Children and grief

Grief is a personal experience, which no two people experience in exactly the same way. Grief occurs not only after a death, but with each loss or change. Some children will experience many, if not all, of these reactions or phases, while others may exhibit behaviors related to only a couple different phases. There is no particular order or timeline for the grief experience.

Infants:

  • Even though infants don't understand death, they are directly affected by a parent's emotions, especially anxiety, and by separation from their parents or caregivers.
  • Symptoms of distress include crankiness, crying and clinging.

2 ½ years - 5 years:

  • At this age, children don't see death as permanent and don't have a concept of "forever."
  • A strong fantasy world exists for children this age, and they may imagine the return or healing of the deceased.
  • Many children also fear they are somehow responsible for the death or illness.
  • They may fear catching the same illness and dying. They may need to talk repeatedly about illness and death to master the concepts.
  • In response to the death, children may wet the bed, have temper tantrums, baby talk, have nightmares or have a greater than normal fear of separating from parents or caregivers.

5 years - 9 years:

  • At this age, children may hide their feelings to protect others or for fear of looking babyish.
  • They understand death is possible, but they have difficulty coping with the emotions related to grief.
  • At this age, children often believe they are somehow responsible for the death.
  • Adults should be particularly aware of this guilt and repeatedly remind them that they are not responsible for the illness/death.
  • Often, young school-age children will seek out concrete information about death. They may have many questions about the body related to the illness and/or what happens to the body after a person dies.
  • They have a strong fantasy life and try hard to return things to the way they were.
  • Children this age may complain of headaches or stomachaches. Nightmares are also very common.
  • They may experience more problems at school and have difficulty concentrating.
  • Children this age may deny the death occurred or have hostile feelings toward the deceased or other caregivers.

9 years - 12 years:

  • At this age, children begin to truly understand that death is irreversible. They may need detailed explanations about the illness or death.
  • In pre-adolescence, independence is fragile and, when threatened, children often respond with anger towards the deceased, themselves or other survivors.
  • Daydreaming, problems in school and fear of additional losses or of dying are common.
  • Children this age also can develop fears and phobias. They may experience anxiety, physical pains, hostility towards others or guilt.

12 years - 18 years:

  • While many adolescents would like to retreat to childhood, they are compelled to act like adults even if their ability to understand death may be more similar to a child's.
  • They often assume different roles to maintain balance within the family. Older children are often told it is their "job" to take care of the family. Adults should be very careful to make sure adolescents are still allowed to be "children" and monitor appropriate responsibilities.
  • Because teens are overly concerned with acceptance, they may suppress their own needs in order to fit in.
  • Adolescents may withdraw from family or caregivers, act out, assume adult roles or regress and become more childlike. They also may become overly preoccupied with death or experience extreme anger in response to the loss.
  • Most teenagers will seek out their peers for support.

Phases of childhood grief

Shock/denial/disbelief/numbness:

  • When a crisis occurs, children's minds can block out what is traumatic and overwhelming. This is normal and healthy.
  • As children begin to feel safer, they start dealing with the reality of the loss at their own pace and begin to move towards grief.
  • Adults can help to create a "safe" environment and encourage emotional expression. The message to "be strong" only prolongs healthy grieving.

Lack of feelings:

  • Children often resort to typical carefree behavior as a way to protect themselves.
  • What may appear as indifference is actually self-protection. Children often need "grief breaks", and it is not that they have forgotten or that they have stopped loving the person who died, but often they need a break from the emotions related to grieving.

Physiological change:

  • It is common in grieving children to see physical symptoms, such as:
  • headaches
  • stomachaches
  • fatigue
  • sleep disturbances
  • changes in appetite
  • general nervousness
  • These changes are normal and temporary. A child may also assume the role of a sick person to sympathize or relate to the ill person.
  • Physical symptoms often occur in children who have difficulty expressing their emotions or have not been given a safe place to express their feelings.

Regression:

  • Under stress, children often wish to return to the feelings of safety they experienced at earlier stages in their lives.
  • Children may become overly dependent on parents. They may want to sleep with parents instead of alone or throw tantrums about separating from parents or caregivers.
  • Children may use baby talk or refuse to work independently on tasks they've already mastered. Many children will wet the bed or need greater assistance with basic skills such as getting dressed.
  • This behavior is normal and typically, children will resume development milestones as they begin to feel "safe" again. But if they continue, it may indicate a need for additional intervention.

