roughly younger than 9 years, do not always understand the ideas/words associated with illness, medicine, or death.  It is often better that they share with people who know them, their experiences and their level of comprehension. It may also be true that communication can be very direct, they are practical creatures, and may be helped by using drawing or painting, models, plasticine etc; again these are usually best managed by familiar people.

ii)        Children under about 12, may gain more immediate relief from well informed loved ones than from strangers.  It is sometimes better for the companion to support the parent or older sibling.  For adolescents this point may not apply because they may be so at odds with their parents that communication is difficult.

iii)        In England , Wales and Northern Ireland, there are guidelines on contacting children, i.e. people under eighteen.  Working through the parent, or other familiar adult, avoids any need to contact the ISA, the Independent Safeguarding Authority         

With these points in mind, the following notes are offered to support the companion who is speaking to an adult about a grieving child.

Children Grieving

1.         The bonds that children develop, especially with their mother, but also with others, e.g. fathers, siblings, grandparents, carers, are very strong; their safety depends upon them.  If that is broken by death, they may be very, very  distressed and it may be very difficult indeed for them to find a replacement.

2.         As with adults, when the attached person dies, the bereaved child has the necessary, natural, painful and slow task of grieving, of managing without that person in frightening circumstances, of trusting replacements.

3.         In adults, grieving involves, (a) actualising, (b) expressing, (c) adjusting, and (d) re-locating. With children these tasks remain, but there may be complications.

i)        The need to recognise the fact of  the loss remains as for adults, but where the nature of death is not understood, when people’s behaviour cannot be understood, and especially when the main attachment figure is not present to give security, then there may be a very grave confusion, anxiety, distrust and distress which it may seem, no-one can help with.

ii)        The need to express emotions remains, but, because a child’s emotional time span is different from that of most adults, it may be hard for the child to find opportunities to express his/her emotions. Endless availability, but perhaps especially at bedtime, can help.

iii)        Of course adjustments have to be made, but where there is confusion of mind, it is particularly hard to understand why adjustments, especially painful ones, can or should be made. The sulks, tantrums and general resistance need gentle containment.

iv)       Adults may be able to control some aspects of their new circumstances so that new purposes, and attachments may be formed. Very often, children, who really need a particular and especially available person to become attached to, do not have that control; often other adults and siblings are either too emotionally distressed to help or have too little understanding or strength to respond to the child’s needs.

 

4.         The idea of  rebuilding a relationship with the deceased has a definite place with children. Just as, for adults, the continuity of the relationship with the dead person, albeit in changed form, is a useful and positive issue in many cases, so it is with children.

There can be no rigid, or absolute rule about this.  It may not be helpful, in any way, to insist upon them, but the following four aspects of grieving seem often to be present, do not seem to be harmful, and seem to develop with the child, assisting emotion growth and not hindering it. They are not unfamiliar:

-- locating the deceased: where, how, can they see, judge, comfort or be proud?

-- reaching out to the deceased, speaking to the deceased, going to some favourite place, leaving secret messages, asking for guidance;

-- remembering the deceased, what they shared, enjoyed together, how much they needed them;

-- keeping linking objects, keeping some personal treasure.

It may be that in time, the remembering and linking change and even disappear as the child takes over the belief systems of the parent which becomes a sort of “living legacy” that the child will always carry.

5.         A warning to helpers.  A child may react to loss by crying, searching and becoming detached.  If a special person is available, then there may be a great deal of positive friendliness and a relaxed attitude towards that person, but the attachment may be very fragile and liable to moments of clinging, expressed hatred or avoidance.

6.         To reduce confusion and to give opportunities for the expression of emotions and to help in adjusting, children should be involved in all appropriate decision making. They should have opportunities to decide to see the body, or not.  They should hear    explanations of what happened, if they want them.  They should be included in discussions about what to do next, how to manage the funeral, what hymns should be chosen, what should happen to the clothes, the room, the toys, whether to go on holiday, ...  Unless there are special reasons, they should not be sent away or left out. The urge to “protect” children through avoidance should be thought through;  it may be appropriate, but it may isolate and fail to provide support.

