Tuesday, April 24, 2012

Advice from the Doctor: Grief Tasks

So much death lately!  We traveled to Kansas last month for my grandfather's funeral and to California two weeks ago for my grandmother in-law's funeral. On top of it all, last week we faced a serious crisis response in my school district when a middle school student was killed after breaking into a home.  This week I responded to a death of a teenage girl with sickle cell anemia. I am a team leader for one of our district's "crisis response teams" that counsel with grieving students and staff. Although in a large urban school district like ours crises are not rare, these two in particular utilized all my previous training in working with people in crisis and grief.

Prompted by these recent events, I'd like to share some information about helping children who have lost a loved one.  With my background in grief counseling and crisis intervention work, it seems appropriate that I start a series on helping your children cope with death.  It's not the light-hearted or humorous content I usually share, but learning to deal with grief is an important part of child development.

Death impacts us all, and children are no exception.  They definitely feel the emotions associated with loss, and work through grief tasks.  If parents and teachers are familiar with these grief tasks and support children during times of loss, children will learn to appropriately cope with grief.  Many people know about Kubler-Ross's famous Stages of Grief theory, but don't realize that when she wrote about those stages she was really writing to people facing terminal illness. We now understand that people experiencing grief do not progress nicely through stages, but rather have several common tasks to accomplish through their grief. 
The first of these tasks is Acknowledging the Reality of the Death. Sometimes, children don't have the cognitive ability or previous experience needed to understand what the word "dead" means and that death is not a temporary state.  Many very young children believe their lost loved one will return.  For this reason, it is important to use the word "dead" and not "lost" or "passed."  Let your children engage in the family rituals surrounding the death (funeral, wake, etc.).  Although this may seem uncomfortable, it helps children grasp the reality of death.  If a loved one is there to support and explain, it will become a valuable experience.  Also, answer your child's questions as honestly as possible (considering their age) and allow them to repeat their questions as often as they need to.  Although this can seem redundant and exhausting for adults, it is how children process and learn about death.  Talk about the death when your child wants to and let them see your emotions.  Let them learn from you that crying is natural and okay!

The second task in a child's grieving process is to Feel the Feelings of Grief.  Children will feel the emptiness associated with a loss of someone they love, even if they don't completely understand what is going on.  They will act out this feeling and their confusion about the loss through their behavior and play.  Think of a child's behavior during this time as communication.  Sleeplessness, fussiness, loss of appetite, yelling, hitting, and other acting out behavior may be your child's way of saying "I'm sad," "I'm angry," or "I'm confused and don't know what in the world is going on!" Play can also serve as your child's language for grief.  Many times, children will act out through play in symbols and metaphors what they are feeling.  (I talked about the importance of play in my previous blog.  I'll probably repost it here soon).  Listen to this language, reflect the feelings you recognize, and accept your child's reaction. You can let your child know you care by reflecting back to the child what they are doing in their behavior and play, rather than asking questions, giving interpretations, or advice.  Encourage safe outlets for play (sports, art).

It is also common for children to blame themselves for the death of a loved one.  Preschoolers often engage in "magical thinking" that convinces them that they could have done something to prevent or even cause the death.  It is important for adults to hear that feeling, empathize with it, and reassure the child that it isn't true thinking. 

The third task for a grieving child is to Go on Living and Loving.  Many authors will divide this into two tasks, but I believe it can be nicely summarized and accomplished in one task.  I like the description that I once heard of this task, explaining it as a "faith process."  Children and adults have different ways of coming to terms with death, but in the end, it requires an amount of faith to move on with life.  We somehow have to learn how to keep the memory of our loved one alive while the death becomes part of who we are as we keep on living.  We can encourage our children to live and love by teaching them ways to remember their dead loved one (through rituals, pictures, memories, etc.) while filling the void the loss left with other loving relationships and activities.  Allow your child and family to take "time out" from their grief to have fun.  If this causes feelings of guilt, remind your child that their loved one would want them to enjoy life.

For Christian families (like my own), it is never too early to teach children about heaven and about the hope we have because we love Jesus.  As we work with our families to go on living and loving, we can remind our children of 2 Corinthians 5:8, "But we do not want you to be uninformed, brethren, about those who are asleep, so that you will not grieve as do the rest who have no hope.  For if we believe that Jesus died and rose again, even so God will bring with Him those who have fallen asleep in Jesus."  How comforting for children to hear the words of Jesus in John 14: 1-3, "Do not let your hearts be troubled.  You believe in God, believe also in me.  My Father's house has many rooms; if that were not so, would I have told you I am going there to prepare a place for you?  And if I go to prepare a place for you, I will come back and take you to be with me that you may be where I am."  An excellent activity for a grieving family can be to talk about what heaven will be like. Let your child's imagination run wild. Draw pictures of your loved one in heaven with Jesus.  There is no greater way to instill hope and joy!

In the next few weeks I'm going to pull out my library of children's books for grieving children and post some recommendations.  Even if your child doesn't need them now, it may be worthwhile to have some on hand!

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