Big man/Big woman syndrome:

  • Often children are given the message that they are now responsible for the family.
  • This is the opposite of regressive behavior. Children attempt to assume adult responsibilities.
  • Adults should monitor appropriate roles and responsibilities.

Disorganization and Panic:

  • When children are overwhelmed, they may not be able to handle basic situations and emotions.
  • They may appear irritable or restless. They may become very forgetful or have difficulty concentrating.
  • Children need reassurance, security and routine during this phase.

Explosive Emotions:

  • Emotions of anger, hatred or terror may be overwhelming and directed toward anyone or anything.
  • These come from children's primary feelings of pain, helplessness, frustration and hurt.
  • Children need to know that feelings of anger and frustration are normal and often shared by adults.
  • There are two parts to "acting out" behavior: explosive feelings and explosive acts. Let them know that "mad" feelings are okay, but hurting others or themselves is not.
  • Children may need help finding appropriate ways to express themselves. Be open to a variety of "tools" (i.e. art, writing, music, sports).

Fear:

  • When illness or death occurs, the world seems even more vulnerable and unpredictable.
  • Children may fear that if one person is sick or has died, everyone else in their lives could get sick and die as well. What children may really be worrying about is if there will always be someone to care for them. They also fear the possibility that they, too, could become sick and die.

Guilt and Self-Blame:

  • Almost all children suffer from guilt and self-blame when someone close to them has died.
  • Most children think that thoughts can cause actions so they blame themselves for the illness or death.
  • Children may assume all the responsibility for the illness or death, but never say a word about their feelings.
  • To prevent children's guilty feelings, adults should repeatedly remind children that they are not responsible for the situation.

Relief

  • If the family member has been sick for along time or in great pain, the child may actually feel relief after the death. If their caregivers' time and energy was dominated by the sick person, they may also be relieved that things can return to "normal".
  • It is quite normal for children to feel relief after a death occurs. This is perhaps the most difficult for children (and adults) to admit.
  • It is crucial for parents and caregivers to let children know that relief is a natural and normal reaction and does not indicate a lack of love.

Loss/emptiness/sadness

  • During this phase, children are trying to accept the reality of the situation.
  • It is natural for children to feel sad.
  • They may lose interest in themselves or others, experience a change in appetite, withdrawal from others, appear nervous or demonstrate low self-esteem.
  • While some children might be able to talk about their feelings, others might express themselves through art, music or physical activities.
  • It is important for adults to be respectful of the child and their grief. Adults should give permission for all feelings and provide opportunities and a "safe place" for children to express themselves.

Reconciliation

  • During this phase, children's grief stops overwhelming daily existence.
  • Children begin to look toward their future with a sense of hope and anticipation.
  • Grief is not time-limited, but lasts a lifetime. Even though a child may appear to feel better, on certain days or at certain times the feelings can emerge strongly.
  • Children also experience their grief differently as they developmentally (cognitively and emotionally) understand the death differently. Their questions about the death or the person who died may also change as they get older.
  • Special days, holidays, or anniversaries may act as triggers. Milestones, such as birthdays, graduations or weddings, can also trigger stronger feelings of grief.

What parents and caregivers can do to help children

  • Listen
  • Try to keep routines as consistent as possible
  • Tell children what to expect
  • Respect the individual child's uniqueness
  • Encourage those who interact with the children to use the proper words, such as "dead" or "dying" And avoid euphemisms, such as the deceased is "sleeping" or on a "long trip."
  • Keep explanations short, simple and truthful. Repeat them as many times as needed.
  • Be honest.
  • Remember that different people have different reactions to death.
  • Provide opportunities for children to express themselves.
  • Allow children to cry.
  • Cry and laugh with children.
  • Make the child feel special and important.

From A Child's View of Grief: A Guide for Caring Adults By Alan Wolfelt, PhD:

  • Allow children to be the teachers about their grief experience and what they need.
  • Don't assume every child in an age group understands death in the same way or has the same feelings.
  • Encourage children to ask questions about death.
  • It's okay to say "I don't know."
  • Don't assume children grieve in some kind of orderly and predictable way. Different people have different reactions.
  • Allow children to participate in the funeral if they want to.
  • Remember that feeling relief after the death doesn't mean a lack of love for the person who died.
  • Healing from grief takes time. It is a process, not an event.