7.         Wherever possible, the facts should be stated or illustrated or shown; the truth { as far as they can understand it} should be told. Words such as “died” should be used and time given to finding {through dead pets or birds etc.} how it looks and how we might react to it. Adult ignorance of issues such as life after death, heaven, the spirit should be admitted. In a family in which a faith is held, some faith-based explanations may be given. If there is no faith, then “faith-based“ explanations should be avoided.

8.         Children sometimes feel that others-in-bereavement are behaving strangely and unexpectedly, and this can be frightening.  Within reason, and remembering that attention and concentration may be newly difficult, it is important for children that “normal” routines, activities, rules or disciplines continue as before, to give stability. Food, cleanliness, times for bed or getting up, behaviour, etc. should be much as usual.

9.         Further, children can become very anxious for their own safety, {See (3) above} either that no-one will be there to care for them {Who’s going to make my tea?  Are you he think I’m to blame?} These can be strongly real terrors, and supporting adults need to watch and stand by and reassure on such matters.

10.       As a child’s understanding of death develops so does their realization of their loss. They may need to grieve several times over, and adults may need to hear and support them in this process, usually just by going over the narrative again, adding an idea or a word.

Grieving in adolescence

Changes

Changes hide the reliabilities of life, the land-marks, and so make life more fearful, decisions more difficult, values more obscure.

Changes towards the new  might be in:

- the body or hormones;

- cognitive understanding, including an appreciation of death;

- social developments, including social skills;

- sexual experiences, physical, personal and social;

- Oedipal relationships.

Changes of loss, i.e those for which the adolescent may already be grieving, might be:

- for childhood, innocence, safety, the “sure” knowledge of parental right judgment and power;

- for close parental/grandparental relationships; for such things as toys, pets, fun, friends, open interests.

Relationships

Two of the most difficult situations in grieving follow dependent or ambivalent relationships; adolescent-parent relationships are often both dependent and ambivalent. They may also be violent or abusive.

But more general is the turmoil of teenage relationships, the difficulty of understanding their significance, the pressure and confusion of their demands.  Reaction to this turmoil may either be fairly continuous or come is great waves of distress.

Particular peer relationships which may cause difficulties include:

identifying with the hero,  adolescent love, feelings of betrayal through misreading the signs.                                                         

Suicide

            Suicide is not an unknown idea to the young.  In the period 1997 to 2002, roughly 250 adolescents between 10 and 19 years old are thought to have taken their own lives in the UK  That might mean that very approximately 10,000  in the same age group deliberately harmed themselves{some possible suicide attempts?}. 

            When raised or hinted at, suicide needs to be taken very seriously bearing in mind that they are at a time of (i) turmoil and risk-taking, variable moods, searching for identity, pressured to achieve, (ii) high social and ecological idealism and fear, (iii) psychological vulnerability from errors in parenting, and from peer pressure and sexual mores,  (iv) considerable vulnerability from depression which may stem from these various forces.                                                          

Increased pressures on teenagers

            Perhaps the pressures on teenagers are significantly greater these days. For example, from drugs, alcohol, family, sexual, social and educational turmoil.  Against such a background, the loss of a confidant, a family member or friend, could prove a very grave blow.

The affect of the above on the grieving process

After a death, adolescent reacts may seem to be inappropriate.  They may delay their grieving so that they appear at first to be casual about the death. They may withdraw, or behave aggressively.

Care-eliciting behaviour may appear; in girls by failing exams or stealing, promiscuity or pregnancy; in boys by fighting or drinking.

After a death, the adolescent may be ignored, be treated with indifference by adults, or on the contrary, they may feel the pressure of expectation too heavy. In reality they need acceptance, and especially the feeling that they are taken seriously by an adult, empathic awareness of their world and their need for confidentiality, and above all honesty.          

 The companions’ needs  Companions needs to realize that teenagers may regard them with such strangely excessive trust or distrust that it is as much good luck as good counselling if they can help - initial rejection by the teenage client is NOT necessarily the companion’s fault.

Continue to Reflections on Chapter 11